The Science of MD Referrals

The Science of MD Referrals

Why do MD’s refer (or not refer) patients to chiropractors. This week, a study on chiropractor characteristics that can drive referrals…there are some important lessons in this paper!

An emphasis on interprofessional practices and education has been growing worldwide, in part because it has been shown to improve patient functional status, produce greater provider compliance with clinical guidelines, and wiser use of health care resources. Chiropractors commonly collaborate with other health care professionals like general practitioners (GPs), a practice that is valued by patients and is one of the World Federation of Chiropractic’s 4 strategic pillars for the development of the profession (EPIC = Evidence-based, People-centered, Interprofessional and Collaborative care). 

The Canadian and Danish chiropractic associations previously developed a framework targeting cooperation between medical doctors and chiropractors in the delivery of care. Three domains for optimizing interprofessional collaboration are provided in the framework including communication, practice parameters, and service delivery:

  • Communication is essential because its lack may lead to unnecessary diagnostic testing and conflicting advice which may lead to fragmented patient care.
  • Practice parameters refers to a chiropractor’s scope and delivery of care in clinical practice, which most medical doctors in Canada consider as being effective for musculoskeletal conditions but not non-musculoskeletal conditions.
  • Service delivery has to do with access to care, affordability, provider reimbursement, and liability. 

In a 2013 study, most chiropractors in Denmark (96%) considered interprofessional practice to be of great importance, and two-thirds of them considered their practice to be interprofessional. The study also revealed that chiropractors commonly collaborate with massage therapists, physical therapists, and acupuncturists, but only 1 out of 10 reported that medical doctors are active participants in interprofessional care. Earlier studies showed that only 11% of Danish chiropractic patients were referred by a GP in 1999 and 17% in 2002, indicating that collaboration between the professions was increasing.

The objectives of this study were to quantify the number of patients referred from GPs to Danish chiropractors per week and to identify characteristics of Danish chiropractors associated with the number of such referrals. 

RESEARCH REVIEW: “Chiropractor Characteristics Associated with Higher Referrals from General Practitioners” 

This paper was published in JMPT (2021) and this Review is posted in Clinical Practice and the 2022 Archive

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