Physicians Providing Alternative Medicine: Empirical Estimates of Early Integrative Medicine

The development of Integrative Medicine (IM) draws attention to the boundaries between allopathic medicine and CAM on several levels: conceptual, organizational and interactional. Systematic reviews found “large numbers” of physicians referring or practicing some forms of CAM, yet the rigor of “surveys using national, representative samples” was solicited (Astin et al. 1998).

The 1996 & 1998 Medical Expenditure Panel Surveys (MEPS) asked respondents about receipt of CAM from allopathic physicians (MDCAM) but sample sizes were small. These surveys were combined to increase multivariate statistical power [N=36,777; MDCAM (n=86)], representing a subpopulation of 992,097 Americans. MDCAM is conceptualized as boundary work (Lamont & Molnar 2002, Tilly 2004) and reflects aspects of internal differentiation within professions (Abbott 1988).

Preliminary analysis found that compared with users of conventional services, recipients of MDCAM were older (45.7 yrs vs. 37 yrs), more likely to be female (70.4% vs. 55%), white (84.9% vs. 79.7%), high school educated (85.8% vs. 78.5%), uninsured (18.2% vs. 7%). MDCAM recipients tended to be less healthy; poor self-rated physical health (7% vs. 3.3%), poor self-rated mental health (3.0% vs. 1.5%), need for help with IADLs (6.7% vs. 5.4%). Interestingly, MDCAM recipients needed less help with ADLs (1.5% vs. 2.9%).

Compared to conventional services, the geographic distribution of MDCAM was less likely in the Northeast (9% vs. 20.3%), and Midwest (14.2% vs. 23.5%). These services were more likely in the South (38.2% vs. 36%), and West (38.6% vs. 20.1%).

Multivariate analyses will be presented for frequency of utilization of specific CAM therapies.