title: [Complementary and alternative medicine in the German outpatient setting: extent, structure and reasons for provision].
abstract: BACKGROUND
  Research on complementary and alternative medicine (CAM) has mainly focused on CAM utilisation by patients. Fewer studies have analysed extent and structure of CAM provision or the reasons why physicians offer CAM as a therapeutic option in the outpatient setting.
  
  
  METHODS
  A standardised questionnaire was developed addressing reasons and patterns of CAM provision. The questionnaire was sent by post to 2,396 general practitioners and specialists in 9 selected German districts. 553 physicians participated in the survey (23%).
  
  
  RESULTS
  63% of the respondents (n=350) answered that they had provided some sort of CAM to their patients within a period of 12 months preceding the study. The most frequently provided methods were acupuncture/traditional Chinese medicine, herbal remedies and homeopathy. In the sample, 90% of the orthopaedists were CAM providers, the highest rate among the participating disciplines. Several reasons for offering CAM were identified: conviction of therapeutic effectiveness regarding the patient's situation (68%), aspects of therapeutic freedom (47%) or less harmful side effects than conventional therapies (34%). 6% provide CAM for monetary reasons.
  
  
  CONCLUSIONS
  Findings suggest that the provision of CAM is widespread in the German outpatient setting. However, it has to be taken into account that a selection bias may apply which may lead to an overestimation of CAM provision. Doctors' reasons to offer CAM are manifold; therapeutic reasons seem to outweigh economic motives.
authors.affiliation: Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Thanner
authors.affiliation: Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth.
authors.forename: E
authors.initials: E
authors.lastname: Nagel
authors.affiliation: Medizinische Soziologie - Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg.
authors.forename: J
authors.initials: J
authors.lastname: Loss
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003657:Decision Making; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D040841:Resource Allocation / Q000706:statistics & numerical data; D014600:Utilization Review