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How to Choose a Practitioner

Introduction
Key Points
How do I choose a practitioner?
I have located the names of several practitioners. How do I select one?
I have selected a practitioner. What questions should I ask at my first visit?
How do I know if the practitioner I have selected is right for me?
Can I change my mind about the treatment or the practitioner?
Will insurance cover the cost of a CAM practitioner?
Public funding for CAM services in New Zealand
Professional CAM Associations

Introduction
Selecting a health care practitioner (of conventional or complementary and alternative medicine) is an important decision and can be key to ensuring that you are receiving the best health care. This fact sheet answers frequently asked questions about selecting a CAM practitioner, such as issues to consider when making your decision and important questions to ask the practitioner you select.

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Key Points
• If you are seeking a CAM practitioner, speak with your primary health care provider(s) or someone you believe to be knowledgeable about the therapy in which you are interested. Ask if they have a recommendation for the type of CAM practitioner you are seeking.
• Make a list of CAM practitioners and gather information about each before making your first visit. Ask basic questions about their credentials and practice. Where did they receive their training? What licenses or certifications do they have? How much will the treatment cost?
• Check with your insurer to see if the cost of therapy will be covered.
• After you select a practitioner, make a list of questions to ask at your first visit. You may want to bring a friend or family member who can help you ask questions and note answers.
• Come to the first visit prepared to answer questions about your health history, including injuries, surgeries, and major illnesses, as well as prescription medicines, vitamins, and other supplements you may be taking.
• Assess your first visit and decide if the practitioner is right for you. Did you feel comfortable with the practitioner? Could the practitioner answer your questions? Did she/he respond to you in a way that satisfied you? Does the treatment plan seem reasonable and acceptable to you?

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How do I choose a practitioner?
Before selecting a CAM therapy or practitioner, talk with your primary health care provider(s) or someone you believe to be knowledgeable about CAM. Tell them about the therapy you are considering and ask any questions you may have. They may know about the therapy and be able to advise you on its safety, use, and effectiveness, or possible interactions with medications. Here are some suggestions for finding a practitioner:
• Ask your doctor or other health professionals whether they have recommendations or are willing to make a referral.
• Ask someone you believe to be knowledgeable about CAM if they can recommend a practitioner for the type of therapy you are seeking.
• Contact a nearby hospital or a medical school and ask if they maintain a list of CAM practitioners or could make a recommendation.
• Ask if your therapy will be covered by insurance, for example some insurers cover visits to a chiropractor. If it will, ask for a list of CAM practitioners who accept your insurance.
• Contact a professional organization for the type of practitioner you are seeking. Often, professional organizations have standards of practice, provide referrals to practitioners, have publications explaining the therapy (or therapies) that their members provide, and may offer information on the type of training needed and whether practitioners of a therapy must be licensed or certified. Professional organizations can be located by searching the Internet or directories in libraries (see below for links and addresses of some New Zealand organizations).

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I have located the names of several practitioners. How do I select one?
Begin by contacting the practitioners on your list and gathering information.
• Ask what training or other qualifications the practitioner has. Ask about her education, additional training, licenses, and certifications. If you contacted a professional organization, see if the practitioner's qualifications meet the standards for training and licensing for that profession.
• Ask if it is possible to have a brief consultation in person or by phone with the practitioner. This will give you a chance to speak with the practitioner directly. The consultation may or may not involve a charge.
• Ask if there are diseases/health conditions in which the practitioner specializes and how frequently s/he treats patients with problems similar to yours.
• Ask if the practitioner believes the therapy can effectively address your complaint and if there is any scientific research supporting the treatment's use for your condition.
• Ask how many patients the practitioner typically sees in a day, and how much time she spends with each patient.
• Ask whether there is a brochure or Web site to tell you more about the practice.
• Ask about charges and payment options. How much do treatments cost? If you have insurance, does the practitioner accept your insurance? Even with insurance, you may be responsible for a percentage of the cost.
• Ask about the hours appointments are offered. How long is the wait for an appointment? Consider whether this will be convenient for your schedule.
• Ask about office location. If you are concerned, ask about public transportation and parking. If you need wheelchair access, ask if this is available.
• Ask what will be involved in the first visit or assessment.
• Observe how comfortable you feel during these first interactions.
Once you have gathered the information, assess the answers and determine which practitioner was best able to respond to your questions and best suits your needs.

