Factors influencing the lack of communication on complementary and alternative medicine by clinicians in higher healthcare: A cross-sectional survey in China
Authors: Xie Hui , Zhou Hongli , Li Li , Li Wenting , Shi Haibo , Sang Tianqing , Chen Haibin , Zhou Hongguang 
Published: December 2020

Abstract
PurposeComplementary and alternative medicine (CAM) is well documented and widely applied in healthcare, however, there is a paucity of knowledge on the attitudes of high healthcare clinicians regarding CAM, as well aspects related to the communications by clinicians on the use of CAM. Such communication can be important in assuring agreement about therapeutic plans and the use of CAM as complimentary higher healthcare. The study investigated the communication about CAM between patients and clinicians, as well as factors that influence the communication of clinicians about CAM.MethodsThe study made use of the CAM Health Belief Questionnaire (CHBQ), a 10-item Likert-scale questionnaire that assesses the attitudes and beliefs of healthcare professionals towards CAM. The cross-sectional survey was distributed to 360 doctors in traditional Chinese Mmedicine (TCM) and western medicine (WM) from the departments of Internal Medicine (physicians) and Surgery (surgeons). The survey was distributed in 5 different hospitals in China over the period from May to August 2019.ResultsWe found that there is generally a positive attitude toward CAM by clinicians, with a large difference between physicians and surgeons. We found that there was a lack of communication about CAM between clinicians and patients, largely associated with the uncertainty about the scientific evidence for the efficacy of CAM, and the possible interactions with conventional medicine and other safety-related components. This made clinicians fearful and worried, and reluctant to share about CAM. Among those who could share or discuss CAM with patients, many were trained in TCM and had previously used CAM, and so they were more likely to communicate CAM to patients. Western medicine doctors were more resultant and did not have a positive attitude towards CAM, and would not recommend it to patients. Moreover, the physicians who typically would communicate about CAM with patients indicated that they were not encouraged to use it due, largely, to lack of access to CAM training, which is evident in the fact that on 10.6% of the clinicians had certificates in TCM. Therefore, there is a need to train clinicians in CAM and to equip them with skills that will enable them to engage patients and offer complementary modalities of treatment, given the historical use of CAM in China.ConclusionsOur results show that there is a generally positive attitude towards CAM in higher health in China. Clinicians have a positive attitude towards CAM but do not generally communicate with patients. The willingness that clinicians, especially the western clinicians, want to communicate with patients was weak. To reduce the reluctance and uncertainty, clinicians should be trained in evidence for those CAM methods in which patients are interested. This will also improve doctor-patient communication and allow for better integration of patient needs in their healthcare plans.