Are You Satisfied?

313px-Jagger_live_Italy_2003[originally published in KCN, June 2003]

When Mick Jagger first belted out his now legendary tune about being devoid in the satisfaction department, I have a feeling he wasn’t referring to health care.  But let’s pretend for a moment (work with me here) that he was.  Would you be singing right along with Mick?:

“I can’t get no health care satisfaction.  I can’t get no healing action.”

Let’s hope not.  But if you find yourself nodding “Yes,”  odds are that you and poor Mick haven’t tried chiropractic.  Because you should know that — not one, not two, but numerous — surveys have been conducted over the past couple of decades regarding patient satisfaction with chiropractic care.  And they all say pretty much the same thing:  patients are satisfied with their chiropractic care — period.

Check it out.

In 1989 a public opinion telephone survey was conducted in Connecticut amongst 500 randomly selected households.  Of the those that had visited a chiropractor (21%), 78% rated their treatment as effective or very effective, and 89% were satisfied or very satisfied with the personal attention they received.

A 1991 New Jersey telephone survey of 693 people found that, of those that had used a chiropractor, 88% were satisfied or fully satisfied with the “effectiveness” of their treatment.   Very high marks were seen with the respondent’s satisfaction of the chiropractor’s professional attitude (97%), competence (93%), and level of attention (96%).

A nationwide Gallup poll conducted in 1991 found that 9 out of 10 chiropractic users felt their treatment was effective.  Eight out of 10 chiropractic users were satisfied with  the treatment they received and felt that most of their expectations had been met.

A report released in 1993 from the Journal of Manipulative and Physiological Therapeutics found that, of the 376 chiropractic patient surveyed in Minnesota and Wisconsin, 84% felt that the care they received was “…just about perfect.”  Ninety-seven percent agreed or strongly agreed with the statement, “I would recommend this doctor to a friend or relative.”

Research Dimensions, Inc. out of Richmond, Virginia completed a study in 1994 that asked 260 chiropractors to randomly distribute surveys to 10 of their patients.  More than 1,000 surveys were returned.  Some of the major findings were:  100% indicated that they were satisfied or very satisfied with the chiropractic treatment they received; 99% were confident or very confident that their chiropractor had diagnosed their problem correctly; 93% responded that their physical problem or condition had improved as a result of chiropractic; 93% said that chiropractic contributes to a healthier, more fit lifestyle; and 71% indicated that they were taking less medication as a result of their chiropractic care.  The study pointed out that over half of the respondents had been chiropractic patients for more than five years — an excellent indicator of patient satisfaction.  When the patients were asked what they like most about their chiropractic care, their answers were that they felt good after treatments, that the treatment provided them with immediate relief from pain, and that they did not have to take medication.

A 2001 study in the Journal of the Neuromusculoskeletal System examined nearly 3000 chiropractic patient survey results and found that 88% of the patients felt their DC always respected their opinion; 85% said their DC always listened to them carefully and explained treatment clearly; 82% said their DC never recommended an excessive number of visits; and 76% claimed their DC involved them in decisions “as much as they wanted.”

Another study asked one hundred and fifty randomly selected chiropractic patients to rate various aspects regarding the quality of their care.  The results were published in a 2001 edition of the Journal of Manipulative and Physiological Therapeutics.  Ninety-two percent rated the personal manner of the chiropractor as “excellent”; 85% rated the length of time to set up appointment as “excellent”; 83% rated the technical skill of the chiropractor as “excellent”; 76% scored the length of wait at the office as “excellent”; time spent with provider was considered “excellent” by 74% of the patients; and 73% rated the chiropractor’s explanation of procedures as “excellent.”  Overall satisfaction was rated as either “very good” or “excellent,” which is probably why 96% claimed that they would recommend their doctor of chiropractic to their family and friends.

Unfortunately for our medical counterparts, their report cards haven’t been quite as glowing.

In 1989, the Western Journal of Medicine reported that “the percentage of chiropractic patients who were ‘very satisfied’ with the care they received for low back pain was triple that for patients of family physicians.”  The report also went on to say that patients of family physicians were significantly less satisfied, versus patients of chiropractors, with the information they received about their back problem — such as the cause of the pain, recovery time, and instructions on exercise, posture, and lifting.  Medical patients were also significantly less satisfied with their perception of the doctor’s concern for their pain, the amount of time that the doctor spent listening to their description of their pain, and the degree to which they felt the doctor believed that their pain was real.

A 1990 Canadian study found that based on a randomly sampled telephone survey, the public was, on average, more satisfied with chiropractic care than physician care.

The medical journal Spine reported in 1996 a survey of 4,438 North Carolina residents that were contacted by phone.  All had suffered at least one episode of severe, acute lower back pain in the previous year.  Of the 39% that decided to seek care, 99% of those that sought out chiropractic felt their care was helpful, while a lesser 80% of those choosing medical care reported their treatment as helpful.   Chiropractic patients were more satisfied with their care (96% vs. 84%) and less likely to seek care from another provider for that same episode of pain (14% vs. 27%).

Apparently studies like these don’t come as a shocker to the the medical profession.  In a 1988 survey of medical doctors and chiropractors, only 55% of the M.D.’s felt that their patients with low back pain were very satisfied with the care they rendered, whereas the chiropractors chimed in with a confident 99%.

Studies also seem to indicate that not only are patients satisfied with chiropractic care, but medical doctors too.

A 1990 study out of Canada speaks to the fact that 62% of physicians surveyed refer patients with musculoskeletal pain to chiropractors.  Of these M.D’s, 69% had increased their frequency of referral during the course of their medical practice, whereas a mere 7.7% indicated that they were referring less often than before.   Interestingly, nearly 10% reported actually consulting chiropractors as patients themselves.

Something more recent perhaps?  How about a February 2003 article praising chiropractic in, none other than, the medical newspaper Orthopedics Today.  The title itself tells you what you need to know:  “Time to Recognize Value of Chiropractic Care?  Science and Patient Satisfaction Surveys Cite Usefulness of Spinal Manipulation.”

How about an objective, third-party, professional opinion?

Pran Manga, PhD., a professor of health economics at the University of Ottawa, is known by most in the health care industry for his 1993 landmark report entitled The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain. With Canada’s socialized-medicine insurance structure, patients opting for chiropractic care are forced to bear a greater “out-of-pocket” cost versus seeing a medical doctor.  Despite this, Dr. Manga points out, the rising utilization of chiropractic services seen in many jurisdictions of Canada is “in itself ample testimony of patient satisfaction….  In the language of economics, the fact that patients choose chiropractic care over physician care despite the higher cost is ‘revealed preference,’ indicating greater patient satisfaction with chiropractic care for low back pain.”

Finally, an interesting story just surfaced this year (2003) out of a Georgia army hospital.  Now that chiropractors have been hired by the military to treat those on active duty at bases and forts across the country, our military men and women are letting the “higher ups” know they approve.  Kudos go out to G. Thomas McKinney, DC, chiropractor at the Martin Army Hospital, who was just recently awarded having the highest patient satisfaction rating of all health care providers on post.  His partner, and only other chiropractor at the hospital, Jerry Vanderheyden, DC,  was right behind him with 3rd place.  Dr. McKinney recalled the awards banquet in a newspaper story, “…as if [winning] was not enough, we received a dozen or more ‘high-fives,’ ‘thumbs-ups,’ and hoots and calls from our medical and osteopathic physician colleagues at the announcement!”

Yes folks, satisfaction is a big deal when it comes to health care — so much so, that The Foundation for Chiropractic Education and Research cited in their 1996 booklet on chiropractic satisfaction a, then recent, Roper-Starch Worldwide poll that indicated patient satisfaction, rather than medical outcomes, was the most critical measure of health care quality.

