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OBJECTIVE: In this study, we explored parents' perspectives toward complementary and alternative medicine (CAM) use by their children and its impact on parent-doctor and doctor–CAM-practitioner communication. PATIENTS AND METHODS: We designed a 2-arm study of parents who approached either conventional primary care or CAM clinics with their children to consult physicians or practitioners regarding their child's health. RESULTS: A total of 599 parents responded to our questionnaire (319 in 5 conventional clinics [83.9% response rate] and 280 in 21 CAM clinics [71.2% response rate]). Parents in conventional clinics reported less use of CAM by their children within the previous year (35.3% vs 73.7%; P < .0001) but used more traditional and homemade remedies (46.4% vs 12.7%; P < .0001). Both parent groups largely supported informing their child's physician regarding CAM use and expected the physician to initiate a CAM–related conversation and to refer their child to a CAM practitioner. The 2 groups' respondents largely supported communication between the child's physician and the CAM practitioner by the use of a referral/medical letter. Compared with respondents in CAM clinics, parents in conventional clinics were more supportive of CAM integration in a pediatric primary care setting and envisioned a more dominant role of physicians regarding CAM referral and a significant role of physicians in providing CAM. CONCLUSIONS: Parents who are referred to conventional and CAM clinics express distinctive attitudes toward CAM integration in pediatric care. Parents perceive physician–CAM practitioner communication as highly important and instrumental in promoting their children's health and safety.

In this article, we present the results of a study that was conducted among 15 family physicians who had incorporated complementary and alternative medicine (CAM) into their clinical work in Israel. We aimed to explore the types of boundaries those physicians encountered, how these boundaries were contoured, and under what circumstances they were crossed. We conducted in-depth interviews with the physicians in 2008, and found that epistemological and cognitive boundaries did not pose a problem for them. However, with regard to the organizational boundary, the participants indicated that it was necessary to use a variety of strategies before they could utilize their CAM skills. Many of the participants indicated that the epistemological differences between the biomedical and CAM paradigms, such as the absence of evidence-based medicine in CAM practices, are not important. The ease with which boundaries were crossed in the complex social context described here is characteristic of postmodern societies. On the whole, the integrative physicians interviewed can be viewed as "postmodern" professionals who reject the impermeability of many long-established boundaries and hierarchies.

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