Addressing provider shortage in underserviced areas: The role of traditional, complementary and alternative medicine (TCAM) providers in Canadian rural healthcare

Introduction: This study examined the role of traditional, complementary and alternative medicine (TCAM) providers in rural/remote communities of Ontario that provide care to underserviced areas and may collaborate with biomedical (BM) providers to provide "integrative" medicine (IM). Research questions: (1) To what extent are TCAM providers delivering care in rural/remote communities? (2) How might TCAM providers be interacting with BM providers? (3) In what specific ways may TCAM providers be contributing to human resources for health (HRH)? Methodology: Using purposive sampling, we conducted 29 in-depth interviews from four TCAM provider groups within multiple rural localities in Ontario: naturopathic doctors, doctors of chiropractic, registered midwives and traditional Aboriginal healers. A minimum of five interviews per provider-group was conducted. Interviews were analyzed using qualitative content analysis. Results: TCAM providers are essential for rural healthcare in Canada, as they are accessible and without common wait time issues as with BM providers. TCAM providers fill healthcare gaps by providing holistic care based on cultural/philosophical and spiritual congruency, "health promotion/education" and lifestyle counseling. TCAM providers deliver primary healthcare, bridged care and interim care. Though they strive toward interprofessional collaboration (IPC) and IM, few TCAM providers accomplish this due to perceived and/or real barriers with interprofessional education (IPE). Conclusion: TCAM providers currently provide rural care to warrant an HRH role in Canada. There is a need for more research into IPE, IPC and IM between rural TCAM professions and the BM community in order for their role to become embedded in future rural health policy. (C) 2012 Elsevier GmbH. All rights reserved.