Smith Monica, Carber Lynne A
Associate Professor, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, San Jose, CA.
J Chiropr Humanit. 2009 Dec;16(1):21-5. doi: 10.1016/j.echu.2010.02.009. Epub 2010 Apr 1.
The purpose of this study was to provide new information that describes chiropractors' professional identity relative to their perceived clinical role as specialist or generalist.
A pragmatic, descriptive, cross-sectional survey was performed of randomly sampled state-board licensed chiropractors in the United States during the period 2002-2003 to assess the chiropractors' perceptions of how their chiropractic patients see them, and how they see themselves, as specialist or generalist. For this exploratory study, we anchored the terms "back pain specialist," "musculoskeletal specialist," and "primary care generalist" to brief generic reference definitions in our survey instrument.
Of our 2598 valid survey contacts, 1343 chiropractors returned their surveys either partially or fully completed, and a total of 720 chiropractor surveys were used in this study. Most of these chiropractors perceived that their new patients viewed them as "back pain specialists." Chiropractors believed that their established patients (80%), more so than their new patients (58%), were likely to view them as a primary care generalist. Chiropractors described themselves as both specialist and generalist, and they expressed a greater capability to diagnose, rather than to treat, health disorders that were not musculoskeletal.
Chiropractic physician perceptions as reported in this study suggest that the nature of certain chiropractor-patient relationships may evolve profoundly over time, particularly as patients transition from new to established patients within the chiropractic practice. Understanding the complex nature of chiropractic health care provision may carry implications for advancing evidence-based chiropractic practice and clinical training, enhancing successful and comprehensive management of the complex health concerns of chiropractic patients, fostering beneficial sustained partnerships between chiropractors and their patients, and improving overall delivery of optimal integrative health care.
本研究的目的是提供新信息，描述脊椎按摩师相对于其作为专科医生或全科医生的临床角色认知的职业身份。
2002年至2003年期间，对美国随机抽取的州委员会许可的脊椎按摩师进行了一项实用、描述性横断面调查，以评估脊椎按摩师对其脊椎按摩患者如何看待他们以及他们如何看待自己作为专科医生或全科医生的认知。对于这项探索性研究，我们在调查问卷中为“背痛专科医生”“肌肉骨骼专科医生”和“初级保健全科医生”这些术语附上了简短的通用参考定义。
在我们的2598个有效调查联系人中，1343名脊椎按摩师部分或全部完成了调查问卷，本研究共使用了720份脊椎按摩师调查问卷。这些脊椎按摩师中的大多数认为他们的新患者将他们视为“背痛专科医生”。脊椎按摩师认为，他们的老患者（80%）比新患者（58%）更有可能将他们视为初级保健全科医生。脊椎按摩师将自己描述为专科医生和全科医生，并且他们表示在诊断非肌肉骨骼疾病方面的能力更强，而不是治疗能力。
本研究报告的脊椎按摩医生的认知表明，某些脊椎按摩师与患者关系的性质可能会随着时间的推移而发生深刻变化，特别是当患者在脊椎按摩治疗过程中从新患者转变为老患者时。了解脊椎按摩保健服务的复杂性质可能对推进循证脊椎按摩实践和临床培训、加强对脊椎按摩患者复杂健康问题的成功和全面管理、促进脊椎按摩师与患者之间有益的持续合作关系以及改善最佳综合医疗保健的整体提供具有重要意义。
