Hospital-Based Chiropractic Integration Within a
Large Private Hospital System in Minnesota:
A 10-Year Example
SOURCE: J Manipulative Physiol Ther. 2009 (Nov); 32 (9): 740–748
Richard A. Branson, DC
Director of Chiropractic Services,
Fairview Sports and Orthopedic Care,
Fairview Health System,
Burnsville, MN 55337, USA.
OBJECTIVE: The purpose of this article is to describe a model of chiropractic integration developed over a 10-year period within a private hospital system in Minnesota.
METHODS: Needs were assessed by surveying attitudes and behaviors related to chiropractic and complementary and alternative medicine (CAM) of physicians associated with the hospital. Analyzing referral and utilization patterns assessed chiropractic integration into the hospital system.
RESULTS: One hundred five surveys were returned after 2 mailings for a response rate of 74%. Seventy-four percent of respondents supported integration of CAM into the hospital system, although 45% supported the primary care physician as the gatekeeper for CAM use. From 2006 to 2008, there were 8,294 unique new patients in the chiropractic program. Primary care providers (medical doctors and physician assistants) were the most common referral source, followed by self-referred patients, sports medicine physicians, and orthopedic physicians. Overall examination of the program identified that facilitators of chiropractic integration were (1) growth in interest in CAM, (2) establishing relationships with key administrators and providers, (3) use of evidence-based practice, (4) adequate physical space, and (5) creation of an integrated spine care program. Barriers were (1) lack of understanding of chiropractic professional identity by certain providers and (2) certain financial aspects of third-party payment for chiropractic.
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