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Complementary and alternative medicine in US family medicine practices: a pilot qualitative study.

CONTEXT
The growth of complementary and alternative medicine (CAM) has led some family medicine practices to include CAM. Acupuncture or herbal medicine, for example, may be offered at such practices. When a practice incorporates both CAM and conventional treatments, its goals and values may differ from those found in traditional primary care. Little is known about the development of these integrated practices, which may be expected to become more widespread.


OBJECTIVE
To identify some of the concepts and challenges shaping family medicine practices that incorporate CAM.


DESIGN
Comparative case study.


METHOD
Multi-method assessment process including participant observation, key informant interviews, semi-structured depth interviews, and observation of patient-provider encounters.


SETTING
Four family medicine/CAM practices in the mid-Atlantic region of the United States.


RESULTS
Key themes that influence these practices' organization include dimensions of health, the selection of therapies used, the practices' approach to evidence, their perspective on the amount of time spent with patients, and their adaptations to financial concerns. Each practice emphasized long patient visits. In each, physicians had expertise that enabled them to draw on both conventional medicine and CAM.


CONCLUSION
Successful incorporation of CAM modalities within a family medicine framework requires adaptation not only at the practice level but also by individual physicians.