Advisory Summary: integration of DCs into hospital-managed employer health centers

The National Association of Worksite Health Centers (NAWHC), in collaboration with the Foundation for Chiropractic Progress (F4CP), recently released the meeting summary of an in-person advisory roundtable showing that hospitals that manage onsite employer clinics require further education and assistance from the chiropractic community in order to better integrate doctors of chiropractic (DC) into their teams.

Working in conjunction with the F4CP, the NAWHC first conducted a survey then convened an advisory roundtable on the topic of “The Use of Chiropractors in Hospital-Managed Employer Health Centers.” The advisory roundtable met to discuss survey findings on Dec. 1 in San Francisco, Calif. Participants of the advisory board are leaders from several large health systems from across the U.S. that manage worksite health clinics.

Findings show that employer and hospital groups still find it challenging to integrate DCs in their worksite clinics, in part, due to unfamiliarity with chiropractic care or inaccurate perceptions about the practice and its doctors. For example, “some hospitals and private medical practices will not credential a DC due to their lack of knowledge about DC training and past perceptions of chiropractic knowledge and abilities,” according to the report.

“While the chiropractic profession has made enormous strides in consumer acceptance and understanding in the last several decades, we can see there is still progress to be made among the healthcare provider and employer communities,” said Sherry McAllister, DC, president, F4CP, who presented to the advisory board. “Fortunately, the report also shows that younger allopathic doctors are eager to add doctors of chiropractic to their worksite clinic teams and that sharing information about the successes our doctors have had in these clinics so far could be an effective way to help more employees access our care.”

Knowledge Gaps and Misperceptions

The employer and/or hospital knowledge gaps or misperceptions explored in the roundtable include:

• Chiropractors’ skill at treating or managing problems related to workplace designs, physical tasks and movements
• The level of DCs’ education, training and experience
• Lack of standardized process for integrating DCs into a clinical team
• The role of the DC in a clinical pathway when working alongside orthopedic MDs and physical therapists
• The clinical and financial ROI of adding a DC to a worksite clinic

The report and roundtable discussion also explored the limited experience institutions have with hospital credentialing for DCs, which is mandatory for delivering care and also necessary to allow access to medical records.

Share Knowledge

To overcome these knowledge obstacles, presenters during the roundtable event shared how adding chiropractic to worksite clinics can reduce absenteeism and increase employee retention. Utilization of chiropractic care can also result in lower utilization of more costly services while improving neuromusculoskeletal function.

For example, combining chiropractic care with standard medical care offers a significant advantage for decreasing pain and improving physical function compared with standard care alone for men and women aged 18 to 35 with acute low back pain. A study by Whedon et al. in Spine (2021) found that when comparing opioid analgesic therapy versus spinal manipulative therapy, harmful medication-related incidents occurred 42 times more often in patients who were first prescribed opioids as opposed to patients who first received spinal manipulative therapy.

The roundtable presenters shared how DCs must go through rigorous training and education to receive a doctor of chiropractic degree, including graduating from a four-year college with a preferred focus on health sciences and then passing written and oral board exams, at national and state levels.

Prioritize Benefit Advisors and Consultants

The NAWHC meeting summary notes that effectively disseminating knowledge about the efficacy and cost-savings of chiropractic care should involve consultants and brokers. These key stakeholders hold tremendous influence over employers on health benefit design and worksite clinic services and need to be a priority.

The report also advises that the chiropractic community should develop and distribute financial analyses to consultants and advisors on how chiropractic care positively impacts neuromusculoskeletal disorders and pain management services based on health plan/employer medical and pharmacy claims data.

“Every employer wants their employees to be healthy, safe and productive,” said Larry Boress, executive director, NAWHC. “We have seen first-hand how integrating chiropractic care into more of these clinics is helping everyone achieve these mutually beneficial goals. This report and roundtable event are important for helping the healthcare community as a whole understand how and why we need to make these integrations happen in more worksite clinics today.”

About Foundation for Chiropractic Progress
A not-for-profit organization with over 29,000 members, the Foundation for Chiropractic Progress (F4CP) informs and educates the general public about the value of chiropractic care delivered by doctors of chiropractic (DC) and its role in drug-free pain management. Visit www.f4cp.org/findadoctor; call 866-901-F4CP (3427).

About the National Association of Worksite Health Centers
The National Association of Worksite Health Centers (NAWHC) is the nation’s only non-profit organization focused on assisting public and private employers and their vendor partners in developing and getting the greatest return from their onsite, near-site, shared and virtual health centers, onsite pharmacies and wellness centers. NAWHC offers educational programs, networking opportunities, resources, benchmarking and support for those interested and involved with worksite clinics. NAWHC serves as a clearinghouse of information on worksite health centers and the marketplace, providing educational programs, resources, benchmarking surveys, and employer case studies. To learn more, visit www.nawhc.org.