MERGING conventional and complementary medicine in a clinic department – a theoretical model and practical recommendations

BMC Complementary and Alternative Medicine

Claudia M. Witt⁴  Christopher Kummer²  David Schweiger¹  Nadine Mittring³  Marion Pérard³ 

[1] Schweiger & Associates, Hilton Head Island, SC, USA;Institute of Mergers, Acquisitions and Alliances (IMAA), Zurich, Switzerland;Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany;Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Sonneggstr. 6, Zurich, CH-8091, Switzerland

关键词: Integrative medicine;    Corporate culture;    Health management;    Complementary medicine;    Fusion;    Merger;   

Others  :  1212019
DOI  :  10.1186/s12906-015-0696-2

 received in 2014-10-24, accepted in 2015-05-27,  发布年份 2015

【 摘 要 】

Background

Today, the increasing demand for complementary medicine encourages health care providers to adapt and create integrative medicine departments or services within clinics. However, because of their differing philosophies, historical development, and settings, merging the partners (conventional and complementary medicine) is often difficult.

It is necessary to understand the similarities and differences in both cultures to support a successful and sustainable integration. The aim of this project was to develop a theoretical model and practical steps that are based on theories from mergers in business to facilitate the implementation of an integrative medicine department.

Methods

Based on a literature search and expert discussions, the cultures were described and model domains were developed. These were applied to two case studies to develop the final model. Furthermore, a checklist with practical steps was devised.

Results

Conventional medicine and complementary medicine have developed different corporate cultures. The final model, which should help to foster integration by bridging between these cultures, is based on four overall aspects: culture, strategy, organizational tools and outcomes. Each culture is represented by three dimensions in the model: corporate philosophy (core and identity of the medicine and the clinic), patient (all characteristics of the professional team’s contact with the patient), and professional team (the characteristics of the interactions within the professional team).

Conclusion

Overall, corporate culture differs between conventional and complementary medicine; when planning the implementation of an integrative medicine department, the developed model and the checklist can support better integration.

