Healthcare Provider Bias: What The Data Shows
According to a recent study published in The Journal of Alternative and Complementary Medicine, many healthcare providers hold biases in the ways they recommend Complementary Health Approaches (CHAs).
U.S. Physician Recommendations to Their Patients About the Use of Complementary Health Approaches is the first study in over a decade to examine physician recommendations across specialties using a national sample, and the first in the literature to use a large probability sample of office-based physicians.
The aim of the study was to fill an existing void in the current literature for robust data on recommendations for Complementary Health Approaches by office-based physicians in the U.S. The CHAs include massage therapy, chiropractic/osteopathic manipulation, herbs/nonvitamin supplements, yoga, and acupuncture. Specifically, the authors identify which Complementary Health Approaches physicians recommend most often, and whether differences exist across physicians’ medical specialty, sex, and other demographic characteristics.
This is important because understanding practice patterns of U.S. physicians related to recommendations for CHAs, and their differences across medical specialties and physician sex, can educate consumers, physicians, and medical schools.
There were 5,622 physicians who provided data for these analyses, representing 338,627 physicians in the U.S. Among nonfederal office-based U.S. physicians, 72.3% were male and 27.7% were female. Excluding the “other” category, the most commonly observed specialty for male physicians was general/family practice (16%), followed by internal medicine (13%). For female physicians, it was general/family practice (20%) and pediatrics (19.7%).
The data show that 53.1% of U.S. physicians recommended any CHA to patients during the previous 12 months, and female physicians recommended every individual CHA at a higher rate than male physicians, except chiropractic/osteopathic manipulation.
Looking at recommendations by specialty, it was found that general/family practitioners recommended chiropractic/osteopathic manipulation and massage therapy at a higher rate than acupuncture, yoga, or mind-body therapies. Psychiatrists recommended mind-body therapies more frequently than any other CHAs, and pediatricians most frequently recommended herbs and nonvitamin supplements.
The high rate of recommendations for mind-body therapies by psychiatrists may be due to findings in previous research that confirms the benefit of relaxation techniques, mediation, and mindfulness-based stress reduction for psychological conditions such as post-traumatic stress disorder, anxiety, and depression. Research based on what ARPF has published in the last two decades.
This study also found increasing age was associated with lower rates of recommendations for yoga and massage therapy for physicians over 65-years-old. Several studies have found younger physicians more likely to refer their patients for CHAs, use CHAs in their practices, or have positive attitudes toward CHAs. Possible reasons why younger physicians may be more likely to recommend CHAs are the incorporation of CHAs into the curricula of U.S. medical schools, and a higher percentage of older physicians being male.
Based on this data, there seems to be a gap in the education/awareness in older male physicians about the powerful benefits of yoga/meditation. However, given the rising rate of female physicians in the United States, there is reason to expect that recommendations for CHAs will increase over time. Rates are also expected to rise as more research is published supporting CHAs which then becomes integrated into the wellness plans of younger physicians.
Furthermore, this goes to show that more outreach is needed to connect and share the research of holistic intervention and prevention strategies with physicians. Patients should also be aware of the resources and integrative medicine available to them even if it is not recommended by their doctor.
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