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I have selected a practitioner. What questions should I ask at my first visit?
The first visit is very important. Come prepared to answer questions about your health history, such as surgeries, injuries, and major illnesses, as well as prescriptions, vitamins, and other supplements you take, your diet and lifestyle. Not only will the practitioner wish to gather information from you, but you will want to ask questions, too. Write down ahead of time the questions you want to ask, or take a family member or friend with you to help you remember the questions and answers. Here are some questions you may want to ask:
• What benefits can I expect from this therapy?
• What are the risks associated with this therapy?
• Do the benefits outweigh the risks for my disease or condition?
• What side effects can be expected?
• Will the therapy interfere with any of my daily activities?
• How long will I need to undergo treatment? How often will my progress or plan of treatment be assessed?
• Will I need to buy any equipment or supplies?
• Could the therapy interact with conventional treatments?
• Are there any conditions for which this treatment should not be used?

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How do I know if the practitioner I have selected is right for me?
After your first visit with a practitioner, evaluate the visit. Ask yourself:
• Was the practitioner easy to talk to? Did the practitioner make me feel comfortable?
• Was I comfortable asking questions? Did the practitioner appear willing to answer them, and were they answered to my satisfaction?
• Was the practitioner open to how both CAM therapy and conventional medicine might work together for my benefit?
• Did the practitioner get to know me and ask me about my condition?
• Did the practitioner seem knowledgeable about my specific health condition?
• Does the treatment recommended seem reasonable and acceptable to me?
• Was the practitioner clear about the time and costs associated with treatment?

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Can I change my mind about the treatment or the practitioner?
Yes, if you are not satisfied or comfortable, you can look for a different practitioner or stop treatment. However, as with any conventional treatment, talk with your practitioner before stopping to make sure that it is safe to simply stop treatment - it may not be advisable to stop some therapies midway through a course of treatment.

Discuss with your practitioner the reasons you are not satisfied or comfortable with treatment. If you decide to stop a therapy or seek another practitioner, make sure that you share this information with any other health care practitioners you may have as this will help them make decisions about your care. Communicating with your practitioner(s) can be key to ensuring the best possible health care.

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Will insurance cover the cost of a CAM practitioner?
Few CAM therapies are covered by insurance and the amount of coverage offered varies depending upon the insurer. Before agreeing to a treatment that a CAM practitioner suggests, you should check with your insurer to see if they will cover any portion of the therapy's cost. In New Zealand, some insurance companies offer cover for GP referrals to chiropractors, osteopaths, acupuncturists, naturopaths and homoeopaths. If insurance does cover a portion of the cost, you will want to ask if the practitioner accepts your insurance. Even with insurance, you may be responsible for a percentage of the cost of therapy.

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Public funding for CAM services in New Zealand
ACC Subsidies
ACC subsidises acupuncture, chiropractic, and osteopathy services provided by specified providers.  Ask your practitioner whether they are ACC providers.

Work and Income New Zealand 
Work and Income New Zealand (WINZ) has a policy of paying a Disability Allowance to cover the cost of CAM treatment that a person requires due to a disability. To qualify, the treatment must be provided by a registered health professional, for example:

• a chiropractor
• an osteopath
• a medical practitioner who practises homeopathy
• a medical practitioner who practises acupuncture
• a physiotherapist who practises acupuncture

A Disability Allowance is not paid for:
• treatment that is not provided or supervised by a registered health professional
• alternative treatments such as iridology, reiki or faith healing provided by people who are not registered health professionals

A Disability Allowance can include the cost of CAM products such as vitamins, supplements, herbal remedies or minerals, so long as a doctor provides verification that:

• there are no suitable subsidised or partly subsidised mainstream pharmaceutical products available to treat the disability
• the doctor has applied to the District Health Board for a subsidy or increased subsidy
• the CAM product is essential for the treatment of the person’s disability


References

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Professional CAM Associations

New Zealand Register of Acupuncturists (NZRA).
http://acupuncture.jalna7.co.nz

Medical Acupuncture Society of New Zealand (MASNZ).
www.converge.org.nz/masnz/

The Physiotherapy Acupuncture Association of New Zealand (PAAN)
www.nzsp.org.nz/Index02/special_interest/08_paanz.html

New Zealand Chiropractic Board.
www.regboards.co.nz/chiropractic

New Zealand Association of Medical Herbalists (NZAMH).
www.nzamh.org.nz

New Zealand Council of Homoeopaths (NZCH).
www.homoeopathy.co.nz

New Zealand Society of Naturopaths
www.naturopath.org.nz

The New Zealand Charter of Health Practitioners Inc
www.healthcharter.org.nz

NZ Natural Health Practitioners Accreditation Board Inc.
PO Box 38-678,
Howick,
Auckland.

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