Review of “Referral Patterns and Attitudes of Primary Care Physicians Towards Chiropractors BioMed Central Complementary and Alternative Medicine. 2006, 6:5 dii:10.1186/1472–6882–6–5”
Does the medical mainstream hate chiropractors? And if so, why is it that chiropractic is well known as an effective and safe treatment option for patients with musculoskeletal complaints.
The objective of this study was to contrast the intra-professional referral patterns of primary care physicians (PCPs) towards DC’s and determine why mainstream medical professionals refer to DC’s.
This data was found by mailing a survey instrument that 517 PCP’s participated in. Descriptive statistics and multivariable logistic regression analyses were conducted to identify the factors associated with inter-professional referral behaviors.
Most Americans Seek Out Natural Alternatives for Pain
A study conducted by Eisenberg et al [1] demonstrated that MORE Americans are consulting alternate care providers 425 (million visits) than conventional allopathic trained physicians (388 million).
It was found that nearly all (87%) physicians have had patients request a chiropractic referral. So it appears that the referrals are being requested by the public. This is further supported by the fact that only 27% of those physicians have made a “formal” chiropractic referral. The common reasons for referring a patient to a chiropractor were back or neck pains, unresponsive chronic pain, fibromyalgia, and musculoskeletal conditions.
While 82.5% of DO’s accepted referrals from a chiropractor only 55.4% of MD’s accepted a referral from a chiropractor because the referral was not formal and the health problem was outside of the physicians expertise. Nineteen percent of physicians had never received a referral from a chiropractor.
Are Physicians Threatened By Chiropractors Drug Free Approach
There are several possible explanations for physicians unwillingness to “formalize” their relationships with chiropractors. They may fear malpractice litigations [19] or they see them as a threat. Many physicians felt they did not know enough about chiropractic to have an opinion, or do not view chiropractic as a legitimate health profession.
“Chiropractic care was found to be one of the most frequently sought after alternative care, and evoked a high level of patient satisfaction…” “…the lack of direct formalized referral relationships between PCP’s and chiropractors has implications for efficiency, continuity, quality, and patient safety in the health care delivery system.”
Conclusion : Their is a lack of direct formalized referral relationships between conventional physicians and their alternative and complementary counterparts even though their is a high degree of interest from the public. I have worked hard to establish a positive referral network with MD’s, DO’s, NP’s, and PA’s in the Rogue Valley to ensure that you get the best care possible.
Check out my eBook on Chronic Neck Pain.
References
- Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Del- banco TL: Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993, 328(4):246–252.Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC: Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national sur- vey. Jama 1998, 280(18):1569–1575.
- Astin JA: Why patients use alternative medicine: results of a national study. Jama 1998, 279(19):1548–1553.
- Cherkin DC, MacCornack FA: Patient evaluations of low back pain care from family physicians and chiropractors. West J Med 1989, 150(3):351–355.
- Carey TS, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR: The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiro- practors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med 1995, 333(14):913–917.
- Nyiendo J, Haas M, Goldberg B, Sexton G: Pain, disability, and sat- isfaction outcomes and predictors of outcomes: a practice- based study of chronic low back pain patients attending pri- mary care and chiropractic physicians. J Manipulative Physiol Ther 2001, 24(7):433–439.
- Coulter ID, Singh BB, Riley D, Der-Martirosian C: Interprofessional referral patterns in an integrated medical system. J Manipula- tive Physiol Ther 2005, 28(3):170–174.
- Sawyer CE, Bergmann TF, Good DW: Attitudes and habits of chi- ropractors concerning referral to other health care provid- ers. J Manipulative Physiol Ther 1988, 11(6):480–483.
- 9. Schulte M, Mehler PS: Promoting primary care-subspecialist interaction through curbside consultations. J Gen Intern Med 1999, 14(3):207.Kuo D, Gifford DR, Stein MD: Curbside consultation practices and attitudes among primary care physicians and medical subspecialists. Jama 1998, 280(10):905–909.Golub RM: Curbside consultations and the viaduct effect. Jama 1998, 280(10):929–930.
- Bergus GR, Randall CS, Sinift SD, Rosenthal DM: Does the struc- ture of clinical questions affect the outcome of curbside con- sultations with specialty colleagues? Arch Fam Med 2000, 9(6):541–547. 15. 280(10):900–904.
- McBride PE, Massoth KM, Underbakke G, Solberg LI, Beasley JW, Plane MB: Recruitment of private practices for primary care research: experience in a preventive services clinical trial. J Fam Pract 1996, 43(4):389–395.
- Russell ML, Verhoef MJ, Injeyan HS, McMorland DG: Response rates for surveys of chiropractors. J Manipulative Physiol Ther 2004, 27(1):43–48.
- Keating NL, Zaslavsky AM, Ayanian JZ: Physicians’ experiences and beliefs regarding informal consultation. Jama 1998,
- White AR, Resch KL, Ernst E: Complementary medicine: use and attitudes among GPs. Fam Pract 1997, 14(4):302–306.
- Berman BM, Singh BK, Lao L, Singh BB, Ferentz KS, Hartnoll SM: Phy- sicians’ attitudes toward complementary or alternative medicine: a regional survey. J Am Board Fam Pract 1995, 8(5):361–366.
- Blumberg DL, Grant WD, Hendricks SR, Kamps CA, Dewan MJ: The physician and unconventional medicine. Altern Ther Health Med 1995, 1(3):31–35.
- Studdert DM, Eisenberg DM, Miller FH, Curto DA, Kaptchuk TJ, Brennan TA: Medical malpractice implications of alternative medicine. Jama 1998, 280(18):1610–1615.
- Lee T, Pappius EM, Goldman L: Impact of inter-physician com- munication on the effectiveness of medical consultations. Am J Med 1983, 74(1):106–112.
- Mainous AG, Gill JM, Zoller JS, Wolman MG: Fragmentation of patient care between chiropractors and family physicians. Arch Fam Med 2000, 9(5):446–450.
- van Haselen RA, Reiber U, Nickel I, Jakob A, Fisher PA: Providing Complementary and Alternative Medicine in primary care: the primary care workers’ perspective. Complement Ther Med 2004, 12(1):6–16.