Table 4 Three-way communication issues: A/C provider to patient to PCP

“I tell the patient, you know, your headaches aren’t because of your musculoskeletal system is off or your mechanics is off. Your function is congested. It’s because your pain medication has side effects. So let’s talk about that. And then give them information that they can take back to their primary, and they can change their meds up.”

“Everything is on an electronic record and I’m supposed to get my medical record so I can give it a chiropractor, and then tell my doctor what the chiropractor…It’s like going out on this totally different area. When kind of the allure, at least for me with [HMO], is this kind of big, managed plan. But then I’m encouraged to go off on my own to go do something, without any…You know, it’s not like a chiropractor can look at my MRI. [Someone agreeing] I’m going to have to request my record, you know. And then is my [HMO] provider really going to trust what this chiropractor, who they don’t even know, is going to recommend for my care?”

“Usually what happens is the acupuncturist will tell the patient, this is a weird lump. Get back in to your doctor and have them check it out. And so then they’ll just come back in on their own and say, hey, they told me to come back and get this checked out. I rarely see any…There’s no back and forth otherwise.”

“The patient should always go back to evaluate with their doctors, right? So I would think that the doctor would see the progress, from their patients, their firsthand report. Yeah?”

“And it annoys me when someone comes back with a wrong diagnosis having to do with their leg or their shoulder. It’s completely wrong. And yet they’re like, well, the chiropractor…You know, as if the chiropractor is qualified to diagnose that. […] it irritates me.”

“And, of course, I always tell the patient, especially if they get really good results […] I’ll say, you know, your doc needs to hear about this.”