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Chicago chiropractor

03 Jul 2008 | Tagged as: Uncategorized

I am perpetually entertained by the disconnection between what we do and what we say we do in the chiropractic profession. If I polled chiropractors and asked if they were actively engaged in public health work in their practices, I think its safe to say that most would say “No” or “Hell, no!” First we must define public health. Herein lies the rub. In chiropractic, our perception of public health is rather narrow (since in chiropractic college our public health courses may have focused on microbes, water sanitation, pasteurization, and immunization!). Several different but acceptable definitions for “public health” can be found in various literature. But what is the true meaning of “public health,” this ethereal and rather elusive term?
As a group, the 50,000 chiropractic professionals make up the third largest health care provider in the United States, after the medical and dental professions. They are also the largest alternative medicine provider of natural health care. There is very promising research evidence supporting the cost-effectiveness, low risk, and high patient satisfaction of chiropractic health services with respect to spinal pain and related conditions. Despite the demand, advantages, and efficacy of chiropractic health services, the chiropractic profession is not being integrated into the health care system. Doctors of chiropractic are largely ignored, and their progress is impeded by strong economic groups. Thus, the American public is not receiving the full benefit of natural alternatives for health care. The chiropractic profession has struggled with its definition and adaptation to the modern needs and demands of the health care market and the American public. It is urgent that the chiropractic profession reengineer itself. A strategic plan is needed to integrate chiropractic services into the health care market to improve the quantity and quality of natural health services rendered to the American public. Although many of the chiropractic professions leaders have eloquently written and discussed many critical issues, these discussions have not resulted in a strategic plan for the chiropractic profession. Since the profession has been without guidance or direction, it has reacted to health care market forces, instead of anticipating and acting on the health care market.
The Medical Expenditure Panel Survey (MEPS) sponsored by the Agency for Healthcare Research and Quality is generalizable to the United States. None of the 25,096 participants in the 2000 MEPS identified a chiropractor as their usual source of care, defined as a particular doctors office, clinic, health center, or other place that the individual usually goes to if he/she is sick or needs health advice. Chiropractic visits comprised 6 percent of all office-based health care visits and nearly one in four visits to the offices of health professionals other than physicians. Chiropractors accounted for 14 percent of non-physician office-based expenditures, more than one third of which were paid out of pocket by patients. Only 9 percent of visits to chiropractors offices were referred by physicians. According to MEPS, most visits to chiropractors involved patients with musculoskeletal problems (see accompanying figure). This limited pattern of care contrasts with the much broader scope of primary care clinicians. This supports the recent decision by the Department of Veterans Affairs not to designate chiropractors as primary care providers. NOTE: The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

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