These respondents describe an ideal process of care that is patient centered and individualized and that supports their unique constellations of problems, shifting priorities and multidimensional decision making. Individual and ongoing care coordination managed by a primary contact person may meet some of these needs. Achieving these goals will require developing efficient methods of assessing patient care needs and flexible care management support systems that can respond to patients' needs for different levels of support at different times.

The goal of this article is to raise issues associated with the underlying assumptions of our research approaches and the nature of health/disease in conventional medical care and complementary and alternative medical care. Different types of efficacy are discussed in terms of randomized controlled trials and outcomes research. The demands of different audiences for research results suggest that researchers need to carefully specify the research question in the context of the state-of-the-knowledge. Appropriate matching of the study design, the nature of the disease, the nature of the treatment and what is known is essential to designing and implementing research that actually could improve patient care.