Technical University of Munich, TUM School of Medicine, Institute of General Practice and Health Service Research, Orleansstrasse 47, D-81667, Munich, Germany.
Ludwig-Maximilans-Universität Munich, Institute of Sociology, Konradstr. 6, D-80801, Munich, Germany.
BMC Complement Med Ther. 2020 Apr 15;20(1):111. doi: 10.1186/s12906-020-02907-6.
Many German general practitioners (GPs) use complementary and alternative medicine (CAM) in their daily work although most CAM procedures are controversial from an academic point of view.
We aimed to investigate how GPs justify their use of CAM.
We performed semi-structured, individual face-to-face interviews with 20 purposively sampled, experienced GPs providing primary care within the framework of the German statutory health insurance system. A grounded theory approach was used for data analysis.
All GPs participating in this study used at least some CAM in their clinical practice. Participants did not have any major conflicts when justifying their use of CAM therapies. Important arguments justifying CAM provision were: using it as a supplementary tool to conventional medicine; the feeling that evidence and science leave many problems in primary care unanswered; a strong focus on helping the individual patient, justifying the use of procedures not based on science for therapeutic and communicative purposes; a strong belief in one's own clinical experience; and appreciation of placebo effects. In general, participants preferred CAM therapies which seemed at least somewhat plausible to them and which they could provide in an authentic manner.
Our results suggest that many German GPs integrate CAM treatments in their routine primary care work without perceiving any major internal conflicts with professional ideals.
许多德国全科医生（GP）在日常工作中使用补充和替代医学（CAM），尽管从学术角度来看，大多数 CAM 程序存在争议。
我们旨在调查全科医生如何证明他们使用 CAM 的合理性。
我们对 20 名经验丰富的、在德国法定健康保险系统框架内提供初级保健的全科医生进行了半结构化、个体面对面访谈。使用扎根理论方法进行数据分析。
参与本研究的所有全科医生在临床实践中都至少使用了一些 CAM。参与者在证明他们使用 CAM 疗法的合理性时并没有遇到任何重大冲突。证明提供 CAM 的重要论点是：将其作为传统医学的补充工具；感觉证据和科学在初级保健中留下了许多未解决的问题；强烈关注帮助个体患者，为治疗和沟通目的而使用非基于科学的程序；对自己的临床经验的强烈信念；以及对安慰剂效应的赞赏。总的来说，参与者更喜欢他们认为至少有些合理的 CAM 疗法，并且可以以真实的方式提供这些疗法。
我们的结果表明，许多德国全科医生在常规初级保健工作中整合了 CAM 治疗方法，而没有感觉到与专业理想有任何重大的内在冲突。
