There has been a movement towards integrating complementary and alternative medicine (CAM) into the NHS and a growing number of general practitioners (GPs) are personally practising CAM to treat their NHS patients (direct integrative practice). While research has begun to examine DIP, time constraints and related issues--of importance not only to practitioners but also to those purchasing and planning health care--have not yet received in depth attention. In response this paper examines GP therapists' experiences of the clinical reality of their DIP. The analysis reveals how a lack of time is perceived by GP therapists as a serious constraint upon their CAM practice and also how they employ a number of strategies in an attempt to overcome such difficulties.