Physicians and complementary-alternative medicine: training, attitudes, and practices in Hawaii

There were only few studies addressing the physicians' training, attitudes, and utilization of complementary and alternative medicine (CAM) therapies, compared to the well-documented escalating use of CAM among consumers. Patients who use CAM, however often do not disclose their utilization to their physicians. This study thus surveyed knowledge, attitudes, and practices of complementary and alternative medicine among physicians on the island of Oahu in Hawaii. The Hawaii Medical Service Association (HMSA) provided physicians' names and contact information.

This is a descriptive study with a questionnaire that was mailed to all physicians on the list. A total of 299 physicians responded to this survey. Response rate was 17.45%.

Physicians reported having moderate acknowledge in acupuncture, massage, prayer/spiritualty chiropractic, hypnosis and meditation. They recognized the value of these treatments and refer their patients to have these treatments. On the other hand, homeopathy naturopathy, electromagnetic therapies, therapeutic/healing touch, and nutriceuticals were consistently rated as having no role in conventional medicine, strongly opposed to in practice, or would not refer patients to. Respondents felt CAM could be most effective for pain, musculoskeletal, psychological conditions and smoking cessation.

Results indicated that the respondents had knowledge about prayer/spirituality, massage, chiropractic, meditation, hypnosis, and acupuncture, and also rated them as playing a role in conventional medicine, and would refer or have referred patients to. When they had little knowledge about naturopathy, electromagnetic therapies, nutriceuticals, and homeopathy, they rated these therapies as having no role in conventional medicine, and were strongly opposed to in practice or would not refer patients to. Respondents reported the least know abut the Aryurveda and Native American medicine. However, there was no significant correlation between negative attitude and practice patterns. Similarly therapeutic touch and chiropractic were perceived as therapies, but no role in conventional medicine although the respondents reported having some knowledge of these therapies. Thus, knowledge may not be necessarily associated with negative attitudes and practice patterns.