Table 1 Communication between PCPs and A/C providers

No effective communication

“We do not get any written documentation of what they’ve done.”

“There’s no effective communication here.”

“I don’t know if I’m supposed to [communicate with PCPs]. I don’t know if they’re open to it, if they want to hear back how these patients are doing.”

Spotty communication

“I’ve had a few [chiropractors] who have actually have sent me like their note or this improved. And that’s great. That’s wonderful. And I actually wish there was a little bit more of that”

“It’s rare, very rare [to interact with HMO clinician]. Usually, I’m communicating through the client. A couple of times through e-mail”

Contrasting attitudes toward communication

“I think if I were getting reports from acupuncturists, I think that would just annoy me. So I’m kind of glad there’s not a lot of back and forth. I feel like, like getting a report from the dentist, I kind of don’t care.”

“I want to be working in conjunction with a primary care doctor.”

“Frankly, I don’t have time to call any other providers or anything like that, unless they contact me with a problem. You know, I have way too many things to do…”

“I think it would be wonderful to have an open channel of communication with whatever the doctor is seeing, you know.”

“I mean, I’m certainly open to it, if someone has something they feel it’s important for me to know. But, the discipline is so very different from Western medicine, that I’m not certain how the information it would provide me would add to what would be familiar enough or make sense to me, to really add anything to what I’m already doing or what I already know.”“I think it [feedback from these providers] would be really helpful. I mean, I think that they probably have insight in terms of the pain…you know, the etiology, the non-physical etiology of the pain.”

“We do our chart notes. And I suppose, yeah, just sending chart notes back and forth. […] all doctors who have a full practice are very busy. And so are acupuncturists. […] would the doctor get the chart note or even want the time to review the chart note. I really don’t know in a perfect world how it could work. But I’m thinking e-mail with just something really quick, back and forth, might reassure the doctor too. I mean, I’m sure doctors worry. What the heck is going on? I haven’t seen this person. And they haven’t been back. And what are they doing? You know, that happens for us too. And we always like when people come back and say, oh, I didn’t keep coming because I got better, so… But there are people that you don’t really know where they stand, you know, how things finished with them or what ended up happening.”“He [PCP] doesn’t know if the patient got better, got worse, who they even went to. I want to use that place again because it seems like they have a pretty good success rate. Doesn’t happen.”