Characteristics of visits to licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians.
BACKGROUND
Despite growing popularity of complementary and alternative medical (CAM) therapies, little is known about the patients seen by CAM practitioners. Our objective was to describe the patients and problems seen by CAM practitioners.


METHODS
We collected data on 20 consecutive visits to randomly sampled licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians practicing in Arizona, Connecticut, Massachusetts, and Washington. Data were collected on patient demographics, smoking status, referral source, reasons for visit, concurrent medical care, payment source, and visit duration. Comparative data for conventional physicians were drawn from the National Ambulatory Medical Care Survey.


RESULTS
In each profession, at least 99 practitioners collected data on more than 1,800 visits. More than 80% of visits to CAM providers were by young and middle-aged adults, and roughly two thirds were by women. Children comprised 10% of visits to naturopathic physicians but only 1% to 4% of all visits to other CAM providers. At least two thirds of visits resulted from self-referrals, and only 4% to 12% of visits were from conventional physician referrals. Chiropractors and massage therapists primarily saw musculoskeletal problems, while acupuncturists and naturopathic physicians saw a broader range of conditions. Visits to acupuncturists and massage therapists lasted about 60 minutes compared with 40 minutes for naturopathic physicians and less than 20 minutes for chiropractors. Most visits to chiropractors and naturopathic physicians, but less than one third of visits to acupuncturists and massage therapists, were covered by insurance.


CONCLUSIONS
This information will help inform discussions of the roles CAM practitioners will play in the health care system of the future.
Cherkin
Daniel C
DC
Center for Health Studies, Group Health Cooperative, Seattle 98101, USA.
Deyo
Richard A
RA
Sherman
Karen J
KJ
Hart
L Gary
LG
Street
Janet H
JH
Hrbek
Andrea
A
Davis
Roger B
RB
Cramer
Elaine
E
Milliman
Bruce
B
Booker
Jennifer
J
Mootz
Robert
R
Barassi
James
J
Kahn
Janet R
JR
Kaptchuk
Ted J
TJ
Eisenberg
David M
DM
D026881:Acupuncture / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona; D002648:Child; D002684:Chiropractic / Q000706:statistics & numerical data*; D003237:Connecticut; D005260:Female; D006302:Health Services Research; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008404:Massachusetts; D008405:Massage / Q000706:statistics & numerical data*; D008875:Middle Aged; D009324:Naturopathy / Q000706:statistics & numerical data*; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D014861:Washington