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Chiropractors as Primary Spine Care Providers:Precedents and Essential Measures

By |December 16, 2013|Health Care Reform, Primary Care|

Chiropractors as Primary Spine Care Providers:
Precedents and Essential Measures

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2013 (Dec); 57 (4): 285–291

W. Mark Erwin, DC, PhD, A. Pauliina Korpela, BSc, and Robert C. Jones, DC APC

Assistant Professor, Divisions of Orthopaedic and Neurological Surgery, University of Toronto, Toronto Western Hospital, Scientist, Toronto Western Research Institute ; Associate Professor, Research, Canadian Memorial Chiropractic College.


Chiropractors have the potential to address a substantial portion of spinal disorders; however the utilization rate of chiropractic services has remained low and largely unchanged for decades. Other health care professions such as podiatry/chiropody, physiotherapy and naturopathy have successfully gained public and professional trust, increases in scope of practice and distinct niche positions within mainstream health care. Due to the overwhelming burden of spine care upon the health care system, the establishment of a ‘primary spine care provider’ may be a worthwhile niche position to create for society’s needs. Chiropractors could fulfill this role, but not without first reviewing and improving its approach to the management of spinal disorders. Such changes have already been achieved by the chiropractic profession in Switzerland, Denmark, and New Mexico, whose examples may serve as important templates for renewal here in Canada.

Keywords: primary care, spine, chiropractor


Introduction:

Between 1999 and 2008 the mean inflationary adjusted costs for ambulatory neck and/or back pain in the United States increased by a factor of 95%. [1] According to the study by Davis et al the largest proportion of increased costs are associated with specialty visits rather than primary consultations, clearly indicating that spine care places a tremendous burden upon the health care system. [1] Davis et al make recommendations with respect to cost containment for spine-related disorders which are similar to those put forth by Maniadakis and Gray ten years ago; and many of these revolve around reducing the reliance on specialty management. [2] A number of professionals with diverse backgrounds (chiropractors, massage therapists, physical therapists, osteopaths, and physicians) care for spinal pain patients. However unlike some other health care professions that have focused upon the management of condition-specific maladies, no one group has chosen to do so for certain aspects of the spine patient. Perhaps lessons learned from other condition-specific professions such as optometry and podiatry could provide important guidance in this regard.


Precedents for Professional Growth and Development:

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The Establishment of a Primary Spine Care Practitioner And Its Benefits To Health Care Reform in the United States

By |October 5, 2013|Evidence-based Medicine, Health Care Reform, Low Back Pain, Primary Care|

The Establishment of a Primary Spine Care Practitioner And Its Benefits To Health Care Reform in the United States

The Chiro.Org Blog


SOURCE:   Chiropr Man Therap. 2011 (Jul 21); 19 (1): 17

Donald R Murphy, Brian D Justice,
Ian C Paskowski, Stephen M Perle and
Michael J Schneider

Rhode Island Spine Center,
600 Pawtucket Avenue,
Pawtucket, RI 02860 USA.


It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs). Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.



From the Full-Text Article:

Introduction

One of the most talked about issues in the United States (US) is health care reform. In other countries as well, discussion commonly revolves around the issue of how health care services can be improved while containing costs. Many in the US have described the current health care situation as a “crisis” [1-4]. In March 2010, the US Congress passed and the President signed into law the Affordable Care Act, which puts in place comprehensive health care reform measures [5]. While various models for providing care to patients have been considered, such as accountable care organizations [6], it is recognized that any meaningful approach to health care reform will require three goals to be achieved:

1. improved patient health;
2. improved patient experience;
3. decreased per capita costs [7].

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