Advising Patients Who Seek Alternative Medical Therapies
Eisenberg, David M.
Annals of Internal Medicine. 1997 Jul 1; 127(1): 61-69.
Alternative medical therapies, such as chiropractic, acupuncture, homeopathy, and herbal remedies, are in great public demand. Some managed care organizations now offer these therapies as an "expanded benefit." Because the safety and efficacy of these practices remain largely unknown, advising patients who use or seek alternative treatments presents a professional challenge. A step-by-step strategy is proposed whereby conventionally trained medical providers and their patients can proactively discuss the use or avoidance of alternative therapies. This strategy involves a formal discussion of patients' preferences and expectations, the maintenance of symptom diaries, and follow-up visits to monitor for potentially harmful situations. In the absence of professional medical and legal guidelines, the proposed management plan emphasizes patient safety, the need for documentation in the patient record, and the importance of shared decision making.
Alternative Therapies; Communication; Competence; Counseling; Consultation; Decision Making; Dissent; Evaluation; Guidelines; Health; Health Insurance; Health Insurance Reimbursement; Health Personnel; Insurance; Medical Records; Managed Care; Organizations; Patient Care; Patients; Physician Patient Relationship; Physicians; Professional Competence; Records; Referral and Consultation; Toxicity; Treatment Refusal;
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