Aspects of quality of primary care provided by physicians certified in phytotherapy in Switzerland.
BACKGROUND
Data on the use of phytotherapy in primary care are scarce and difficult to compare (e.g. different health-care systems, study designs).


OBJECTIVE
Are there differences in Switzerland regarding demographic data, practice structure, process of care and outcome/ treatment satisfaction between primary care physicians certified in phytotherapy (CAM) and physicians performing conventional primary care (COM) and their patients?


METHODS
Subgroup analysis of the data of phytotherapy of an observational study (2 cross-sectional surveys with 3 questionnaires) which was performed as part of a nationwide evaluation program on complementary medicine (PEK). A descriptive analysis was used to compare data.


RESULTS
In survey A, 20 CAM and 191 COM physicians participated, of which 14 and 84, respectively, continued for survey B and recruited at least 276 CAM and 1,395 COM patients. Findings show that CAM physicians had less technical equipment (e.g. x-rays) than COM physicians, their consultation time was 25% longer, and they used more non-drug therapies. Whereas in the SF-36 no differences could be identified between the groups, the EUROPEP showed significant differences in favour of CAM patients.


CONCLUSIONS
Preliminary data of the comparison between CAM and COM physicians indicate few differences in demographic and practice structure data. Yet, due to differences in the process of care CAM patients showed better treatment satisfaction than COM patients. This is probably due to their doctors' communicative qualities and patient-oriented skills. To which degree this might be triggered due to phyto-pharmacosemiotic aspects needs to be investigated in a future study.
Melzer
Jörg
J
Institute of Complementary Medicine, Department of Internal Medicine, University Hospital Zurich, Switzerland. joerg.melzer@usz.ch
Saller
Reinhard
R
Meier
Beat
B
D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D008517:Phytotherapy / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome