MDs Do Refer for Chiropractic Care

There is more evidence again that MDs do refer patients for chiropractic care.  In a article published in 2006, the authors specifically looked at primary care physicians and their referral patterns for MD to MD and MD to DC.  This article’s objective stated, “Despite the increasing usage and popularity of chiropractic care, there has been limited research conducted to examine the professional relationships between conventional trained primary care physicians (PCPs) and chiropractors (DCs).  The objectives of our study were to contrast the intra-professional referral patterns among PCPs with referral patters to DCs, and to identify predictors of PCP referral to DCs” (Greene, Smith, Allareddy, & Hass, 2006, p. 1).

The authors stated, “Chiropractic care was found to be one of the most frequently sought after alternative care, and evinced a high level of patient satisfaction and continuous utilization” (Greene et al., 2006, p. 2).  We have heard that over and over again and see it on a daily basis.  What is important is to really look at how patients get to DCs and how to increase exposure to care on a national level.  There was a study in 2009 that looked at the referral patterns of orthopedic surgeons to DCs and was just about spot on when compared to my personal experiences in the 2 hospital based clinics and personal conversations with medical specialists.  This paper is interesting since it is related to primary care and not specialty care.  

Let’s take a look at the important points in the paper.  This paper will be posted as an e-learning module, so for this consultation, I will only be reviewing the PCP to DC referral information.  The PCP to PCP data is in the paper and will be reviewed with the e-learning questions. 

The authors stated, “Five hundred seventeen physicians responded to the survey.  This is 33% of the entire universe of 1,561 primary care physicians in the state of Iowa” (Greene et al., 2006, p. 3).

“Eighty-one percent of DO’s and 87% of MD’s reported that their patients had asked them for information about chiropractic, and close to 75% of PCPs have patients who have requested a referral to a chiropractor” (Greene et al., 2006, p. 5).

“Approximately 65% of DO’s and MD’s had recommended that their patients consult a chiropractor.” (Greene et al., 2006, p. 5)

“However, only 24% of DO’s and 29% of MD’s had themselves formally referred a patient to a chiropractor” (Greene et al., 2006, p. 5).

“The common reasons for referring a patient to a chiropractor were back or neck pains, unresponsive chronic pain, fibromyalgias, and musculoskeletal conditions” (Greene et al., 2006, p. 5).

“A vast majority of both DO’s and MD’s preferred that their patients contact chiropractors on their own rather than the physicians initiating a formal referral themselves” (Greene et al., 2006, p. 5).

“An important finding from our study is that when PCPs recommend chiropractic care, close to 88% preferred that patients contact a chiropractor on their own” (Greene et al., 2006, p. 6)

The authors felt the PCPs had not wanted to formalize their relationship with the DC for a few reasons.  “PCPs fear malpractice litigations.  A perception that alternative care providers could be a threat to their practices could also have been an influence. Some of the PCPs in our study mentioned that they do not know enough about chiropractic to have an opinion, or do not view chiropractic as a legitimate health profession” (Greene et al., 2006, p. 6).  This is a really interesting point because the reasons stated are REALLY easy to fix once you know how to build relationships with the medical community.  Research, communication and education is the key.  You will see in the e-learning module that few DCs send clinical information.  Interestingly, many PCPs also would like clinical information sent to them if the patient was referred FROM a DC to them.