title: [Manual medicine from the user's perspective: a qualitative study with physicians].
abstract: BACKGROUND
  Manual medicine (MM) has high importance in the ambulant treatment of complaints of the musculoskeletal system. Although there are several randomized controlled trials and meta-analyses, evidence about its efficacy is limited due to different organizations offering MM courses teaching different techniques. The aim of this study was to gain an understanding of the motivation and experiences of physicians using MM in daily practice.
  
  
  METHODS
  In a qualitative study, 21 semi-structured phone call interviews were performed with physicians who have an additional qualification in MM. Recruitment was done by sending an e-mail to every physician listed on the homepage of the German Society for Manual Medicine or known to be interested in MM research from a previous study. Interviews were performed, recorded, transcribed and evaluated content-analytically using the software program Atlas.ti.
  
  
  RESULTS
  One of the main motivations for using MM therapy was a better doctor-patient relationship because of improved patient access, with often rapid treatment success. Further advantages were the relative simplicity of the method, the independence from spatial or apparatus conditions and the associated low costs. Positive factors discussed as directly influencing the satisfaction with MM are the possibility to use own skills, the gratitude of the patient, and the possibility to influence the patient towards a healthy lifestyle. Factors negatively influencing the satisfaction were named as follows: the low gratification for the therapy, heterogeneous evidence, the indication in often self-limiting diseases, the risk of serious adverse effects and the risk of iatrogenic fixation.
  
  
  CONCLUSIONS
  The results of this study show a wide range of mostly positive views and experiences of physicians when applying MM. The immediate curative action seems to be a welcome change for physicians who perceive the practice of their profession seen as distant from the patient.
authors: Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Deutschland.
authors: Anne
authors: A
authors: Knüpfer
authors: Stefanie
authors: S
authors: Joos
authors: Katja
authors: K
authors: Götz
authors: Jost
authors: J
authors: Steinhäuser
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D026201:Musculoskeletal Manipulations / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations