title: Patient and clinician openness to including a broader range of healing options in primary care.
abstract: OBJECTIVE
  We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care.
  
  
  METHODS
  Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach.
  
  
  RESULTS
  Both patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician's personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specific treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefits, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confidently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients.
  
  
  CONCLUSIONS
  Integrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments.
authors.affiliation: Center for Community Health and Evaluation, Group Health Research Institute, Seattle, Washington, USA. hsu.c@ghc.org
authors.forename: Clarissa
authors.initials: C
authors.lastname: Hsu
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cherkin
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hoffmeyer
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Sherman
authors.forename: William R
authors.initials: WR
authors.lastname: Phillips
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003142:Communication; D000529:Complementary Therapies / Q000009:adverse effects* / Q000191:economics; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012449:Safety; D016896:Treatment Outcome; D035502:Trust / Q000523:psychology; D055815:Young Adult