Abstract
BackgroundA variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment. While there are frequently problems in communication and coordination of care within conventional health systems, more opportunities for communicative disruptions seem possible when providers use different explanatory models and are not within the same health management system. We sought to describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor (A/C) providers, and CMP patients.MethodsWe collected qualitative data from CMP patients (n = 90) and primary care physicians (PCPs) (n = 25) in a managed care system, and community acupuncture and chiropractic care providers (n = 14) who received high levels of referrals from the system, in the context of a longitudinal study of CMP patients’ experience.ResultsMultiple points of divergence and communicative barriers were identified among the main stakeholders in the system. Those that were most frequently mentioned included issues surrounding the referral process (requesting, approving) and lack of consistent information flow back to providers that impairs overall management of patient care. We found that because of these problems, CMP patients were frequently tasked and sometimes overwhelmed with integrating and coordinating their own care, with little help from the system.ConclusionsPatients, PCPs, and A/C providers desire more communication; thus systems need to be created to facilitate more open communication which could positively benefit patient outcomes.
Highlights
A variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment
Not all CMP patients had knowledge of or exposure to complementary and alternative medicine (CAM), or knew that they could receive that care under their insurance benefits
According to primary care physician (PCP), they would usually only outright deny a request for referral if the patient’s medical condition contraindicated acupuncture or chiropractic treatment according to the benefit guidelines
Summary
A variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment. We sought to describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor (A/C) providers, and CMP patients. Penney et al BMC Complementary and Alternative Medicine (2016) 16:30 allopathic providers and their CAM counterparts [16, 17], making this an important place to study communication within a patient care management network. This work has identified areas that frequently inhibit better care coordination, such as lack of disclosure of CAM use by patients [18, 24], poor interprofessional communication [22, 28], and providers working from different explanatory models and utilizing distinct sets of jargon [21]. With few exceptions [30, 31], they have not looked at these groups within the contexts of systems in which providers are working for the same insurer system but are not colocated or within an integrative medicine program
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
