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BackgroundInfertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility.MethodsTen semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine.ResultsCAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described.ConclusionsIntegrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM’s holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.

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UNSTRUCTURED Recently, cases of patients recording clinical encounters without the physician's knowledge have been reported, raising ethical and legal questions. No study to date has examined surgeon's and trainee's attitudes towards this practice. An anonymous online survey was developed and administered to surgeons and trainees in a large academic department of surgery. The responses between the surgeons and trainees were then compared. There were a total of 114 responses (response rate of 12.6%). Attitudes on the utility of recording clinical encounters varied. When comparing surgeons to trainees, 22% of surgeons disagreed that memory aide alone was sufficient when discussing difficult information while only 5.3% of trainees (p<0.05) did. Surgeons were more likely to think it was reasonable (38.8%) for patients to request recording their clinical encounter than trainees (13.5%, p<0.05). Trainees were also more likely to agree that this would hinder their therapeutic relationship (62.2%) compared to surgeons (38.8%, p<0.05). Trainees were more likely to believe this could be used against them in a medico-legal dispute (52.8%) compared to surgeons (29.25, p<0.05). Trainees were also more concerned that these clinical recordings could be taken out of context (86.1%) compared to surgeons (54.2%, p<0.05). In summary, surgeons' opinion on patient recording of clinical encounters vary. Few were aware of the legal implications. Trainees are even less likely to value recording clinical encounters and more likely to believe that these recordings could be harmful.