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Objective - To document the frequency of conversations about alternative medicine during primary care consultations for back pain in diverse settings. Design - "Exit interview" type patient survey. Settings - General practices in Seattle, Washington; rural Israel; and Birmingham, England. Patients - A convenience sample of 218 adults completing a doctor visit for back pain. Main outcome measures - Frequencies of doctor-patient discussions of alternative medicine. Results - Alternative medicine was discussed in a minority of visits (US site 40%, Israel site 37%, UK site 14%, p < 0.05). At each site, patients initiated at least half of the discussions. Users were five to six times more likely to discuss alternative medicine with their doctor than non-users (p < 0.05 for comparison at each site). The percentage of patients who used alternative medicine but left the consultation without discussing it was similar at all sites (US site 17%, Israel site 23%, UK site 15%). Conclusions - Discussions of alternative medicine occurred in a minority of consultations for back pain although the rate varied considerably by site. Discussions were initiated primarily by patients who use it.

Original publication




Journal article


Scandinavian Journal of Primary Health Care

Publication Date





237 - 240