June 2, 2015 — Last month, Anthony Hamm, DC, FACO, president of the American Chiropractic Association, posted a letter addressed to the editor of Modern Healthcare regarding an article written by Bob Herman, “Drugmakers funnel payments to high-prescribing doctors.” The piece explored the fees and financial perks received by almost 25 percent of Medicare’s top-prescribing physicians. The letter reads as follows:
To the Editor:
The American Chiropractic Association (ACA) commends Modern Healthcare for bringing to light the influence of drug manufacturers on physicians’ medication prescribing practices.
As the article “Drugmakers funnel payments to high-prescribing doctors” states, “Nearly one-quarter of Medicare’s top-prescribing physicians received consulting fees or other financial perks from the manufacturers of the drugs they prescribed in 2013. More than 400 physicians prescribed at least $1 million worth of drugs in the Medicare Part D drug benefit program.” According to CMS, one of the most-prescribed drugs was hydrocodone-acetaminophen, a painkiller.
Such prescribing incentives have undoubtedly contributed to the rampant rise in the overuse and abuse of hydrocodone and other prescription pain medications, resulting in potential serious side effects for some patients.
While a multifaceted plan to address the problem is needed, people in pain should be apprised of all pain management strategies, including nondrug interventions to reduce their risk of overuse and addiction.
Chiropractic services offer patients a conservative approach to treating musculoskeletal pain— one of the top causes of disability worldwide. A 2014 study in the Journal of Manipulative and Physiological Therapies (JMPT) concludes that chiropractic use in episodes of care for uncomplicated back conditions has protective benefits against functional declines in older Medicare beneficiaries over a two-year period.
Conservative approaches make economic sense as well. In another JMPT study, low-back pain treatment, when initiated by a doctor of chiropractic, was 20 percent less expensive than care initiated by a medical doctor for the same condition.
Each patient is unique, and care plans should be tailored to focus on what is the safest, most effective treatment for the individual. With this in mind, medical physicians and doctors of chiropractic should aim to work together to help patients reduce or avoid the need for unnecessary pain medications and the risks that accompany them.
Anthony Hamm, DC, FACO
President, American Chiropractic Association