What Do Academic Physicians Think of Tai Chi? A Qualitative Study

Background: Although there is extensive evidence from randomized controlled trials (RCTs) that Tai Chi maintains health, prevents injury, and mitigates the effects of a number of chronic diseases, it appears that physicians do not commonly recommend it. The objective of this study was to understand academic physicians' views on Tai Chi and why there is an apparent gap between the evidence on Tai Chi and its application in practice. Design: A qualitative study was conducted using purposive and snowball sampling and semistructured interviews with 15 academic physicians in 6 countries: Australia, Canada, France, New Zealand, the Netherlands, and the United States. The interviews were recorded and transcribed and then coded and analyzed with NVivo 12 software. Results: All participants were aware of Tai Chi. More than half had never attended a continuing education event where Tai Chi was mentioned or read a scientific article on it. Most had seen or heard of science-based evidence on it, and a few were well versed in the literature in their area of expertise. Almost three-quarters of physicians interviewed thought Tai Chi could be a therapeutic option; however, when asked how often they recommended Tai Chi, about a third indicated never, about a half said only occasionally, and a few identified it regularly. Three factors-lack of access, lack of both physician and patient awareness, and an anticipated lack of patient receptivity to it-seemed to account for most of the hesitation to recommend it. Some thought Tai Chi may be seen as foreign. All made useful suggestions on how to increase the uptake of Tai Chi, including learning from other physicians and integrating more of the evidence into knowledge products, as well as learning more about Tai Chi in undergraduate and continuing medical education. Conclusions: This exploratory study found that although all the academic physicians interviewed had heard about Tai Chi, most were unaware of the extent of evidence from RCTs supporting its therapeutic effects. To apply this evidence in their practice, they wanted to learn more about it from other physicians, have better integration of the evidence into medical knowledge products, and know that there was access, and patient receptivity, to Tai Chi classes in the communities where they practiced.