Characteristics of complementary medicine therapists in Switzerland: A cross-sectional study


Autoři: Julie Dubois aff001;  Anne-Sylvie Bill aff001;  Jérôme Pasquier aff001;  Silva Keberle aff003;  Bernard Burnand aff001;  Pierre-Yves Rodondi aff001
Působiště autorů: Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland aff001;  Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland aff002;  Empirical Medicine Register, Basel, Switzerland aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224098

Souhrn

Objective

More than 27,000 complementary medicine (CM) therapists are registered in Switzerland, but limited data are available on their occupational profile and role in the healthcare system. Herein we aimed to gain a better understanding of the professional profile of non-physician licensed therapists, focusing on acupuncture, osteopathy, and European naturopathy.

Design

This cross-sectional study was based on an online anonymous survey conducted from March to June 2017.

Setting and participants

All 1549 non-physician registered osteopaths, acupuncturists, and naturopaths in the French-speaking part of Switzerland were asked to complete the survey.

Main outcome measures

We measured the therapists’ demographics, training and practice characteristics, and workload.

Results

A total of 426 therapists returned the questionnaire (response rate: 27.5%). The mean age of the respondents was 46.0 years (SD 11.6) and most were women (67.8%). CM represented the main professional activity for a majority of therapists (82.8%), most of whom were independent (86.3%). The length and number of consultations per month varied across professions. Multivariate analysis showed that acupuncturists and naturopaths performed significantly fewer consults per month than osteopaths did. However, consultation length was significantly longer for acupuncturists and naturopaths than for osteopaths. Acupuncturists (71.6%) and naturopaths (64.4%) were significantly more favorable than osteopaths (27.7%) to have consultation costs covered by basic health insurance. Professional profiles differed between osteopaths, on the one hand, and naturopaths and acupuncturists, on the other, mainly regarding workload, treatment duration, and main reasons to consult.

Conclusions

This first study to investigate a variety of therapist profiles in Switzerland provides useful information about their activities and role within the Swiss healthcare system. Although all three professions are encompassed under the same umbrella term (CM), our study showed that they have specific work cultures and areas of intervention in the healthcare system.

Klíčová slova:

Acupuncture – Complementary and alternative medicine – Health insurance – Physicians – Professions – Switzerland – Naturopathy – Osteopathy


Zdroje

1. Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. National health statistics reports. 2015;(79):1–16. Epub 2015/02/12. 25671660; PubMed Central PMCID: PMC4573565.

2. Steel A, McIntyre E, Harnett J, Foley H, Adams J, Sibbritt D, et al. Complementary medicine use in the Australian population: Results of a nationally-representative cross-sectional survey. Sci Rep. 2018;8(1):17325–. doi: 10.1038/s41598-018-35508-y 30470778.

3. Eardley S, Bishop FL, Prescott P, Cardini F, Brinkhaus B, Santos-Rey K, et al. A systematic literature review of complementary and alternative medicine prevalence in EU. Forschende Komplementarmedizin (2006). 2012;19 Suppl 2:18–28. Epub 2012/01/01. doi: 10.1159/000342708 23883941.

4. Klein SD, Torchetti L, Frei-Erb M, Wolf U. Usage of Complementary Medicine in Switzerland: Results of the Swiss Health Survey 2012 and Development Since 2007. PLoS One. 2015;10(10):e0141985. Epub 2015/10/30. doi: 10.1371/journal.pone.0141985 26513370; PubMed Central PMCID: PMC4626041.

5. von Ammon K, Frei-Erb M, Cardini F, Daig U, Dragan S, Hegyi G, et al. Complementary and alternative medicine provision in Europe—first results approaching reality in an unclear field of practices. Forschende Komplementarmedizin (2006). 2012;19 Suppl 2:37–43. Epub 2012/01/01. doi: 10.1159/000343129 23883943.

6. Hostettler S, Kraft E. Statistique médicale 2017 de la FMH. Bulletin des médecins suisses. 2018;99(13–14):408–13.

7. Cherkin DC, Deyo RA, Sherman KJ, Hart LG, Street JH, Hrbek A, et al. Characteristics of licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians. The Journal of the American Board of Family Practice / American Board of Family Practice. 2002;15(5):378–90. Epub 2002/09/28. 12350060.

