Albertson Andrea, Kells Holli, Sawyer Charles, Maiers Michele
Northwestern Health Sciences University, Bloomington, Minnesota, USA.
RAND Research Across Complementary and Integrative Health Institutions (REACH) Center, Santa Monica, California, USA.
J Integr Complement Med. 2025 Mar;31(3):301-307. doi: 10.1089/jicm.2024.0681. Epub 2024 Nov 28.
Federally Qualified Health Centers (FQHCs) provide comprehensive primary care to underserved populations. While the presence of chiropractic services in these multidisciplinary systems is of growing interest, little is known. The purpose of this study is to identify and map where Doctors of Chiropractic (DCs) are employed or providing care within FQHCs and describe their employment characteristics. Websites for FQHC clinics identified by the Health Resources and Services Administration were reviewed to determine whether chiropractic services are offered and/or a DC is employed at that clinic. Identified DCs were invited to participate in a cross-sectional survey, which included questions about their employment. Analysis of survey data utilized descriptive statistics and content analysis of open-ended questions. We identified 233 DCs working full- or part-time in 146 of 1537 (9.5%) FQHC systems, with two thirds of those employing more than one DC. Chiropractic services are delivered at FQHCs in 28/50 U.S. states, 75.0% of which offer a chiropractic benefit in their state Medicaid program. California had the largest concentration of FQHCs offering chiropractic services (65/146, 44.5%). Of surveys sent to 206 viable DC e-mail addresses, 101 were completed (49.0% response rate). Most DCs responded to personal (39.0%) or advertised (26.0%) solicitation for employment by the FQHC, while some DCs (14.0%) initiated the opportunity. Average employment at the FQHC was 5.1 years. Credentialing levels and compensation structures were inconsistent. DCs predominantly spend their time on clinical care (mean 88.0%) compared with administrative tasks (mean 10.4%). This study provides important baseline information about the presence of chiropractic within FQHCs and DCs employment characteristics. Future research should include exploring the roles DCs fulfill within FQHCs, skills necessary for successful collaboration, and barriers to incorporating chiropractic services within these systems.
联邦合格健康中心（FQHCs）为服务不足的人群提供全面的初级保健服务。虽然这些多学科体系中整脊服务的存在越来越受到关注，但人们对此了解甚少。本研究的目的是确定并绘制整脊医生（DCs）受雇于FQHCs或在其中提供护理的地点，并描述他们的就业特征。对美国卫生资源与服务管理局确定的FQHC诊所网站进行了审查，以确定该诊所是否提供整脊服务和/或雇用了整脊医生。被确定的整脊医生受邀参与一项横断面调查，其中包括有关他们就业情况的问题。对调查数据的分析采用了描述性统计和对开放式问题的内容分析。我们确定有233名整脊医生在1537个FQHC体系中的146个（9.5%）全职或兼职工作，其中三分之二的体系雇用了不止一名整脊医生。在美国50个州中的28个州，FQHCs提供整脊服务，其中75.0%在其州医疗补助计划中提供整脊福利。加利福尼亚州提供整脊服务的FQHCs最为集中（65/146，44.5%）。在发送到206个有效的整脊医生电子邮件地址的调查问卷中，101份得到了回复（回复率49.0%）。大多数整脊医生回复是因为FQHC的个人招聘（39.0%）或招聘广告（26.0%），而一些整脊医生（14.0%）主动争取了这个机会。整脊医生在FQHC的平均工作年限为5.1年。资质认证水平和薪酬结构不一致。与行政任务（平均10.4%）相比，整脊医生主要将时间花在临床护理上（平均88.0%）。本研究提供了有关FQHCs中整脊服务的存在情况以及整脊医生就业特征的重要基线信息。未来的研究应包括探索整脊医生在FQHCs中所扮演的角色、成功合作所需的技能以及在这些体系中纳入整脊服务的障碍。
