Complementary medicine and general practice: an urban perspective

Background: Complementary medicine appears to be an increasingly popular op tion amongst both doctors and patients. General practitioners in more afflu ent parts of Britain have showed considerable interest in its use. Objectiv es:To ascertain use of and attitudes towards complementary medicine, amongs t general practitioners working in a socioeconomically deprived urban area. Methods: A postal questionnaire survey of all general practice principles in Liverpool, using freepost envelopes and one reminder after 3 weeks. With respect to eight common complementary therapies, respondents were asl(ed w hether they treat with, refer to or endorse each therapy; for their views o n NHS funding, effectiveness, adverse reactions, training needs, and theore tical validity, for each therapy. Results:The response rate was 131/252 (52 %), higher amongst women and doctors aged under 40. During the previous wee k 74 (56%) of respondents had been involved in complementary medical activi ty with their patients: 13% had treated directly, 31% had referred to and 3 8% had endorsed one or more complementary therapies. Acupuncture was most p opular as an NHS option, and along with osteopathy and chiropractic was the therapy most highly regarded by respondents in terms of effectiveness. Hom eopathy and hypnotherapy received a mixed reaction,while medical herbalism, aromatherapy and reflexology were viewed more sceptically. Sixty-two per c ent of respondents reported successful outcomes of complementary treatments , compared with 21% reporting adverse reactions. Knowledge and training des ires were highest for homeopathy and acupuncture. Respondents were generall y uncertain about the theoretical validity of these therapies: 50% though a cupuncture had a valid basis, compared with only 23% for homeopathy and 8% for reflexology. Conclusions:The degree of support for complementary medici ne therapies amongst general practitioners in this socioeconomically depriv ed urban area was similar to that found elsewhere in Britain. These general practitioners appeared to tolerate high levels of clinical uncertainty, en dorsing a wide range of therapies, despite little knowledge of their conten t or conviction of their validity, (C) 2000 Harcourt Publishers Ltd.