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Table 4 Older adult perceptions of potential facilitators and barriers of low back pain co-management by MDs and DCs

From: Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

  MD clinic DC clinic Senior center Senior housing
LBP Co-management facilitators M M D D C C C H H H
  1 2 1 2 1 2 3 1 2 3
Co-management would benefit LBP patient  
Collegial approach needed for LBP care
Historically strained relations between MDs and DCs has improved over time  
Referrals/consultations/phone calls between MD and DC needed for co-management  
Coordinated LBP treatment plan  
Health record/X-ray sharing required  
Offices located together or nearby         
Individualized care for LBP      
LBP Co-management barriers/concerns M M D D C C C H H H
  1 2 1 2 1 2 3 1 2 3
Medication: do not want to use any medicine, side effects, no improvement, narcotic addiction, masking pain
Financial costs or insurance issues from receiving care from 2 or more doctors  
Providers may not support a co-management approach to LBP care  
Chiropractic: Side effects, providers who do not treat a condition, no improvement   
Receiving care from multiple doctors    
Duplicate/unneeded tests/treatments      
Conflicting information or treatments      
Scheduling and transportation concerns     
Questionable benefit of either medical, chiropractic, or co-management based on previous LBP treatment experience     
  1. MD = Medical Doctor.
  2. DC = Doctor of Chiropractic.
  3. LBP = Low back pain.
  4. M# = Medical clinic focus group 1 or 2.
  5. D# = Chiropractic clinic focus group 1 or 2.
  6. C# = Senior center focus group 1, 2 or 3.
  7. H# = Senior housing focus group 1, 2 or 3.