As alternative and complementary therapies gain popularity, more patients are bringing these options into the exam room. Many arrive informed and curious, having already explored approaches they’ve encountered online, through family, or in other healthcare systems.
Recently, a clinician on Healthcasts wondered how others handle these conversations and asked their peers how they approach discussing alternative medicine with patients.
Across their responses, one theme stands out: effective care starts with open dialogue, grounded in evidence, and focused on making sure alternative approaches complement, rather than compromise, standard treatments.
Have you been asked about alternative medicine options, and how did you respond? Log in or sign up to read the full post, leave a comment, and see the Consensus.
Key takeaways about clinical approaches to alternative medicine:
Rheumatology
"1. I attempt to keep on top of the latest trends, both through "influencers" and those shown to be scientifically effective. In a non-judgmental manner, I will inform patients of what is known, side effects, effectiveness, and costs. A dialogue is established. If the patient desires something ineffective, costs little, and carries minimal risk or downside, I will let them find out on their own. They generally respect this approach.
2. I discuss options regularly. If a patient desires an exclusive naturopathic approach, I will refer them to someone who offers this."
Oncology/Hematology
"1. I clarify the difference between alternative (done to the exclusion of standard therapies) and complementary (done in conjunction with standard therapies). Ask about reasons, where they got their information, discuss risks and benfits including interference with other medications they may be taking. Make a recommendation, be honest, and be able to show why that recommendation is made. At some point, the patient will decide either to accept or reject that recommendation.
2. I do not refer to integrative providers; I do try to provide education and answer questions. Some patients will be open to discussion, others already have their minds made up. I will remain available to assist these individuals. If they ask me to prescribe something I think is harmful, the answer is no."
Internal Medicine
"1. I try to be open to alternative options, as long as there is no harm. However, if there is an effective evidence-based treatment, I will recommend it and encourage alternative therapies as supplemental approaches.
2. I do regularly recommend acupuncture for pain control of arthritic pain. Side effects (none) are much better than NSAIDs."
Rheumatology
"1. I encourage patients to be open about the use of alternative or off-label medications. As long as they are following their recommended therapy and as long as the patients are open to the use of alternative therapies, I will discuss it. If I feel that there are potential interactions or side effects, I will point this out. I believe open communication is very important to achieve honest and effective therapy.
2. Beyond leaving the discussion open regarding these therapies, I usually do not refer to integrative providers. I mainly focus on education about benefits and risks, and the importance of following their recommended therapy from me."
Internal Medicine
"1. I get a lot of queries regarding CIM. I don't dismiss their questions, but rather discuss the scientific data of their efficacy or otherwise. Most of the concerns are regarding the products or practices in their native countries, and it becomes very difficult to know about these. So, I usually comment that let us try the treatments that have a scientific validation for efficacy, and we should do deeper research about CIM products.
2. I usually ask my patients regarding any OTC products they are using, but I don't recommend any particular CIM products or practices except for those for which we have scientific data."
Unspecified/Other
"1. I want to understand why they want alternative treatments, and frame the choice between allopathic and complementary approaches as objectively as I can in terms of safety, efficacy, side effects, evidence from studies, etc.
2. Yes, being an integrative provider myself, I think most patients want a provider who is well-versed in both the allopathic and alternative approaches. I will occasionally refer to NDs, acupuncturists as well."
Internal Medicine
"1. This depends on the treatment and the purpose. If the patient is terminal and might derive benefit from "hope" (one of the best medicines), I would encourage it, as long as I determined it was not harmful. Acupuncture and chiropractic care, when used appropriately, can have benefit, Homeopathy doesn't.
2. The latter. Surprisingly, this does not come up often."
Rheumatology
"1. I recommend that the patient please consider alternative therapies as a supplement. Additionally, given expense and quality considerations, I caution patients to make wise financial decisions when purchasing items, especially those ones with broad claims.
2. I do not generally discuss these therapies. I tend to focus on the risks and benefits of controlling their chronic rheumatologic condition with evidence- based therapies. We do need to explain to patients the utility of AI in clinical decision-making. When AI-based decision tools are available, we need to be upfront and honest with the patient that these tools are being used in their clinical diagnostic and management decisions."
Internal Medicine
"1. I use specific specialists who have expertise in alternative medicine.
2. I do not discuss alternative medicine therapies routinely. I will refer to specific integrative providers. I will sometimes do a quick AI search and go to reputable websites and review the information there."
Unspecified/Other
"1. Start by exploring the patient’s goals and preferences, then review evidence and safety for complementary therapies
2. Focus on patient education while referring to integrative medicine specialists when appropriate."
Do you prefer to personally discuss alternative medicine with your patients or refer them to a specialist? Share your approach and read all of the comments on the post on Healthcasts.