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Chiropr Man Therap. 2018 Jun 22;26:29. doi: 10.1186/s12998-018-0200-4. eCollection 2018.

Be good, communicate, and collaborate: a qualitative analysis of stakeholder perspectives on adding a chiropractor to the multidisciplinary rehabilitation team.

Author information

1
1Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA USA.
2
Independent Consultant, Milford, NH USA.
3
Spine IQ - The Spine Institute for Quality, Davenport, IA USA.

Abstract

Background:

While chiropractors are integrating into multidisciplinary settings with increasing frequency, the perceptions of medical providers and patients toward adding chiropractors to existing healthcare teams is not well-understood. This study explored the qualities preferred in a chiropractor by key stakeholders in a neurorehabilitation setting.

Methods:

This qualitative analysis was part of a multi-phase, organizational case study designed to evaluate the planned integration of a chiropractor into a multidisciplinary rehabilitation team. The setting was a 62-bed rehabilitation specialty hospital located in the northeastern United States. Participants included patients, families, community members, and professional staff of the administrative, medical, nursing, and therapy departments. Data collection consisted of audiotaped, individual interviews and profession-specific focus groups guided by a semi-structured interview schedule. Transcripts were imported into a qualitative data analysis program for data analysis. An iterative coding process using thematic content analysis categorized key themes and domains.

Results:

Sixty participants were interviewed in June 2015, including 48 staff members, 6 patients, 4 family members, and 2 community members. Our analysis generated a conceptual model of The Preferred Chiropractor for Multidisciplinary Rehabilitation Settings composed of 5 domains and 13 themes. The central domain, Patient-Centeredness, or the provision of healthcare that is respectful, responsive, and inclusive of the patient's values, preferences, and needs, was mentioned in all interviews and linked to all other themes. The Professional Qualities domain highlighted clinical acumen, efficacious treatment, and being a safe practitioner. Interpersonal Qualities encouraged chiropractors to offer patients their comforting patience, familiar connections, and emotional intelligence. Interprofessional Qualities emphasized teamwork, resourcefulness, and openness to feedback as characteristics to enhance the chiropractor's ability to work within an interdisciplinary setting. Organizational Qualities, including personality fit, institutional compliance, and mission alignment were important attributes for working in a specific healthcare organization.

Conclusions:

Our findings provide an expanded view of the qualities that chiropractors might bring to multidisciplinary healthcare settings. Rather than labeling stakeholder perceptions as good, bad or indifferent as in previous studies, these results highlight specific attributes chiropractors might cultivate to enhance the patient outcomes and the experience of healthcare, influence clinical decision-making and interprofessional teamwork, and impact healthcare organizations.

KEYWORDS:

Chiropractic; Interprofessional relations; Musculoskeletal pain; Patient-centered care; Professional competence; Rehabilitation

Conflict of interest statement

Ethics approval was granted by the Institutional Review Boards of the Palmer College of Chiropractic (Assurance #2015 V166 – April 20, 2015) and the Crotched Mountain Foundation. Written informed consent was obtained from all participants.Not applicable.Dr. Christine Goertz reports personal fees received as a member of the Board of Governors of the Patient-Centered Outcomes Research Institute, as a consultant to the American Chiropractic Association, and as Chief Executive Officer of Spine IQ. Dr. Goertz also holds stock options in Prezacor, Inc. Drs. Stacie Salsbury, Robert Vining, and Christine Goertz have received personal fees from Palmer College of Chiropractic for the presentation of information from this study. Ms. Gosselin declares that she has no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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