The interface with naturopathy in rural primary health care: a survey of referral practices of general practitioners in rural and regional New South Wales, Australia

Abstract

BackgroundNaturopathy forms an increasingly significant part of the Australian healthcare setting, with high utilisation of naturopaths by the Australian public and a large therapeutic footprint in rural and regional Australia. However, despite these circumstances, there has been little exploration of the interface between naturopathy providers and conventional primary health care practitioners in rural and regional Australia. The study reported here examined the referral practices and factors that underlie referral to naturopaths amongst a sample of rural and regional Australian general practitioners (GPs).MethodsA 27-item questionnaire was sent to all 1,486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia.ResultsA total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). One-quarter of GPs (25.8%) referred to a naturopath at least a few times per year while nearly half (48.8%) stated that they would not refer to a naturopath under any circumstances. GPs were more likely to refer to a naturopath if the GP: was not initially from a rural area (OR=1.78; 95% CI: 0.95, 3.33); believes in the efficacy of naturopathy (OR=5.62; 95% CI: 2.42, 11.36); has seen positive results from naturopathy previously (OR=2.61; 95% CI: 1.35, 5.05); perceives a lack of other treatment options for their patient (OR=5.25; 95% CI: 2.42; 11.36); uses peer-reviewed literature as their major source of CAM information (OR=3.03; 95% CI: 1.65, 5.55); uses CAM practitioners as a major source of CAM information (OR=6.09; 95% CI: 2.91, 12.72); and does not have an existing relationship with any CAM provider (OR=3.03; 95% CI: 1.53, 6.25).ConclusionsThere is little interaction (both via referrals as well as the development of professional relationships) between the naturopathic and GP communities in rural and regional Australia, with significant levels of both support and opposition for naturopathic referral amongst GPs. The significant presence and high utilisation of naturopathy in rural primary health care, which appears to work in parallel to conventional medical care rather than in conjunction with it, should serve as an impetus for increased research into naturopathy practice, policy and regulation in rural and regional health.

Overview of international naturopathic practice and patient characteristics: results from a cross-sectional study in 14 countries

“…These local differences may also impact on care provision and whether naturopathy is being accessed in a complementary or primary care context. Previous research has indicated the potential for naturopaths to be functioning as primary care practitioners [37]. Legislative frameworks in specific states in the United States and Canada already clearly position naturopathic practitioners as primary care physicians [15].…”

Associations between complementary medicine utilization and influenza/pneumococcal vaccination: Results of a national cross-sectional survey of 9151 Australian women

“…As such, there may be utility in further examination of specific factors that one-third of naturopathic practitioners are consulted by patients who use them as their primary provider 26,27 . Naturopaths are Australia's largest CM profession with a primary point of care role 28 and as such, naturopaths may be able to attract a larger pool of patients who are resistant to conventional approaches to care for a broad range of conditions, or attracted to a 'natural' healthcare approach, rather than those seeking specific treatments.…”

Longitudinal analysis of associations between women's consultations with complementary and alternative medicine practitioners/use of self-prescribed complementary and alternative medicine and menopause-related symptoms, 2007-2010

“…1 In addition, previous regional and national surveys conducted in Australia have indicated that approximately half of family medicine practitioners would not refer to naturopaths/herbalists, as naturopaths/herbalists were considered to be at risk for delayed diagnosis or lack of awareness of the interaction between prescribed herbs and conventional medication. 28,29 It would seem that postmenopausal women experiencing headaches are using different modalities for menopause-related headaches in line with this guideline. However, it is not clear from our data whether women's lack of consultation with a naturopath/herbalist in this context is caused by the input or information provided by different professionals or caused by other influences.…”