Chiropractic in the News Chiropractic Research

CHIROPRACTIC PUTTING HEALTH AND CARE BACK INTO HEALTHCARE Part 1/3

The Chiropractic profession is poised to help millions suffering from spinal disorders that will save the healthcare system millions of pounds by avoiding the use of opioid drugs, MRI scans1, expensive hospital stays, and ineffective and over-utilised spinal surgery based on a disproved disc theory2.

The current Healthcare crisis is one of a Self-Care crisis. It is not that we lack the understanding of an acute care model of traumas and surgeries etc, it is that we have not taken a greater responsibility for what we can do to educate ourselves to activate the body’s best version of itself through self-education, responsibility and choice.

There are challenging times ahead for the government with the financial burden on the NHS increasing. The new focus of the NHS is on value, especially new, valuable procedures that are shown to be better value than current, out-of-date forms of treatment.

How Chiropractic can SAVE the Government Money

The Health Care system must find ways to slow the rate of spending whilst still delivering quality healthcare. The Chiropractic profession is poised to help millions suffering from spinal disorders that will save the healthcare system millions of pounds by avoiding the use of opioid drugs, MRI scans1, expensive hospital stays, and ineffective and over-utilised spinal surgery based on a disproved disc theory2.

Low back pain is one of the most common causes of disability among people of working age and its impact on industry is enormous. It is estimated that four out of five adults (80%) will experience back pain at some point in their lives3 and that 10% of sufferers have visited a practitioner of complimentary medicine4.The Chartered Institute of Personal Development reported that absenteeism costs UK companies £673 per employee per year. Musculoskeletal Injuries, Back pain and stress appear in the top 5 most common causes for short and long-term absence and are key contributors to this cost5.

The positive impact that Chiropractic can have on the Health Care of the UK can be most readily equated to the reduced burden on an ever-increasingly stretched NHS. When used as Primary Healthcare Providers, Chiropractors can help to:

  • Reduce hospital admissions
  • Reduce days spent in hospitals
  • Reduce outpatient procedures, and
  • Reduce pharmaceutical costs

The results of a seven year clinical and cost utilisation study in Illinois demonstrated decreases of 60.2% in hospital admissions, 59.0% less hospital days, 62.0% less outpatient surgeries and procedures and 85% less pharmaceutical costs when compared with conventional medicine IPA 6 performance for the same health maintenance organisation product in the same geography and time frame. The inclusion of evidence-based healthcare approaches such as Chiropractic care within emerging value-based health plans represents a significant advancement in cost and clinical effectiveness. Recent research documented in “A Hospital- Based Standardized Spine Care Pathway: report of a Multidisciplinary, Evidence-Based process”7 confirms this perspective.

According to the study, those 402 low back pain patients treated exclusively by Chiropractors at the low back pain program implemented at Jordan Hospital, Plymouth, Massachusetts achieved successful clinical outcomes in an average of 5.2 visits at the low cost of $302 (£193) per case, whilst maintaining satisfaction rates above 95%. In addition, self-reported pain and disability scores were reduced by about 70% over the course of a few weeks.

These studies show the enormous power and benefits of 2 things:

  1. The utilization of Chiropractic in a primary care setting; and
    2. The magnitude of successful outcomes, both clinical and cost, that can be achieved when all members of the health sciences work together as a team for the betterment of the patient putting aside all professional rivalries.

With the recent publication of the Mercer Report8, published in peer-reviewed literature in October 2009, Chiropractic’s reputation as being a cost-effective modality has been further enhanced. Prepared by two distinguished medical researchers using EU figures and extrapolated to USA utilisation of Chiropractic care their findings were:

  1. Chiropractic care is widely used with almost half of all patients with persistent back pain seeking out this form of treatment
  2. Chiropractic care ‘for low back & neck pain is highly cost effective, represents a good value in comparison to medical physician care and to widely accepted cost effectiveness thresholds
  3. Chiropractic care & health insurance coverage… “we project that insurance coverage for chiropractic physician care… is likely to drive improved cost effectiveness of US care”

 

Put simply, Chiropractic care is hugely successful and provides great value.

