Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities: 1) it's occurring on an increasingly frequent basis; and 2) doing so yields significant value to providers, patients and the health care system in general. Consider a recent study published in the Journal of Alternative and Complementary Medicine1 that found high levels of clinician, administrator and patient satisfaction with chiropractic care in terms of outcomes, productivity, costs and other variables.
Investigators from the Palmer Center for Chiropractic Research and the Yale Center for Medical Informatics interviewed doctors of chiropractic, medical and other health care clinicians, support staff, administrators, and patients during two-day site visits to nine private-sector medical facilities (five hospitals, four clinics) that provide chiropractic care. Interviews with 135 key facility stakeholders revealed the following:
Across sites, DCs were sought to take an evidence-based approach to patient care, work collaboratively within a multidisciplinary team, engage in interprofessional case management, and adopt organizational mission and values. Chiropractic clinics were implemented within existing human resources, physical plant, information technology, and administrative support systems, and often expanded over time to address patient demand. DCs usually were co-located with medical providers and integrated into the collaborative management of patients with musculoskeletal and co-morbid conditions. Delivery of chiropractic services was perceived to have high value among patients, medical providers, and administration. Patient clinical outcomes, patient satisfaction, provider productivity, and cost offset were identified as markers of clinic success.
A Palmer College press release following publication of the study findings emphasized the positive nature of chiropractic inclusion at the facilities:
"Medical physicians, nursing staff and other healthcare professionals reported their generally favorable impressions of the new service. Many health-care workers started using chiropractic care themselves after seeing the results achieved by their mutual patients. Patient satisfaction scores for chiropractic services were reported as being among the highest of all providers. Patients interviewed for the project found it convenient to receive chiropractic care in a facility where they go for their other health-care needs and were reassured that their providers worked together closely and shared records."
A study by the same authors, published earlier this year in JMPT,2 noted the trend – and opportunity – for DCs to work in integrated health care facilities, concluding: "Doctors of chiropractic are working in diverse medical settings within the private sector, in close proximity and collaboration with many provider types, suggesting a diverse role for chiropractors within conventional health care facilities."
Reference
- Lisi AJ, Salsbury SA, Twist EJ, Goertz CM. Chiropractic integration into private sector medical facilities: a multisite qualitative case study. J Altern Complement Med, 2018 Aug;24(8):792-800.
- Salsbury SA, Goertz CM, Twist EJ, Lisi AJ. Integration of doctors of chiropractic into private sector health care facilities in the United States: a descriptive survey. JMPT, 2018 Feb;41(2):149-155.
