Integrating complementary and alternative
medicine into academic medical centers: Experience and perceptions of
nine leading centers in North America
Sunita Vohra1, Kymm Feldman2, Brad Johnston1, Kellie Waters1 and Heather Boon3
1CARE Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
2Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
3Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
BMC Health Services Research 2005,
5:78doi:10.1186/1472-6963-5-78. Open Access article distributed under the terms of the Creative Commons Attribution License.
Patients across North America are using complementary and
alternative medicine (CAM) with increasing frequency as part of their
management of many different health conditions. The objective of this
study was to develop a guide for academic health sciences centers that
may wish to consider starting an integrative medicine program.
We queried North American leaders in the field of integrative
medicine to identify initial sites. Key stakeholders at each of the
initial sites visited were then asked to identify additional potential
study sites (snowball sampling), until no new sites were identified. We
conducted structured interviews to identify critical factors associated
with success and failure in each of four domains: research, education,
clinical care, and administration. During the interviews, field notes
were recorded independently by at least two investigators. Team
meetings were held after each visit to reach consensus on the
information recorded and to ensure that it was as complete as possible.
Content analysis techniques were used to identify key themes that
emerged from the field notes.
We identified ten leading North American integrative medical
centers, and visited nine during 2002–2003. The centers visited
suggested that the initiation of an integrative medicine program
requires a significant initial outlay of funding and a motivated
"champion". The centers had important information to share regarding
credentialing, medico-legal issues and billing for clinical programs;
identifying researchers and research projects for a successful research
program; and strategies for implementing flexible educational
initiatives and establishing a functional administrative structure.
Important lessons can be learned from academic integrative programs
already in existence. Such initiatives are timely and feasible in a
variety of different ways and in a variety of settings.