60% of German Family Practitioners use CAM
The study Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey was published in 2010. It was co-authored by a team of German physicians from the University of Heidelberg and Tübingen led by Professor Stefanie Joos, and sums up the results of a nationwide survey that was conducted in Germany in 2007.
The introduction to the study describes the CAM situation in Germany: The percentage of people who had utilized CAM in Germany increased from 52% in 1970 to 73% in 2002. Some CAM disciplines (naturopathy, chiropractic, homeopathy, physiotherapy, acupuncture, etc.) are accredited by the German Federal Medical Chamber. Family physicians can obtain additional CAM qualifications once they have completed their theoretical and practical training. At the end of 2006, there were 47,193 registered CAM qualifications among Germany’s 407,000 doctors. In addition, Germany offers a wide range of CAM therapies which are provided by licensed non-medical practitioners, so-called Heilpraktiker. This profession does not require a medical education. However, a Heilpraktiker must pass a test to demonstrate basic medical knowledge and skills in order to obtain a license from the state. Due to the growing demand for CAM in Germany, the number of Heilpraktiker increased from 9,000 in 1993 to 20,000 in 2007.
The survey clearly shows that CAM is highly valued by German family physicians and contributes significantly to healthcare in Germany. The authors of the study state that patients expect not only a combination of CAM and conventional medicine, but an integrated system. Integrative medicine is such a system that adopts a complex approach to the patient. (174)
The following abstract from this study was originally published in PubMed:
More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners ("Heilpraktiker"). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-participation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned.” (175)
(175) Joos S, Musselmann B, Szecsenyi J. Integration of complementary and alternative medicine into family practices in Germany: results of a national survey [online]. Evid Based Complement Alternat Med 2009; Mar 17 [cit. 2016-06-29]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19293252