title: The challenges of establishing an integrative medicine primary care clinic in Sydney, Australia.
abstract: BACKGROUND
  In May 2006, a multidisciplinary community-based integrative medicine (IM) clinic was established in Sydney, Australia. It was designed to offer a wide range of IM services, for primary care and to serve as a referral center.
  
  
  OBJECTIVE
  The aim of this study was to determine which factors were successful and which ones posed challenges for establishing this kind of clinic.
  
  
  METHODS
  A study of the first 4 years of this primary care integrative medicine clinic was undertaken, using mixed methods--both qualitative and quantitative.
  
  
  RESULTS
  Consistent with success factors identified in the literature, the clinic had an open-minded culture, credible supporters, suitable facilities, and clinically competent practitioners. Throughout the 4 years of its existence, the clinic strove to create an economically sustainable environment and to develop the service. As time progressed, it became evident that at least half of the practitioners needed to be biomedical doctors for the practice to remain viable. The challenges encountered were creating an economically sustainable clinic, managing high staff and practitioner turnover, finding the right balance between practitioners and services offered, developing an integrative medicine team, and building research capacity to evaluate the clinic and patient outcomes.
  
  
  CONCLUSIONS
  Although many integrative medicine clinics fail to survive the first few years, after 4 years, this multidisciplinary primary care clinic had succeeded in establishing a viable health care service offering both integrative medicine and conventional, traditional, complementary, and alternative medicine. Finding the right mix of staff members and following up with evaluations to track progress are important.
authors.affiliation: Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, Australia. drjenniferhunter@yahoo.com.au
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hunter
authors.forename: Katherine
authors.initials: K
authors.lastname: Corcoran
authors.forename: Kerryn
authors.initials: K
authors.lastname: Phelps
authors.forename: Stephen
authors.initials: S
authors.lastname: Leeder
mesh_terms: D000554:Ambulatory Care Facilities; D001315:Australia; D000529:Complementary Therapies; D003695:Delivery of Health Care; D006296:Health Services; D006801:Humans; D055048:Integrative Medicine; D011320:Primary Health Care; D012017:Referral and Consultation