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Medicine and the Overtreatment of Back Pain

By |November 3, 2009|Education, News, Politics, Safety|

Medicine and the Overtreatment of Back Pain

The Chiro.Org Blog

SOURCE:   J Am Board Fam Med. 2009 (Jan); 22 (1): 62-68

Commentary by Dan Murphy, D.C.

I just read a fascinating article in the January edition of the Journal of the American Board of Family Medicine, as it documents the massive increase in costs for medical management of chronic back pain, with no comparable improvements in patient outcomes, or decreases in disability rates. Worse yet, significant increases in post-intervention complications (including death) also appear to be on the rise.

This article documents:

  • a 629% increase for epidural steroid injections
  • a 423% increase in expenditures for opioids for back pain
  • a 307% increase in the number of lumbar magnetic resonance images
  • a 231% increase in facet joint injections
  • a 220% increase in spinal fusion surgery rates
  • Manufacturers aggressively promote new drugs and devices for the treatment of back pain, yet there is evidence of misleading advertising, kickbacks to physicians, and major investments by surgeons in the products they are promoting.
  • Prescription opioid use is steadily increasing, especially for musculoskeletal conditions. Emergency department reports of opioid overdose parallel the numbers of prescriptions. Deaths related to prescription opioids are greater than the combined total involving cocaine and heroin. Ironically, “Opioid use may paradoxically increase sensitivity to pain.”
  • New and improved spinal fusion techniques and devices, such as implants, increase the risk of nerve injury, blood loss, overall complications, operative time, and repeat surgery, but do not result in improved disability or reoperation rates.
  • Increases in the rates of imaging, opioid prescriptions, injections, and fusion surgery might be justified if there were substantial improvements in patient outcomes; unfortunately, they are not. In fact, statistics indicate that disability from musculoskeletal disorders is rising, not falling. “Prescribing yet more imaging, opioids, injections, and operations is not likely to improve outcomes for patients with chronic back pain.”

At the same time that medicine has ramped up costs (gobbling up the Medicare pie), a long line of studies have shown the clear superiority of chiropractic management for low back pain. Please review the most in-depth study, published in May of 2007 which compared medical and chiropractic management for LBP in a managed care group:

Clinical and cost utilization, based on 70,274 member-months, over a 7-year period, demonstrated:

  • decreases of 60.2% in-hospital admissions
  • 59.0% less hospital days

  • 62.0% less outpatient surgeries and procedures, and

  • 83% less pharmaceutical costs

when patients were seen by a chiropractor, instead of seeing a conventional medical IPA doctor.

It’s time to end the

Medical Mis-Management of Low Back Pain

Millions spent by lobby firms fighting Obama health reforms

By |October 2, 2009|Politics|

Source The Guardian
America’s healthcare industry has spent hundreds of millions of dollars to block the introduction of public medical insurance and stall other reforms promised by Barack Obama. The campaign against the president has been waged in part through substantial donations to key politicians.

Supporters of radical reform of healthcare say legislation emerging from the US Senate reflects the financial power of vested interests ‑ principally insurance companies, pharmaceutical firms and hospitals ‑ that have worked to stop far-reaching changes threatening their profits.

The industry and interest groups have spent $380m (£238m) in recent months influencing healthcare legislation through lobbying, advertising and in direct political contributions to members of Congress. The largest contribution, totalling close to $1.5m, has gone to the chairman of the senate committee drafting the new law.

“It’s a total victory for the health insurance industry,” said Dr Steffie Woolhander, a GP, professor of medicine at Harvard University and co-founder of Physicians for a National Health Programme (PNHP).

“What the bill has done is use the coercive power of the state to force people to hand their money over to a private entity which is the private insurance industry. That is not what people were promised.”

Robert Reich, the labour secretary in the Clinton administration, says the Obama White House, mindful of how the health industry killed off Clinton’s attempts at reform, has grown so fearful of industry money that it has quietly reached agreement to pull back from price caps and public health insurance.

Read the the full article.

2 and 2 is? [Humor Alert!]

By |September 22, 2009|Education, Health Care, Media, News, Politics, Safety|

2 and 2 is? [Humor Alert!]

The Chiro.Org Blog

The news media has been having a LOT of fun reporting on the Congressional Health Care Overhaul lately, so I will too.

Chiropractic’s *scientific critics* state we don’t have the kind of statistics they (grin) rely on, so we shouldn’t toot our own horn like they do. Hmmm? Well, let’s take a closer look at them. Here’s some amazing scientific statistics about modern medicine:

1. The total number of iatrogenic deaths caused by conventional medicine is an astounding 783,936 deaths per year at a cost of $282 billion dollars. That is a mind-boggling 2147 people killed every day. That’s as if 7 jumbo jet planes crashed every day. That’s a 9-11 incident, happening every other day…FOREVER. God help us all. [1]

2. A report by the British Medical Journal correlated a strike by medical doctors with lower death rates during the strike. Hmmm?

3. Recent surveys suggest that “45% Of Doctors (MDs) Would Consider Quitting If Congress Passes Health Care Overhaul.” [3]

So, if we put that all those facts together, supporting Congress’s new Health Care Plan could reduce the medical population by up to 45%, thus significantly reducing the incidence of medically-induced iatrogenic illness and death, and all the money they would save ($126.9 billion dollars) would help to pay for the new Plan.

And, perhaps with some of those savings, they could even consider adding conservative chiropractic care as another cost-saving option. [4, 5]