Integrative Health Care Practice Patterns, Policies, and Procedures: A Survey Among International Members of the Society for Integrative Oncology (SIO)

Background: Integrative health care facilities, including those that provide integrative oncology services, have proliferated in recent years. Little is known about the institutional settings, traditional/complementary and alternative medicine (TCAM) modalities, practitioners, treatment styles, and patterns of professional interaction of such facilities. Methods: Institutional review board approval was obtained for an online survey of members of the Society for Integrative Oncology (SIO) via surveymonkey.com. The survey URL was disseminated to the SIO membership email list. Results: Of 779 SIO members emailed, 177 (22.7%) responded. Most respondents were female (59.9%), White (81.4%), and affiliated with a hospital or cancer center (75.7%), institution offering integrative therapies (83.5%), or employed by a Joint Commission-accredited institution (59.1%). Although 61.0% referred patients outside their institution for acupuncture, 61.9% were required to document outside referrals. 37.3% did not know their institution's inpatient dietary supplement policy; 39.6% documented supplement use in the hospital chart. Among institutions offering integrative therapies, 71.3% of physicians, 63.8% of acupuncturists, and 60.0% of nutritionists were required to chart; TCAM practitioners filed notes in outpatient charts (83.1%), inpatient charts (60.2%), or separate service charts (21.7%). Almost all institutions (94.6%) required TCAM practitioners to have a valid state license; 71.6% required credentialing certification, and 59.5% documentation of malpractice insurance. Conclusion: SIO member respondents reported widely varying TCAM practice patterns, and had limited knowledge of institutional policies and procedures regarding TCAM. Guidelines for communication, documentation, and care may improve integration of TCAM with conventional care at SIO members' institutions.