title: Facilitators and barriers to improving interprofessional referral relationships between primary care physicians and chiropractors.
abstract: OBJECTIVE
  Findings from recent studies suggest that there are poor interprofessional referral relationships between primary care physicians (MDs) and chiropractors (DCs) and this can lead to fragmentation of care. The objective of this study is to identify potential facilitators and barriers to developing positive interprofessional referrals relationships between MDs and DCs.
  
  
  METHODS
  We conducted 2 rounds of focus group interviews on a convenience sample of MDs and DCs. The focus groups were audiotaped, and transcripts were prepared for each focus group interaction. These data were analyzed through content analysis by 2 independent evaluators to determine the key themes and concepts provided by the focus groups.
  
  
  RESULTS
  Both MDs and DCs suggested that good communication, openness to discussion by providers, and patient interest are key factors for developing positive interprofessional referral relationships and implementing interprofessional practice-based research networks. Barriers to interprofessional relationships include lack of good communication between the 2 provider types, bias toward alternative medicine, lack of knowledge or understanding of chiropractic care, geographic constraints, and economic considerations.
  
  
  CONCLUSIONS
  This study identified several facilitators and barriers for developing positive referral relationships between primary care physicians and chiropractors. Future studies must focus on demonstrating the role of these factors on developing positive interprofessional relationships.
authors.affiliation: Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Veerasathpurush
authors.initials: V
authors.lastname: Allareddy
authors.forename: Barry R
authors.initials: BR
authors.lastname: Greene
authors.forename: Monica
authors.initials: M
authors.lastname: Smith
authors.forename: Mitchell
authors.initials: M
authors.lastname: Haas
authors.forename: Junlin
authors.initials: J
authors.lastname: Liao
mesh_terms: D002684:Chiropractic; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D007484:Iowa; D010821:Physicians, Family; D012017:Referral and Consultation