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 | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |