Exploring the perceptions and experiences of chiropractors in the eThekwini Municipality regarding interprofessional referrals

Abstract

Background Interprofessional collaboration refers to the collaboration among various healthcare practitioners with the intention of providing patients with the most effective and appropriate form of care. These collaborations can be defined as interactions and relationships formed among various healthcare practitioners. This collaboration allows for improved patient outcomes, cost effective healthcare, allocation of resources, and improved satisfaction for the patient and practitioner. A referral among various healthcare practitioners can enable and facilitate interprofessional collaboration. The perceptions and experiences of South African chiropractors needed to be explored and understood. Many studies have focused on how other healthcare practitioners view chiropractors and their perceptions and experiences from the collaboration. Referrals occur when healthcare practitioners interact with one another to provide their patient with the best possible care. Understanding interprofessional referral networks requires a comprehensive analysis of all parties involved in the referral process. The perspectives and experiences offer valuable insights into barriers and challenges encountered in the interaction and collaboration among healthcare practitioners. In South Africa, chiropractors are trained to diagnose any physical defect, illness or deficiency. The treatment for these conditions may be outside chiropractors’ scope of practice, necessitating the use of the referral network. Exploring the perceptions and experiences of South African chiropractors facilitates the identification of potential barriers and challenges, as well as the development of solutions to address them. Aim of the study The aim of this study was to explore the perceptions and experiences of chiropractors with respect to their interprofessional referrals to healthcare practitioners. Methodology This study entailed a qualitative design, using an explorative study design. The study population was qualified chiropractors registered with the Allied Health Profession Council of South Africa, in the location of the eThekwini Municipality, KwaZulu-Natal, South Africa. Purposive and snowball sampling strategies were used to recruit participants. A sample size of 13 participants was used and one-on one interviews were conducted using a semi-structured interview guide. The interviews were approximately 30 to 40 minutes long and were transcribed verbatim. The transcripts were analysed and a list of topics were made. The topics were abbreviated into codes and these were arranged in alphabetical order. The codes that were similar and regular were grouped to form categories. Themes or concepts were made from the categories and a theoretical construct was formed. Thematic analysis was conducted using Tesch’s method of thematic analysis. Results The study identified four main themes, namely interprofessional collaboration and referral dynamic, patient perspectives on referral and continuation of care, challenges encountered in the referral process, and enhancement of the referral network. The participants expressed reasons for patient referrals in the chiropractic profession, as well as other professions. They emphasised their personal networks and expressed shared values on interprofessional interactions, with noted positive outcomes. The participants noted a correlation among patient preferences and their healthcare decisions. Obstacles encountered by patients impacted their referrals and the participants emphasised the relevance of these obstacles to patient care. A variety of obstacles encountered by the participating chiropractors were discussed, including stereotypes, misconceptions surrounding the chiropractic scope of practice, geographical location, communication barriers, chiropractic jargon, other practitioners age and sense of ownership, as well as the exclusion of chiropractic from the public healthcare system. Methods to improve interprofessional referrals and collaboration were then outlined and discussed in detail. Conclusion This qualitative study explored the perceptions and experiences of chiropractors in eThekwini Municipality regarding interprofessional referrals and collaboration. This study emphasised the importance and value of referrals when patient care falls outside the scope of chiropractic and emphasised that positive working relationships facilitate evidence-based and patient-centred care. Several challenges to collaboration were found to be stereotyping, communication barriers, and exclusion from the public healthcare system. This study outlined the need for better communication, new graduate guidance and clinical training to facilitate and improve the collaborative relationships among chiropractors and other professions. It offers insights from the perspective of South African chiropractors and recommends further investigative studies in other municipalities.