Sustaining complementary therapy provision in primary care: lessons from existing services

General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study

“…Most questions had a closed format, as this was thought of as timesaving and thus preferable for the respondent. The answer choices were based on interviews of GPs [16,17].…”

Organizational Determinants of Interprofessional Collaboration in Integrative Health Care: Systematic Review of Qualitative Studies

“…, filling BM's effectiveness gaps) appeared to receive less resistance [20], [22], [31]–[36]. Gaining legitimatization by highlighting limitations of BM may promote the adoption of TCAM treatments as a last resort when all BM treatments are exhausted [19], [37], [38]. At times TCAM is regarded as a first-line treatment for “difficult to treat” diseases given its inexpensive and non-invasive nature [31].…”

“…, treating illnesses, not diseases) that are often impractical to implement during a short BM consultation [27], [31], [35], [39], [40]. Enhancing the patient-centeredness of BM services represents another important incentive for organizational and management support for developing integrative services [37], [41], although some BMD believe that conventional care alone is holistic enough for promoting wellness [23].…”

“…Whereas the potential financial benefits to BM institutions and practitioners form the business case for providing IHC services [20], [38], [42], [43], securing funding for launching and sustaining IHC services is a major challenge for the central authorities before such gain is harvested [19], [28], [37]. Sufficient funding is not only essential for recruiting experienced, qualified TCAMP [44], but it also carries strong implications for TCAMP's sense of belonging within predominantly BM institutions as well as effecting the intention to work collaboratively with BMD [19], [35], [45].…”

“…Thus, many TCAM services operate on a self-financing basis, and even when public funding is available, caps on the maximum number of treatments are often applied [29], [36], [48]. Under such funding arrangements, the flexibility of TCAM provision may be compromised because services would need to be geared to serving the purpose of cost containment and demand management [25], [37]. For example, patients with acute problems may be given preference over those with chronic problems needing osteopathic treatment since effects will be evident in a shorter time span than for those with chronic diseases [29].…”