Why do doctors recommend (or not recommend) complementary therapies?

The use of complementary therapies in the United States has been extensively studied. The studies show that approximately 40% of Americans use complementary therapies. Now, a group of researchers from the United States (Stussman et al. 2022) wanted to find out why doctors in the United States either recommend or do not recommend complementary treatments to patients.

The researchers chose four different forms of treatment as subjects of the study:

1. herbs and supplements
2. chiropractic / osteopathy
3. acupuncture
4. body-mind exercises, such as meditation and various relaxation exercises

The doctors’ reasons were found out using an extensive survey conducted in 2012. The researchers decided to use the “Andersen Behavioral Model” as the basis of the study. The model deals with complementary treatments as health behavior within the US health care system: the reasons for the recommendation may stem from a need (symptoms, general well-being, patient’s request), the background may be an already benign approach (such as personal experience) or enabling factors (for example, a colleague’s recommendation or a peer-reviewed study that one is familiar with) .

The studied information affects the decision to recommend

In a 2012 survey of 5,622 US physicians, approximately 53% had recommended at least one complementary therapy to a patient in the past 12 months. Differences in the frequency of recommendation were observed with regard to gender: female doctors recommended complementary treatments more than their male colleagues. The doctor’s age, on the other hand, did not matter.

Chiropractic, osteopathy and acupuncture were most often recommended for physical symptoms, body-mind exercises for psychological symptoms. However, for reasons based on need, the patient’s own wishes became important for all forms of treatment. Peer-reviewed studies or scientific articles about complementary therapies often influenced the doctors’ recommendations, as well as the doctor’s own experience.

And why didn’t doctors recommend complementary treatments? According to the survey, the most common reason was a lack of perceived benefit. In other words, doctors do not have either their own experiences of the benefits or research results about them.

Information is needed so that decision-making is in the best interest of the patient

According to the researchers, this review shows that doctors’ decisions are influenced by both their own experiences and scientific evidence, and those doctors who give recommendations on the use of complementary therapies may trust both their colleagues and their patients.

However, it is clear that doctors need researched information about complementary treatments and their effectiveness.

The 2012 survey was used in this study because it is the only comprehensive survey on this topic in the United States. The researchers admit that the situation may have changed in 10 years, but still the results give a good indication of the backgrounds of doctors’ decision-making. And these results provide a basis for future research.

If the reasons for doctors’ decision-making to recommend or not recommend complementary therapies were understood, researchers and educators would have the opportunity to help doctors make decisions that are best for patients. After all, good research results have been obtained from the effectiveness of many complementary treatments in the treatment of various diseases and in supporting a person’s comprehensive well-being.

It would also be important to break down potential barriers that prevent doctors from recommending evidence-based complementary therapies. A better understanding of doctors’ decision-making helps bring them the right kind of information and support.

Source:

Stussman BJ, Nahin RL, Barnes PM, Scott R, Feinberg T, and Ward BW. Reasons Office-Based Physicians in the United States Recommend Common Complementary Health Approaches to Patients: An Exploratory Study Using a National Survey. Journal Of Integrative And Complementary Medicine. 2022.

https://pubmed.ncbi.nlm.nih.gov/35549394/