RHEUMATOLOGISTS AND THEIR PATIENTS WHO SEEK ALTERNATIVE CARE: AN AGREEMENT TO DISAGREE

Alternative treatment, such as homoeopathy, acupuncture andspiritual healing, are popular among patients with rheumaticdiseases. Rheumatologists are therefore likely to be confrontedwith patients who make use of less orthodox health care. Patients'and rheumatologists' views on the subject and on the rheumatologists'role, however, have not yet been assessed. A questionnaire on alternative medicine was sent to all 101practising Dutch rheumatologists (response rate: 70%). Afterthe results had been analysed 17 rheumatologists, seven rejectingalternative medicine and ten accepting it, handed out a questionnaireto a sample of their patients: 1466 patient questionnaires weredistributed (response rate: 80%). Of the respondents 43% had visited an alternative practitionerat least once for their rheumatism and 26% in the year beforethe survey was held. Hand healers, homoeopaths and acupuncturistswere most often visited. Rheumatologists, on their part, werenot too enthusiastic about these visits. Only patients' visitsto spa treatment centres were welcomed by a majority of them;visits of their patients to manipulative therapists, acupuncturistsand homoeopaths were judged positively by a large minority,whereas other therapies were strongly disapproved. Nevertheless,most patients informed their rheumatologist about their visitingan alternative practitioner. A surprisingly low percentage ofthese patients noticed that the rheumatologist did not sympathizewith it. Although many patients paid a visit to an alternativepractitioner because regular care did not really help them,their satisfaction with the alternative treatment turned outto be less than their satisfaction with the rheumatologists'help. Although a growing number of Dutch general practitioners andphysiotherapists apply alternative methods themselves—contributingto an integration of (parts of) it in the regular care system—therheumatologists do not follow their example. KEY WORDS: Alternative treatment, Homoeopathy, Acupuncture, Spiritual healing