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The role of chiropractors in the delivery of interdisciplinary health care in rural areas.

OBJECTIVE
To examine the current and potential role of chiropractors in rural interdisciplinary health care teams.


DESIGN
Information was gathered from three sources to summarize rural health care delivery needs and interdisciplinary practice as they relate to chiropractic to develop a position statement: a literature review, a series of semistructured phone interviews with health care providers and a workshop for interdisciplinary health care practitioners, rural chiropractors and chiropractic college faculty.


RESULTS
The health care needs of rural populations are diverse and not adequately addressed in the current system. Interdisciplinary teams operating in a community base are recommended as one way to better serve rural needs. Chiropractors are not routinely involved on such teams. Both interprofessional barriers (no chiropractic "niche," lack of knowledge of chiropractic practice and training and lack of medical acceptance) and intraprofessional barriers (lack of consensus on scope of practice, lack of standardization of training and lack of knowledge of other professions) were identified.


CONCLUSIONS
Strategies for increasing integration of chiropractic care into the health care delivery system were development of interdisciplinary preceptorships, development of post-graduate curricula for rural DCs in interdisciplinary team concepts and practices, dissemination of information about chiropractic and consensus on chiropractic scope of practice.