posted by Foundation for Chiropractic Progress
on May 26, 2020
Since healthcare began, doctors were in charge. Like Generals in the military, the doctors made the decisions and designed the care plan while the other clinicians and patients followed it. Over the course of the 20th Century, however, healthcare delivery became more specialized and complex than one doctor could manage on his or her own; hence, the introduction of multidisciplinary care teams. The doctor still served as the leader, but consulted with and relied on multiple other doctors, clinicians, as well as patients, to design an optimal care plan.
Although healthcare had been team-oriented for much longer, the policy activity surrounding team-based care can be traced to at least the late 1990s with the Institute for Healthcare Improvement’s Chronic Care Model.1 Since then, care teams have continued to diversify to include other healthcare disciplines that were not typically included even in the 1990s, such as chiropractic.
Enter the opioid crisis.2 The epidemic of Americans misusing and abusing opioids in the United States has sent shockwaves across the healthcare industry. Doctors, government officials, public health leaders and other stakeholders sought new ways to stem the crisis starting at its source: prescriptions. By changing doctors’ prescribing habits, it was hoped fewer Americans would become dependent or addicted to prescription opioids, which would prevent them from seeking more potent and less expensive opioids, such as heroin.
The more these stakeholders studied the issue, the more they found that doctors of chiropractic (DCs) had a lengthy evidence-based history of managing acute, subacute and chronic pain without pharmaceutical interventions. Patients often prefer less invasive, more holistic options than drugs or surgery, which aligns with the Bulletin of the World Health Organization’s article highlighting that after educating patients about low back pain and urging them to remain active, the second-step care options generally include: therapies such as spinal manipulation, most often performed by a DC, as well as massage and exercise.3
In this context, a growing number of DCs are being included in collaborative, multidisciplinary care teams to help curb opioid prescriptions, but also to help patients achieve greater sustained pain relief and mobility. As recent research has shown, the involvement of DCs is having a profound effect on outcomes, as well as patient satisfaction. This white paper details recent cost and outcomes research and insight into how DCs, medical doctors and healthcare organizations can integrate on care teams.