Chiropractors' characteristics associated with physician referrals: results from a survey of Canadian doctors of chiropractic.
OBJECTIVE
The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with the number of patients referred by medical doctors (MDs).


METHODS
Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires, 2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed sample included 2040 respondents. Bivariate analyses were conducted between predetermined potential predictors and the annual number of patients referred by MDs, and negative binomial multivariate regression was performed.


RESULTS
On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary with MD), the province of practice (Atlantic provinces), the number of treatments provided per week, the number of practicing hours, rehabilitation and sports injuries as the main sector of activity, prescription of exercises, use of heat packs and ultrasound, and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client of a chiropractic management service, and considering maintenance/wellness care as a main sector of activity were associated with fewer MD referrals.


CONCLUSIONS
Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs.
PhD Student, Public Health PhD program, School of Public Health, University of Montreal, Montreal QC, Canada. Electronic address: Marc-andre.blanchette@umontreal.ca.
Marc-André
MA
Blanchette
Professor, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada; Researcher, Public Health Research Institute, University of Montreal, Montreal, QC, Canada.
Michèle
M
Rivard
Professor, Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, QC, Canada; Senior Scientist, Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec City, QC, Canada.
Clermont E
CE
Dionne
Professor, Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Senior Scientist, Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada; Professor, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
J David
JD
Cassidy
D001291:Attitude of Health Personnel; D002170:Canada; D002684:Chiropractic / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D026882:Manipulation, Chiropractic / Q000706:statistics & numerical data*; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000628:therapy; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
Chiropractic; Physicians; Referral and Consultation