Opinions of health policy makers on integration of complementary and conventional medicine

Stakeholder attitudes to the regulation of traditional and complementary medicine professions: a systematic review

“…The diversity of knowledge claims made uniform standards difficult to achieve Leaders looked forward to the raised minimum education standards that regulation would impose but differing educational standards between homeopathy schools impeded the setting of uniform standards. High standards were seen as important to protect the public Some saw the need for more clinical and peer-reviewed research to support regulation claims but debated what research was required Challenges included no intra-professional agreement on the best standards to follow, which knowledges to codify or what kind of research should be conducted Some considered encouraging more cohesion through conflict resolution to successfully deal with government and achieve regulatory status Policy-makers ( n = 2) Kelly 2005 [ 65 ] Canada (Alberta, British Columbia) Qualitative Semi-structured interviews Regional health policy-makers 10 Acupuncture, chiropractic, herbal medicine, homeopathy, hypnosis, massage Policy-makers held a positive view for the integration of T&CM at the clinical and primary care levels of practice Public safety was an important concern Policy-makers supported the movement towards integrative health services, but emphasised that the issues of evidence-based T&CM research, standards of accreditation and training for T&CM practitioners, as well as the issue of who pays, needed to be addressed to ensure the improved health and well-being of the public CAM credibility and the potential for integration suffered from a lack of evidence demonstrating beneficial outcomes More rigorous training and licensing of T&CM practitioners would contribute positively to movement towards integration Poor and uneven accreditation of T&CM practitioners was a significant barrier More thorough and consistent accreditation procedures for T&CM practitioners would increase legitimacy in the eyes of the conventional healthcare system, the government and the general public Some identified the need for medical training in the T&CM curricula and viewed this step as the 'point of real leverage' for T&CM integration A few felt that integration was hampered by potential boundary disputes between conventional and T&CM practitioners Kelner 2004 [ 66 ] Canada (Ontario) Qualitative Semi-structured interviews Federal, provincial, and municipal government health department officials 10 Acupuncture/traditional Chinese medicine, chiropractic, homeopathy, naturopathy, reiki Most comments were focussed on acupuncture/traditional Chinese medicine, chiropractic, and naturopathy The role of the state was to fulfil their mandate to protect the public while responding to consumer demand for T&CM services Statutory self-regulation was regarded as a mechanism for ensuring public safety, creating accountability for practitioners Regulation was regar...…”

“…Representatives of Canadian conventional medicine associations indicated reluctance for encouraging T&CM groups to pursue regulation and reported that while regulation may be important for T&CM it had to be earned through established evidence and standards [ 67 ]. Canadian policy-makers were generally supportive of T&CM professional regulation and integration into mainstream health provision [ 65 , 66 ].…”

“…Twenty studies reported stakeholder attitudes regarding the impact of regulation on the public. Studies from Australia, Canada, New Zealand, and UK reported consumer, practitioner, and policy-maker views that regulation of T&CM practices was needed to safeguard the public [ 65 , 66 , 75 , 94 , 99 , 101 ] and protect patients from unqualified, incompetent or unethical T&CM practitioners [ 50 , 52 , 60 , 65 , 66 , 69 , 71 , 74 , 93 ].…”

“…The training and qualifications of T&CM practitioners came under scrutiny from all stakeholder groups in 16 studies conducted in Australia, Canada, New Zealand, Sierra Leone, and UK. Consumers [ 76 ], conventional medicine practitioners [ 59 , 62 , 64 , 103 ], and policy-makers [ 65 , 66 ] expressed concerns regarding the training, qualifications or biomedical knowledge of T&CM providers. T&CM practitioners indicated that regulation would improve training standards, qualification standards [ 60 , 69 , 71 , 73 , 77 ], and practitioner competence [ 71 , 77 ].…”

“…Regulation was seen to confer intra-professional and inter-professional advantages to T&CM practitioners. These include enhancing status and prestige [ 50 , 71 , 73 , 74 , 77 , 78 ], promoting professional acceptance and recognition [ 60 , 69 , 71 , 73 , 77 , 78 ], granting legitimacy [ 63 , 65 , 66 , 71 ], improving inter-professional relationships [ 71 , 77 ], encouraging greater collaboration [ 88 ], and facilitating integration into health care systems [ 74 , 77 ]. GPs perceived that training quality assurance would promote patient referral to T&CM providers [ 64 ] or conversely did not favour patient referral due to perceived inadequate training standards [ 103 ].…”