According to the American Chiropractic Association (ACA), approximately 500 hospitals in the United States - roughly one in 12 - have at least one doctor of chiropractic each on staff. While that number may not sound impressive, it's a far cry from the way chiropractic was viewed only a quarter-century ago, when the American Medical Association (AMA) still considered it unethical for medical doctors to associate with chiropractors professionally, much less refer their patients to DCs for treatment.
Monroe Community Hospital (MCH) in Rochester, N.Y., is one facility that has embraced chiropractic, and it's done so in innovative fashion. In January 2003, a full-time chiropractic clinic was officially established at MCH, designed to operate in conjunction with the hospital's nursing home, one of the largest in western New York.
MCH is a teaching hospital, part of the University of Rochester's School of Medicine and Dentistry. It is also home to the Finger Lakes Geriatric Center, sponsored by the Health Resources and Service Administration (HRSA) Bureau of Health Professions. The clinic, which offers chiropractic in the setting of a long-term care institution, is believed to be the first of its kind in the country.
"We're not trying to be medical physicians. That's not what we do," said Dr. Paul Dougherty, a 1990 graduate of Logan College of Chiropractic, who heads the clinic. "But we do think that we have a role to play in pain management."
Now in its 10th month of operation, the clinic is operated jointly by MCH and New York Chiropractic College (NYCC) in nearby Seneca Falls, where Dr. Dougherty is an assistant professor of chiropractic practice and technique. Medical doctors and chiropractors often work side-by-side in the facility, with the goal of relieving pain and suffering in elderly patients with chronic illnesses. In addition to providing care for residents at the nursing home, the clinic offers services to members of the surrounding community on an outpatient basis. The clinic also serves as a teaching site for NYCC students and medical doctors. Internal medicine residents and geriatric Fellows rotate through the clinic, allowing them to gain exposure to what chiropractic care can offer their patients. Chiropractic students also can participate in the educational opportunities at MCH, including medical grand rounds and service at the hospital's geriatric assessment clinic.
"The clinic has grown from seeing about 10 patients a week to about 70 patients per week," noted Dr. Dougherty. "We always have three students observing and helping with the treatment."
Although the chiropractic clinic wasn't formally established until this year, chiropractic has had a presence at MCH since 2002. Its origins can be traced to J. Donald Dishman, DC, an associate professor at NYCC, who created the clinic last year as part of an experiment to see if chiropractic could play a role in a long-term care hospital. Dr. Dishman's group treated 48 elderly residents who suffered from back pain, neck pain, headaches and shoulder stiffness. Officials at the hospital were impressed with the results Dr. Dishman achieved, and decided to increase the availability of chiropractic care to the residents of MCH and to community elderly patients.
The effectiveness of chiropractic in treating geriatric patients has caught the attention of several medical doctors at the hospital, including Paul Katz, MD, MCH's medical director.
"I admit it that when I was in medical school in the '70s, chiropractic had a very negative connotation to it," said Dr. Katz. "But there's a lot more science behind what they do now, and it's really given me a greater appreciation for their role."
"The goal is to reduce pain, and however you do it, I don't care as long as it's safe and effective," he added.
According to Dr. Dougherty, although chiropractic may be an effective form of pain relief, more research is needed to learn exactly how it relieves pain. To find the answer, he and officials from NYCC and MCH applied for a $750,000 grant earlier this year from the Department of Health and Human Services and HRSA to conduct a three-year study to see how elderly patients react to chiropractic care in the treatment of back pain.
The grant wasn't approved, but that hasn't deterred Dr. Dougherty and his colleagues. They remain optimistic about the future of chiropractic in the hospital setting and are committed to conducting scientific research that demonstrates the effectiveness of chiropractic in treating pain in the elderly. As we go to press, the clinic team at MCH has begun work on two new grant proposals: one that will examine the role of chiropractic in the long-term care setting, and another that will investigate the use of chiropractic in the ambulatory outpatient geriatric population.
"I think there's a future in integrating chiropractic with traditional medicine, and it's exciting to be on the front end of it," said Dr. Daugherty. "We hope that [the clinic] is a model that will be duplicated, as chiropractic care has been very helpful, even in the very frail and disabled."
Resources
- NYCC helps create hospital chiropractic clinic. Dynamic Chiropractic, April 7, 2003.
- Leingang M. MCH offering chiropractic. Rochester Democrat and Chronicle, Aug. 24, 2003.
- E-mail sent by Dr. Paul Dougherty to Dynamic Chiropractic, Sept. 15, 2003.
- E-mail sent by Dr. Paul Dougherty to Dynamic Chiropractic, Sept. 16, 2003.
Michael Devitt, senior associate editor
