M Teitelbaum1. 1. Abt Associates, Inc, Bethesda, Md., USA.
Abstract
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.