by NCCAM
 

Introduction

Selecting a health care practitioner--of conventional (1) or complementary and alternative medicine (CAM)--is an important decision and can be key to ensuring that you are receiving the best health care. The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet to answer frequently asked questions about selecting a CAM practitioner, such as issues to consider when making your decision and important questions to ask the practitioner you select.

Key Points

• If you are seeking a CAM practitioner, speak with your primary health care provider(s) or someone you believe to be knowledgeable about CAM regarding the therapy in which you are interested. Ask if they have a recommendation for the type of CAM practitioner you are seeking.
• Make a list of CAM practitioners and gather information about each before making your first visit. Ask basic questions about their credentials and practice. Where did they receive their training? What licenses or certifications do they have? How much will the treatment cost?
• Check with your insurer to see if the cost of therapy will be covered.
• After you select a practitioner, make a list of questions to ask at your first visit. You may want to bring a friend or family member who can help you ask questions and note answers.
• Come to the first visit prepared to answer questions about your health history, including injuries, surgeries, and major illnesses, as well as prescription medicines, vitamins, and other supplements you may take.
• Assess your first visit and decide if the practitioner is right for you. Did you feel comfortable with the practitioner? Could the practitioner answer your questions? Did he respond to you in a way that satisfied you? Does the treatment plan seem reasonable and acceptable to you?

Questions and Answers

1. What is complementary and alternative medicine?

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be a part of conventional medicine, such as acupuncture, chiropractic, massage, and homeopathy. People use CAM therapies in a variety of ways. CAM therapies used alone are often referred to as "alternative." When used in addition to conventional medicine, they are often referred to as "complementary." The list of what is considered to be CAM changes continually as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge. For more about these terms, see the NCCAM fact sheet "What Is Complementary and Alternative Medicine?"

2. I am interested in a CAM therapy that involves treatment from a practitioner. How do I go about finding a practitioner?

Before selecting a CAM therapy or practitioner, talk with your primary health care provider(s) or someone you believe to be knowledgeable about CAM. Tell them about the therapy you are considering and ask any questions you may have. They may know about the therapy and be able to advise you on its safety, use, and effectiveness, or possible interactions with medications. Here are some suggestions for finding a practitioner:

• Ask your doctor or other health professionals whether they have recommendations or are willing to make a referral.
• Ask someone you believe to be knowledgeable about CAM if they can recommend a practitioner for the type of therapy you are seeking.
• Contact a nearby hospital or a medical school and ask if they maintain a list of area CAM practitioners or could make a recommendation. Some regional medical centers may have CAM centers or CAM practitioners on staff.
• Ask if your therapy will be covered by insurance, for example some insurers cover visits to a chiropractor. If it will, ask for a list of CAM practitioners who accept your insurance.
• Contact a professional organization for the type of practitioner you are seeking. Often, professional organizations have standards of practice, provide referrals to practitioners, have publications explaining the therapy (or therapies) that their members provide, and may offer information on the type of training needed and whether practitioners of a therapy must be licensed or certified in your state. Professional organizations can be located by searching the Internet or directories in libraries (ask the librarian). One directory is the Directory of Information Resources Online (DIRLINE) compiled by the National Library of Medicine (dirline.nlm.nih.gov). It contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations. You may find more than one member organization for some CAM professions; this may be because there are different "schools" of practice within the profession or for other reasons.
• Many states have regulatory agencies or licensing boards for certain types of practitioners. They may be able to provide you with information regarding practitioners in your area. Your state, county, or city health department may be able to refer you to such agencies or boards. Licensing, accreditation, and regulatory laws for CAM practices are becoming more common to help ensure that practitioners are competent and provide quality services.

3. Will insurance cover the cost of a CAM practitioner?

Few CAM therapies are covered by insurance and the amount of coverage offered varies depending upon the insurer. Before agreeing to a treatment that a CAM practitioner suggests, you should check with your insurer to see if they will cover any portion of the therapy's cost. If insurance does cover a portion of the cost, you will want to ask if the practitioner accepts your insurance or participates in your insurer's network. Even with insurance, you may be responsible for a percentage of the cost of therapy.

4. I have located the names of several practitioners. How do I select one?

Begin by contacting the practitioners on your list and gathering information.

• Ask what training or other qualifications the practitioner has. Ask about her education, additional training, licenses, and certifications. If you contacted a professional organization, see if the practitioner's qualifications meet the standards for training and licensing for that profession.
• Ask if it is possible to have a brief consultation in person or by phone with the practitioner. This will give you a chance to speak with the practitioner directly. The consultation may or may not involve a charge.
• Ask if there are diseases/health conditions in which the practitioner specializes and how frequently he treats patients with problems similar to yours.
• Ask if the practitioner believes the therapy can effectively address your complaint and if there is any scientific research supporting the treatment's use for your condition.
• Ask how many patients the practitioner typically sees in a day, and how much time she spends with each patient.
• Ask whether there is a brochure or Web site to tell you more about the practice.
• Ask about charges and payment options. How much do treatments cost? If you have insurance, does the practitioner accept your insurance or participate in your insurer's network? Even with insurance, you may be responsible for a percentage of the cost.
• Ask about the hours appointments are offered. How long is the wait for an appointment? Consider whether this will be convenient for your schedule.
• Ask about office location. If you are concerned, ask about public transportation and parking. If you need a building with an elevator or a wheelchair ramp, ask about them.
• Ask what will be involved in the first visit or assessment.
• Observe how comfortable you feel during these first interactions.

Once you have gathered the information, assess the answers and determine which practitioner was best able to respond to your questions and best suits your needs.

5. I have selected a practitioner. What questions should I ask at my first visit?

The first visit is very important. Come prepared to answer questions about your health history, such as surgeries, injuries, and major illnesses, as well as prescriptions, vitamins, and other supplements you take. Not only will the practitioner wish to gather information from you, but you will want to ask questions, too. Write down ahead of time the questions you want to ask, or take a family member or friend with you to help you remember the questions and answers. Some people bring a tape recorder to record the appointment. (Ask the practitioner for permission to do this in advance.) Here are some questions you may want to ask:

• What benefits can I expect from this therapy?
• What are the risks associated with this therapy?
• Do the benefits outweigh the risks for my disease or condition?
• What side effects can be expected?
• Will the therapy interfere with any of my daily activities?
• How long will I need to undergo treatment? How often will my progress or plan of treatment be assessed?
• Will I need to buy any equipment or supplies?
• Do you have scientific articles or references about using the treatment for my condition?
• Could the therapy interact with conventional treatments?
• Are there any conditions for which this treatment should not be used?

6. How do I know if the practitioner I have selected is right for me?

• After your first visit with a practitioner, evaluate the visit. Ask yourself:
• Was the practitioner easy to talk to? Did the practitioner make me feel comfortable?
• Was I comfortable asking questions? Did the practitioner appear willing to answer them, and were they answered to my satisfaction?
• Was the practitioner open to how both CAM therapy and conventional medicine might work together for my benefit?
• Did the practitioner get to know me and ask me about my condition?
• Did the practitioner seem knowledgeable about my specific health condition?
• Does the treatment recommended seem reasonable and acceptable to me?
• Was the practitioner clear about the time and costs associated with treatment?

7. Can I change my mind about the treatment or the practitioner?

Yes, if you are not satisfied or comfortable, you can look for a different practitioner or stop treatment. However, as with any conventional treatment, talk with your practitioner before stopping to make sure that it is safe to simply stop treatment--it may not be advisable to stop some therapies midway through a course of treatment.

Discuss with your practitioner the reasons you are not satisfied or comfortable with treatment. If you decide to stop a therapy or seek another practitioner, make sure that you share this information with any other health care practitioners you may have as this will help them make decisions about your care. Communicating with your practitioner(s) can be key to ensuring the best possible health care.

8. Can I receive treatment or a referral to a practitioner from NCCAM?

NCCAM is the Federal Government's lead agency dedicated to supporting research on CAM therapies. NCCAM does not provide CAM therapies or referrals to practitioners.

9. Can I receive CAM treatment through a clinical trial?

NCCAM supports clinical trials (research studies in people) of CAM therapies. Clinical trials of CAM are taking place in many locations worldwide, and study participants are needed. To find out more about clinical trials in CAM, see the NCCAM fact sheet "About Clinical Trials and Complementary and Alternative Medicine." To find trials that are recruiting participants, go to the Web site nccam.nih.gov/clinicaltrials. You can search this site by the type of therapy being studied or by disease or condition.

For More Information

NCCAM Clearinghouse

Toll-free in the U.S.: 1-888-644-6226
International: 301-519-3153
TTY (for deaf or hard-of-hearing callers): 1-866-464-3615

E-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
NCCAM Web site: nccam.nih.gov
Address: NCCAM Clearinghouse, P.O. Box 7923, Gaithersburg, MD 20898-7923

Fax: 1-866-464-3616
Fax-on-Demand service: 1-888-644-6226

The NCCAM Clearinghouse provides information on CAM and on NCCAM. Services include fact sheets, other publications, and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

ClinicalTrials.gov
Web site: clinicaltrials.gov

ClinicalTrials.gov is a database of information on clinical trials, primarily in the United States and Canada, for a wide range of diseases and conditions. It is sponsored by the National Institutes of Health and the U.S. Food and Drug Administration.

National Library of Medicine (NLM)
Web site: www.nlm.nih.gov
Toll-free: 1-888-346-3656
E-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Address: 8600 Rockville Pike, Bethesda, MD 20894

NLM is the world's largest medical library. Services include MEDLINE, NLM's premier bibliographic database, which contains journal abstracts covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical science. MEDLINE is accessible through NLM's PubMed system at www.pubmed.gov. NLM also maintains DIRLINE (dirline.nlm.nih.gov), a database that contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations.

(1) Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Other terms for conventional medicine include allopathy; Western, mainstream, orthodox, and regular medicine; and biomedicine. Some conventional medical practitioners are also practitioners of CAM.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy in this information is not an endorsement by NCCAM.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM Publication No. D168
Date Reviewed: August 2003
Changes Made: September 2004

References

What is Complementary and Alternative Medicine. nccam.nih.gov/health/whatiscam

Selecting a Complementary and Alternative Medicine (CAM) Practitioner. nccam.nih.gov/health/practitioner