PMC full text: | Published online 2013 Sep 16. doi: 10.1186/1472-6882-13-225
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Table 4
| MD clinic | DC clinic | Senior center | Senior housing | ||||||
---|---|---|---|---|---|---|---|---|---|---|
LBP Co-management facilitators | M | M | D | D | C | C | C | H | H | H |
1 | 2 | 1 | 2 | 1 | 2 | 3 | 1 | 2 | 3 | |
Co-management would benefit LBP patient | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | | ✓ | ✓ |
Collegial approach needed for LBP care | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Historically strained relations between MDs and DCs has improved over time | ✓ | ✓ | ✓ | ✓ | | ✓ | ✓ | ✓ | ✓ | ✓ |
Referrals/consultations/phone calls between MD and DC needed for co-management | ✓ | ✓ | ✓ | ✓ | | ✓ | ✓ | ✓ | ✓ | ✓ |
Coordinated LBP treatment plan | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | | ✓ | ✓ |
Health record/X-ray sharing required | ✓ | ✓ | | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Offices located together or nearby | | ✓ | ✓ | | ✓ | | ✓ | ✓ | | |
Individualized care for LBP | ✓ | ✓ | | | | ✓ | ✓ | ✓ | ✓ | |
LBP Co-management barriers/concerns | M | M | D | D | C | C | C | H | H | H |
| 1 | 2 | 1 | 2 | 1 | 2 | 3 | 1 | 2 | 3 |
Medication: do not want to use any medicine, side effects, no improvement, narcotic addiction, masking pain | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Financial costs or insurance issues from receiving care from 2 or more doctors | ✓ | ✓ | ✓ | | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Providers may not support a co-management approach to LBP care | ✓ | ✓ | ✓ | | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Chiropractic: Side effects, providers who do not treat a condition, no improvement | ✓ | ✓ | ✓ | | | ✓ | ✓ | ✓ | ✓ | ✓ |
Receiving care from multiple doctors | ✓ | | | | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Duplicate/unneeded tests/treatments | ✓ | | | | ✓ | ✓ | ✓ | ✓ | ✓ | |
Conflicting information or treatments | ✓ | | | | ✓ | ✓ | ✓ | ✓ | ✓ | |
Scheduling and transportation concerns | | | | | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Questionable benefit of either medical, chiropractic, or co-management based on previous LBP treatment experience | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
MD = Medical Doctor.
DC = Doctor of Chiropractic.
LBP = Low back pain.
M# = Medical clinic focus group 1 or 2.
D# = Chiropractic clinic focus group 1 or 2.
C# = Senior center focus group 1, 2 or 3.
H# = Senior housing focus group 1, 2 or 3.