Table 2 Summary of findings, including barriers and facilitators to interprofessional practice
Reference | Key IPP-related findings | Facilitators | Barriers |
|---|---|---|---|
[9] | Integrating chiropractic care into an established conventional medical setting, specifically a community health center, can be achieved over a relatively short period and with a high degree of comfort Integration had a positive impact on provider’s individual practices and changed opinions and views of healthcare practitioners towards chiropractic | The ‘right’ type of chiropractor that can integrate in an IPP setting IPE to ground the understanding of professional practice, roles and functions Collaborative practices such as team meetings and the clinic’s physical location Chiropractic care as a free service | Lingering concerns about ‘chiropractic’ |
[24] | The incorporation of chiropractic into the system of sport medicine professions derives from a clearly defined and commonly accepted understanding of the purpose of sport medicine Consumer demand (not professional acceptance) represents the main driver for the integration of chiropractors into high level athletics | A structural hierarchy that clarifies roles and responsibilities Clear understanding of professional boundaries and complementarity in each profession’s scope of practice Chiropractor’s accepting role limitations | Inability to work within a team framework Misaligned views regarding primary care status Misunderstandings about treatment provided by the chiropractor Clashes in philosophy of health stances |
[13] | Even in the highly systematized settings of primary care hospital clinics, the addition of chiropractors, offers a useful addition to the management of MSK pain-related conditions | Credible champions leading the change towards IPP Thorough preparation of the IPP environment implementing IPP Clear support by senior level administration Chiropractor demonstrates a high level of profession expertise | Poor knowledge and of awareness of ‘the chiropractic service’ Perception of risk of chiropractic treatment Unstable funding model |
[10] | Chiropractic services for back pain, offered either concurrently (dual care) or integrated (shared care) with standard medical care offers additional benefits beyond standard medical care alone with respect to patients global perceived improvement and satisfaction with care | Not reported | Not reported |
[22] | Family medicine residents and Doctor of Chiropractic viewed collaborative care as a useful practice model for older adults with low back pain | IPE to establish, improve and maintain collaborative back pain care A team-based, patient-centered system of management practices An effective time scheduling and clinical records exchange platform Care facilities supportive of collaborative management | Care options unacceptable to patient due to high co-payment Inefficiencies in electronic journaling system Clinicians not participating in IPE are unlikely to refer patients to chiropractors |
[21] | Complementary and integrative health providers collaborate both formally and informally with each other and other providers, and operate from a patient-centered perspective Providers overwhelmingly reported that interprofessional collaboration had a positive impact on patient care, professional satisfaction, and their practice | Collaborative practices such as interprofessional meetings Sharing supportive research for interventions with other providers and the target community Being present in a teaching hospital settings Creating clinical-experiential training sites allowing access to students from different disciplines Previous exposure to IPE Being in physical proximity of other providers Licensure, when required advised to consult with a medical doctor | The use of exclusive, discipline-specific language and nomenclature Clashes in professional opinions Poor of understanding about other disciplines Multiple electronic health records platforms Loss of income due to the extra time required to include collaborative practices Loss of income due to delays in treatment Licensure, when an obstacle to having hospital rights or limited the ability to bill third-party payers |
[12] | Chiropractors are engaged in the role of a spine-related MSK health care expert, as part of a provider team. The rationale for adding a chiropractor is to broaden the shared pool of knowledge. However, when not utilized, the role of chiropractor as spinal health experts is challenged | Chiropractors shifting from external to in-house practitioners Perceived need for a (spinal) MSK expert Athlete demand for services provided by chiropractors | No clear niche for a Back Pain expert (Back pain perceived as self-remitting) Competition from existing provider groups Financial limitations to adding a chiropractor to the team |