 

Utilisation of Chiropractic and the NHS

Currently access to Chiropractic care is not readily available through the NHS and is dependant on localised NHS Trust agreements and GP-gated restrictions. This obviously leads to under-utilisation of Chiropractic and a greater cost to the NHS. The provisions for Chiropractors to gain Any Qualified Provider status (AQP) may improve this however they are tailored to a managed care environment.

The best model for the provision of Chiropractic service to NHS patients would be one of independent assessment and self- referral, much like that which currently exists between a patient and their registered GP. Using this model the patient can either self-refer for assessment by their Chiropractor or their GP can refer them for care. This would result in quicker resolutions and better clinical outcomes for the patient and a reduced cost of care (i.e. better value) for the NHS. The Chiropractor would therefore be working in co-operation with the NHS and the G.P in particular.

As primary healthcare practitioners, Chiropractors are well placed to assess the patient as a first port of call, place them in the appropriate care pathway and maintain an overview of the full clinical process. Referral to other healthcare professionals when necessary is commonplace to enhance the overall outcome. The best model of care is one that is patient-centred and where the individual choices of the patient are paramount. It is in this way that Chiropractors can be a major part of the healthcare team and both provide better value and better clinical outcomes for all.

“The doctor of the future will give no medicine but will interest her or his patients in the care of the human frame in a proper diet, and in the cause and prevention of disease”

– Thomas A Edison

 

“Chiropractors also place an emphasis on nutrition, exercise, wellness and healthy lifestyle modifications which, when correctly applied, will improve the health of individuals”.

Whilst it is easy to read these words and understand them, the reality is that the modern health care system, which has evolved over the last century does not reflect this sentiment. The modern approach to health care has become highly expensive and technologically based, focusing mainly on diagnosing disease and treating it rather than exploring the true meaning of health and how it can be achieved and then maintained. Modern socialised health care has actually turned into a sickness care industry because you have to be sick in order to qualify for care.

Health is achieved through striving towards a healthy lifestyle. The future health of the nation can be fulfilled by creating a health care system that provides education and example, and by dismantling the established sickness care system and its costly palliative approach. Chiropractic can help to put Health and Care back into Healthcare.

 

References:

1M Brandt, Stamford University Medical Centre, “MRI Abundance May Lead to Execess In Back Surgery” (Oct 14, 2009)
JD Baras and LC Baker, “Magnetic Resonance Imaging and low Back Pain Care for Medicare Patients” Health Aff (Millwood) 28/6(2009):1133-40 2MC Jensen, MN Brant-Zawadzki, N Obuchowski, MT Modic, D Malkasian, JS Ross, “Magnetic Resonance Imaging Of The Lumbar Spine In People Without Back Pain,” N Engl J Med. 331 (1994):69–73
RA Deyo and DL Patrick, Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises (2002):191.
3Palmer KT, Walsh K, et a. Back Pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000
4Dept of Health Stats Div. The prevalence of back pain in Great Britain in 1998. London: Government Statistical Service, 1999

5CIPD Absence management report 2011.
6Journal of Manipulative and Physiological Therapeutics (JMPT) 2007 Vol 30 Issue 4: Clinical Utlization and Cost Outcomes from an Integrative Medicine Independent Physician Association
7Journal of Manipulative and Physiological Therapeutics (JMPT) 2011 Feb;34 (2) – 98 -106: A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process
8Choudrey N, Milstein A, – 2009 Mercer Report: Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans?

9 Jouranl of Manipulative & Physiological Therapeutics 1197, 20(4):235-240 “The Chiropractic Outcome Study: pain, functional ability & satisfaction with care”
10 The Rand Study

Original article was put together by the Alliance of UK Chiropractors and can be found on the UCA website: https://www.united-chiropractic.org/

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