Addressing communication dynamics in traditional medicine use disclosure to physicians

Background: Although traditional medicine (TM) has historically been marginalised within the allopathic medicine (AM) systems and policy frameworks, it remains a core component of healthcare-seeking behaviour among South Africans. However, communication regarding TM use between patients and physicians is often inhibited by cultural stigma, trust deficits and isolated systems. Aim: This study explored physicians' perceptions of communication dynamics influencing TM disclosure, guided by communication privacy management (CPM) theory. Setting: The study setting was four district hospitals with outpatient departments in Gauteng province. Methods: This qualitative descriptive study collected data from 14 physicians through semi-structured interviews. The findings were inductively analysed using open and axial coding, with CPM theory serving as a sensitising framework. Results: Four interrelated themes aligned with CPM theory's core concepts: (1) disclosure practices, (2) facilitation of collaboration, (3) managing disclosed information and (4) challenges in non-disclosure. Physicians reported that patients regulate TM disclosure according to trust, perceived judgement and cultural norms. Respectful, non-judgemental communication fostered openness, whereas dismissive attitudes reinforced secrecy. Conclusion: Communication privacy management theory provided a valuable lens for understanding physicians' perceptions of privacy management within South Africa's dual healthcare context. Disclosure of TM is a relational and culturally mediated process shaped by social trust and institutional dynamics. Contribution: The study contributes theoretically by extending CPM theory to a multicultural and interprofessional setting; methodologically by illustrating its use as a sensitising framework for analysing healthcare communication; and practically by identifying strategies such as cultural humility training, structured disclosure frameworks and collaboration between TM and AM practitioners that can strengthen transparency and patient-centred care.