Talking to Skeptical MDs: "Just the Facts, Ma'am"

The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.

Approximately two-thirds of MDs don't understand chiropractic and therefore should not be expected to have a favorable opinion about it. Their primary source of "acceptable" clinical information is studies published in peer-reviewed journals. This is supplemented by case studies and interactions with colleagues.

QuantiaMD recently featured a presentation on chiropractic to its members. QuantiaMD is "the largest social learning and collaboration platform for physicians" and boasts that "1-in-3 U.S. physicians visit QuantiaMD, online and through their phones." The presentation, "Talking to Your Patients About Chiropractic Care,"1 was given by Christine Goertz, DC, PhD, vice chancellor for research & health policy at Palmer College of Chiropractic (not to mention a DC columnist).

The information Dr. Goertz provides on chiropractic is intended to help MDs better understand the value of chiropractic as it relates to patient care. It is delivered in a "Just the facts ma'am" format, with heavy references. Here are some excerpts of the more significant points Dr. Goertz makes:

• Nine percent of U.S. adults use chiropractic and/or osteopathic spinal manipulation each year.
• With approximately 70,000 DCs, chiropractors constitute the third largest doctoral-level health care provider group.
• There are approximately 100 reviews of SMT (spinal manipulative therapy) for low back pain (LBP).
• SMT (for LBP) is significantly more effective at reducing pain in the short term when compared to placebo or no treatment.
• Twelve sessions of chiropractic SMT may yield the most favorable response in patients with chronic LBP.
• Manual therapy with exercise was more effective than other noninvasive interventions for neck pain.
• SMT was more effective than medication for acute and subacute neck pain for short- and long-term outcomes.
• SMT is effective for cervicogenic and migraine headaches.
• Several small pilot studies for nonmusculoskeletal conditions have been conducted;
• There is no evidence of excess risk of vertebrobasilar artery (VBA) stroke associated with chiropractic care compared to primary care.
• There are only 5-10 serious complications per 10 million manipulations.
• A recent study of 12,036 Medical Expenditure Panel Survey (MEPS) respondents with LBP and neck pain showed that seeing a DC did not add to overall medical spending.
• Lower overall episode costs of care are achieved when LBP treatment is initiated with a DC as compared to an MD (20-40 percent lower costs).
• Thirty-eight percent of surveyed PCPs reported understanding the medicinal use of chiropractic, and felt comfortable counseling their patients on its use.

Reading these points as a medical doctor, you get an interesting picture of chiropractic. You discover that there are 70,000 DCs, 100 studies on SMT, and that it is effective for LBP as well as neck pain and headaches. You also learn (contrary to what you may have heard) that chiropractic is much safer than most other interventions, less expensive and specifically cheaper than medical care.

For MDs to hear and understand this, in their language, with lots of references, will ultimately encourage them to seek DCs with whom they can work. One of the things you can do to help facilitate this is to share this presentation with MDs in your area.

Some MDs have a low opinion of chiropractic just because of what they were taught in medical school or have been told by other MDs. Others are just ignorant and need to be educated. Many younger MDs are more willing to listen and learn. This presentation by Dr. Goertz is a great conversation starter you can use to break the ice.

Read more findings on my blog: http://blog.toyourhealth.com/wrblog/. You can also visit me on Facebook.