Practitioner-client relationships in integrative medicine clinics in Australia: a contemporary social phenomenon.

摘要

OBJECTIVES: The increasing use of complementary and alternative medicine (CAM) in developed countries has been attributed more to contemporary cultural trends than to inherent problems in mainstream medicine. The aim of this study was to examine the impact of post-modern values on relationships between practitioners and clients in integrative medicine (IM) clinics in Australia. DESIGN: This research used hermeneutic phenomenology to uncover experiences of practitioner-client relationships in IM and the meanings clients and practitioners attached to these relationships. Data were collected using cumulative case studies, focus groups and key informant interviews. Data analysis consisted of reading and re-reading texts derived from interview transcripts and field notes and constantly comparing texts to identify meanings and patterns. Themes extracted from the data set were continually refined, discarded and elaborated until meta-themes emerged. SETTING: Australian IM clinics where general medical practitioners and CAM practitioners were co-located. RESULTS: Post-modern values were evident in practitioner-client relationships in Australian IM clinics and were manifested in two ways. (1) Clients did not bring an expectation that they would receive prescriptive treatment regimens. They regarded consultations as opportunities for obtaining information or advice, or for monitoring their health. (2) Practitioners valued clients' knowledge and judgments and respected clients' right to choose and direct their health care. CONCLUSIONS: In the IM clinics in this research, the traditional role of the practitioner as sole possessor of expertise had changed. Practitioners had become one among a number of resources that informed clients used when designing personal health care plans or negotiating health care with practitioners.