What if research could prove doctors of chiropractic are best-suited to lead a multidisciplinary approach to managing low back pain from an effectiveness and cost perspective? The Duke University School of Medicine's Duke Clinical Research Institute (DCRI) is spearheading an exciting new study that puts primary spine practitioners including DCs at the head of a collaborative team approach to improving LBP outcomes.
Christine Goertz, DC, PhD, will serve as DCRI co-principle investigator with Adam Goode, DPT, PhD, joining Jon Lurie, MD, MS, of Dartmouth-Hitchcock Medical Center, to lead the lead the clinical coordinating center for the trial. DCRI's Hrishikesh Chakraborty, DrPH, will lead the data coordinating center.
The patient population will be drawn from 22 family medicine, primary care and general internal medicine clinics in three health care systems – Duke, Dartmouth and the University of Iowa; with plans to enroll 1,800 patients with a primary complaint of LBP. Doctors of chiropractic and physical therapists are considered primary spine practitioners for trial purposes.
A DCRI press release announcing the pragmatic IMPACt-LBP trial noted three primary goals investigators hope to achieve in the course of their research: "To compare the effectiveness of the multidisciplinary/Primary Spine Practitioner (PSP) model compared to usual care; to estimate the cost of implementation of the intervention; and to evaluate barriers and facilitators to implementing a multidisciplinary/PSP care model."
In the DCRI release, Dr. Goertz noted: "Current guidelines call for patients with lower back pain to be treated with non-pharmacological care options first. This study seeks to evaluate guideline-based care by placing patients at the forefront and having a collaborative, multidisciplinary structure in place to support their care."
The National Center for Complementary and Integrative Health is funding the study, with support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute of Child Health and Human Development.
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?
There has long been an attempt by those who are not legitimate doctors of chiropractic to usurp the title of chiropractor from those who have earned their degree from an accredited chiropractic program. This generally happens in countries where the local doctors of chiropractic have yet to pass legislation requiring a degree from an accredited institution. The result is essentially two chiropractic professions. Nowhere is this danger more pronounced than in Japan.
Effective Sept. 1, 2024,UHC/Optum is requiring prior authorization for the following services delivered in office and outpatient hospital settings, excluding services in the home: Medicare-covered chiropractic services (when billed with the AT-modifier), as well as physical therapy (PT), occupational therapy (OT), and speech therapy (ST).
