A recent study published by Palmer Center for Chiropractic Research investigators and collaborators in the Journal of Alternative and Complementary Medicine says patients, health-care administrators and medical physicians see value when chiropractic care is integrated into multidisciplinary settings.
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.
The multisite qualitative case study, funded by the NCMIC Foundation, involved 135 key facility stakeholders from nine private-sector U.S. medical facilities, including five hospitals and four clinics. Investigators from the Palmer Center for Chiropractic Research (PCCR) and the Yale Center for Medical Informatics conducted two-day site visits to each facility. The team interviewed doctors of chiropractic (D.C.s), medical and other healthcare clinicians, support staff, administrators, and patients about the process of establishing chiropractic clinics within conventional medical settings.
Regardless of setting, the facilities shared similar journeys when implementing the chiropractic service. During the planning stage, professional relationships between D.C.s and key facility leaders opened a door to the collaboration but were only a starting point. Chiropractors often had to introduce stakeholders to findings from chiropractic research studies and provide educational programs to address initial resistance to the practice change. Most facilities also engaged in a formal planning process, implemented the service with a small number of D.C.s and focused on evidenced-based approaches to musculoskeletal care for adult patients.
Chiropractors working in medical settings reported a median full-time annual salary of $125,000, well-above the average salary calculated by the Bureau of Labor Statistics of $68,000. These D.C.s enjoyed the ease of referral, patient scheduling, and interprofessional communication supported by the information technology infrastructure of their facilities. However, some problems with billing, documentation and insurance reimbursement were noted early in the implementation phase at some facilities.
This study adds to a growing literature base supporting the integration of chiropractors into multidisciplinary teams and settings. The research team was led by Christine Goertz, D.C., Ph.D. and included Anthony Lisi, D.C., Stacie Salsbury, Ph.D., R.N., and Elissa Twist, D.C., M.S.
Reports describing these innovative practice models are available from the PCCR Evidence-Based Clinical Practice Toolkit.
Two peer-reviewed publications from this project also are available.
Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study
Integration of Doctors of Chiropractic Into Private Sector Health Care Facilities in the United States: A Descriptive Survey
The Palmer Center for Chiropractic Research, headquartered on Palmer College of Chiropractic’s main campus in Davenport, Iowa, is the most highly-funded chiropractic research center in the U.S. Within the past 10 years, the PCCR has been awarded grants from the National Institutes of Health, National Center for Complementary and Integrative Health, the U.S. Health Resources and Services Administration and the Department of Defense, in addition to private foundation grants. Since 2000, these grants have totaled more than $35 million.
Contact: James O’Connor, Palmer College of Chiropractic, 563-884-5662; james.oconnor@palmer.edu
