The California State Compensation Insurance Fund (SCIF) on July 1, 1992 began a pilot project in two areas of the state to test chiropractic care in a managed care environment.
According to SCIF Medical Director, Gideon Letz, M.D., the program will be "evaluating the application of the managed care concept to the care of the injured worker." It is designed to "monitor medical care of disabling back and neck strain/sprain injuries. The objective of the program is to assure quality care for these individuals and to facilitate maximal recovery with timely return to work."
Initially the pilot study will involve DCs in Northern California (Stockton area), and in Southern California (Arcadia area).
Jonathan Kantor, D.C., a chiropractor consulting on the project, stated: "The parameters for chiropractic care... have been drawn from existing work (RAND Study, Quebec Study, State of Washington Standards' Document, etc.), but lean most heavily on the Mercy Center Guidelines, the chiropractic consensus document soon to be published."
Dr. Kantor assessed the program: "There is enormous potential for gain in the State Fund's managed care program. The results of the project will be closely scrutinized. If we can demonstrate that chiropractors can deliver high quality care at reasonable cost within the California workers' compensation setting, we validate the benefits of chiropractic treatment for workers' compensation in other states. And, by extension, the benefits of chiropractic care in the larger health care systems."
The importance of these types of test projects to the future of chiropractic involvement can't be overstated. In this case, the Mercy Guidelines are providing the bulk of an effective rule base that will ultimately allow chiropractic care to be tested on a level playing field. It is hoped that those chiropractors involved will recognize the importance of the project.
Back pain? Blame the psoas. Seems as if everybody wants to dive headfirst into their psoas at the first sign of trouble with the lumbopelvic-hip region. Perhaps no other muscle is blamed more for causing problems than the psoas. Yes, it is an important stabilizer of the lumbar spine, but it shouldn't be the only one on which you focus. There is another big player on the scene: the iliacus.
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