Patient Satisfaction With the Chiropractic
Clinical Encounter: Report From a
Practice-based Research Program

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   J Neuromusculoskeletal System 2001: 9 (4): 109–117

Cheryl Hawk, Cynthia Long, and Karen Boulanger

Palmer Center for Chiropractic Research,
741 Brady Street,
Davenport, IA 52803

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When 2,987 patients from a variety of rural and urban locations in the United States and Canada completed a data collection survey, 85 percent stated that their chiropractor always listened carefully. 85.3 percent stated, their chiropractor explained things understandably. 88.2 percent stated, that the chiropractor showed respect for what they had to say. Overall, the majority of patients were highly satisfied with their care. From their Poster Presentation: Data were collected from 2986 adult patients of 172 U.S. and Canadian chiropractors in a practice-based research program over a one-week period in November 1999. Patients reported chief complaints and rated their chiropractors on aspects of the doctor-patient interaction as assessed by the Components of Primary Care Instrument (CPCI) and a nine-question adaptation of the Chiropractic Supplemental Item Set for the Consumer Assessment of Health Plans Study. Practice and practitioner characteristics were collected from the participating chiropractors. On the CPCI, patients rated their chiropractors highest in advocacy and interpersonal communication and lowest in comprehensiveness of care. Of the 1822 patients reporting pain, 56.2% rated the care they received for it as "excellent," 30.6% "very good;" 9.5% "good;" 1.3% "fair;" and 0.2% "poor;" 2.0% did not respond. The majority of patients (85.3%) answered they had enough time with the chiropractor; 11.0% would have liked a little more, 1.3% a lot more, and 0.4% less time (2.0% did not respond). Patients were quite satisfied with the care they received with 85% reporting that their chiropractor always listened carefully to them and always explained things in a way they could understand; 88% reported their chiropractor always showed respect for what they had to say; 78% felt their chiropractor always spent enough time with them. Most (82.3%) thought their chiropractor never recommended more visits than necessary. The frequency of contact and high level of interpersonal rapport that exists in the chiropractic encounter could provide opportunities for reinforcement of prevention and health promotion information.

The purpose of this study was to describe aspects of the clinical encounter in diverse chiropractic practices and assess patient satisfaction among a sample of their patients. There were 2987 eligible patients of the 172 participating doctors of chiropractic (DCs) in the U.S. and Canada, all members of a practice-based research program operating in a chiropractic research center. Patients aged 18 years and older who had visited the office at least once prior to that day's visit were eligible; each DC was asked to enroll the first 20 eligible patients presenting on a specified date in 1999.

Chief complaints were primarily pain-related (61.6%), with 31.4% saying they had "no problem today," indicating a follow-up or maintenance care visit. For the 2796 U.S. patients, 57.9% paid some out-of-pocket expense and 31.3% reported paying cash only. The median number of reported visits in the past year to their chiropractor was 13 (Interquartile Range-IQR: 18). The majority of patients were highly satisfied with their care; 85.0% reported that their chiropractor always listened carefully; 85.3% that the DC explained things understandably; 88.2% that the DC showed respect for what they had to say; and 75.6% that he/she involved them in decisions as much as they wanted. The median proportion of patients, per DC, with a chief complaint who said their doctor always spent enough time with them was 82% (IQR: 19%) and 82.3% reported that their chiropractors never recommended more visits than necessary.

It appears that interpersonal aspects of the clinical encounter may play a larger role in patient satisfaction with chiropractic care than actual time spent or specific procedures used.

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