title: Referral to massage therapy in primary health care: a survey of medical general practitioners in rural and regional New South Wales, Australia.
abstract: OBJECTIVE
  Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care.
  
  
  METHODS
  A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas.
  
  
  RESULTS
  A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as "no longer at this address" (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study.
  
  
  CONCLUSIONS
  There appears to be substantial interface between massage therapy and GPs in rural and regional Australia. There are high levels of support for massage therapies among Australian GPs, relative to other CAM professions, with low levels of opposition to the incorporation of these therapies in patient care.
authors.affiliation: Chancellor's Postdoctoral Research Fellow, Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Network of Researchers in the Public Health of Complementary and Alternative Medicine, Sydney, Australia. Electronic address: Jon.wardle@uts.edu.au.
authors.forename: Jon L
authors.initials: JL
authors.lastname: Wardle
authors.forename: David W
authors.initials: DW
authors.lastname: Sibbritt
authors.forename: Jon
authors.initials: J
authors.lastname: Adams
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008405:Massage / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D009517:New South Wales; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data* / Q000639:trends; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population
keywords: General Practice; Massage; Primary Health Care; Referral and Consultation