Podcast episode (Evidence Based Chiropractor, host Dr. Jeff Langmaid) reviewing a 2016 BMC Complementary and Alternative Medicine paper titled "Primary Care Physicians, Acupuncture and Chiropractic Clinicians and Chronic Pain Patients: A Qualitative Analysis of Communication and Care Coordination Patterns." The episode highlights research findings that communication between primary care physicians and CAM providers is deficient (patients often forced to manage information), that CAM plays a major role in chronic pain care with poor coordination harming outcomes, and that many PCPs feel they lack knowledge about acupuncture/chiropractic and practitioners to make referral decisions. Host gives practical advice: share concise case notes (date of service, patient name, diagnosis, treatment plan), send monthly research updates, and hold MD meetings to build referral relationships. Also includes sponsor pitch (RockTape) and calls for iTunes reviews.
Questions this episode answers
October 17, 2016.
"Primary Care Physicians, Acupuncture and Chiropractic Clinicians and Chronic Pain Patients: A Qualitative Analysis of Communication and Care Coordination Patterns" (BMC Complementary and Alternative Medicine, 2016).
Date of service; patient name; diagnosis; treatment plan.
Over 2,500 chiropractors per week.
Welcome to the Evidence Based Chiropractor. Providing you with elegant and efficient research based content to help your practice prosper and succeed. Now get ready for a variety of dynamic communication tools designed for immediate growth. Courtesy of your host, Dr. Jeff Langmaid.
Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. This week we have a great episode and it is somewhat special because I am recording it live on location in Burlington, Vermont. So I've had a great weekend up here. The leaves are just turning. It's absolutely beautiful, although a little bit cold compared to what I am used to in Tampa. But we've had a great weekend and I'm recording this up there. So. So this week's episode is interesting and I think it's a really great one because we actually look at the research behind referrals. So we're going to look at a paper called or titled Primary Care Physicians, Acupuncture and Chiropractic Clinicians and Chronic Pain Patients. A Qualitative Analysis of Communication and Care Coordination Patterns. This was in BMC complementary and alternative medicine in 2016. So this is a brand new one and it really dives in to communication flow and challenges between PCPs, acupuncturists and chiropractors and how that communication could be improved for the betterment of the patient's condition. Before we dive in, I will ask you when we finish up, take a moment and go to itunes and give us a review if you are new to the evidence based chiropractor. I know there is quite a few people out there that are new because because we have topped over 2,500 chiropractors downloading and listening each and every week, which really blows my mind. So I thank you for taking the time to listen. We will continue to keep giving you research in the time it takes to get to your office. Delivered every Monday morning. So thank you for listening. Tell a friend if you have a chiropractor that hasn't been listening. But most importantly, please get into itunes, give us a ranking or a review. It helps other people find us, it helps spread the message and we would really, really appreciate it. So as we dive in, I'll say a few words about Rocktape as we do each and every week. Rocktape is proud to be a sponsor of the Evidence Based Chiropractor. Rock Tape offers the world's best kinesiology tape, pain relief, topicals, mobility tools and functional fitness accessories. New from Rocktape is Rocksauce Chill, a powerfully cool pain relief topical in a convenient roll on with 6% menthol. It's stronger than the freeze competition. They are more than a tape company, they are a movement company. Learn more and get access to your medical discount by visiting rocktape.com so we talked at the Top this week. Our piece of research touches on communication patterns between complementary or alternative care providers and primary care families. Physicians research continually indicates to us that quality interdisciplinary communication combined with evidence based care strongly contributes to positive outcome for patients with chronic conditions. This article from BMC showcases the challenges that exist between primary care physicians and CAM providers. So we recommend every office out there as a chiropractor take a proactive approach to these challenges. Provide by providing case notes during evaluation, reevaluation and active care discharge as well as providing monthly research updates. Those are two legs of the stool. The third leg of the stool is meeting those MDs and building that rapport. And certainly that sounds like a lot, but at the Evidence Based Chiropractor, all of our members each and every month receive that research kind of hand delivered to their email box with all of their practice information white labeled on it. Certainly case notes are very easy. We've touched on them previously, we will touch on them again. Don't overthink the case notes and meeting those MDs can be very systematic. I know all of you out there have probably met some medical doctors and haven't got where you wanted to go with the conversation. But there's no reason to be upset or to despair or think that it quote unquote doesn't work. You just need a good strategy. Now we talk about this all the time at the Evidence Based Chiropractor, but if you want kind of a cheat sheet or a swipe guide to doing so, we have a free tool called the MD Meeting at our website. So if you haven't picked that up yet, if you're not a member of the Evidence Based Chiropractor but you want a taste of what we offer, you can go to the evidencebasedchiropractor.com click on Resources and then Free Tools and you will find the MD Meeting which outlines how to go about that in the most effective and efficient way possible. So research continually shows that patients receive the best outcomes when their primary care provider and care providers are working together. And you know, as referral partners with other doctors in town. You know you should always be reaching out to them and letting them know if there's any ways that you can assist with them and their patients. But what this Research looked at specifically was the communication between providers. And if we highlight a few quotes that they found, I think they really tell the story. Before we do that, let me repeat the title. You're gonna find a link to this directly