Original Article| Volume 38, ISSUE 6, P395-406, July 2015

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Chiropractors' Characteristics Associated With Physician Referrals: Results From a Survey of Canadian Doctors of Chiropractic

  • Marc-André Blanchette
    Submit requests for reprints to: Marc-André Blanchette, DC, MSc, PhD Student, Institut de recherche en santé publique, Université de Montréal, Pavillon 7101 avenue Parc, local 3113, C.P. 6128 Succursale Centre Ville, Montréal, QC, H3C 3J7, Canada.
    PhD Student, Public Health PhD program, School of Public Health, University of Montreal, Montreal QC, Canada
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  • Michèle Rivard
    Professor, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada

    Researcher, Public Health Research Institute, University of Montreal, Montreal, QC, Canada
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  • Clermont E. Dionne
    Professor, Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, QC, Canada

    Senior Scientist, Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec City, QC, Canada
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  • J. David Cassidy
    Professor, Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark

    Senior Scientist, Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada

    Professor, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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      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).


      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.


      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.


      Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs.

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