The health professional-patient-relationship in conventional versus complementary and alternative medicine. A qualitative study comparing the perceived use of medical shared decision-making between two different approaches of medicine.
OBJECTIVE
To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective.


METHODS
Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation.


RESULTS
The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g., longer consultation time) and internal provider beliefs (e.g., attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM.


CONCLUSIONS
Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM.


CONCLUSIONS
Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM.
Independent Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany. berger.stephanie@rocketmail.com
Stephanie
S
Berger
Elmar
E
Braehler
Jochen
J
Ernst
D000328:Adult; D000368:Aged; D015510:Clinical Medicine; D003142:Communication; D000529:Complementary Therapies; D003299:Cooperative Behavior; D003657:Decision Making; D005194:Family Practice / Q000379:methods; D005260:Female; D058005:General Practitioners; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010358:Patient Participation; D010465:Perception; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires