Thanner Mirjam, Nagel Eckhard, Loss Julika
Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Deutschland.
Forsch Komplementmed. 2013;20(1):23-32. doi: 10.1159/000346608. Epub 2013 Feb 15.
In Germany, not only physicians are allowed to practice medicine but also non-medically trained practitioners, so-called Heilpraktiker, can obtain a licensure to treat patients. In contrast to cooperation between doctors, a division of tasks and responsibilities between non-medically trained practitioners and physicians seems to be difficult. The aim of the study was to clarify to what extent doctors in private practice are willing to cooperate with non-medically trained practitioners. At the same time, conditions, opportunities, and obstacles of cooperation are described.
In order to evaluate the willingness to collaborate with non-medically trained practitioners, semi-structured interviews were conducted with 15 physicians and 2 dentists in an outpatient setting. The interviews further focused on conditions, advantages, and obstacles to cooperation. The interviews were transcribed literally and analyzed using qualitative content analysis.
The interviews showed that physicians partly are willing to cooperate with non-medically trained practitioners, but there were strict conditions and also some serious obstacles to cooperation. Doctors who are open-minded about collaboration consider non-medically trained practitioners as additional therapists for minor ailments. Non-medically trained practitioners would have to respect their limitations, and health insurances should launch transparent contracts for remuneration and reimbursement. Physicians showed low confidence in training programs for Heilpraktiker. Additionally, it was thought to be harmful when non-medically trained practitioners interfere with the physician-patient relationship and try to interrupt conventional treatment or medication.
Quantitative research is necessary to quantify data and generalize results from the sample to the population of physicians. Further, the willingness of non-medically trained practitioners to collaborate with physicians should be evaluated. Physicians should try to reduce communication obstacles so that patients can speak frankly about consultations of non-medically trained practitioners.
在德国，不仅医生被允许行医，未经医学专业培训的从业者，即所谓的“自然疗法医师”，也可以获得治疗患者的执照。与医生之间的合作不同，未经医学专业培训的从业者与医生之间的任务和责任划分似乎很困难。本研究的目的是明确私人执业医生在多大程度上愿意与未经医学专业培训的从业者合作。同时，描述合作的条件、机会和障碍。
为了评估与未经医学专业培训的从业者合作的意愿，在门诊环境中对15名医生和2名牙医进行了半结构化访谈。访谈进一步聚焦于合作的条件、优势和障碍。访谈逐字转录并采用定性内容分析法进行分析。
访谈表明，医生部分愿意与未经医学专业培训的从业者合作，但存在严格的条件以及一些严重的合作障碍。对合作持开放态度的医生将未经医学专业培训的从业者视为治疗小病的额外治疗师。未经医学专业培训的从业者必须尊重自身的局限性，医疗保险应推出透明的薪酬和报销合同。医生对自然疗法医师的培训项目信心不足。此外，当未经医学专业培训的从业者干扰医患关系并试图中断传统治疗或用药时，被认为是有害的。
有必要进行定量研究以量化数据并将样本结果推广至医生群体。此外，应评估未经医学专业培训的从业者与医生合作的意愿。医生应努力减少沟通障碍，以便患者能够坦诚地谈论与未经医学专业培训的从业者的会诊情况。
