While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
The Future of Chiropractic in Hospitals: A Survey of Hospital Chiefs on Alternative Care
What's the future for chiropractic inclusion in hospitals? A survey of 240 hospital chiefs conducted by the consulting firm CampbellWilson of Dallas, Texas, gives these figures:
- 25% said they plan to add some form of alternative health care within the next 12 months.
- 35% plan to offer "holistic medicine."
- 16% plan to offer chiropractic.
- 9% plan to offer biofeedback.
The hospital chiefs were not optimistic about health care in general:
- 38% said they would not recommend health care as a career to high school or college age students.
- 65% claimed that a decrease in Medicare and Medicaid reimbursement was a principal concern.
"Health care executives are being asked to do more with less, and the pressure is taking its toll," observed Dana Wilson, a senior partner of CampbellWilson. Wilson noted, however, that hospital administrators see the services of complementary and alternative medicine practitioners as a possible way to make up for the revenues they expect to lose under the new Medicare Outpatient Prospective Payment System (OPPS).
The OPPS is widely viewed with disfavor by administrators: 80 percent indicated they expected to lose revenue under the OPPS; 75 percent said they expected OPPS losses to be greater than five percent; and 39 percent estimated losses would be greater than 10 percent.