OBJECTIVE: The purpose of this study is to report on attitudes of doctors of chiropractic (DCs) toward integrative medicine and their self-reported interdisciplinary practices for older adults with back pain.
METHODS: This descriptive survey was conducted with licensed DCs in a Midwestern community in the United States. Respondents completed a 53-item postal survey of demographics, practice characteristics, referral and co-management patterns, attitudes toward interdisciplinary practice, and the Integrative Medicine-30 Questionnaire (IM-30). Descriptive statistical analysis was performed.
RESULTS: Fifty-seven DCs completed the survey (29% response). Geriatric-focused chiropractic practices were uncommon (<15%), although 56% reported that 25% to 49% of the patients treated each week were older adults. Respondents had a moderate orientation toward collaboration with other health care providers (IM-30 mean [standard deviation] 61.3 [11.5]). The IM-30 subscales placed DCs high on measures of integrative medicine safety; moderate on patient-centeredness, openness to working with other providers, and referral readiness; and low on learning from alternative paradigms. Doctors of chiropractic most referred older patients to neurologists, family physicians, massage therapists, orthopedists, and other chiropractors. Doctors of chiropractic reported the highest levels of co-management with family physicians, physical therapists, and massage therapists. Most DCs (92%) were confident in their own ability to manage back pain in older adults, with modest confidence expressed for treatments from professionals using manual therapies. Most (77%) responded that older patients would experience the most improvement if DCs collaborated with another chiropractor, rather than with medical professionals.
CONCLUSION: Doctors of chiropractic in one geographic community are moderately oriented toward interprofessional practice with other health care providers for older adults with back pain. Follow-up studies in representative national and international samples are recommended.
Author keywords: Chiropractic, Integrative Medicine, Geriatrics, Referral and Consultation, Attitude of Health Personnel
Author affiliations: SAS, RDV: Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa; MAH: Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas; RBW: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa; KJL: Independent Consultant, Philadelphia, Pennsylvania; LZK: Department of Clinical Sciences, Palmer College of Chiropractic, Davenport, Iowa; CMG: The Spine Institute for Quality (Spine IQ), Oskaloosa, Iowa.
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