Issue 2 - February 2005

Hospital chiropractic: Good for everyone
By Joseph Salamone, DC. and John L. Cerf, DC

Does chiropractic belong in hospital emergency rooms? Judged by the comments we hear, the work of chiropractors in emergency departments is appreciated.

For example: Every emergency department (ED) physician in our hospital has commented that a chiropractor should be assigned to every ED in the country.

And one emergency department physician said that putting a chiropractor on call in the ED was the best change she had seen in all of her time in medicine.

Although the total number of hospitals that admit DCs is unknown, the trend is growing. This opens up opportunities for chiropractors throughout the country.

WHAT DO YOU GAIN?

You have much to gain from working in a hospital. Some benefits include:

• Improved credibility in court. In court, lawyers frequently ask doctors about their hospital affiliations to help establish expertise.

• ‘Vicarious respectability.’ Chiropractors with hospital privileges benefit from the “vicarious respectability” of being associated with an established institution. Medical physicians who have frequent contact with chiropractors are less likely to verbalize prejudice against chiropractic.

• Improved referral network. The social and professional interaction between medical and chiropractic physicians in the hospital leads naturally to a referral network. The medical physicians get to know you as a person. When the physician feels comfortable that you are moral and cautious in your approach to patients, the MD becomes much more comfortable about making referrals.

• Ongoing education. Learning occurs through formal lectures and in hallway interactions. Imagine being able to tap the knowledge of an ED physician with thirty years of experience or asking a neurologist a simple question only to have her invite you to the radiology department and spend half an hour teaching you how to read CT scans of the head for trauma and pathology.

And the availability of a medical library and the assistance of a professional medical librarian is a luxury not available in the solo practitioner’s office.

OTHERS BENEFIT, TOO

Patients, hospitals and third party payers have even more to gain than chiropractors. Here are some of the benefits to these groups:

• More smiling patients. Patient satisfaction is very high when the hospital’s chiropractor is involved in the patient’s care. Chiropractic treatment offers a mechanical approach to the patient’s problem that was previously unavailable.

• Lower hospital costs. Many patients can be discharged earlier.

• Less medication. Many patients are able to avoid narcotic analgesia when treated by the chiropractor.

• Lower treatment costs. Patients return to the ED less often and make fewer requests for re-medication when a chiropractor is involved in their care.

• Better exams. The chiropractor has more time to examine the patient and explain the patient’s condition than the busy ED physician. The nurse’s time is also more available for other patient care activities.

The chiropractor is available as a member of the ED team to perform as needed during times of emergency. The hospital staff frequently enjoys having an on-site chiropractor for their personal needs as well.

• Better treatment options. Medical and chiropractic physicians in the hospital have access to diagnostic equipment and tests that help to accurately diagnose the patient with severe pain and ensure the safety of treatment. Patients who would otherwise be “untouchable” receive analgesia so the chiropractor is able to offer treatment.

The small number of patients who do not respond to chiropractic adjusting, in the office setting, may begin to respond to chiropractic adjustments after receiving manipulation under anesthesia.

Patients who have received manipulation under anesthesia can then return to the chiropractic office to continue to receive the benefits of chiropractic adjustments that had previously been less effective due to patient intolerance, severe pain, fibrous adhesions and guarding mechanisms.

At a time when some insurance companies are trying to close doors to chiropractic, it is inspiring to see hospital doors starting to open. Most importantly, and contrary to what many might believe, chiropractors who work in the hospital environment are not “imitation MDs.” Rather, they practice chiropractic as complement to traditional allopathic medical care.