Integrative Medicine in General Practice in Australia: A Mixed-Methods Study Exploring Education Pathways and Training Needs

Abstract

Background Globally, a substantial proportion of general practitioners (GPs) incorporate integrative medicine (IM) into their clinical practice. Objective This study aimed to map the IM education and training pathways and needs of a cohort of Australian GPs who are members of the Royal Australian College of General Practitioners’ IM Specific Interest Network, which is a group of GPs with interest in IM. Methods We conducted a mixed-methods study comprising of an online, cross-sectional survey supplemented with in-depth semi-structured interviews. Data from the survey and interviews were initially analysed separately and then combined. Results Eighty-three (83) of 505 eligible GPs/GPs in training (16.4%) participated in the survey, and 15 GPs were interviewed. Results from the two datasets either converged or were complementary. Almost half (47%) of survey respondents had undertaken formal undergraduate or postgraduate IM education, a short course (63%), informal education (71%) or self-education (54%), in at least one of 20 IM modalities listed. Interviewees affirmed there was no single education pathway in IM. Survey respondents who identified as practicing IM were significantly more likely to have IM education, positive attitudes towards IM, particularly natural products, and higher self-rated IM knowledge and competencies. However, knowledge gaps were identified in professional skills domains of population health and context, and organisational and legal dimensions of applied IM practice. Interviewees also highlighted a range of professional and systemic barriers to the practice of IM, education, and training. There was broad support for recognition of IM as a sub-specialty through formalised post-graduate training and accreditation. Most survey respondents (62%) expressed interest in post-fellowship recognition of GPs with advanced skills in IM. Conclusion Our findings demonstrate that it is important to define best practice in IM for GPs in Australia and provide a standardised pathway towards recognition of advanced skills in IM.

Centros de Atenção Psicossocial e formação profissional para oferta das Práticas Integrativas e Complementares: estudo com profissionais ofertantes dos serviços

“…Uma revisão sistemática também encontrou uma diversidade de intervenções educacionais para profissionais da Atenção Primária à Saúde no Brasil, abrangendo desde a simples exposição de informações até aulas práticas e oficinas 36 . Na Austrália, os médicos generalistas têm múltiplas opções educacionais, incluindo educação informal e cursos de curta duração para se capacitarem em PICS 37 .…”

The relationship between psychology practice and complementary medicine in Australia: Psychologists’ demographics and practice characteristics regarding type of engagement across a range of complementary medicine modalities

“…This finding from our study is consistent with, and may well be influenced in part by, CM engagement identified amongst general practitioners (GPs) [ 63 , 74 – 76 ]. Some GPs in Australia report a motivation to engage with CM as part of a patient-centred, whole person approach to health care, as well as to meet demand from client groups that are high CM users, such as those experiencing chronic illness and mental health problems [ 62 , 77 , 78 ]. Given CM use for mental health problems is high [ 14 , 79 , 80 ] and GPs are the main referral pathway for these clients to psychologists, it may be that GPs are partly facilitating the inclusion of CM in the treatment planning for those clients also consulting a psychologist.…”

“…However, some psychologists express concern about a broader lack of education and guidelines for the integration of CM within psychology [ 27 , 52 , 54 , 57 , 58 ]. Overall, the acceptance of CM within the discipline of psychology remains contested [ 58 – 61 ]—a situation not dissimilar to that for medicine and other health disciplines [ 62 , 63 ].…”

Atenção primária e capacitação profissional para aplicação das práticas integrativas e complementares: revisão integrativa

“…As PICS mais frequentemente aplicadas por profissionais na APS, segundo a presente revisão integrativa, foram a Fitoterapia, apresentada em oito estudos (61,5%) [11][12][13][14][15]19,22,23 , seguida da Acupuntura em cinco estudos (38,4%) 11,15,18,22,23 e Auriculoterapia, em quatro estudos (30,7%).…”

“…O profissional enfermeiro apresentou destaque entre os profissionais que executam as PICS, visto que cinco estudos (38,4%) tratavam das práticas exercidas apenas por enfermeiros. [14][15][16][17]20 O uso das PICS pelo profissional de medicina foi apresentado em quatro estudos (30,7%) 18,19,21,22 , e os fisioterapeutas receberam destaque em um estudo (7,7%). 12 Os demais estudos (23%) versavam sobre a aplicação das PICS na APS independente da categoria profissional.…”