Enablers and barriers to the development of interprofessional collaboration between physicians and osteopaths: A mixed methods study

ABSTRACT

Osteopathy is a complementary and alternative medicine (CAM) that is growing in popularity. Increasing numbers of parents are seeking pediatric osteopathic care in addition to conventional medical care. Information about the development of interprofessional collaboration (IPC) between these practitioners is scarce. This explanatory sequential mixed methods study aimed to explore enablers of and barriers to the development of IPC between physicians and osteopaths involved with pediatric patients in primary care in Quebec, Canada. Postal questionnaires about collaborative practices were first sent to all physicians and osteopaths working with pediatric patients in Quebec. Semi-structured individual interviews were then conducted with a subset of 10 physicians and 11 osteopaths. A total of 274 physicians (14%) and 297 osteopaths (42%) completed the survey. Forty-five percent (n = 122) of physicians reported that they referred at least one pediatric patient per month to an osteopath. Thirty-six percent (n = 96) of physicians and 41% (n = 122) of osteopaths indicated having professional relationships. Personal consultation, professional relationship, perceived utility of osteopathy and community practice were positively associated with osteopathic referrals. According to participants, the strongest enabler of the development of collaboration was positive clinical results reported by parents. Additional enablers included the osteopath having previous health professionals training such as physiotherapist, pediatric experience, mutual respect for professional boundaries and complementarity, perceived safety of osteopathy, and parents’ requests for collaboration. Barriers were the absence of a common language, the organizational and legal context, uncertainty regarding one another’s roles, lack of interprofessional interactions, and limited scientific evidence. These results related to enablers of and barriers to collaboration between physicians and osteopaths and the illustration of their dynamic interaction could be used to guide efforts to promote productive collaboration and safe patient-oriented care.

KEYWORDS:

• Barriers
• interprofessional collaboration
• mixed methods
• osteopaths
• pediatric
• physicians

Acknowledgments

We would like to thank to all participant physicians and osteopaths for their time participating in this study.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Additional information

Funding

Financial support for CM (doctoral candidate) and IG (Junior 1 Researcher) by the Fonds de la Recherche du Québec en Santé (FRQ-S) is gratefully acknowledged. This study was supported by the Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research (INCAM). INCAM had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the articles; and in the decision to submit it for publication.