【 授权许可】

   
2015 Pérard et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van RM et al.. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA. 1998; 280:1569-75.
• [2]Adams J. An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle. Compl Ther Clin Pract. 2006; 12:40-7.
• [3]Richardson MA, Straus SE. Complementary and alternative medicine: opportunities and challenges for cancer management and research. Semin Oncol. 2002; 29:531-45.
• [4]Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States. Adv Data. 2002; 2004:1-19.
• [5]Watkins CL, Fernandez-Robles C, Miller KM, Pine A, Stern TA. Use of complementary and alternative medicine by patients with cancer. Prim Care Companion CNS Disord. 2011; 13:CC.
• [6]Willich SN, Girke M, Hoppe JD, Kiene H, Klitzsch W, Matthiessen PF et al.. Verständnis und Zusammenarbeit müssen vertieft werden. Deutsches Ärzteblatt. 2004; 101:1314-9.
• [7]Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther. 2012; 11:187-203.
• [8]National Center for Complementary and Alternative Medicine: Complementary, Alternative, or Integrative Health: What's In a Name? [http://nccam.nih.gov/health/whatiscam].
• [9]American Hospital Association: Latest Survey Shows More Hospitals Offering Complementary and Alternative Medicine Services [http://www.aha.org/presscenter/pressrel/2008/080915-pr-cam.shtml].
• [10]Hollenberg D. Uncharted ground: patterns of professional interaction among complementary/alternative and biomedical practitioners in integrative health care settings. Soc Sci Med. 2006; 62:731-44.
• [11]Holmberg C, Brinkhaus B, Witt CM. Experts' opinions on terminology for complementary and integrative medicine - a qualitative study with leading experts. BMC Complement Altern Med. 2012; 12:218. BioMed Central Full Text
• [12]IM Consortium: Definition of Integrative Medicine [https://www.imconsortium.org/about/about-us.cfm].
• [13]Dobos G. Integrative Medicine - Medicine of the future or ‘Old Wine in New Skins’? Eur J Integr Med. 2009; 1:109-15.
• [14]Keshet Y, Ben-Arye E, Schiff E. Can holism be praticed in a biomedical setting? A qualitative study of the integration of complementary medicine to a surgical department. Health. 2012; 16:585-601.
• [15]Coulter Ian D, Ellison MA, Hilton L, Rhodes HJ, Ryan G. Hospital-based integrative medicine: a case study of the barriers and factors facilitating the creation of a center. RAND Corporation ed, Santa Monica, CA; Arlington, VA; Pittsburgh, PA; 2008.
• [16]Davenport TO. The integration challenge. Manag Rev. 1998; 87:25.
• [17]Hofstede G. Culture Consequences. Comparing Values, Behaviors, Institutions and Organizations across Nations. 2nd ed. Sage Publications, Thousand Oaks, London, New Delhi; 2001.
• [18]Cartwright S, Cooper CL. Managing mergers, acquisitions & strategic alliances. Integrating People and cultures. 2nd ed. Butterworth-Heinemann publications, Oxford, Oakland, Boston; 1996.
• [19]Ahern KR, Weston JF. M&As: The Good, the Bad, and the Ugly. J Appl Finance. 2007; 17:5-20.
• [20]Investor Words dictionary: Definition of Merger [http://www.investorwords.com/3045/merger.html].
• [21]O'Reilly CA, Chatman J, Caldwell DF. People and organizational culture: a profile comparison approach to assessing person-organization fit. Acad Manag J. 1991; 34:487-516.
• [22]Wilkins AL, Ouchi WG. Efficient Cultures: Exploring the Relationship between Culture and Organizational Performance. Admin Sci Q. 1983; 28:468-81.
• [23]Berry JW. Contexts of acculturation. In: The Cambridge handbook of acculturation psychology. Sam D, Berry JW, editors. Cambridge University Press, Cambridge; 2006: p.27-42.
• [24]Schweiger DM. M&A Integration A framework for executives and manager. McGraw-Hill, New York, Chicago, San Francisco; 2002.
• [25]Lubatkin M, Schweiger D, Weber Y. Top Management Turnover in Related M&A's: An Additional Test of the Theory of Relative Standing. J Manag. 1999; 25:55-73.
• [26]Business and management case studies: Daimler-Chrysler merger [http://www.casestudyinc.com/daimler-chrysler-and-the-failed-merger].
• [27]Kummer C. Overcoming the challenges and issues of post-merger integration: Putting PMI in the drivers's seat in the M&A Process. In: Mergers and acquisitions - Issues and perspectives from the Asia-Pacific Region. Ganesh C, editor. Asian Productivity Organization, Tokyo; 2012: p.133-47.
• [28]Schweiger Larkey Group: The SLOCI 15 Dimensions [http://www.sloci.com/sloci/sloci-dimensions.htm].
• [29]Tataryn DJ, Verhoef MJ. Combining conventional, complementary, and alternative health care: vision of integration. Advisory group on complementary and alternative health care perspectives on complementary and alternative health care. 2001. VII.87-VII.109.
• [30]Mittring N, Pérard M, Witt CM. Corporate Culture Assessments in Integrative Oncology: A Qualitative Case Study of Two Integrative Oncology Centers. Evid Based Complement Alternat Med. 2013; 2013:316950.
