The Article in Brief

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Brian M. Shelley and colleagues

Background Although the use of traditional, complementary, and alternative medicine (TM/CAM) is widespread, clinicians and patients often don't discuss patients' TM/CAM use. This study explores factors that encourage or discourage communication between clinicians and patients about TM/CAM.

What This Study Found Three main themes help determine whether and how patients and clinicians communicate about TM/CAM: acceptance/nonjudgment, initiation of communication, and safety/efficacy concerns. Most patients who use TM/CAM expect the clinician to initiate discussion of it. It is easier for patients to discuss TM/CAM if the clinician initiates the discussion in a nonjudgmental, accepting way. Discussion is limited by clinicians' belief that there is little TM/CAM use among their patients, lack of understanding about TM/CAM, and limited time in the patient visit. Many clinicians are skeptical about TM/CAM safety and effectiveness.

Implications

• Clinicians should initiate discussion of TM/CAM with their patients, but they do not have to be experts in TM/CAM therapies. Instead, they should demonstrate interest, nonjudgment, and honesty about their limited knowledge.
• The study findings provide the foundation for a model of improved patient-clinician communication about TM/CAM. Future research should look at how implementing such a model will affect patient care, satisfaction, and trust, and how clinicians can better integrate the different types of care their patients utilize.