Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2004; 9: 07–8
The purpose of this study was to develop a model for collaboration between chiropractors and family physicians in a primary healthcare setting. In this paper, we explore and discuss perspectives regarding ‘integration’ and ‘collaboration’, and how they can be understood to facilitate the development of the model.
Semi-structured, 30–60-min interviews were conducted with experts in primary healthcare practice/research from academia, administration, chiropractic, family medicine, midwifery, nursing and physiotherapy professions, across North America. The interview transcripts were coded and analysed using grounded theory techniques.
The 16 interview participants viewed integration to be interaction between professionals of different disciplines that extended beyond working together in the delivery of care to include organisational (e.g. defined referral mechanisms, practice guidelines, treatment planning and decision-making) and structural (e.g. reimbursement strategies, office practice standards) elements. Collaboration was defined as enabling healthcare providers to maintain their autonomy while working together in the absence of formal structure and processes to deliver optimal patient care. Integration was thought to subsume healthcare professionals representing different disciplines under a common policy, organisation and structure. For some key informants, however, the distinction between integration and collaboration was less clear and they often used the two words interchangeably.
Participants generally described a model of professions working closely together (i.e. collaborating) in the delivery of care but not being subsumed into a single organisational structure (i.e. integration). It is therefore necessary to question whether integrative or collaborative care should be the goal of future team-based initiatives.
This study was funded by the Ontario Ministry of Health and Long Term Care and the Ontario Chiropractic Association (CANADA).