• [31]Witt CM, Pérard M, Berman B, Berman S, Birdsall TC, Defren H et al.. Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or services. Patient Prefer Adherence. 2014; 8:1-8.
• [32]Barrett B, Marchand L, Scheder J, Plane MB, Maberry R, Appelbaum D et al.. Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine. J Altern Complement Med. 2003; 9:937-47.
• [33]Barry CA. The role of evidence in alternative medicine: contrasting biomedical and anthropological approaches. Soc Sci Med. 2006; 62:2646-57.
• [34]Douwes FR. Wissenschafltiche Medizin und alternativ Medizin in der Onkologie - Gegensatz oder Ergänzung? In: Wissenschaftliche Medizin - alternative Heilmethoden, XVII, Symposium des Forschungsinstitutes für Sozialmedizin, Prävention und Rehabilitation e. V. Tobiasch V, editor. W. Zuckschwerdt Verlag, Münschen, Bern, Wien; 1987: p.16-36.
• [35]Thurneysen A. Regulation oder Reparation? Die Medizin am Scheideweg? In: Kontraste in der Medizin, Zur Dialektik gesundheitlicher Projekte. Volume 12. Thurneysen A, editor. Peter Lang, Bern, Berlin, Bruxelles; 2009: p.9-20.
• [36]Marian F, Widmer M, Herren S, Donges A, Busato A. Physicians' philosophy of care: a comparison of complementary and conventional medicine. Forsch Komplement med. 2006; 13:70-7.
• [37]Dalen JE. "Conventional" and "unconventional" medicine: can they be integrated? Arch Intern Med. 1998; 158:2179-81.
• [38]Niggemann B, Gruber C. Does unconventional medicine work through conventional modes of action? J Allergy Clin Immunol. 2006; 118:569-73.
• [39]Strauß B, Berger U, Von Troschke J, Braehler E. Lehrbuch medizinische Psychologie und medizinische Soziologie. hogrefe, Göttingen, Bern, Toronto, Seattle, Oxford, Prag; 2005.
• [40]Begenau J, Schubert C, Vogd W. Medizinsoziologie der ärzlichen Praxis. Szenarien - Fälle - Theorien. Verlag Hans Huber, Bern; 2005.
• [41]West MA, Borill CS, Dawson JF, Brodbeck F, Shapiro DA, Harward B. Leadership clarity and team innovation in health care. Leadersh Q. 2003; 14:393-410.
• [42]Berger S, Braehler E, Ernst J. The health professional-patient-relationship in conventional versus complementary and alternative medicine. A qualitative study comparing the perceived use of medical shared decision-making between two different approaches of medicine. Patient Educ Couns. 2012; 88:129-37.
• [43]Bauch J. Medizinsoziologie. Oldenburg, München, Wien; 2000.
• [44]Balint E, Norell JS. Fünf Minuten pro Patient. Suhrkamp Verlag, Frankfurt am Main; 1975.
• [45]Esch BM, Marian F, Busato A, Heusser P. Patient satisfaction with primary care: an observational study comparing anthroposophic and conventional care. Health Qual Life Outcomes. 2008; 6:74. BioMed Central Full Text
• [46]Ausfeld-Hafter B. Der Weg ist das Ziel: die ative Rolle des Patienten. In: Medizin und Macht. Die Arzt Patient Beziehung im Wandel: mehr Entscheidungsfreiheit?. Ausfeld-Hafter B, editor. Lang Verlag, Bern; 2007: p.195-202.
• [47]Heiligers PJ, de Groot J. Koster D, van DS: Diagnoses and visit length in complementary and mainstream medicine. BMC Complement Altern Med. 2010; 10:3. BioMed Central Full Text
• [48]Tetenbaum TJ. Beating the odds of merger & acquisition failure: seven key practices that improve the chance for expected integration and synergies. Organ Dynam. 1999; 28:22-35.
• [49]Epstein MJ. The drivers of success in post-merger integration. Organ Dynam. 2004; 33:174-89.
• [50]Caspi O, Bell IR, Rychener D, Gaudet TW, Weil AT. The Tower of Babel: communication and medicine: An essay on medical education and complementary-alternative medicine. Arch Intern Med. 2000; 160:3193-5.
• [51]Frenkel MA, Borkan JM. An approach for integrating complementary - alternative medicine into primary care. Fam Pract. 2003; 20:324-32.
• [52]Bergmann S, Göttl C. Bedeutung der Kommunikation in der medizinischen Systemen. Status quo, historische Aspekte und Zukunft. Integr Ther. 1999; 25:394-417.
• [53]Buddenberg C, Willi J. Psychosoziale Medizin. 2nd ed. Springer, Berlin, Heidelberg; 1998.
• [54]Frewer A, Winau R. Geschichte und Theorie der Ethik in der Medizin. Grundkurs Ethik in der Medizin. Frewer A, Winau R, editors. Verlag Palm & Enke, Erlangen und Jena; 1997.
• [55]Hyman MA. Integrative health and medicine: an opportunity for leadership and collaboration. Altern Ther Health Med. 2004; 10:10-1.
• [56]Business Dictionary: Definitions [http://www.businessdictionary.com/].
• [57]Random House Webster’s Unabridged Dictionary. 2nd ed. Random House, New York, Toronto, London; 1997.
• [58]Collins English Dictionary - Complete and Unabridged. HarperCollins Publishers, London; 2003.
• [59]The American Heritage Dictionary of the English Language. 4th ed. Houghton Mifflin Company, Boston; 2009.
• [60]Merriam-Webster's Collegiate Dictionary. 1st ed. Merriam-Webster, Inc, Springfield MA; 2008.
• [61]Dictionary O. The Compact Oxford English Dictionary. 2nd ed. Oxford University Press, New York; 1991.
• [62]Investor Words dictionary. [http://www.investorwords.com/3045/merger.html]