title: Dissecting the doctor-dancer relationship: health care decision making among American collegiate dancers.
abstract: OBJECTIVE
  To examine perceptual influences on dancers' health care-seeking decisions and whether dancers' beliefs correlate with actual use of provider services when they are injured. Secondary aims were to understand how dancers may select physicians and what they consider to be the most important features of the medical consultation.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University and conservatory dance departments.
  
  
  METHODS
  Forty American collegiate dancers.
  
  
  METHODS
  Before the start of the dance semester, all participants completed a retrospective survey that included baseline demographic data, dance experience, a dance-related injury (DRI) inventory, previous health care exposures, and perceptions regarding health care treatment providers. Data regarding new DRIs and health care exposures were then prospectively collected every 2 weeks for 6 months.
  
  
  METHODS
  A DRI was defined as any neuromusculoskeletal condition sustained as the result of dancing activity that caused a dancer to stop or modify his or her dancing for more than 3 consecutive days.
  
  
  RESULTS
  Dancers perceived dance teachers to be first-line treatment providers (47.5%), followed by physical therapists (PTs; 30%). Physicians were ranked third (12.5%) and only marginally higher than a dance colleague (10%). The dancers expressed a strong preference for nonsurgical rather than surgical physicians (87.5% versus 5.0%), and among physicians, the majority of dancers preferred subspecialists (60%), namely nonsurgical sports medicine doctors and physiatrists. During the 6-month prospective data-collection period, 25 dancers (69.4%) sustained 55 unique injuries, with 22 dancers (88%) and 34 injuries (61.8%) undergoing evaluation. Only 17.7% of injuries were evaluated by a physician. Dancers showed greater incongruity between their preinjury perceptions and postinjury use of physicians than they did with PTs (P = .0002).
  
  
  CONCLUSIONS
  Although dancers did not perceive physicians to be first-line treatment providers for DRIs, these perceptions about physicians were poorly correlated with use. Instead, injured dancers' health care-seeking behaviors were more likely related to relatively decreased barriers to other nonphysician providers, as well as pre-existing referral pathways to PTs.
authors.affiliation: Department of Physiatry, Hospital for Special Surgery, 429 E 75th St, New York City, NY, 10021(∗). Electronic address: mamie.air@gmail.com.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Air
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA(†).
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Grierson
authors.affiliation: Preferred Orthopedics of the Palm Beaches, Boynton Beach, FL(‡).
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Davenport
authors.affiliation: Department of Rehabilitation, Orthopedic and Sports Medicine, University of Washington and Seattle Children's Sports Medicine, Seattle, WA(§).
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Krabak
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003615:Dancing / Q000293:injuries* / Q000523:psychology; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007398:Interpersonal Relations; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D055815:Young Adult