Should I use acupuncture, doc?: Do physicians influence aging veterans' decision to use acupuncture?

Background: Most research regarding influences of acupuncture use has surveyed either patients or physicians. To our knowledge, no study has evaluated the influence of a treating physician over patient acupuncture decision-making. This exploratory descriptive study, focusing on the aging U.S. Veteran population, investigated physician influence on acupuncture decision-making along with sociodemographic-factors.

Methods: An attitude towards acupuncture questionnaire was sent to 1100 randomly selected patients from the Veterans Affairs (VA) computerized patient record system in Georgia (U.S.). Participants were asked to identify the VA physician who most influences their healthcare decisions. Identified physicians completed an acupuncture attitudes questionnaire. Of the 402 completed patient questionnaires, 114 were matched with 33 responding physicians.

Results: Mean patient age was 57 years old (range: 29-92 years); 51% were non-white and 28% reported acupuncture use. Acupuncture use was more likely if the treating physician believed it would influence patient satisfaction (x²(1, N=114))=6.95, p=.01. We found only a marginally significant difference in acupuncture use between patients whose physicians were more likely to refer for treatment and those whose provider did not refer (p=.06, two-tailed Fischer's exact test). Open-ended questions revealed physicians had misconceptions about acupuncture availability and lacked knowledge about the treatment. Younger-white patients were significantly more likely to use acupuncture than older-white patients, t (54)=2.25, p<.05, but age was not predicative of acupuncture use in non-white patients.

Conclusion: Physicians have some influence on patient decision-making, and these findings show that important referral-barriers and potential disparities may also exist. Implications of these findings are discussed.