Integrating CAMI Into Conventional Medicine

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DESCRIPTION (Provided by applicant): This proposal is a multi-disciplinary collaboration between a scientist, clinicians, educator, medical anthropologist, statistician, health service provider, and community healers to identify barriers and facilitators to incorporation of complementary and alternative approaches (CAM) into conventional medicine. We hypothesize that the major barrier to the integration of CAM modalities into conventional medicine is that the underlying premises such as energy, "life- force", and spirituality on which most CAM modalities rest are not an accepted part of the Western scientific paradigm in which most physicians have been trained. Rather than attempt to convince physicians to use modalities that are outside of the paradigm within which they operate, we propose an intervention in which we will focus on nurturing a new paradigm. Specific Aim 1 is to determine whether an experiential program designed to nurture a blending of CAM and Western medicine paradigms can lead to an increased incidence of referrals to CAM practitioners. We will a) assess whether there is a change in the intention to refer patients immediately after the intervention; b) whether there has been a change in behavior 6 months after the intervention. Specific Aim 2 is to determine whether such an experiential program can increase the perceived understanding of underlying CAM paradigms, and whether the increased understanding is related to the increased referrals. We will a) assess whether there is an increased understanding of underlying CAM paradigms compared to the controls; b) calculate the frequency with which increased understanding of CAM paradigms is noted as an important feature in changing referrals; c) calculate the frequency with which other components of the intervention are noted as being important features in changing referrals. To accomplish these aims, we propose a randomized study for physicians in the Department of Cardiology at The Cleveland Clinic Foundation, in which one arm receives an educational intervention. The experimental group will attend a two-day experiential workshop that will feature lectures by a medical anthropologist, an educator experienced in educational theories of integration of paradigms, a research scientist familiar with research for mind-body interactions provided by molecular biology, neuroscience, and immunology, and a physicist familiar with concepts of quantum physics that are not inconsistent with features of CAM philosophies. Participants will have the opportunity to experience a number of CAM practices and to discuss issues with CAM practitioners including a physician who is Medical Director of an integrated center. Instruments will be designed to determine whether a change in behavior of cardiologists is affected by this intervention and, if so, to assess positive features. We anticipate that these studies will identify a sustainable, reproducible strategy for integrating CAM research into conventional practice and should provide insight into features that favor successful integration.