COMPLEMENTARY PRACTITIONERS AS PART OF THE PRIMARY HEALTH-CARE TEAM -EVALUATION OF ONE MODEL

Background. A four-partner, non-fundholding, urban practice with 6000 patients has since September 1991 worked closely with nine complementa ry practitioners working part time on a private, fee-paying basis. Aim . This study set our to describe and evaluate a model of integrating c omplementary practitioners into the primary health care team. Method. A description of the model operating in the practice was compiled. Qua litative analysis was carried out of semistructured interviews with al l members of the primary health care team using the method of a cooper ative enquiry. Retrospective quantitative data on patients attending c omplementary practitioners were also examined. Results. The model allo wed patients to refer themselves or be referred by a team member, enco uraged communication between team members, and did not require any spe cific funding. After two years the model had been largely successful i n preventing conflict over power, control and decision making; had mai ntained commitment to the idea of integrating complementary and allopa thic medicine; and was self-funding. However, despite varied mechanism s set up to share knowledge and ideology, the rate of change in this a rea was slower than expected and referral rates were varied. The dilem ma of charging patients for complementary medicine in an environment w here health care is free emerged as a major concern among the doctors and practice staff. Conclusion. The method of cooperative inquiry allo wed the whole team to gain an understanding of other viewpoints and to use the research to tackle the problems raised. This model could be a dopted and used by any enthusiastic general practice.