8. Floden L, Howerter A, Matthews E, Nichter M, Cunningham JK, Ritenbaugh C, et al. Considerations for practice-based research: a cross-sectional survey of chiropractic, acupuncture and massage practices. BMC complementary and alternative medicine. 2015;15:140. Epub 2015/05/03. doi: 10.1186/s12906-015-0659-7 25933801; PubMed Central PMCID: PMC4429345.

9. Adams J, Sibbritt D, Steel A, Peng W. A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project. BMC health services research. 2018;18(1):352. Epub 2018/05/12. doi: 10.1186/s12913-018-3158-y 29747647; PubMed Central PMCID: PMC5946419.

10. Bensoussan A, Myers SP, Wu SM, O'Connor K. Naturopathic and Western herbal medicine practice in Australia-a workforce survey. Complementary therapies in medicine. 2004;12(1):17–27. Epub 2004/05/08. doi: 10.1016/j.ctim.2004.01.001 15130568.

11. Burke SR, Myers R, Zhang AL. A profile of osteopathic practice in Australia 2010–2011: a cross sectional survey. BMC Musculoskelet Disord. 2013;14:227. Epub 2013/08/07. doi: 10.1186/1471-2474-14-227 23915239; PubMed Central PMCID: PMC3733950.

12. Cottingham P, Adams J, Vempati R, Dunn J, Sibbritt D. The characteristics, experiences and perceptions of naturopathic and herbal medicine practitioners: results from a national survey in New Zealand. BMC complementary and alternative medicine. 2015;15:114. Epub 2015/04/19. doi: 10.1186/s12906-015-0616-5 25888473; PubMed Central PMCID: PMC4405865.

13. Lin V, McCabe P, Bensoussan A, Myers S, Cohen M, Hill S, et al. The practice and regulatory requirements of naturopathy and western herbal medicine in Australia. Risk Manag Healthc Policy. 2009;2:21–33. Epub 2009/01/01. doi: 10.2147/RMHP.S4652 22312205; PubMed Central PMCID: PMC3270908.

14. Moore A, Komesaroff PA, O'Brien K, Xu H, Bensoussan A. Chinese Medicine in Australia. Journal of alternative and complementary medicine (New York, NY). 2016;22(7):515–25. Epub 2016/05/25. doi: 10.1089/acm.2015.0260 27219354.

15. Orrock P. Profile of members of the Australian Osteopathic Association: Part 1 –The practitioners. International Journal of Osteopathic Medicine. 2009;12(1):14–24. doi: 10.1016/j.ijosm.2008.04.002

16. Steel A, Leach M, Wardle J, Sibbritt D, Schloss J, Diezel H, et al. The Australian Complementary Medicine Workforce: A Profile of 1,306 Practitioners from the PRACI Study. Journal of alternative and complementary medicine (New York, NY). 2018;24(4):385–94. Epub 2018/01/03. doi: 10.1089/acm.2017.0206 29293360.

17. Wardle J, Adams J, Magalhaes RJ, Sibbritt D. Distribution of complementary and alternative medicine (CAM) providers in rural New South Wales, Australia: a step towards explaining high CAM use in rural health? Aust J Rural Health. 2011;19(4):197–204. Epub 2011/07/21. doi: 10.1111/j.1440-1584.2011.01200.x 21771161.

18. Wardle JL, Barnett R, Adams J. Practice and research in Australian massage therapy: a national workforce survey. International journal of therapeutic massage & bodywork. 2015;8(2):2–11. Epub 2015/06/18. 26082824; PubMed Central PMCID: PMC4455611.

19. Fawkes CA, Leach CM, Mathias S, Moore AP. A profile of osteopathic care in private practices in the United Kingdom: a national pilot using standardised data collection. Manual therapy. 2014;19(2):125–30. Epub 2013/10/22. doi: 10.1016/j.math.2013.09.001 24139392.

20. Hopton AK, Curnoe S, Kanaan M, Macpherson H. Acupuncture in practice: mapping the providers, the patients and the settings in a national cross-sectional survey. BMJ Open. 2012;2(1):e000456. Epub 2012/01/14. doi: 10.1136/bmjopen-2011-000456 22240649; PubMed Central PMCID: PMC3278493.

21. KPMG. KPMG data survey—How do osteopath practise? 2011.

22. Robinson N, Lorenc A, Ding W, Jia J, Bovey M, Wang XM. Exploring practice characteristics and research priorities of practitioners of traditional acupuncture in China and the EU-A survey. Journal of ethnopharmacology. 2012;140(3):604–13. Epub 2012/02/18. doi: 10.1016/j.jep.2012.01.052 22338645.

