Cherkin D C, MacCornack F A
West J Med. 1989 Mar;150(3):351-5.
We compare health maintenance organization enrollees' evaluations of the care they received from family physicians and chiropractors for low back pain. Patients of chiropractors were three times as likely as patients of family physicians to report that they were very satisfied with the care they received for low back pain (66% versus 22%, respectively). Compared with patients of family physicians, patients of chiropractors were much more likely to have been satisfied with the amount of information they were given, to have perceived that their provider was concerned about them, and to have felt that their provider was comfortable and confident dealing with their problem. Although the more positive evaluations of chiropractors may be related to differences in the patient populations served by the two providers or to benefits of spinal manipulation, it is suggested that a potentially more potent force--the therapeutic effect of the patient and provider interaction itself--may explain the observed differences.
我们比较了健康维护组织参保者对家庭医生和脊椎按摩师针对腰痛所提供护理的评价。脊椎按摩师的患者报告称对腰痛护理“非常满意”的可能性是家庭医生患者的三倍（分别为66%和22%）。与家庭医生的患者相比，脊椎按摩师的患者更有可能对所获信息的数量感到满意，更有可能感觉到其医疗服务提供者关心他们，也更有可能觉得其医疗服务提供者在处理他们的问题时从容自信。尽管对脊椎按摩师的更积极评价可能与这两类医疗服务提供者所服务的患者群体差异或脊柱推拿的益处有关，但有人认为，一种可能更具影响力的因素——患者与医疗服务提供者互动本身的治疗效果——或许可以解释所观察到的差异。
