The industry needs to shore itself up on several fronts to enter the mainstream and make wellness chiropractic the norm
As an alternative to traditional medicine, an increasing number of people are seeking care centered around wellness chiropractic as well as spinal-related complaints.
Chiropractic wellness care can foster lasting value through improved bodily function, a welcome change from drugs, surgery, basic biometric screening and late intervention offered by allopathic counterparts. Standard medical recommendations for back pain, such as bed rest and medication, have been shown to be ineffective. Incorporating chiropractic care and other conservative options allows for improved outcomes that last.1
Growing public awareness and compelling research are creating multiple opportunities in the health care marketplace for doctors of chiropractic.
A bigger pond to fish in
Governing agencies and insurance companies are helping to create a larger marketplace for chiropractors in the field of pain management. Data collected by large health systems across the United States confirm the benefits of a natural approach compared to drugs and surgery. Research presented by the American Academy of Pain Medicine suggests that chiropractors can play an important role combating the opioid epidemic in America, and one recent study found a 50% reduction in filled opioid prescriptions for patients who utilized chiropractic services for pain management.2
This echoes many previous studies, which show how utilizing chiropractors as primary care providers reduces the likelihood of undergoing spinal surgery and incurring additional health care costs.3-4
Becoming the leading force
From a wellness chiropractic standpoint, the understated power of the body to heal itself and the lack of long-term outcomes noted with allopathic interventions is the strength of chiropractic.5 A greater role of non-invasive care for chiropractors will allow for patients to avoid devastating outcomes associated with medicine and spinal surgery.
Chiropractic should be a leading force for non-surgical and drug-free approaches. The profession is poised to fill this niche through both traditional manual treatment and utilizing state-of-the-art equipment. Optimizing each individual practice for excellence might mean updating equipment, adding a new technique, or utilizing advanced therapies. Reading trade magazines or attending conventions can assist doctors in determining which protocol or device could be the best fit for his or her practice.
Every doctor of chiropractic should be open to adopting new technologies and techniques to provide better measurable outcomes and proven results. Providing a better way for our communities begins with excellent care through great results and building relationships.
Technology will lead the way
Great strides are already being made in chiropractic to provide the best outcomes with repeatable treatment protocols. Many clinics are now adopting and utilizing app-based software or smart devices.
This disruptive technology, applied with adjusting or traditional manual care, allows for treatment to become more potent and efficient.6 Enhanced technology also shapes our knowledge and understanding of the conditions commonly treated in practice. Advanced imaging provides clarity for soft tissue evaluation; detecting spondylolysis before displacement, improved understanding of tendinopathy and arthropathy, and visualization of disc bulging or herniation. Neurological evaluation is also boosted through ever-advancing imaging techniques and evaluation.
As health care technology continues to advance, chiropractors should also be adapting clinical practice to keep pace.
Barriers to advancement
Despite the advancement seen in the chiropractic profession, there are still barriers that limit practice to the fullest. The most common barrier is misconceptions. Often due to a lack of education, many patients perceive chiropractors as the doctor who “cracks bones back into place.”
Furthermore, we are sometimes labeled as quasi-scientific, unessential, expensive or outright scammers despite little basis for these accusations. As a profession, doctors of chiropractic should avoid making concessions in patient education that support these views or devalue our services. It is our job as providers to tell both existing and new patients the benefits of treatment.
Whether improved bodily function, reduction in frequency and severity of a symptom, or better health, there should be an aim or goal to care. These objectives should be reviewed every few visits. This may be accomplished with outcome assessments. Regular re-evaluations will create an opportunity to reiterate the progression of care in wellness chiropractic.
The outcome of care should be focused on the measurable rather than the nebulous results. This creates a purpose behind care, and effort should be made in separating visits with purpose from a redundant appointment without a clear intention. Doctors and patients both benefit from this consistency in communication and goal-setting.
The reimbursement barrier
Another source of compromise common to practice surrounds reimbursement. Third-party payers, such as governmental agencies or insurances, limit chiropractic care. This is done through the number of allowed visits, high out-of-pocket costs, and low per diem rates. Fee schedules also limit access to the full chiropractic scope of practice, barring some services from reimbursement altogether.
Chiropractic organizations work against these policies on a large scale, but that doesn’t exclude providers and case managers from discussing these topics in-office with patients. Regrettably, some doctors over-exaggerate the extent of an injury to attain active status for the sole sake of reimbursement. Interventions may also be intentionally prescribed based on the allowed visits rather than objective measures.
Some providers may write off fees that should be charged to induce additional visits. This creates distrust and can bring the entire profession down. Trying to game the reimbursement system is a losing battle. The validity and value of treatment is not determined by the patient, insurance company or even Medicare policy. Value and the care plan are determined by the clinician.
Communication remains the key
Regardless of technique or practice style, patient communication must be dynamic and evolving. Avoid the pitfall of “simple” analogies to describe chiropractic care. For example, many chiropractors compare their care with dentistry. There are similarities on a surface level. Unfortunately, a patient can misinterpret this to mean a visit to the chiropractor is only necessary one or two times per year to optimize their health.
A common correlation that should change surrounds the intervertebral disc. Is the disc really like a jelly donut? That equivalence sounds silly. If it really is like a donut, why can’t we get a new donut full of jelly just like at the donut shop? Disc physiology, as well as pathology, is far more complex.
Comparisons to everyday life are useful to explain ideas such as misalignment, spinal maintenance and other complex disorders of human physiology. Instead of relying on the same few analogies, challenge patients to reassess their views on health care. Many patients are misinformed. After all, a majority of people accept the concept that putting an addictive chemical in their body to relieve pain, for example, is a good idea.
Follow-up management and wellness chiropractic care
Advancements in technology and practice, with improved clinical research, allow for care to be cutting-edge. Symptoms are often not homogenous in etiology, and patients are more than a label or diagnosis.
Most individuals seeking chiropractic care will require management rather than a singular intervention. Working together with you, patients who are informed, committed to their care plan, and want to avoid the dangers of drugs and surgery are those wellness chiropractic care serves best.
Follow-up management will build better long-term relationships between the patient and the provider for a lasting outcome that will foster further referrals and improved practice image. This will serve the profession well for 2020 and in the future.
RYAN M. BURKHART, BS, DC, is committed to delivering innovative health care solutions to maximizing patient quality of life through chiropractic care. He is accomplishing this mission through the integration of the latest technologies and rehabilitation protocols into his family practice, Burkhart & Chapp Chiropractic PLC. He graduated Summa Cum Laude from Sherman College of Chiropractic and is a member of the Michigan Association of Chiropractors. He can be contacted through burkhartchappchiropractic.com.
TIMOTHY J. BURKHART, DC, BCIM, has successfully treated thousands of patients with acute to chronic neck and back pain since 1984. He is an authority on the integration of NSSD into clinical practice. He is a member of the ACA and MAC, and serves on the Davenport University Health Professionals Advisory Board. He also developed the Hill DT Solutions certification program. He can be contacted through hilldtsolutions.com.
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