Chiropractors have been actively treating whiplash soft tissue injuries for decades. This article explores how the chiropractic profession has fared in recent years compared to medical doctors and physical therapists. The comparisons illustrate the percentage of claimants seeing the various providers in five-year time increments. It also shows that the chiropractic profession continues to have a upward growth trend, whereas the number of claimants seeing MDs and PTs has declined or grown little in recent years.
Knowing the status of the profession can be useful, particularly when determining what fees to charge for services. That knowledge is also useful when responding to a doctor who has reviewed your file and determined treatment necessity, or during a deposition/trial in which the defense expert opines as to the reasonableness of treatment given by a chiropractor in a whiplash case.
This paper reviews data published by the Insurance Research Council (IRC), an independent nonprofit research organization whose funding is obtained from insurance carriers in America. The IRC's staff collected auto injury claim information from the larger insurance carriers in the United States and from one consumer survey. (See Table 1 for the number of claims that were evaluated). The IRC evaluates claim data from all 50 states. Four of their publications have looked at the chiropractic, physical therapy, and medical professions.
Table 1. Number of insurance carriers and claims evaluated in each of the IRC publications
Table 2 shows that in auto injury cases, nearly 42% of all claimants went to an emergency room in 1997, down 21% from 1987. There was a 30% decline in the number of claimants seeing general practitioners or internists. Physical therapists have had a 50% increase in the number of cases in the past 10 years. However, the majority of that gain occurred before 1992, with only a 5% gain seen in the past five years. Chiropractors have had a 40% gain over the past 10 years - the largest gain seen for any type of provider.
Table 2. Percentage of auto-injury claimants seeing providers in five-year increments. Data adapted from All-Industry Research Advisory Council. Compensation for Automobile Injuries in the United States, 1989, Oak Brook, Illinois; Insurance Research Council. Auto Injuries: Claiming Behavior and its Impact on Insurance Costs, 1994, Oak Brook, Illinois; Injuries in Auto Accidents: An Analysis of Auto Insurance Claims, 1999, Malvern, Pennsylvania.
Nordhoff and Banerjee5 found in their analysis of 300 chiropractors, who were surveyed about their practice perceptions, that the median total number of office visits for an uncomplicated case was 21 visits, compared to 28 visits for the more complicated case. This data is consistent with that published in the IRC literature. In the 1999 IRC publication,4 claim data from 1997 was analyzed for the average number of office visits by a type of provider. When looking at the chiropractic profession, the IRC found that in bodily injury cases the:
This review of IRC data clearly shows that the chiropractic profession continues to have substantial growth in the personal injury field, whereas the number of claimants seeing MD/PT providers have declined or stagnated. In states that have bodily injury coverage, the IRC found that 33 percent of the total aggregate payment to all providers by the carriers was to chiropractors.4
With these optimistic figures, my only caution is this: The chiropractic profession is going to undergo more scrutiny in the future, as the IRC data is reviewed by all of the leading insurance carriers. For the profession to continue to prosper, it is important that chiropractors continue to focus on getting good results, obtaining excellent patient satisfaction, keeping costs competitive, and maintaining good management ethics.
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