WASHINGTON--A critical mass of recent surveys and studies document the
fact that the public, and conventional health care providers and payers,
have come to recognize that traditional medicine can't answer all of
consumers' health care needs. In particular, more people are turning to
chiropractic services. A study published in the July 1, 1998 issue of
the Annals of Internal Medicine shows that chiropractic treatment is
appropriate for low-back pain in a considerable number of cases. This
study by the Rand Corporation found that 46 percent of a sample of
low-back pain patients received appropriate care from doctors of
chiropractic - an appropriateness rating similar to that of common
medical procedures. Poll results released in January 1998 by Landmark
Healthcare, Inc., showed that one in every five adults ages 55 to 64 has
used chiropractic care. A December 1997 report from the Federal Agency
for Health Policy and Research (AHCPR) notes that the chiropractic
profession is now the third largest group of doctoral-level providers in
the United States (after medical doctors and dentists). That same AHCPR
report shows that fully 80 percent of American workers in conventional
insurance plans, preferred providers organizations (PPOs), and
point-of-service plans now have coverage that pays at least part of the
cost of chiropractic care. As the recent AHCPR report states, "In the
areas of training, practice and research, chiropractic has emerged from
the periphery of the health care system and is playing an increasingly
important role in discussions of health care policy." And, notes a March
1998 article in Business and Health magazine, "Many companies say
chiropractic coverage has lowered their medical and workers' comp costs,
while raising overall health and productivity. 'It's one of the best
benefits possible from a quality, quantity and pricing perspective,'
says George McGregor, president of [a firm that is a third-party
administrator]." The article also cites an Oregon study, which found
that median work time lost for employees with back injuries who used
chiropractic care was only 9 days as compared with 34.5 days for workers
who used medical care. Quick relief of symptoms and sustained
effectiveness have long attracted consumers to chiropractic care. In
fact, in just one year -- 1997 -- more than 20 million adults used
chiropractic services. The 1994 AHCPR guidelines for low-back pain
concluded that spinal manipulation, chiropractic's primary treatment
technique, is one of only three treatments whose effectiveness is
substantiated by rigorous research. According to a 1992 RAND Corp.
study, patients see a chiropractor primarily for low back pain and neck
pain, though many seek chiropractic care for mid-back pain, extremity
problems, headaches and other symptoms as well. Because back pain is so
pervasive in our society, a recent study published in the British
Medical Journal pointing out that back pain doesn't go away that easily
confirmed what chiropractors have always known. Only 25 percent of low
back pain sufferers had fully recovered 12 months after their first
visit to a general practitioner, the study said. This low number is in
conflict with the commonly-held notion that low back pain episodes go
away by themselves after a month. "This hardly comes as a surprise to
low back pain sufferers who have been told by their medical doctors not
to worry - the pain will go away on its own," said Dr. Michael Pedigo,
president of the American Chiropractic Association. "In many cases,
further treatment is necessary." Doctors of chiropractic have long
understood the cyclic nature of low back pain, and perhaps this is one
of the reasons they consistently rate higher than MDs in patient
satisfaction in this area. In a recent Gallup poll, 90 percent of all
people who visited a chiropractor agreed that their care was effective.
Successful outcomes in both effectiveness and patient satisfaction, have
paved the way for chiropractors to enter the mainstream of health care
services. Some have even begun to collaborate with medical doctors in
integrated health care practices. As reported in the May/June 1998 issue
of Health magazine, the prestigious Texas Back Institute (TBI) at one
time included only surgeons and other M.D.s. Then, about ten years ago,
when TBI's medical doctors discovered chiropractic's success with lower
back pain, they hired their first chiropractor. Now, according to one
administrator quoted in the article, about 50 percent of the Institute's
patients see a chiropractor first when beginning their treatment. Also,
the Washington Post recently reported on the success of the 5-year-old
company, American WholeHealth, whose clinics incorporate a
consumer-driven mix of traditional medical and alternative health care
including chiropractic. Due to years of criticism -- and even an illegal
boycott by the American Medical Association -- chiropractic training
was sometimes called into question. However, the fact remains,
chiropractors must complete a minimum of 6 and, on average, 7 years of
college and post-graduate study to earn their degrees. Their education
includes at least 4,200 hours of classroom, laboratory and clinical
experience, and as much -- and sometimes more than -- course work in
anatomy and physiology as most medical doctors. After they receive their
degrees from one of the nation's 17 accredited chiropractic colleges,
they have to pass rigorous exams and be licensed by the state before
they can open a practice. The practice of chiropractic is licensed in
all 50 states, and in 1994 there were approximately 50,000 chiropractors
licensed in the United States. This number is expected to double by the
year 2010, according to the 1997 AHCPR report. "These recent surveys
and reports finally vindicate the chiropractic profession after years of
enduring doubt, questions and criticism about our training and
practices," said Dr. Pedigo. "What the health care and medical
communities are just beginning to accept is what our patients have known
all along -- that our treatment is safe, effective and highly
successful at improving their quality of life."
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