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Practice Characteristics and Pediatric Care

Anne C. C. Lee, BSE; Kathi J. Kemper, MD, MPH

Arch Pediatr Adolesc Med. 2000;154:75-80.

Objective  To describe the practice characteristics and pediatric care of homeopathic practitioners (HPs) and naturopathic doctors (NDs).

Design  Cross-sectional, descriptive survey.

Setting  Homeopathic and naturopathic practices in Massachusetts.

Participants  Homeopathic practitioners (N = 42) and NDs (N = 23) identified from the yellow pages, regional and national society membership lists, schools, magazine advertisements, and by word-of-mouth. The response rate was 55% (23/42) for HPs and 65% (15/23) for NDs.

Main Outcome Measures  Demographics, practice characteristics, fee structure, and amount of pediatric care. Practitioners were asked for their approach to childhood immunizations and to treating a febrile neonate. Data were analyzed using simple descriptive statistics.

Results  Almost all respondents were white. Among the HPs, 13 (57%) were licensed medical doctors. Naturopathic doctors and HPs reported having an average of only 25 to 40 patient visits per week, but children and adolescents accounted for up to one third of these visits. Nearly all reported treating children, but fewer than half of the practitioners reported any formal pediatric training. Initial patient visits typically lasted more than 1 hour and cost $140 to $150. Follow-up visits were scheduled every 4 to 6 weeks and lasted more than 30 minutes on average. Insurance covered less than one third of the patient visits, and sliding scale payments were offered by less than half of the respondents. Most practitioners reported that they did not actively recommend immunizations and fewer than half of the nonphysician practitioners reported that they would refer a 2-week-old neonate with a fever to a medical doctor or emergency medical facility.

Conclusions  Many patients using homeopathy and naturopathy are children. Visits to these providers are frequent and fees are primarily paid out-of-pocket. Failure on the part of these providers to recommend immunizations or recognize potentially serious illnesses is cause for concern.

From the Center for Holistic Pediatric Education and Research, Children's Hospital, Harvard Medical School, Boston, Mass.

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