Working together benefits patients and the DC industry for chiropractors and MDs
HEALTH CARE SOMETIMES RECEIVES A BAD RAP for being difficult to navigate, slowed down by bureaucratic red tape and a frustrating referral system. But in integrated settings, where chiropractors and MDs work alongside other medical practitioners, those problems can disappear. Collaboration results not only in improved patient outcomes, but also growth for participating clinicians and stronger research efforts.
Better collaboration, better care
When a nurse practitioner approached Ross Mattox, DC, RMSK, for help with a patient who was experiencing severe back pain but refused an ambulance, Mattox’s team jumped into action. Mattox leads Logan University’s chiropractic clinic within CareSTL Health, an integrated, federally-qualified health center in St. Louis. After just a few minutes, the chiropractors found a directional preference, cutting her pain in half.
“Once the back pain was controlled, it became evident that the patient was also experiencing abdominal pain that had been masked by the more severe back pain. That generated an imaging order, which showed a ruptured ovarian cyst,” Mattox said.
The whole ordeal — back pain, chiropractic care, imaging and cyst diagnosis — took just an hour.
This is just one of countless patient success stories highlighting the benefits of integrated care. In general, patients with this type of care available benefit from the convenience of having many doctors under one roof with open lines of communication.
“What I love about integrated care is I can effectively manage low-back pain and if the patient has another problem, they can just walk down the hall to see another doctor,” said Patrick Battaglia, DC, DACBR, lead clinician at Logan University’s chiropractic clinic at Affinia Healthcare in St. Louis, where he works alongside primary care doctors, women’s health practitioners, physician’s assistants and nurse practitioners.
Integrated spine care
At Froedtert & The Medical College of Wisconsin’s (MCW) SpineCare Clinic in Milwaukee, Jeff King, DC, MS, works along-side a team of physiatrists, neurosurgeons, other chiropractors, pain psychologists and physical therapists to treat adults with back pain and other spinal issues. Patient care is their primary concern, and working together allows them to deliver the best treatment plan possible, King said.
“Patients can come to the SpineCare clinic and have all of the options they’re likely to need to manage spine pain in one place,” he noted. “If there’s something unique about a patient’s case, it’s easy for me to give my colleagues a heads-up. When patients know their doctors are talking to one another, it’s reassuring. Patients intuitively respond to that.”
For some conditions, such as chronic pain, working alongside MDs allows chiropractors to ensure their patients are receiving the entire spectrum of treatment needed.
“There is no single treatment for chronic pain, so it’s nice to have different providers under the same roof who are part of a team treating chronic pain with a multi-disciplinary approach,” Mattox said.
In addition to frontline patient care, chiropractors and MDs in integrated settings often work alongside one another on research studies to further improve patient care and outcomes. Battaglia is in the middle of conducting a study on opioids; one of the study’s investigators is Christopher Prater, MD, a faculty member at the Washington University School of Medicine in St. Louis. Likewise, King is in the midst of a chart review looking at the prevalence of cervical spine pain in mild traumatic brain injury and concussion patients presenting to a pediatric emergency department. His physiatry colleague has added valuable perspective, he said.
“She suggested a lot of things we should look at that we hadn’t considered that ultimately helped us create a stronger research project,” King said.
The ideal training ground
DC students who complete part of their training in an integrated setting reap many benefits. Battaglia believes training in an integrated environment should be mandatory. “The educational component that our setting provides for students is enormous,” he said. “It gives them a broad appreciation for health care and lets them know where they fit in within the health care system and the immense value they can add.”
Practicing in an integrated setting also teaches chiropractors how to operate within a patient team, which is becoming an increasingly crucial skill in the chiropractic field, said King, who established a preceptorship program at MCW last year.
“It’s important for DC students to get exposed to many other health care professionals because at the end of the day, everyone is trying to help patients,” he said. “Training in an integrated setting removes a lot of the stigma we may have about working with other types of providers or co-managing cases. Our goal with the preceptorship is to give students confidence in communicating with patients and other providers because ultimately, when the patient has multiple providers who are communicating and understand the patient’s goals, the patient benefits. We also wanted to expose our interns to a broader spectrum of spine-related problems. Being an academic medical center, we see plenty of common spine problems but also more complex conditions.”
Integrated settings may provide unique career opportunities as well. King, for example, was recently named the first-ever director of chiropractic at MCW’s SpineCare clinic. His new role was created partly in recognition of the large number of patients who come to the clinic wishing to see a chiropractor but remain with a large health system. As director of chiropractic, King leads chiropractic across SpineCare’s four clinic locations and weighs in on referral patterns and educational programs to enhance the role of chiropractic care at the institutional level, further enhancing the value of integrated care.
STEPHANIE ZEILENGA is a writer and public relations communicator specializing in health care, technology and trade. She is based in St. Louis and can be contacted at firstname.lastname@example.org or commongroundpr.com.