Doctor-patient discussions of alternative medicine for back pain

Objective - To document the frequency of conversations about alternative medicine during primary care consultations for back pain in diverse settings. Design - "Exit interview" type patient survey. Settings - General practices in Seattle, Washington; rural Israel; and Birmingham, England. Patients - A convenience sample of 218 adults completing a doctor visit for back pain. Main outcome measures - Frequencies of doctor-patient discussions of alternative medicine. Results - Alternative medicine was discussed in a minority of visits (US site 40%, Israel site 37%, UK site 14%, p < 0.05). At each site, patients initiated at least half of the discussions. Users were five to six times more likely to discuss alternative medicine with their doctor than non-users (p < 0.05 for comparison at each site). The percentage of patients who used alternative medicine but left the consultation without discussing it was similar at all sites (US site 17%, Israel site 23%, UK site 15%). Conclusions - Discussions of alternative medicine occurred in a minority of consultations for back pain although the rate varied considerably by site. Discussions were initiated primarily by patients who use it.