to the PubMed article in the show notes, but it is titled Primary Care Physicians, Acupuncture and Chiropractic Clinicians and Chronic Pain Patients. We see a few of those every day, that's for sure. A qualitative analysis of communication and care coordination patterns and this was released in 2016. The researchers found, quote, our analysis of the main players in the CAM healthcare triad highlight deficiencies of communication between PCPs and AC providers with patients being left to manage the information and communication. So I mean I just. That does not sit well with me. When there's not good communication and the patients are left to manage that information and communication, it's going to lead to, as they said, deficiencies. It's not going to be accurate and we can't do it everything for the primary care providers, but we certainly can't control that. But what we can control is the information we produce from our practice. And case notes go a long way with that. But let's talk about the second quote. They found CAM plays a major role in the management of chronic pain for many patients. Thus the inefficiencies and quality of care deficiencies inherent in such a dysfunctional communication system may be contributing materially to sub optimal outcomes. This gets right to what we talked about at the top of the episode, which is the best outcomes are provided when a primary care provider and their other care providers, in this case chiropractors, are accurately communicating the progress, the treatment choices, the diagnosis and ultimately the plans of care for those patients. So both of the first quotes we looked at really play well together. Meaning when there is a lack of communication, it hurts the efficiencies of the system and it can result in poor outcomes when there is communication. When there is optimal communication, it helps the patient progress through their treatment goals and ultimately leads to a better outcome. So the third quote that the researchers found in this study is notably many PCPs stated they did not know enough about acupuncture or chiropractic, nor about the practitioners who are treating the patients to feel qualified to make decision about referrals. So this quote really, really hits home for me because it gets to what we do at the evidence based chiropractor. So again, the quote stated many primary care providers didn't know enough about acupuncture or chiropractic and they didn't know enough about the practitioners to feel like they can make a quality decision for a referral. It does not say that they don't want to make a referral, it doesn't say that they won't make a referral. But it indicates very strongly and very clearly that they are not making those referrals based upon the knowledge that they currently have. Well, there's one way that we can change that and that's by reaching out to them through, through those three legs of the stool that we harp on quite frequently at the evidence based chiropractor. Reaching out to them through research, monthly updates, positioning your practice as a local leader in interdisciplinary or conservative care for that matter. Certainly reaching out through case notes. Number two, showcasing the social proof that patients get great results in your practice. Every patient that comes in and gets a great result with their permission to share their health record gives you an opportunity to showcase that result that was achieved in your practice. And that goes a long way towards educating that provider about what you do, how you do things and what results patients can expect. Third leg of that stool, of course, being meeting medical doctors, the MD meetings themselves. And again the quote touches on the fact that they don't know enough about the practitioners. That's a one on one relationship. So making sure that you're able to get over that, you're able to meet with other care providers in your community and can go a significant way towards building that rapport, building the relationship from which ultimately the referral stems from. So never hesitate to do any three legs of the stool. You have to be doing at least one or two. But to really light your practice on fire as far as referrals, incoming referrals go from other care providers, you have to have all three legs working together. Now if you've been listening here and you are a member of the evidence based chiropractor, I thank you because a lot and also a lot of what we talked about and touched on here is going to be very familiar to you because our process, our system, our five module system dives into each and every one of the items addressed in this paper. And this is again a recent paper that was released in 2016. So this is current information. There's one other item I'd like to touch on in this paper before we break for the and there was some quotes found by primary care physicians and acupuncture chiropractic providers. And I think they're telling from primary care providers. One of the quotes that they found was we do not get any written documentation of what they've done. This gets right back to case notes as we talked about, evaluation, reevaluation and discharge. And make sure that you keep it short and simple. The four items date of service, patient name, diagnosis and treatment plan. That'll go a long way towards quenching that thought from a chiropractic perspective. The quote is just the other side of the coin. I don't know if I'm supposed to communicate with primary care providers. The answer is yes and you should be, with the patient's permission and making sure that you keep them, meaning the primary care provider, up to date on patient progress. Which means reevaluation, discharge from active care. If the patient continues on a maintenance path in your office, that's a okay, but keep them up to date on any discharge from active care and certainly on any evaluation of a patient that comes into your office. So I hope you get a lot of value out of this. I think it really frames the state, the current state of communication and how we can better outcomes, how we can better communication and ultimately how we can better our practices as chiropractic providers. And if you have listened this far again, I thank you. Please take the opportunity, go on itunes, give us a rating or review. It helps other chiropractors find us. I give you a lot of gratitude and thanks for listening again. We are over 2,500 chiropractors per week listening to the Evidence Based Chiropractor podcast. I hope you have a fantastic weekend practice and I will talk to you soon.
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