The Danish Institute for Health Technology Assessment (DIHTA) has published low back pain guidelines "to manifest today's knowledge on the problem and the most rational way to handle it." The Danish National Board of Health is not only dedicated to establishing guidelines, but serious about seeing them applied, as indicated by this published statement:
Denmark will ensure that international HTA (health technology assessment) initiatives are monitored and the results applied to the Danish National Health Services."
Chiropractic, which received it authorization in Denmark in 1992, is flourishing. According to Henrik Laugesen,DC, president of the DCA, the chiropractic profession in Denmark cannot meet the demand for chiropractic.
The guidelines are divided in two volumes. The first volume gives a thorough discussion of back pain, its risks and diagnosis. The second volume deals with the treatment parameters and identifies the health professions that treat patients with low back pain.
Under the section "The chiropractor in the primary health care sector," the scope of chiropractic practice is delineated: "diagnosis, treatment and prevention of biomechanical functional lesions for patients suffering from low back pain." The Danish guidelines stratify their recommendations into three areas:
Treatments recommended only for certain conditions include: injections; trigger point injections; facet joint injections; epidural injections; acupuncture; massage; heat/cold therapy; back surgery; bed rest; and transcutaneous nerve stimulation.
Under "treatments which can generally be recommended," manual therapy (which includes chiropractic) is the first listed. It is cited as having "moderate costs" with the following recommendations:
Denmark joins a growing list of countries that have examined the scientific literature and found sufficient evidence to recommend chiropractic for low back pain. While it is understood chiropractic is effective for more than just back pain, this is an important step in establishing chiropractic's value and place in each country's health care system.
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Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
