Wir meinen, dass nun durch die Vielzahl der Beiträge das Themenfeld klarer als zuvor ist, Schwachpunkte bzw. Nicht-zu-Ende-Gedachtes in unserem...
Wir meinen, dass nun durch die Vielzahl der Beiträge das Themenfeld klarer als zuvor ist, Schwachpunkte bzw. Nicht-zu-Ende-Gedachtes in unserem...
Summary: Among academics in family medicine there is debate whether it is legitimate to use complementary and alternative medicine (CAM) interventions or placebos. This article discusses social and professional aspects strongly influencing this discussion while rarely being made explicit. Based on the classical sociological analysis by Parsons the crucial role of functional specificity for legitimizing the acting of individual physicians and of medicine as profession is emphasized. Functional specificity itself is grounded on the scientific method. But in daily family practice functional specific knowledge is often insufficient. For those believing in CAM interventions these offer additional functionally specific tools. Yet, CAM therapies are typically based on theoretical concepts which are not backed up by science or even seem scientifically completely implausible. In this situation the evidence from clinical trials is often interpreted very differently by proponents and sceptics. Some physicians sometimes use treatments they consider themselves placebos or non-specific. Since patients are usually not fully informed this approach seems ethically and scientifically problematic.
Background: This study aimed to investigate whether family practitioners (FPs), internists and orthopedists working in private practice in Germany believe in the specific effects of complementary therapies, to what extent they use complementary therapies, placebos and non-specific therapies, and how basic professional attitudes are associated with specific patterns of use.Methods: A four-page questionnaire was sent to random samples of 700 physicians per specialist group.Results: Of 2018 questionnaires delivered correctly 935 (46 %) were sent back and analyzed. Belief in specific effects varied greatly within and between specialties. 23 % of FPs, 6 % of internists and 31 % of orthopedists use four or more complementary therapies more often than weekly, further 45 %, 15 % and 54 %, respectively, use two or three therapies. 76 % of FPs, 56 % of internists and 43 % of orthopedists reported the use of placebos and/or non-specific therapies in the last year. However, the frequency of such use was low. In addition to specialisation lower agreement to a scientific professional orientation was associated with a higher use of complementary therapies, placebo and non-specific therapies.Conclusions: German orthopedists and FPs use complementary therapies frequently, internists less often. While many FPs report some use of placebos and non-specific therapies orthopedists claim to almost never use such interventions.
