Driven by rising health care costs, the constant barrage of new research knowledge and the increasing integration of technology, the way in which all health care providers take care of patients in this country--in this world--is changing rapidly. This evolving health care environment means that, while we remain steadfast at the core of who we are and what we do stand for as a chiropractic profession, expectations regarding some of the ways in which we practice are beginning to change.
The #MeToo stories that have flooded social media in recent weeks have initiated a much-needed conversation across the country, a conversation that illustrates the very different experiences that men and women can have in male-dominated professions. In her latest blog post, ACA Senior Scientific Advisor Christine Goertz, DC, PhD, notes that, as one of a very small handful of women who has served in chiropractic leadership roles since she was a student, she has had a great deal of experience navigating the awkward and sometimes very uncomfortable waters generated by gender bias.
It’s pretty difficult to open up a newspaper these days without seeing an article on the devastating public health impact of the opioid epidemic in the United States. While there appears to be general agreement on the scope of the problem, there is less consensus regarding what can be done to solve it. Policy-makers and professional associations taking on this challenge have tended to focus on mortality statistics and/or expert opinion. These are obviously critically important pieces of the puzzle but it is also important to take a patient-centered approach. To facilitate discussion on this important topic, Gallup held a research release event on Sept. 12 in Washington, D.C., titled “Addressing the Opioid Epidemic With Drug-Free Pain Management.”
The first ACA Choosing Wisely® recommendation states: In the absence of red flags, do not obtain spinal imaging (X-rays) for patients with acute low-back pain during the six weeks after the onset of pain. Some doctors of chiropractic may be surprised that ACA included this recommendation. There are many DCs who are committed to delivery of high-quality patient care that currently take or order X-rays on a majority of their patients because they believe that X-rays are a necessary component of the examination process. There are a number of reasons why this is the case.
Long before many of us can remember, there were only two people sitting in the chiropractic treatment room – the patient and the doctor. Gradually, the state licensing boards starting showing up. They were joined by the insurance industry. Then health policy makers like Medicare and Medicaid. Followed by more members of the insurance industry. Then scientists made an appearance, talking about evidence-based clinical practice. Now this already very crowded room may become even more crowded if we open the door to the ever-loudly-knocking performance measurers. We have had time to get at least somewhat used to the state and national boards, insurers, policy makers and even the scientists, to some extent. But what is performance measurement and how might it be beneficial to the practice of chiropractic?
By now you are no doubt familiar with the concept of evidence-based clinical practice (EBCP). But what does that really mean for the doctor of chiropractic? How does one actually implement the “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of an individual patient” when that individual patient is on the adjusting table? It is not that easy, for a number of reasons.
*Member-Exclusive Content* Health care payment systems in the United States have come a long way from the traditional fee-for-service model that dominated in year’s past. Today, numerous new payment models have emerged that aim to increase cost efficiency and enhance value to patients. Following is a review of some of the most common and emerging systems today, including insights into pros and cons as well as answers to frequently asked questions.
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