Perceiving integration of a complementary medicine service within a general surgery department through documentation of consultations: a thematic analysis

Abstract

Objective: This study aims to examine the meaning and practical implications of integration of a complementary medicine-based surgery service in a hospital setting (CISS--Complementary/Integrative Surgery Service) through analysis of consultation reports associated with this service.

Methods: Thematic analysis was used to evaluate CISS consultation reports in a hospital electronic consultant charting system during the first half year of the service's activity.

Results: 304 consultation reports were analyzed. Nurses initiated significantly more consultations than physicians (55% vs 7%). Consultation requests were gradually more focused on specific symptoms, possibly manifesting a better understanding of the scope of complementary medicine in the surgery setting. CISS practitioners responded in more biomedical language over time, albeit offering a more holistic perspective regarding patients' needs as well as clarifications regarding the nature of the treatment they provided.

Conclusions: Diverse communication patterns in consultations evolved over time representing dynamics in multiple levels of integration of the CISS.

Practice implications: Documented communication through consultations can provide a window to the process of integration of complementary medicine-based services in health systems.