197469 Referral Patterns Between Allopathic Physicians & Complementary and Alternative Medicine Practitioners

Monday, November 9, 2009: 12:45 PM

Daniel Gale , University of Vermont College of Medicine, Burlington, VT
Shohei Ikoma , University of Vermont College of Medicine, Burlington, VT
Quinn Meisinger , University of Vermont College of Medicine, Burlington, VT
Caroline Moats , University of Vermont College of Medicine, Burlington, VT
Jessica Sayre , University of Vermont College of Medicine, Burlington, VT
Marvin Scott , University of Vermont College of Medicine, Burlington, VT
Susan Varga , University of Vermont College of Medicine, Burlington, VT
Mimi Reardon, MD , General Internal Medicine, University of Vermont College of Medicine, Burlington, VT
Robert Davis, MD , Acupuncture Vermot, South Burlington, VT
Helene Langevin, MD , University of Vermont College of Medicine, Burlington, VT
Margaret Epstein, PhD , University of Vermont, Burlington, VT
Philip Trabulsy, MD , University of Vermont College of Medicine, Burlington, VT
Jan K. Carney, MD MPH , Department of Medicine, University of Vermont College of Medicine, Burlington, VT
ntroduction and Objective. Because of interest in the intersection between allopathic and CAM medicine, information was gathered to assess referral patterns between these two groups of practitioners.

Methods. Two sets of questionnaires were developed to determine specific referrals and factors influencing referral patterns. The questionnaires surveyed referral frequency and reasons for, or against referrals between allopathic and CAM practitioners.

Results. Forty-seven percent of the allopathic physicians responded (34/71 Family Practice physicians and 20/43 Obstetrician/Gynecologists), as did forty-five percent of the CAM practitioners (12/25 Acupuncturists and 22/51 Chiropracters). The referral patterns in the network studied were heterogeneous, with few practitioners making a lot of cross-class referrals, and many practitioners making few or none. Similarly, there are few practitioners who receive many cross-class referrals and many practitioners who receive few or none. Chiropractors who make many referrals, receive many referrals, however, chiropractors did not typically make referrals to the same practitioners who referred to them; there is low reciprocity. The reciprocity between acupuncturists and allopathic physicians is much higher. Qualitative date suggest that CAM practitioners wish to work more closely with allopathic physicians and allopathic physicians wish to know more about CAM practices.

Conclusion. The majority of CAM responders made referrals to allopathic physicians and the majority of allopathic responders made referrals to CAM practitioners.

Learning Objectives:
1. Describe benefits of integrative medicine to patients 2. Explain referral patterns between allopathic and CAM practitioners 3. Define the concept of reciprocity and how it can provide information needed to understand referral patterns among practitioners

Keywords: Access to Care, Alternative Medicine/Therapies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: All students participated in design, implementation, and/or analysis, and writing, review and presentation of project as a poster. This project was part of a required course for medical students called "Public Health Projects" at the University of Vermont College of Medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Developing Integrative Approaches to Patient Care
See more of: Chiropractic Health Care