In recent years, a new pattern of Integrated Care (IC) has been developing in Israel and other countries, with physicians applying the methods of complementary/alternative medicine (CAM) to treat patients in conjunction with conventional medicine. IC poses specific medical, legal, ethical and financial dilemmas, among them: the safety and effectiveness of treatments; the training, licensing and supervision of care-providers, and questions of funding.
The study goals were to describe and analyze the practice of IC in primary care from the perspective of IC physicians, their patients and policymakers. It examined the implementation of IC, its advantages and disadvantages; the impact of CAM methods on physician treatment decisions, the patterns of conventional treatment and quality of care; and attitudes toward the regulation of the work of IC physicians.
The study was based on qualitative methods. We conducted in-depth, semi-structured interviews with 15 IC physicians, 14 of their patients and 16 policymakers having influence on the regulation of the field.
The study findings shed light on the complexity of IC, and its advantages and difficulties as perceived by the interviewees. The study revealed various patterns of IC provision that differ in terms of the boundaries set between the conventional, public and complementary medicine administered privately by the same physician. The complexities also emerged in the attitudes of physicians, patients and policymakers to the regulation of the field. Varied arguments were raised against regulation (e.g., trusting to the physicians’ professional integrity) and its feasibility was questioned (e.g., the absence of standardization tools for complementary medicine). At the same time, several aspects warranting regulation were cited, especially as regards the need for organized training in complementary medicine and a clear separation of private treatments and treatment provided to health-plan members in the framework of public health insurance.
The study was funded by the Israel National Institute for Health Policy and Health Services Research.
Citing suggestion: Gross, R., Ashkenazi, Y., Elroy, I., Schacter, L., & T. Shuval, J. (2011). Perceptions of Physicians, Patients and Policymakers of Integrating Alternative and Conventional Medicine. RR-571-11. Myers-JDC-Brookdale Institute. (Hebrew)