Diagnoses and visit length in complementary and mainstream medicine

<p>Abstract</p> <p>Background</p> <p>The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate.</p> <p>Methods</p> <p>Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis.</p> <p>Results</p> <p>The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC) were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs.</p> <p>Conclusions</p> <p>CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to specific diagnoses. Between CM practices differences were found on specific domains of complaints. Visit length was much longer in CM practices compared to mainstream GP visits, and such ample time may be one of the attractive features of CM for patients.</p

Promoting appreciation of the study and practice of medicine: inner workings of a Mini-Med program

Jacob Jay Lindenthal,1 Joel A DeLisa21Department of Psychiatry, Institute for the Public Understanding of Health and Medicine, 2Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USAAbstract: Dissatisfaction with the restrictions of the health care system, diminished reliance on the word of health care professionals, increased costs of medical care, and access to information online have increased consumers&amp;#39; interest in their own health care as well as their thirst for medical literacy. Mini-Med programs run by medical schools offer a more reliable method of learning about disease and disorders than does the indiscriminate surfing of the Internet. This article describes the efforts of the University of Medicine and Dentistry of New Jersey &amp;ndash; the largest public university of the health sciences in the nation &amp;ndash; to run and maintain such a program. The Mini-Med course provides lay students with insight into what a student undergoes while studying medicine and guides them through complex topics that range from anatomy and basic life support to the latest in stem cell research. It also provides early guidance for potential medical students, addresses patients&amp;#39; concerns, and gives some insight into the levels of comprehension of current medical students.Keywords: Mini-Med program, medical education, consumer education, health literac

Exposing medical students to expanding populations

JJ Lindenthal,1,2 JA DeLisa,3 GF Heinrich,4 WS Calder&oacute;n Gerstein,5 1Department of Psychiatry, Institute for the Public Understanding of Health and Medicine, 2Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA; 3Department of Orthopedics and Rehabilitation, University of New Mexico Health Science Center, Albuquerque, NM, USA; 4Department of Preventive Medicine and Community Health, New Jersey Medical School, Rutgers University, Newark, NJ, USA; 5Hospital Nacional Ramiro Prial&eacute;, EsSalud, Huancayo, Peru Abstract: Physicians are required to advocate for and counsel patients based on the best science and the interests of the individual while avoiding discrimination, ensuring equal access to health and mental services. Nonetheless, the communication gap between physician and patients has long been observed. To this end, the Institute for the Public Understanding of Health and Medicine of the Rutgers University New Jersey Medical School has expanded its efforts. This report describes two new programs: a legacy lecture series for medical students and an international &ldquo;experience&rdquo;, in Huancayo, Peru, for medical students and faculty. The MiniMed outreach program, now in its ninth year and first described in this journal in 2012, was designed to empower the powerless to communicate more effectively with clinicians, thus improving both the effectiveness of the physician&ndash;patient relationship and health care outcomes. The approach of the two new programs and their effects on patients, particularly the underserved, and medical students and faculty, are outlined in the following article. Keywords: MiniMed program, equal access, underserved populations, Newark Renaissance House, Kintock Group, role modeling&nbsp