[INTEGRATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE WITH PRIMARY HEALTH CARE IN CROATIA – OPINIONS OF PRIMARY HEALTH CARE PHYSICIANS].

Since the turn of the century, Complementary and Alternative Medicine (CAM) has been on the fast track in Croatia, particularly in big cities. Following the examples of developed health systems in the world, it was to be expected that sooner or later CAM would be integrated within primary health care system in Croatia as well. The main aim of this survey was to reveal the actual attitude and opinion of the Croatian primary health care physicians toward CAM. Specific aims were to reveal the physicians’ need for additional education and to reveal the need for keeping CAM therapy records in patient history of illness. On-line questionnaire consisted of 10 questions with two possible answers, Yes or No. The questionnaire was sent to 388 e-addresses and 84 (21.6%) of them responded. This response rate we considered sufficient for further statistical analyses. Although most of the respondents could differentiate alternative and complementary medicine, 21.4% of them still did not know the difference between these two types of medical approach. Furthermore, 79.8% of the respondents confirmed patient interest in CAM. Almost 72% of the respondents considered they did not have sufficient knowledge for informative conversation about CAM with their patients. Only 27.4% of the respondents had enrolled some kind of formal education related to CAM, and almost 73% confirmed their need for formal education on the topic; 88.1% of the respondents considered that CAM methods should be combined with conventional medicine and 97.6% believed that primary health care physicians should keep records on patient use of CAM methods. Interestingly, 76.2% of the same randomly chosen primary health care physicians considered that there is strong resistance among medical doctors towards CAM methods, but our results did not show it. According to the results of our survey, although the majority of respondents (primary care physicians) distinguished alternative and complementary medicine, 21.4% of respondents still did not differentiate these two concepts. Accordingly, it is concluded that as many as 21.4% of general practitioners and family physicians lack even basic knowledge about CAM and thus are not qualified for even initial communication with their patients on the subject of CAM. These physicians show no interest in CAM since they could have learned about this difference independently of their formal education through numerous articles published daily in popular media. Furthermore, the results showed that 79.8% of respondents received queries from their patients with regards to CAM, and this indicator clearly shows that there is strong market demand for this service. In order to meet this demand, it is necessary to urgently organize or expand the existing formal education with regards to CAM with the aim of encompassing as many primary health care physicians as possible, which is also considered necessary by physicians themselves (76.2%). These data indicate the need for urgent organization of teaching and training programs on the subject of CAM, as well as expansion and increased scope of the existing programs. Unresolved legislation and lack of appropriate registered academic state and private institutions and programs for education in CAM certainly contribute to the current situation in which the position of CAM in Croatia is not regulated. Acts and declarations do not automatically make CAM services safer, but will start the new age of CAM integration in the health care system, thus empowering patient rights.