Chiropractors and return to-work: The experiences of three Canadian focus groups

Objectives: To explore the views of chiropractors about timely return-to-wo rk in treating patients with musculoskeletal injuries, to identify the appr oaches used by chiropractors when treating injured workers with musculoskel etal disorders, and to learn about chiropractors' perspectives on the barri ers and facilitators of successful return-to-work. Design: Qualitative study of 3 focus groups of chiropractors. Methods: Focus groups of 8 to 11 chiropractors were conducted in 3 large Ca nadian cities. The selected participants were experienced in treating patie nts with occupational musculoskeletal injuries. Standard questions were use d to collect data. The data from each focus group were coded and analyzed s eparately and then considered in relation to each other. Results: The participants indicated that timely return-to-work depends on p atients' characteristics, severity of injury, clinical progress, the availa bility of work accommodation, and clinical judgment. The chiropractors comm ented that their treatment of injured workers rests on their strength in di agnosis and treatment and on providing patient-centered care. Positive huma n relations within workplaces and the ability to accommodate the work of an injured worker were described as important in return-to-work programs. The participants believed that a bias against chiropractic is present within t he medical profession and workers' compensation boards. They viewed this bi as as an important barrier when assisting their patients to successfully re turn to work. Conclusion: The broad approaches described by the participating chiropracto rs to return injured workers to work are consistent with those proposed in evidence-based practice guidelines. Better communication among chiropractor s, medical doctors, and workers' compensation boards would likely decrease interprofessional tensions and improve the recovery of workers with musculo skeletal injuries.