The findings will be published in the online issue of Evidence-based
Complementary and Alternative Medicine (eCAM) on January 20,
2010.
"Complementary and alternative medicine is receiving increased attention in
light of the global health crisis and the significant role of traditional
medicine in meeting public health needs in developing countries," said study
author Ryan Abbott, a researcher at the UCLA Center for East-West Medicine.
"Integrating CAM into mainstream health care is now a global phenomenon, with
policy makers at the highest levels endorsing the importance of a historically
marginalized form of health care."
CAM, which includes therapies such as massage, yoga, herbal medicine and
acupuncture, is characterized by a holistic and highly individualized approach
to patient care. It's emphasis is on maximizing the body's inherent healing
ability; getting patients involved as active participants in their own care;
addressing the physical, mental and spiritual attributes of a disease; and
preventive care. While interest in these fields has increased dramatically in
the United States in recent years, information about such therapies has not yet
been widely integrated into medical education.
"Even with the high prevalence of CAM use today, most physicians still know
little about non-conventional forms of medicine," said study author Michael S.
Goldstein, Ph.D., a senior research scientist at the UCLA Center for Health
Policy Research and professor of Public Health and Sociology, UCLA.
"Investigating medical students' attitudes and knowledge will help us assess
whether this may change in the future."
The team of UCLA and UC San Diego experts in the fields of CAM, integrative
medicine, Western medicine, medical education and survey development created a
novel 30-question survey and sent it to 126 medical schools throughout the
United States. In return, the team received 1,770 completed surveys from a pool
of about 68,000 medical students nationwide, roughly three percent.
While the current results offer valuable insight into medical students'
perceptions of CAM, given the low response rate, researchers plan future studies
to further refine the tool and see if the findings can be more generalized.
Researchers found that although medical students endorsed the importance of
complementary and alternative medicine, obstacles remain that may prevent future
doctors from recommending these treatments in their practices. According to the
findings:
- 77 percent of participants agreed to some extent that patients whose doctors
know about complementary and alternative medicine in addition to conventional
medicine, benefit more than those whose doctors are only familiar with Western
medicine.
- 74 percent of participants agreed to some extent that a system of medicine
that integrates therapies of conventional and complementary and alternative
medicine would be more effective than either type of medicine provided
independently.
- 84 percent of participants agreed to some extent that the field contains
beliefs, ideas, and therapies from which conventional medicine could benefit.
- 49 percent of participating medical students indicated that they have used
complementary and alternative treatments however few would recommend or use
these treatments in their practice until more scientific assessment has
occurred.
"Our research suggests that persuading doctors to integrate CAM will require
investment in the types of clinical research that form the backbone of Western
medicine," adds Abbott. "Even now, medical schools have the opportunity to train
the next generation of medical practitioners in health care systems outside of
conventional medicine. Core values of CAM can help students develop a more
holistic and individualized approach to patient care."
The study also found that the further along in school the student was, the
more likely they were to believe their learning regarding CAM therapies was
sufficient. Still, researchers note that more than 60 percent of participants
favored more education related to this field during their time in medical
school. Although more than half of all U.S. medical schools currently offer some
type of CAM course, researchers say these courses could be augmented or
streamlined into more formal, standardized curricula.
"Although the content of integrative medicine programs remains controversial,
medical schools across the country are moving forward with ambitious new
programs to teach the next generation of health care leaders," said Dr. Ka Kit
Hui, Wallis Annenberg Chair in Integrative East-West Medicine at UCLA, founder
and director, UCLA Center for East-West Medicine, and chair, of UCLA's
Collaborative Centers for Integrative Medicine. "Through the Collaborative
Centers for Integrative Medicine, UCLA has become one of the nation's leading
academic centers for integrative medical education. UCLA offers training
programs for health sciences students and residents, as well as fellowships for
clinicians and researchers."
Hui added that the importance of integrative medical education is
increasingly being realized outside of UCLA. Forty-four highly esteemed academic
medical centers now comprise the Consortium of Academic Health Centers for
Integrative Medicine, which was established to advance the principles and
practices of integrative health care within academic institutions. It provides a
community of support for academic missions and a collective voice for
influencing change. The Consortium also helps disseminate evidence-based
information on CAM, informs health care policy, and supports medical
education.
The study was funded by the National Institutes of Health, the Gerald
Oppenheimer Family Foundation, and the Annenberg Foundation.
Additional authors include Ron D. Hays, Ph.D., UCLA professor of medicine and
senior health scientist at RAND; Dr. Jess Mandel, associate professor and
assistant dean of undergraduate medical education, UC San Diego; Babbi
Winegarden, Ph.D., assistant dean, Educational Development and Evaluation, UC
San Diego; Dale Glaser, Ph.D., adjunct assistant professor, San Diego State
University; and Laurence Brunton, Ph.D., professor of pharmacology and medicine,
UC San Diego.