Teitelbaum M
Abt Associates, Inc, Bethesda, Md., USA.
J Manipulative Physiol Ther. 2000 Nov-Dec;23(9):601-9. doi: 10.1067/mmt.2000.110945.
To assess, through qualitative studies of 4 medically underserved communities, the receptivity of chiropractors, other health care providers, and consumers to the idea of chiropractors' assuming a focal role in primary care.
Visits by a team of 2 researchers to 4 medically underserved communities: (1) rural towns in eastern Oregon; (2) rural towns in Iowa; (3) underserved areas of Miami, Fla; and (4) underserved areas of Chicago, Ill. Each site visit included interviews with chiropractors, other health care providers, and managers of health facilities as well as with focus groups of consumers.
If chiropractors were to pursue a primary care role based on an allopathic model of primary care, there would not be widespread consumer receptivity. Those consumers who are most likely to use chiropractors as primary care providers are those who prefer health care models that have a close affinity with lay conceptualizations of illness and health care.
The community studies suggested that chiropractors and consumers might prefer that chiropractors not be primary care providers in a conventional way and that the allopathic community might be indifferent or even hostile to the idea of chiropractors and other non-MDs as major primary care providers. Current practice models of chiropractors do not include a strong allopathic model of primary care, although they are consistent with consumer preferences and satisfying to chiropractors.
通过对4个医疗服务欠缺社区的定性研究，评估脊椎按摩师、其他医疗服务提供者以及消费者对脊椎按摩师在初级保健中担任核心角色这一想法的接受程度。
由2名研究人员组成的团队走访4个医疗服务欠缺社区：（1）俄勒冈州东部的乡村小镇；（2）爱荷华州的乡村小镇；（3）佛罗里达州迈阿密的医疗服务欠缺地区；（4）伊利诺伊州芝加哥的医疗服务欠缺地区。每次实地走访包括对脊椎按摩师、其他医疗服务提供者、医疗机构管理人员以及消费者焦点小组进行访谈。
如果脊椎按摩师要基于对抗疗法的初级保健模式来承担初级保健角色，不会得到消费者的广泛接受。那些最有可能将脊椎按摩师作为初级保健提供者的消费者，是那些更喜欢与疾病和医疗保健的外行概念密切相关的医疗保健模式的人。
社区研究表明，脊椎按摩师和消费者可能更倾向于脊椎按摩师不以传统方式担任初级保健提供者，而且对抗疗法群体可能对脊椎按摩师及其他非医学博士作为主要初级保健提供者的想法漠不关心甚至持敌对态度。脊椎按摩师目前的执业模式并不包括强大的对抗疗法初级保健模式，尽管它们与消费者偏好一致且令脊椎按摩师满意。
