Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study.

Area of Science:

• Integrative Medicine
• Healthcare Management
• Patient Outcomes

Background:

• Chiropractic care shows potential for improving patient outcomes and reducing opioid reliance.
• Limited understanding exists regarding the integration process and drivers for adopting chiropractic services within conventional medical settings.

Purpose of the Study:

• To describe the organizational structures, care processes, and perceived value of chiropractic integration within U.S. private sector medical facilities.

Main Methods:

• A multisite, comparative organizational case study was conducted across nine U.S. private sector medical facilities (five hospitals, four clinics).
• Data collection involved 2-day site visits, semi-structured interviews with 135 stakeholders (including doctors of chiropractic and non-DC clinicians), organizational data tables, and document review.
• Thematic content analysis was performed on interview transcripts by an interdisciplinary team.

Main Results:

• Facilities initiated chiropractic care for diverse reasons, emphasizing evidence-based practice, multidisciplinary collaboration, and alignment with organizational values.
• Chiropractic clinics were integrated into existing infrastructure and often expanded based on patient demand.
• Doctors of chiropractic (DCs) were co-located with medical providers, contributing to the collaborative management of musculoskeletal and comorbid conditions.
• High perceived value was reported by patients, medical providers, and administrators, with success markers including improved clinical outcomes, patient satisfaction, provider productivity, and cost offsets.

Conclusions:

• Diverse U.S. private sector medical facilities have successfully implemented chiropractic clinics.
• High satisfaction with chiropractic care is reported by a wide range of facility stakeholders.