Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Kosloff, Thomas M.; Elton, Dave; Shulman, Stephanie A.; Clarke, Janice L.; Skoufalos, Alexis; Ms, Amanda Solis

doi:10.1089/pop.2012.0096

Cited by 37 publications

(27 citation statements)

References 38 publications

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“…Although some chiropractors complain that only a small number of people use chiropractic services, these data suggest otherwise. Patients with low back pain chose to see a chiropractor as their first contact provider in numbers that almost equaled those who chose to see a PCP as their first contact provider 19 . These data provide compelling evidence that the general public views the chiropractor as the “go to” health care provider for low back pain and also support a spine care identity for the chiropractic profession.…”

Section: Discussionmentioning

confidence: 82%

“…Claims data from United Health Care, the largest insurance company in the United States, reveal that 40% of patients with an acute episode of low back pain choose to see a chiropractor as their first contact provider 19 . Compare this with the 38% of patients who choose to see PCPs and the less than 8% who choose to see a physical therapist.…”

Section: Discussionmentioning

confidence: 99%

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Spine Care as a Framework for the Chiropractic Identity

Schneider

Murphy

Hartvigsen

2016

Journal of Chiropractic Humanities

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ObjectiveThe purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system.DiscussionSurveys of the general public and chiropractors indicate that the majority of patients seek chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic scope of practice as based on a foundation of spine care. Educational accrediting and testing organizations have been shaped around a chiropractic education that produces graduates who focus on the diagnosis and treatment of spine and musculoskeletal disorders. Spine care is thus the common denominator and theme throughout all aspects of chiropractic practice, legislation, and education globally.ConclusionAlthough the chiropractic profession may debate internally about its professional identity, the chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Spine Care as a Framework for the Chiropractic Identity

Schneider

Murphy

Hartvigsen

2016

Journal of Chiropractic Humanities

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“…Some evidence suggests that chiropractic care provides cost savings 15 and has been found to reduce the use of opioids and lower odds of developing long-term disability in workman’s compensation patients 16, 17. At least for lower back complaints, doctors of chiropractic (DCs) are increasingly being the first provider consulted 18 . Indeed, as noted by the Government of Canada in 2015, 19 the overall prospects for the profession are promising.…”

Section: Progress In Cultural Authoritymentioning

confidence: 99%

“…This is a living process that evolves with the maturation of the abstract knowledge base and society’s values. Three standards are expected for legitimacy that is accorded by extension to a practitioner18, 36, 37:His or her knowledge and competence have been validated by a community (ie, the collective profession).His or her knowledge and competence are based on rational, scientific grounds.His or her judgment and advice are altruistic and oriented toward a set of substantive values that society upholds, such as health 3, 35…”

Section: Norms Of Professional Identity and Organizational Legitimacymentioning

confidence: 99%

Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services

Triano

McGregor

2016

Journal of Chiropractic Humanities

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ObjectiveThe use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action.DiscussionThis is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors’ cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care.ConclusionThe practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.

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“…По данным анализа обращаемо-сти в США, 40% пациентов с болью в спине обращаются к мануальным терапевтам, 34% -к врачам общей практики, 8% -к ортопедам и спортивным врачам, 3% -к невроло-гам, 4% -к врачам неотложной помощи, физиотерапевтам, 1% -в мультидисциплинарные центры [2]. В идеале все эти специалисты должны ориентироваться на самые современ-ные научные данные, чтобы свести к минимуму примене-ние неэффективных, излишне дорогих и даже вредных про-цедур.…”

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