Boon Heather S, Cherkin Daniel C, Erro Janet, Sherman Karen J, Milliman Bruce, Booker Jennifer, Cramer Elaine H, Smith Michael J, Deyo Richard A, Eisenberg David M
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
BMC Complement Altern Med. 2004 Oct 20;4:14. doi: 10.1186/1472-6882-4-14.
Despite the growing use of complementary and alternative medicine (CAM) by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut.
Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. The main outcome measures were: Sociodemographic, training and practice characteristics of naturopathic physicians; and demographics, reasons for visit, types of treatments, payment source and visit duration for patients.
One hundred and seventy practitioners were interviewed and 99 recorded data on a total of 1817 patient visits. Naturopathic physicians in Washington and Connecticut had similar demographic and practice characteristics. Both the practitioners and their patients were primarily White and female. Almost 75% of all naturopathic visits were for chronic complaints, most frequently fatigue, headache, and back symptoms. Complete blood counts, serum chemistries, lipids panels and stool analyses were ordered for 4% to 10% of visits. All other diagnostic tests were ordered less frequently. The most commonly prescribed naturopathic therapeutics were: botanical medicines (51% of visits in Connecticut, 43% in Washington), vitamins (41% and 43%), minerals (35% and 39%), homeopathy (29% and 19%) and allergy treatments (11% and 13%). The mean visit length was about 40 minutes. Approximately half the visits were paid directly by the patient.
This study provides information that will help other health care providers, patients and policy makers better understand the nature of naturopathic care.
尽管美国消费者对补充和替代医学(CAM)的使用日益增加,但对CAM从业者的实践情况却知之甚少。本研究的目的是描述和比较华盛顿州和康涅狄格州自然疗法医生的实践模式。
对华盛顿州和康涅狄格州获得执照的自然疗法医生进行全州范围的随机电话访谈,并收集1998年和1999年连续患者就诊的数据。主要观察指标包括:自然疗法医生的社会人口统计学、培训和实践特征;以及患者的人口统计学、就诊原因、治疗类型、支付来源和就诊时长。
共访谈了170名从业者,99人记录了总共1817次患者就诊的数据。华盛顿州和康涅狄格州的自然疗法医生在人口统计学和实践特征方面相似。从业者及其患者主要为白人女性。几乎75%的自然疗法就诊是针对慢性疾病,最常见的是疲劳、头痛和背部症状。4%至10%的就诊进行了全血细胞计数、血清化学检查、血脂检查和粪便分析。所有其他诊断检查的开出频率较低。最常开具的自然疗法药物为:植物药(康涅狄格州就诊的51%,华盛顿州的43%)、维生素(41%和43%)、矿物质(35%和39%)、顺势疗法(29%和19%)和过敏治疗(11%和13%)。平均就诊时长约为40分钟。约一半的就诊费用由患者直接支付。
本研究提供的信息将有助于其他医疗保健提供者、患者和政策制定者更好地了解自然疗法的本质。