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Goals
and Objectives
Goals
Residents will:
- Broaden their knowledge of
complementary medical principles and practices,
and their use when safe and effective.
- Be able to effectively communicate
with patients and their families about complementary
and integrative medicine.
- Increase awareness of
complementary therapeutic options that they may provide in
the family medicine setting.
- Reflect on the rich variety
of approaches to health enhancement and disease
treatment available in the community, and be able
to appropriately refer to and work collaboratively
with licensed CAM providers.
- Understand the integrative
approach to family medicine re-emphasizing relationship-centered
care, shared decision making and the use of appropriate
conventional and/or complementary approaches while
attending to patient and physician wellness.
- Explore and reflect on their
own health enhancement practices and model this
for patients.
Objectives
Upon completion of residency training,
residents will attain competency in the following
knowledge, skills and attitudes:
Knowledge:
- Understand prevalence and patterns
of use of complementary medicine including
Regional variation particularly within this community
- Conditions for which patients
most commonly seek out complementary approaches
Consider patterns of pathology
amenable to each modality
Understand legal issues regarding
referral, collaboration with complementary medicine
practitioners, and appropriate documentation
Be aware of the current status
of insurance reimbursement for complementary therapies
in the Portland area
Consider how the principles of
evidence-based medicine apply to the study of CAM
Understand training, licensing,
and credentialing standards for practitioners of chiropractic,
acupuncture, massage therapy and naturopathy
Understand the importance to patient
care of modeling health enhancement practices and
maintaining personal well-being.
Be able to describe, for each
of the modalities listed below,
- Basic theory and philosophy
- Tools and equipment related
to each modality
- Common clinical applications
- Potential for adverse effects
- Research evidence for efficacy
- One reputable reference source
for more information
- Mind/body medicine, e.g. hypnotherapy,
biofeedback, meditation, yoga, use of imagery and
visualization, spirituality in healing including
use of ceremony and ritual
- Alternative systems/culturally-based
healing traditions, e.g. Chinese traditional medicine,
including acupuncture and herbology, homeopathy,
and Ayurvedic medicine.
- Manual therapy, manipulation,
and energetic systems
- Diet, nutrition, and lifestyle
therapies
- Dietary supplements including
the use of vitamins, minerals, and herbal/botanical
medicine
Skills:
Inquire into
patients' use of complementary therapies in a non-threatening,
non-judgmental manner
Gather and evaluates relevant
information regarding safety, efficacy, and cost of
each intervention and communicates the information
clearly to patients
Collaborate with and assists patients
in their desire to integrate complementary and conventional
medicine for maximum benefit
Interact with CAM practitioners
in a collegial manner to facilitate quality patient
care
Evaluate strengths, weaknesses,
and appropriate applications of a range of research
methodologies to the area of complementary and integrative
medicine
May choose to develop skill in
one or more of the following areas for application
in clinical practice:
- Herbal medicine
- Nutritional medicine
- Mind/body medicine
- Manipulation
- Homeopathy (5-10 common remedies
for acute situations)
- Acupuncture (through additional
course work)
Attitudes:
Appreciate the
complex means of homeostasis and healing that human
beings possess and understands that one reasonable approach
to addressing illness is at times the use of gentle,
inexpensive, non-pharmaceutical or non-surgical options
Understand and respect cultural/ethnic
influences on health beliefs and health care choices,
to include patients desiring "traditional" cultural
and ethnic approaches to therapy and healing
Discuss patients' use of complementary
therapies as a necessary part of finding a common
ground when practicing patient-centered medicine
Respect the potential of certain
complementary therapies to be equally or perhaps more
effective than conventional approaches for the treatment
of certain conditions
Demonstrate willingness to seek
out and collaborate with CAM practitioners to ensure
patients' access to quality health care
Understand that physicians' attitudes
toward their own self-care, self-awareness, and personal
growth play a critical role in promoting the process
of change in patients' lives
Understand the role that physicians'
own core beliefs and cultural, ethnic, or religious
background may play in their choice of recommendations
regarding their treatments
Many of the
objectives above were inspired by:
Kligler B, Gordon A, Stuart M,
Sierpina V. Suggested Curriculum Guidelines on Complementary
and Alternative Medicine: Recommendations of the Society
of Teachers of Family Medicine Group on Alternative
Medicine. Fam Med. 1999;31(10):31-33.
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