ChiroACCESS Article

How Rheumatologists View Chiropractic and CAM Providers

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

ChiroACCESS Editorial Staff



Published on

May 18, 2010

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Collegial interactionA (2010) survey responded to by 345 rheumatologists evaluated how beneficial they viewed complementary and alternative medicine and how likely they were to refer patients to CAM providers.  Chiropractic was included in the “spinal manipulation” category.  The table below was adapted from the original table published in this study.  Chiropractic did not share nearly the same degree of acceptance as massage and was pretty evenly split between those that thought it was beneficial versus those that did not.  In a separate table the study noted that only 6% were very likely to refer to a chiropractor and 35% somewhat likely.  It was interesting that gender had a significant (P=.02) effect on the acceptance of CAM providers among these rheumatologists with females being much more likely to believe CAM therapies were beneficial.  This gender difference has been noted in previous studies with other medical specialists.

Responses %

Moderately Beneficial
Not  Very Beneficial
Not at all Beneficial
Spinal Manipulation (e.g. chiropractic)
Energy medicine (e.g. Reiki)
Meditation practices (e.g. yoga)
Glucosamine ± chondroitin
Body work (e.g. massage)

“Survey response of rheumatologists.  Views of respondents regarding the benefit of various types of complementary and alternative medicine.”

A similar study was posted here in 2009 when orthopedists were surveyed about their views of chiropractic.  That work can be found here: The Attitude of Orthopedic Surgeons toward Chiropractors.  In view of the turf issues and competition that sometimes exists between these disciplines, these survey results are not surprising.  In practice it is the failed medical cases that chiropractors see not the great success stories.  The reciprocal is true of the medical provider.

What rheumatologists in the United States think of complementary and alternative medicine: results of a national survey.

BMC Complement Altern Med. 2010 Jan 28;10:5.

Manek NJ, Crowson CS, Ottenberg AL, Curlin FA, Kaptchuk TJ, Tilburt JC.
Division of Rheumatology, Department of Medicine, Mayo Clinic, 200 First St., Rochester, MN 55905, USA.

BACKGROUND: We aimed to describe prevailing attitudes and practices of rheumatologists in the United States toward complementary and alternative medicine (CAM) treatments. We wanted to determine whether rheumatologists' perceptions of the efficacy of CAM therapies and their willingness to recommend them relate to their demographic characteristics, geographic location, or clinical practices.

METHODS: A National Institutes of Health-sponsored cross-sectional survey of internists and rheumatologists was conducted regarding CAM for treatment of chronic back pain or joint pain. In this study we analyzed responses only from rheumatologists. Response items included participant characteristics and experience with 6 common CAM categories, as defined by the National Institutes of Health. Descriptive statistics were used to describe attitudes to CAM overall and to each CAM category. Composite responses were devised for respondents designating 4 or more of the 6 CAM therapies as "very" or "moderately" beneficial or "very likely" or "somewhat likely" to recommend.

RESULTS: Of 600 rheumatologists who were sent the questionnaire, 345 responded (58%); 80 (23%) were women. Body work had the highest perceived benefit, with 70% of respondents indicating benefit. Acupuncture was perceived as beneficial by 54%. Most were willing to recommend most forms of CAM. Women had significantly higher composite benefit and recommend responses than men. Rheumatologists not born in North America were more likely to perceive benefit of select CAM therapies.

CONCLUSIONS: In this national survey of rheumatologists practicing in the United States, we found widespread favorable opinion toward many, but not all, types of CAM. Further research is required to determine to what extent CAM can or should be integrated into the practice of rheumatology in the United States.
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