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Finally…A Little Respect

© Dr. David L. Phillips

For what seems like generations, we in chiropractic have been trying to convince those who mold health insurance policies that our profession will save them money. After all, to the health insurance industry, money and the bottom line are what it's all about. Historically that industry has resisted including our services because they felt that we would become just another expensive "add-on". This meant that people would use their medical coverage as well as coming to us, therefore costing companies more.

Chiropractors have always maintained that, in fact, if more people came to see us, we could actually save the costs of more invasive and more costly medical procedures, especially in the area in which we are most gifted...lower back pain and most other musculoskeletal conditions. Now we have been vindicated.

A major study recently published in the Journal of Occupational and Environmental Medicine (2004;46:847-855) was the result of 4 years of research. The authors examined 1.4 million records of patients in California who had used the services of a managed care network of health insurance. All the cases studied were identified as having neuromusculoskeletal (NMS) complaints, which is the bailey wick of chiropractic. Of this large group, 175,000 were chiropractic patients, 332,000 were medical patients who also had insurance coverage for chiropractic care, and 888,000 were medical patients who had no chiropractic coverage.

What the researcher discovered is quite interesting. They said that their findings indicated that "patients use chiropractic care as a direct substitute for medical care". They went on to elaborate that "the addition of a chiropractic benefit would be that it is the equivalent of expanding the network of available providers for care of NMS conditions. Patients with back pain, neck pain, and related complaints can choose either chiropractic care or medical care, and this expanded choice does not seem to result in more patients seeking care."

In other words, giving people a choice does not cost more, and of those who had the choice, nearly ½ chose chiropractic care for their aches and pains. The study is very clear that including chiropractic care as an insured benefit does not increase the overall rates of complaints, nor does it cause a duplication of services. "Patients appear to be directly substituting chiropractic care for medical care," the authors wrote.

This is where we begin to run afoul to medicine. MD's really don't like to lose people to us, even if we can do a better job, safer and quicker than they can. It all comes down to dollars and cents. There's not a lot of altruism here. But the people who pay the bills will ultimately have the say. A few more studies like this one and perhaps more people will have better and freer choices as to where to take their physical troubles.

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