title: Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care.
  
  
  METHODS
  Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage.
  
  
  RESULTS
  Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach.
  
  
  CONCLUSIONS
  From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services.
authors.affiliation: University Centre for Rural Health, University of Sydney, PO Box 3074, Lismore NSW 2480, Australia. judy.singer@ucrh.edu.au.
authors.forename: Judy
authors.initials: J
authors.lastname: Singer
authors.forename: Jon
authors.initials: J
authors.lastname: Adams
mesh_terms: D000328:Adult; D001315:Australia; D002908:Chronic Disease / Q000628:therapy; D000529:Complementary Therapies; D005260:Female; D006293:Health Promotion; D006296:Health Services; D006298:Health Services Administration; D006801:Humans; D055048:Integrative Medicine; D008603:Mental Health; D016387:Women's Health