A Self-Report Measure of Clinicians' Orientation toward Integrative Medicine

Authors

  • An-Fu Hsiao,

    Search for more papers by this author
    • Address correspondence to An-Fu Hsiao, M.D., Ph.D., UCLA Department of Medicine, Division of GIM/HSR, 911 Broxton Plaza, Los Angeles, CA 90095-1736. Ron D. Hays, Ph.D., and Neil S. Wenger, M.D., M.P.H., are with the UCLA Department of Medicine, Division of GIM/HSR, Los Angeles, CA. Gery W. Ryan, Ph.D., and Ian D. Coulter, Ph.D., are with RAND Health, Santa Monica, CA. Ronald M. Andersen, Ph.D., is with the Departments of Health Services and Sociology, University of California, Los Angeles, Los Angeles, CA. Mary L. Hardy, M.D., is with the UCLA Center for Dietary Supplement Research in Botanicals, Los Angeles, CA. David L. Diehl, M.D., is with NYU School of Medicine, New York. Ka-Kit Hui, M.D., is with the UCLA Center for East–West Medicine, University of California, Los Angeles, CA.

  • Ron D. Hays,

  • Gery W. Ryan,

  • Ian D. Coulter,

  • Ronald M. Andersen,

  • Mary L. Hardy,

  • David L. Diehl,

  • Ka-Kit Hui,

  • Neil S. Wenger


  • We do not have any financial interests or conflicts of interest associated with this research project.

Abstract

Objective. Patients in the U.S. often turn to complementary and alternative medicine (CAM) and may use it concurrently with conventional medicine to treat illness and promote wellness. However, clinicians vary in their openness to the merging of treatment paradigms. Because integration of CAM with conventional medicine can have important implications for health care, we developed a survey instrument to assess clinicians' orientation toward integrative medicine.

Study Setting. A convenience sample of 294 acupuncturists, chiropractors, primary care physicians, and physician acupuncturists in academic and community settings in California.

Data Collection Methods. We used a qualitative analysis of structured interviews to develop a conceptual model of integrative medicine at the provider level. Based on this conceptual model, we developed a 30-item survey (IM-30) to assess five domains of clinicians' orientation toward integrative medicine: openness, readiness to refer, learning from alternate paradigms, patient-centered care, and safety of integration.

Principal Findings. Two hundred and two clinicians (69 percent response rate) returned the survey. The internal consistency reliability for the 30-item total scale and the five subscales ranged from 0.71 to 0.90. Item-scale correlations for the five subscales were higher for the hypothesized subscale than other subscales 75 percent or more of the time. Construct validity was supported by the association of the IM-30 total scale score (0–100 possible range, with a higher score indicative of greater orientation toward integrative medicine) with hypothesized constructs: physician acupuncturists scored higher than physicians (71 versus 50, p<.001), dual-trained practitioners scored higher than single-trained practitioners (71 versus 62, p<.001), and practitioners' self-perceived “integrativeness” was significantly correlated (r=0.60, p<.001) with the IM-30 total score.

Conclusion. This study provides support for the reliability and validity of the IM-30 as a measure of clinicians' orientation toward integrative medicine. The IM-30 survey, which we estimate as requiring 5 minutes to complete, can be administered to both conventional and CAM clinicians.

Ancillary