Integrative health care in a hospital setting: communication patterns between CAM and biomedical practitioners

Research in the area of collaboration between complementary and alternative medicine (CAM) and biomedical practitioners often describes their relationships as fraught with power struggles. This paper explores communication among the various stakeholders at an integrative health clinic for artists located in a university hospital. Qualitative research methods were used, in-depth interviews and semi-structured focus groups, to facilitate the gathering of information about patterns of communication among stakeholders involved at the clinic. The findings describe the challenges to communication and integration at the clinic. The lack of communication is described as a scheduling issue, or lack of consistent presence of CAM practitioners, and a lack of formal methods of communication (patient charting). The consequences of these gaps were felt mostly by the CAM practitioners, as their scope of practice was not well understood by other practitioners. CAM practitioners stated that this had a direct effect on their confidence levels. CAM practitioners were relegated to the periphery of the hospital in their role as part-time, contract employees. Their lack of consistent presence at the clinic lead to a lack of understanding of their scope of practice, hence, a lack of referrals from other health-care practitioners, particularly those who were biomedically-oriented.