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

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.

Informations de copyright

© The Author(s) 2021.

Déclaration de conflit d'intérêts

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: CE declares that she is the Jacka Foundation Senior Research Fellow, practicing GP and acupuncturist, Chair of the RACGP IM Specific Interest Network (voluntary role), Program Lead of an academic integrative healthcare centre (no financial interest), past GP Advisory Board member for Blackmores Research Institute, has received industry funding from nutraceutical and acupuncture device companies to conduct clinical trials, and has received honoraria and had travel expenses covered for presenting at TCIM events. JHar is Senior Lecturer in Complementary Medicine (CM) at The University of Sydney where she engages in the development, delivery, and evaluation of CM curricula and conducts CM research. JHar has received travel and research funding from key stakeholders in CM. JHar and JHu are former board members of AIMA. JHu is an academic GP with a clinical interest in IM and has received honoraria and had travel expenses for presenting at TCIM events. GD is a practicing GP in an integrative medical practice and was a past GP Advisory Board member for Blackmores Research Institute. SM is an academic GP and holds positions at Southern Cross University and Western Sydney University. He is a board member of the Australasian College of Nutritional and Environmental Medicine, which provides education training to medical doctors and allied health professionals. He has received consultancy and research funding from the complementary medicines industry and undertakes clinical, laboratory and epidemiological research on the pharmacology of natural products and complementary medicines. GS is a practicing GP and Senior Medical Education Advisor for the RACGP and was paid to coordinate development of the 2016 IM Contextual Unit within the RACGP Curriculum. VK and MP declare no conflicts of interest. As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies, and industry. Sponsors and donors provide untied and tied funding for work to advance the vision and mission of the Institute. The project that is the subject of this article was not undertaken as part of a contractual relationship with any donor or sponsor.