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Table 4 Older adult perceptions of potential facilitators and barriers of low back pain co-management by MDs and DCs

From: Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

 

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

    

✓

✓

✓

✓

✓

✓

  1. MD = Medical Doctor.
  2. DC = Doctor of Chiropractic.
  3. LBP = Low back pain.
  4. M# = Medical clinic focus group 1 or 2.
  5. D# = Chiropractic clinic focus group 1 or 2.
  6. C# = Senior center focus group 1, 2 or 3.
  7. H# = Senior housing focus group 1, 2 or 3.