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U.S. health care continues move toward multidisciplinary medicine

Opportunities abound in light of recent health care changes and a shift towards multidisciplinary medicine for offering patients...

Opportunities abound in light of recent health care changes and a shift towards multidisciplinary medicine

MORE AND MORE DOCTORS OF CHIROPRACTIC ARE WORKING IN INTEGRATED OR MULTIDISCIPLINARY SETTINGS, and there’s good reason for that. This is the best time in history for DCs to be working closely with other medical disciplines to promote holistic, patient-centered, evidence-based primary care.

There are several reasons for this conclusion, but no matter how you look at it, changes to the health care landscape are increasing the demand for quality patient care that is affordable, effective and efficient.

DCs have an opportunity to be on the forefront of health care innovation. DCs are uniquely positioned to help address the growing opioid crisis, skyrocketing health care costs, generally poor allopathic management of musculoskeletal injuries, and the impact of chronic pain. DCs are also well-positioned to serve the growing segment of informed patients seeking effective alternatives to costly medical interventions.

Combating the opioid crisis

Chiropractic needs to be heavily involved in the war against the opioid epidemic. According to the Centers for Disease Control and Prevention, in 2017, 17,029 people died from overdosing on prescription opioids alone. That number skyrockets to 47,600 when you take into account all opioid-related deaths, including the use of illicit opioids. Research indicates the majority of illicit users first misused prescription opioids. Early integration of effective and appropriate chiropractic care could have potentially saved thousands of lives.

Most experts agree that improving prescribing practices and the way pain is treated is an effective avenue to help prevent misuse, addiction and overdose. At the same time, it’s critical that patients continue to receive legitimate access to effective pain management. Educating patients and collaborating with other medical professionals on effective utilization of chiropractic care is the right thing to do for patients, and an important part of addressing this national crisis.

Making health care affordable

The American health care system is the most expensive health care system in the world and spends more per capita on health care than all other countries. Skyrocketing health care costs have placed an enormous burden on society, which has led to legislation designed to both improve quality and lower costs. Health care systems will be required to create innovative delivery systems with a coordinated model that reduces costs while delivering high-quality care across a continuum of care.

The Patient Protection and Affordable Care Act (PPACA) encourages integrated health systems, providing incentives for physicians to form “Accountable Care Organizations.” In these groups, doctors can better coordinate patient care and improve quality, help prevent disease and illness, and reduce unnecessary hospital admissions.

Chronic pain affects more than 100 million people in the United States and leads to more than $635 billion per year in costs attributable to medical treatment and lost productivity. It is obvious musculoskeletal injuries are often poorly managed, and this lack of a clear path to pain resolution leaves patients frustrated, confused and suffering unnecessarily. Unfortunately, only about 10% of the public seeks care from chiropractors without a referral, leaving the other 90% to seek more expensive traditional avenues to manage pain.

However, as implementation of PPACA and the National Prevention Strategy moves health care from a system of sick care to one based on wellness and prevention, primary care providers will increasingly be called upon to provide treatment of chronic pain through coordinated care. This means medical providers are more open to collaborating with chiropractors than at any other time in history.

Making health care more effective

There is an obvious need in the United States to improve the evaluation and management of patients with chronic pain, and chiropractic services can be an integral part of the solution.

Ill-defined care pathways can lead to inappropriate service utilization, including unnecessary imaging. In fact, one major area of rising health care costs is the increased use of diagnostic testing to identify the cause of a patient’s symptoms, often in lieu of a careful clinical evaluation. New service models are being designed to better coordinate care for patients with musculoskeletal disorders along defined care pathways. Early clinical triage of musculoskeletal patients has demonstrated the ability to consistently improve patient outcomes and reduce health care costs.

In addition, non-physician-led triage systems have been shown to be effective in terms of diagnostic validity, treatment effectiveness, and health care provider and patient satisfaction.

DCs should be the point of entry for triaging musculoskeletal injuries within integrative health care settings, as they are experts in the diagnosis and treatment of these conditions.

The future is now

In today’s current landscape, patients are challenged to take more ownership of their own health care, especially with skyrocketing deductibles with most insurance coverage, resulting in a more informed consumer base. The opportunity for chiropractic in this challenging environment is greater than ever.

The growing understanding and popularity of alternative and complementary medicine, along with the high prevalence of musculoskeletal disorders in the United States and a new emphasis on pragmatic patient outcomes, are just a few of the reasons why chiropractic care is expected to thrive in the coming years.

The integration of chiropractic services into coordinated care organizations would complement the goal of health care reform: to provide affordable health care to all Americans.

If you haven’t considered incorporating a multidisciplinary approach with your patient care, you might be missing the boat. In today’s environment, innovation is the key to success. Don’t get left behind. 

JASON GARRETT, DC, is managing vice president of clinical development at Airrosti, an outcome-based provider group committed to helping patients achieve full, lasting recoveries. Learn more at

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