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Chiropractic Physicians

Chiropractic Physicians. Filling the Role of Non-surgical Spine Specialists A West Hartford Group Presentation . Agenda. LBP Management and the Need for a Nonsurgical Spine Specialist Current Strategies in LBP management Evidenced-based interventions Fiscal Impact Access

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Chiropractic Physicians

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  1. Chiropractic Physicians Filling the Role of Non-surgical Spine Specialists A West Hartford Group Presentation

  2. Agenda • LBP Management and the Need for a Nonsurgical Spine Specialist • Current Strategies in LBP management • Evidenced-based interventions • Fiscal Impact • Access • DC’s as the Nonsurgical Spine Specialist • Integration • WHG MVV

  3. Common LBP Management Strategies • Medications, bed rest, recommended inactivity • Possible directed exercise programs (PT) • Imaging/ advanced imaging • Facet/ Epidural injections • Surgical intervention – discectomy, fusion, rhizotomy, etc.

  4. LBP Interventions Lacking Evidence • Bed rest and inactivity • Most prescription meds for LBP • Epidural and other spinal injections • Surgeryfor many acute LBP/sciatica conditions. • Rhizotomy

  5. LBP Interventions with Good Supporting Evidence • Manipulation • Exercise • Biopsychosocial approach to activating patients and reducing fear of movement.

  6. Implications of Current Non-Evidence Based Recommendations • Catastrophizes LBP and induces passive coping strategies in the patient • Leads to increased chronicity due to inappropriate application of therapies and the patient’s psychological outlook on their ability/ disability • Creates a high cost-burden on the healthcare system  overall

  7. Fiscal Impact of LBP • Back pain management in the USA is extremely costly primarily due to the lack of application of the best available evidence to clinical practice. • The most expensive aspects of LBP care are prescription drugs andadvanced diagnostic imaging/testing.

  8. Fiscal Impact of LBP • By applying evidence-based back pain management protocols, patients will have greatly improved outcomes at a lower overall cost individually and to the healthcare system as a whole.

  9. Access to Appropriate Care • There has been a trend of an overall decline of doctors going into general practice medicine. • With LBP being the one of the highest presenting complaints into a GP’s office, there will be a growing need for access to appropriate care.

  10. DC’s – Fulfilling a need • Evidence-based DCs as non-surgical spine specialists can fulfill this need in the healthcare system of the 21st century. • By applying the evidence, DC’s can serve as portal of entry physicians to improve patient outcomes and reducing current cost burden of spine care.

  11. Integration • Integration of DC’s in the general healthcare community is key to the success of this model. • Current examples: • Hospital-based back pain programs • Integrated private group practices (MD, DO, DC) • ER-based DC care • Integrated referral systems for private practices

  12. West Hartford Group, Inc Mission, Objectives, Values

  13. West Hartford Group, Inc - Mission • WHG, Inc. is a think tank dedicated to the acquisition of social, cultural and professional authority for the chiropractic profession, where the Doctor of Chiropractic serves within the mainstream health delivery system as a patient-centered, evidence based musculoskeletal specialist.

  14. West Hartford Group, Inc – Objectives (Vision) • To provide the profession with a viable model of integrative practice. • To foster inclusion of WHG members in the fabric of the profession to promote WHG’s mission. • To create a public and professional image of chiropractic as a profession dedicated to scholarship, research and the patient-centered, evidence-based practice paradigm. • To advance chiropractic education (undergraduate & graduate) and scholarship consistent with WHG’s mission.

  15. West Hartford Group, Inc - Values • Chiropractors are healthcare providers who provide non-surgical clinical management of musculoskeletal (MS) conditions, with an emphasis on the spine. • Chiropractic clinical management includes diagnosis and treatment, with an emphasis on prevention, rehabilitation, wellness and holism. • Objective measurable treatment effectiveness must be demonstrated.

  16. West Hartford Group, Inc - Values • A Bio-psycho-social (BPS) approach is essential for the management of pain and dysfunction. • Treatment must focus on active care that empowers the patient toward management of his/her own healthcare. • Treatment goals must be functional, and focused on return to normal activities of daily living (ADL) and improved quality of life. • Treatment must be based upon the best evidence available.

  17. Questions and Discussion

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