<![CDATA[Vietnam operates a unique, state-mandated healthcare system that structurally integrates Traditional Vietnamese Medicine (TVM) within conventional hospitals. However, the operational success of this dual model relies heavily on the clinical behaviors and collaborative practices of Western-trained conventional physicians. This multi-center, cross-sectional study investigated the levels of objective knowledge, professional attitudes, and cross-departmental referral workflows regarding TVM among conventional physicians practicing in major urban medical hubs in Vietnam. A validated, 28-item structured questionnaire was distributed to licensed modern medicine physicians across tertiary (Tier-1) and secondary (Tier-2) hospitals in Hanoi and Ho Chi Minh City. Data from 412 completed surveys were analyzed using descriptive statistics and binary logistic regression to identify independent predictors of active referral workflows. The data revealed a critical “Attitude-Knowledge Paradox.” While a majority of conventional physicians exhibited highly positive cultural attitudes toward TVM (Mean Likert Score: 3.8 0.6), objective pharmacological knowledge was critically low (Mean Score: 4.2 1.8 out of 10). Specifically, 78.4% of respondents failed to identify verified herb-drug interactions. Consequently, active outbound referrals were low (24.3%) and heavily restricted to chronic musculoskeletal pain (82.0%) and neurological rehabilitation (68.0%). The leading institutional bottlenecks were a lack of randomized controlled trial (RCT) data on native Vietnamese flora (86.5%) and fears of unpredictable drug-herb toxicities (79.2%). Formal TVM exposure during medical school was a powerful independent predictor of active clinical referral practice (aOR = 2.45; 95% CI: 1.32 - 4.56; p < 0.01). Structural integration in Vietnamese hospitals has not achieved functional clinical synthesis. Conventional physicians default to defensive prescribing habits due to an educational vacuum and a lack of evidence-based pharmacological parameters. To bridge this divide, the Ministry of Health must prioritize pharmacology-focused curriculum reforms, automated electronic drug-herb interaction screening, and state-funded clinical trials for indigenous phytotherapeutics.]]>
