Your Chiropractor as Your Primary Care Physician
In terms of outcome and costs, it's a smart choice
I've long felt that my chiropractor was the logical choice for my Primary Care Physician.
- When I was nearly dead, yet medical professionals couldn't find anything wrong with me, it was my chiropractor who not only diagnosed the problem, but offered me effective treatment.
- Similarly, a few years ago, Linda (my wife) was sick. She felt generally yucky, and was coming home from work and vomiting almost every night. When it became obvious that this wasn't just a bug or food poisoning, we got her in to see our medical doctor. Repeated visits proved worthless. He ran several very expensive tests, but couldn't find anything wrong. Our chiropractor diagnosed her in less than three minutes, and provided treatment that was 100% effective. (It was a systemic fungal overgrowth.)
Those are just two of possibly hundreds of instances where our chiropractor served well as our Primary Care Physician (PCP). Though we've kidded back and forth with him about his role, compared to that of a real doctor, there is no question that he is — in our hearts and minds — our Primary Care Physician.
New studies to support the role of chiropractors as PCPs
A new study of Managed Care (HMO) demonstrated that those that use chiropractors as Primary Care Physicians (PCPs) had improved patient outcomes, and achieved this at substantially lower costs.
New research, published in the Journal of Manipulative and Physiological Therapeutics (JMPT), has found that a managed care network consisting of chiropractors as Primary Care Providers (PCPs) provided equivalent care, and saved substantial costs, compared to patient management utilizing medical doctors and osteopaths.
Editor's note: While this study views the 6.9% disagreement in diagnosis as an indication that chiropractors are not quite as able to diagnose a patient's problem as a conventional medical specialist, my experience would lead me to accept the chiropractic, instead of the medical view, in most of these instances.
This study found that patient diagnoses by chiropractors as PCPs were in agreement with conventional medical specialist 93.1% of the time. In other words, a properly credentialed chiropractor could diagnose conditions almost as well as medical doctors, including conditions that are outside the normal scope of the conventional chiropractic setting.
This study also compared patient outcomes of those enrolled in the Alternative Medicine Inc. (AMI) network versus those in the traditional HMO setting. From 1999-2000, they found that:
- there were significantly fewer hospital admissions among patients seeing a chiropractic PCP,
- there were fewer outpatient surgeries, and
- the cost associated with pharmaceutical usage among chiropractic PCP patients was approximately half that seen in traditional HMO patients.
These findings demonstrated the chiropractic network's "apparent superior clinical outcomes", compared to conventional managed care statistics over the same time period.
One of the most dramatic differences between patients in the chiropractic network and those in other HMOs was in terms of hospital stays.
- In 2000, chiropractic patients spent 115 days in the hospital for every 1,000 "member months" they were enrolled in the network.
- For patients of medical/osteopathic PCPs, the number of hospital days per 1,000 member months ranged from 171 to 344 days.
Outcome studies are showing that the conventional drug/surgical model of disease care as the primary, first method to be used has a lot of disadvantages. Cost is just one of them.
"Tiering": the new model for healthcare payments
The new word in managed care is "Tiering", a grading of your outcomes, and then paying you accordingly.
"In the state of Washington, health plans have started tiered networks for primary care physicians. This tiering is based on clinical outcomes, most notably efficacy. In this brave new world, all doctors are going to be profiled for, not only their costs, but also their clinical outcomes. Their skill, art and science will be monitored through patient outcomes.
"Tiering based on clinical outcomes appears to be here to stay, at least for the near future."
Quoted from an article by
- Reiner Kremer, DC, DABCI, FAACP
Chairman, American Academy of Chiropractic Physicians Franktown, Colorado, - James Winterstein, DC, DABCR, FAACP (Hon)
President, National University of Health Sciences Lombard, Illinois, and - Reed Phillips, DC, PhD
President, Southern California University of Health Sciences Whittier, California.
The conclusion of this research was that "Reliance on the conventional medical model, in which pharmaceuticals and surgical interventions represent first-line treatment, may not provide the best therapeutic index to our patients." The study's authors added that a chiropractic gatekeeper (PCP) model of managed care "seems to demonstrate the potential superiority of an integrated healthcare system in which chiropractic and Complementary and Alternative Medicine (CAM) therapies play a significant, primary care role."
Chiropractic for preventative care
In this study, the chiropractors participating in the Independent Practice Association (IPA) had a higher number of initial patient visits than did conventional medical practitioners. These visits were scheduled specifically for the correction structural abnormalities in patients (chiropractic adjustments); but, during these visits, chiropractors also provided information on lifestyle and diet modifications that would help to prevent more serious diseases from occurring in the future.
In many instances, Alternative Medicine Inc.(AMI) a part of the HMO, enrollees saw their chiropractors an average of twice per month, sometimes more. This was in stark contrast to the conventional medical Independent Practice physicians in the system, who saw the majority of their patients on a "crisis-only" basis.
This means that, in terms of patient care and the prevention of disease, chiropractics as the Primary Care Physician standard offers significant advantages over the now-standard model. And this doesn't begin to factor in the serious dangers posed by standard medical practice.
(Source: Dynamic Chiropractic, September 1, 2004, Volume 22, Issue 18.)