When it comes to chiropractic the surveys are pretty clear:  the public likes chiropractic care.  And while one lone survey might not make much of an impact on a person’s decision making, the consistent and obvious trend of multiple surveys should.
Perhaps this is why more and more DC’s (including myself) are happy to assume some of the financial “risk” that new patients take on when they decide to step foot in a chiropractor’s office by offering a “satisfaction guarantee.”  Not a guarantee of a cure, but simply a guarantee that they will be satisfied with their decision to consult the office.  Odds are they will be.

So, if you, like Mick, have been yearning for some “health care satisfaction,” look no further.  Give chiropractic a try.  Find out for yourself what the surveys have consistently been saying all along.  Chances are, you’ll be glad you did.   And you’re sure to start crooning a different tune — “guaranteed.”

__________

sources used for this article:
Callahan.  Patient satisfaction study yields positive results.  Dynamic Chiropractic. 13(3). 1995.                www.chiroweb.com/archives/13/03/04.html
Carey, Evans, et. al.  Acute severe low back pain:  a population-based study of prevalence and care-seeking.  Spine  21(3), 339-44.  1996.  (cited in FCER Chiro. pt. satisfaction…)
Cherkin and MacCornack. Managing low back pain – a comparison of the beliefs and behaviors of family physicians and chiropractors. Western Journal of Medicine. 149(4), 475-80. 1988. (cited in Manga, et. al.)
Cherkin and MacCornack. Patient evaluations of low back pain care from family physicians and chiropractors.  Western Journal of Medicine. 150(3), 351-5. 1989. (cited in Manga, et. al.)
Chiropractic patient satisfaction and utilization:  a review of the current research.  Foundation for Chiropractic  Education and Research (FCER).  Arlington, VA.  1996.
Chiropractic recognized by Orthopedics Today.  Dynamic Chiropractic 21(8). 2003.                    www.chiroweb.com/archives/21/08/14.html.
COMPAS. A report on public attitudes toward issues associated with the chiropractic profession in Ontario.  Prepared for the Ontario Board of Chiropractic.  1990.   (cited in Manga, et. al.)
Demographic characteristics of users of chiropractic services.  The Gallup Organization, Princeton, NJ. 1991.  (cited in FCER Chiro. pt. satisfaction…)
Esteb. Making Change. (Assuming the risk).  Orion Associates, Inc.  Distributed by Balk Talk Systems. Colorado Springs, CO.  1995.
Gemmell and Hayes.  Patient satisfaction with chiropractic physicians in an independent physicians’ association.  Journal of Manipulative and Physiological Therapeutics.  24(9), 556-59. 2001.  (reported in   www.chiroweb.com/find/archives/musculoskeletal/other/satisfaction.html)
Harrison.  DC garners “best patient satisfaction” rating at Georgia army hospital.  Dynamic Chiropractic. 21(13).  2003. www.chiroweb.com/archives/21/13/10.html
Hawk, Long, and Boulanger.  Patient satisfaction with the chiropractic clinical encounter:  report from a practice-based research program.  Journal of the Neuromusculoskeletal System. 9 (4), 109-17. 2001.   (reported in www.chiroweb.com/find/archives/musculoskeletal/other/satisfaction.html)
Manga, et. al.  The effectiveness and cost-effectiveness of chiropractic management of low-back pain.  Pran Manga and Associates.  Ottawa, Ontario, Canada.  1993.
Maust et. al.  The chiropractic patient in rural, health professional shortage areas of the United States:  an exploratory analysis.  Research Dimensions Inc.  Richmond, VA. 1994.  (cited in FCER Chiro. pt.             satisfaction…)
Patel-Christopher.  Family physicians and chiropractors:  a need for better communications and cooperation.   (unpublished mimeo). 1990.   (cited in Manga, et. al.)
Sawyer and Kassak.  Patient satisfaction with chiropractic care.  Journal of Manipulative and Physiological Therapeutics. 16(1), 25-32.  1993.  (cited in FCER Chiro. pt. satisfaction…)
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