title: Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored.
  
  
  OBJECTIVE
  We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure.
  
  
  METHODS
  Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed.
  
  
  RESULTS
  Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient-provider relationship mitigated racial/ethnic differences in CAM disclosure.
  
  
  CONCLUSIONS
  Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient-physician communication across racial/ethnic groups.
authors.affiliation: Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA. chaom@ocim.ucsf.edu
authors.forename: Maria T
authors.initials: MT
authors.lastname: Chao
authors.forename: Christine
authors.initials: C
authors.lastname: Wade
authors.forename: Fredi
authors.initials: F
authors.lastname: Kronenberg
mesh_terms: D003142:Communication; D000529:Complementary Therapies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D044469:Racial Groups; D014481:United States