Objective - To document the frequency of conversations about alternative medicine during primary care consultations for back pain in diverse settings. Design - "Exit interview" type patient survey. Settings - General practices in Seattle, Washington; rural Israel; and Birmingham, England. Patients - A convenience sample of 218 adults completing a doctor visit for back pain. Main outcome measures - Frequencies of doctor-patient discussions of alternative medicine. Results - Alternative medicine was discussed in a minority of visits (US site 40%, Israel site 37%, UK site 14%, p