Chiropractors as primary care provider on the increase

More patients are choosing a chiropractor as their primary care provider to find non-opioid pain relief before seeing a traditional MD

As the shortage of MDs increases, so does the number of chiropractors who are serving as primary care providers.

Bruce Godfrey, DC, of Godfrey Chiropractic, PC, in Omaha, Neb., says that DCs can be primary caregivers, mainly within spinal care.

Can a DC act as a primary care provider for the whole person and all ailments?

In my opinion, chiropractors can serve as primary care providers in that we can triage patients between conservative care and medical care, mainly in the area of spine pain. Spine pain is the leading cause of disability in the U.S. and is among the top reasons people seek medical care, accounting for billions of dollars in direct costs and lost productivity (See here for more information).

Chiropractors can likely help 75-80% of those patients achieve pain relief. If we can divert pain patients out of the medical systems and emergency rooms, that would ease the pressure on those systems.

I focus on spine pain, but we can also do a general screening exam including taking vitals (temperature, pulse, etc.). This helps us recommend medical care for potential infection. We can also perform in-office physical examinations such as orthopedic and neurologic tests to rule-in or out the need for surgical consultations.

Do you think that a lot of patients don’t realize that they can see their DC as their primary care provider?

I have been in practice since 1998. During the past 22 years, more and more evidence has been published confirming what chiropractors have been saying for decades about our ability to affect the overall function of the body.

More and more evidence has emerged showing that the function of the spine affects the function of the central nervous system, which in turn controls the function of the rest of the body. Thus, chiropractic care can potentially aid in the function of non-spinal systems such as digestive and immune. 

Due to the increasing evidence of the effectiveness and safety of chiropractic care, documents such as the Joint Commission statement on pain management have been issued. When chiropractic care is included in government programs like Medicare, Medicaid, COVID-19 care and the VA, and is offered in military base clinics, its credibility rises. When the ACA listed chiropractic as an “essential service,” making it a part of every ACA insurance plan, more people gained access to our care. 

The recent focus on the opioid epidemic has increased awareness in the medical community of non-drug alternatives to managing pain. I’ve seen an increase in the number of people telling me their ER doctor or PCP has recommended chiropractic for treatment of pain, especially after injuries like falls and car accidents.

I’ve seen the acceptance of chiropractic rising steadily for the above reasons. We have also been held to the same high standards as MDs under HIPAA and other government guidelines, so our practice standards have improved. I think there has also been a general trend toward CAM therapies and holistic wellness. More people are practicing yoga, getting massage, seeing acupuncturists, taking an interest in improving their diet, and taking nutritional supplements. Chiropractic care is included in that trend, I think.

What can DCs not do as primary caregivers?

Under Nebraska law, chiropractors are obligated to establish a diagnosis and treatment plan for whatever ailment the patient presents. So our primary job is to triage patients into those we can help, those we can’t help, and those needing co-management with other providers. It is incumbent upon us to properly manage each case. This means we need to make outside referrals to other primary care provider when necessary.

My scope of practice does not include treating conditions like cancer, fracture, acute infection, diabetes, rheumatoid arthritis, or heart disease, for example.  However, our care can serve as a supplement in such cases due to its holistic nature.