Wednesday, December 31, 2014

Chiropractors as Primary Spine Specialists

By Dr. Brandon Manson
For Columbia-Greene Media

Spine related disorders (SRDs) are one of the most common and costly health problems in society, affecting almost every person at some point in life. These disorders encompass a group of conditions directly related to the spine: back pain, neck pain, many types of headache, radiculopathy or referred pain, and a variety of other symptoms.
Recent statistics indicate the cost to the United States health system is huge, and growing. Well over $100 billion is spent annually on SRDs. Yet despite the fact that between 1997 and 2005 expenditures for back and neck pain alone rose by 65 percent (inflation adjusted), patients with SRDs are now worse off than ever. In fact, measures of physical functioning, work productivity, school and social activity, and mental health among patients with SRDs all declined during the same period. Clearly, the dramatic increase in health care costs for diagnosis and medical treatment of SRDs has failed to improve the health of patients. Instead, chronicity and disability related to these disorders continues to steadily rise.
So, you might be saying, “This is just another example of the health system not working… what’s new?” Because spine related disorders account for a significant drain to our health system, it would make sense for policy makers to look at ways that these disorders can be better managed.

In the late 1990s this is exactly what a group of health economists from the University of Ottawa did. They were commissioned by the Ontario government to examine ways to reduce the financial costs of SRDs to the province’s health system. The researchers reviewed every study, every trial, every government inquiry and every scrap of evidence done to date related to treatment of back and neck associated disorders.

What these researchers found was profound: by transferring the care of back pain alone from medical doctors to chiropractors, the government health system would be able to save an estimated 12 percent of its annual health budget annually. The savings could be significantly higher if care of other spine related conditions, such as neck pain and various forms of headache, were also transferred to chiropractic doctors. The researchers showed that the benefit would be not only financial. They concluded that chiropractic care for these conditions was not only significantly more cost effective than medical care, it was more effective (better outcomes) and safer. Numerous studies on patient satisfaction have underlined this conclusion: patients are about three times more satisfied with chiropractic care for back pain than medical care.

Clearly, the time has come for a major change in our management of spine related disorders. It is time for policy makers to get serious about this crippling problem and begin to do what is best for patients and the health system: take steps to establish chiropractic doctors as “primary spine care specialists”.

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