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Interprofessional collaborations in integrative medicine.

OBJECTIVES: Little is known about the implementation of integrative medicine (IM) in Australian health care and the nature of interprofessional collaborations that have been established in IM. The aim of this research was to examine the relationships among general medical practitioners (GPs) and complementary and alternative medicine (CAM) practitioners and their respective roles in co-located integrative practices.

DESIGN: This research adopted hermeneutic phenomenology as an effective methodology for revealing people's experiences of IM and the meanings they attached to these experiences. Three (3) data collection methods were used: cumulative case studies, focus groups, and key informant interviews. Data analysis consisted of constant comparison of data from multiple sources to identify patterns and meta-themes.

SETTINGS/LOCATION: The setting for this research was Australian IM clinics where GPs and CAM practitioners were co-located.

RESULTS: Three (3) practice styles were identified among IM practitioners in this research: (1) mutually empowering when GPs and CAM practitioners regarded each other as peers, (2) GP-directed with varying levels of autonomy afforded CAM practitioners, and (3) limited collaboration where patients were offered mainstream medicine and CAM, which GPs performed themselves.

CONCLUSIONS: IM practice styles differed in terms of interprofessional power-sharing and roles assigned to CAM practitioners. Practice styles where CAM practitioners were highly valued and able to exercise high levels of professional autonomy were perceived as making effective use of the available CAM workforce. Both GP-directed and intragrative practice styles (where GPs practiced CAM themselves without referral to CAM practitioners) were perceived by many GPs and CAM practitioners as enhancing patient safety.

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