Abstract
Objective
The purpose of this study was to identify characteristics of Canadian doctors of chiropractic
(DCs) associated with the number of patients referred by medical doctors (MDs).
Methods
Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian
Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey
included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires,
2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed
sample included 2040 respondents. Bivariate analyses were conducted between predetermined
potential predictors and the annual number of patients referred by MDs, and negative
binomial multivariate regression was performed.
Results
On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals
from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary
with MD), the province of practice (Atlantic provinces), the number of treatments
provided per week, the number of practicing hours, rehabilitation and sports injuries
as the main sector of activity, prescription of exercises, use of heat packs and ultrasound,
and the percentage of patients referred to other health care providers were associated
with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral
conditions, using a particular chiropractic technique (hole in one and Thompson),
taking his/her own radiographs, being the client of a chiropractic management service,
and considering maintenance/wellness care as a main sector of activity were associated
with fewer MD referrals.
Conclusion
Canadian DCs who interacted with other health care workers and who focus their practice
on musculoskeletal conditions reported more referrals from MDs.
Key Indexing Terms
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References
- CHSRF synthesis: interprofessional collaboration and quality primary healthcare.Canadian Health Services Research Foundation, Ottawa2007
- Integrative medicine: a tale of two clinics.BMC Complement Altern Med. 2008; 8: 32
- Developing integrative primary healthcare delivery: adding a chiropractor to the team.Explore (N Y). 2008; 4: 18-24
- Collaborative community-based teaching clinics at the Canadian Memorial Chiropractic College: addressing the needs of local poor communities.J Manipulative Physiol Ther. 2007; 30: 558-565
- Chiropractors and collaborative care: an overview illustrated with a case report.J Can Chiropr Assoc. 2010; 54: 147-154
- The integration of chiropractors into healthcare teams: a case study from sport medicine.Sociol Health Illn. 2008; 30: 19-34
- Interprofessional referral patterns in an integrated medical system.J Manipulative Physiol Ther. 2005; 28: 170-174
- Attitudes toward chiropractic: a survey of North American orthopedic surgeons.Spine (Phila Pa 1976). 2009; 34: 2818-2825
- Family physicians' views of chiropractors: hostile or hospitable?.Am J Public Health. 1989; 79: 636-637
- Referral patterns and attitudes of primary care physicians towards chiropractors.BMC Complement Altern Med. 2006; 6: 5
- Medical referral for chiropractic care: a survey of "unconventional" medical practitioners.J Manipulative Physiol Ther. 1995; 18: 302-307
- Knowledge and opinions of Downsview physicians regarding the chiropractic profession.J Can Chiropr Assoc. 1994; 38: 90-97
- Alternative medicine and general practitioners. Opinions and behaviour.Can Fam Physician. 1995; 41: 1005-1011
- Attitudes towards chiropractic: an analysis of written comments from a survey of North American orthopaedic surgeons.Chiropr Man Ther. 2011; 19: 25
- Chiropractic referral: the views of a group of conventional medical practitioners with an interest in unconventional therapies.J Manipulative Physiol Ther. 1995; 18: 512-518
- Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study.BMC Complement Altern Med. 2013; 13: 225
- Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study.Spine (Phila Pa 1976). 2013; 38: 627-634
- A randomized, placebo-controlled clinical trial of chiropractic and medical prophylactic treatment of adults with tension-type headache: results from a stopped trial.J Manipulative Physiol Ther. 2009; 32: 344-351
- Canadian Chiropractic Resources Databank (CCRD): a profile of Canadian chiropractors.J Can Chiropr Assoc. 1997; 41: 155-191
- Pairwise multiple comparison procedures with unequal n’s and/or variances: a Monte Carlo study.J Educ Behav Stat. 1976; 1: 113-125
- Some physicians' perceptions of chiropractors, osteopaths, and podiatrists.Percept Mot Skills. 1965; 20 ([Suppl]): 1167-1168
- Physicians’ perspectives on chiropractic treatment.J Can Chiropr Assoc. 1996; 40: 214-219
- Facilitators and barriers to improving interprofessional referral relationships between primary care physicians and chiropractors.J Ambul Care Manage. 2007; 30: 347-354
- How often are physicians and chiropractors provided with patient information when accepting referrals?.J Ambul Care Manage. 2007; 30: 344-346
- Fragmentation of patient care between chiropractors and family physicians.Arch Fam Med. 2000; 9: 446-450
- Medical-chiropractic correspondence.J Can Chiropr Assoc. 1985; 29: 29-31
- Early management of persistent non-specific low back pain: summary of NICE guidance.BMJ. 2009; 338: b1805
Article info
Publication history
Published online: May 01, 2015
Accepted:
October 16,
2014
Received in revised form:
October 15,
2014
Received:
September 3,
2014
Identification
Copyright
© 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