23. van Dun PLS, Nicolaie MA, Van Messem A. State of affairs of osteopathy in the Benelux: Benelux Osteosurvey 2013. International Journal of Osteopathic Medicine. 2016;20:3–17. doi: 10.1016/j.ijosm.2016.01.003

24. Vaucher P, Macdonald RJD, Carnes D. The role of osteopathy in the Swiss primary health care system: a practice review. BMJ Open. 2018;8(8):e023770. Epub 2018/09/03. doi: 10.1136/bmjopen-2018-023770 30173163; PubMed Central PMCID: PMC6120650.

25. Alvarez Bustins G, Lopez Plaza PV, Carvajal SR. Profile of osteopathic practice in Spain: results from a standardized data collection study. BMC complementary and alternative medicine. 2018;18(1):129. Epub 2018/04/13. doi: 10.1186/s12906-018-2190-0 29642901; PubMed Central PMCID: PMC5896131.

26. Humphreys BK, Peterson CK, Muehlemann D, Haueter P. Are Swiss chiropractors different than other chiropractors? Results of the job analysis survey 2009. Journal of manipulative and physiological therapeutics. 2010;33(7):519–35. doi: 10.1016/j.jmpt.2010.08.003 20937430

27. Schwarz I, Hondras MA. A survey of chiropractors practicing in Germany: practice characteristics, professional reading habits, and attitudes and perceptions toward research. Chiropractic & osteopathy. 2007;15:6. Epub 2007/05/08. doi: 10.1186/1746-1340-15-6 17480221; PubMed Central PMCID: PMC1887523.

28. Goetz K, Kattge S, Steinhäuser J. Satisfied naturopathic practitioners? Results from a job satisfaction survey in the federal state of Schleswig-Holstein, Germany. Eur J Integr Med. 2017;11:41–4. doi: 10.1016/j.eujim.2017.04.001

29. Baer HA. The drive for legitimation in Australian naturopathy: successes and dilemmas. Social science & medicine (1982). 2006;63(7):1771–83. Epub 2006/06/09. doi: 10.1016/j.socscimed.2006.04.021 16759776.

30. Cherkin DC, Deyo RA, Sherman KJ, Hart LG, Street JH, Hrbek A, et al. Characteristics of visits to licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians. The Journal of the American Board of Family Practice / American Board of Family Practice. 2002;15(6):463–72. Epub 2002/12/05. 12463292.

31. Sherman KJ, Cherkin DC, Eisenberg DM, Erro J, Hrbek A, Deyo RA. The practice of acupuncture: who are the providers and what do they do? Annals of family medicine. 2005;3(2):151–8. Epub 2005/03/31. doi: 10.1370/afm.248 15798042; PubMed Central PMCID: PMC1466855.

32. Morin C, Aubin A. Primary reasons for osteopathic consultation: a prospective survey in Quebec. PLoS One. 2014;9(9):e106259. Epub 2014/09/04. doi: 10.1371/journal.pone.0106259 25184204; PubMed Central PMCID: PMC4153609.

33. Chen L, Michalsen A. Management of chronic pain using complementary and integrative medicine. BMJ (Clinical research ed). 2017;357:j1284. Epub 2017/04/26. doi: 10.1136/bmj.j1284 28438745.

34. Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific low back pain: a systematic review. BMC Musculoskelet Disord. 2013;14(1):129. Epub 2013/04/11. doi: 10.1186/1471-2474-14-129 23570655; PubMed Central PMCID: PMC3623881.

35. Vickers AJ, Linde K. Acupuncture for chronic pain. Jama. 2014;311(9):955–6. doi: 10.1001/jama.2013.285478 24595780; PubMed Central PMCID: PMC4036643.

36. Lorenc A, Feder G, MacPherson H, Little P, Mercer SW, Sharp D. Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ Open. 2018;8(10):e020222. doi: 10.1136/bmjopen-2017-020222 30327397

37. Myers SP, Vigar V. The State of the Evidence for Whole-System, Multi-Modality Naturopathic Medicine: A Systematic Scoping Review. The Journal of Alternative and Complementary Medicine. 2019;25(2):141–68. doi: 10.1089/acm.2018.0340 30785315

38. Oberg EB, Bradley R, Cooley K, Fritz H, Goldenberg J, Seely D, et al. Estimated effects of whole-system naturopathic medicine in select chronic disease conditions: A systematic review. 2015;4(2):1–12.


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2019 Číslo 10