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January 5, 2000

Conventional Medical Care and Unconventional Therapies

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(1):56-57. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-1-jbk0500

To the Editor: Drs Druss and Rosenheck1 found that 8.8% of users of both conventional and unconventional therapies in their study were referred to those unconventional therapies by physicians. We recommend that this be taken into consideration in their analysis, because their conclusion that unconventional therapies were "associated with increased use of physician services" may be the result of physician referrals. If these patients were excluded from their logistic regression analysis (in Table 5 of their article), the results could be substantially different. For example, some physicians may refer patients with unresolved pain or stress for massage, biofeedback, or chiropractic care. It also would be of interest for the authors to present the distribution of referrals of unconventional therapies for these patients.