Chiropractors and the Primary Care Debate Under New Health Care Legislation

Since the late 1960s, the chiropractic industry has been debating the definition of primary care and whether chiropractors can fulfill that definition. In the January and February 2012 issues of the industry’s publication, ACA News, the American Chiropractic Association reviews the history of its industry on this point.
The article notes, “In primary care, the physician is expected to treat end-organ dysfunction to a certain level before referring to a specialist and then to manage a chronic condition referred back from the specialist (once a treatment plan is agreed upon), and important to this model is the expectation of the physician to manage medications. Can our profession fulfill these expectations with what the health care industry and medical community consider to be truly primary care?”
The association says conservative primary care physicians can take the burden from traditional primary care physicians in spinal pain, sports injuries, common sprains/strains and headaches related to structural faults, and can encourage lifestyle changes for tobacco
use and alcohol and drug abuse among other chronic diseases.
In making a case for a place for chiropractors in conservative primary care the ACA says they must do the following four things:
1. Strive to integrate into the nation’s health care system.
2. Participate in the emerging multi-physician primary care approach.
3. Continue educational growth.
4. Encourage colleges to allow students and doctors to have greater exposure to primary care patients in integrated settings.
The industry must address wellness and preventive medicine without prescriptive rights, according to the ACA. “It becomes clear that we currently treat patients with primary care issues that are not being fully addressed, and that we are naturally positioned to fill in the treatment gap,” writes the ACA news.
The article suggests chiropractors improve their results by thoroughly questioning the history of the present illness, past medical history, family history and social history. A ROS (Review of Systems) can help move into the diagnosis and treatment stage seamlessly.
It concludes, “Doctors of chiropractic are the physicians most poised to embrace this lifestyle treatment approach to address primary care problems. In other words, for many patients, resolution of chronic back pain may require a primary care approach, so why not embrace this tremendous opportunity?”
Note: Now that I have become a patient of a local chiropractor, who fixed my back strain, and now I can walk straight up instead of bent over (!), I watch chiropractic news more than in the past, and I absolutely swear by their care whereas in the past I discounted the effectiveness of chiropractic treatment. Not anymore. Two visits with my chiro and I was better, and I learned a lot about how to care for my back.



Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:






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