In the distant past, healthcare decisions were often fueled by stories of miracle cures. When these stories were told by patients, beginning in the early 1900s, they were called testimonials. DD Palmer’s fame began with a testimonial from Harvey Lillard. To this day, testimonials have been woven into advertising for hospitals, pain clinics, occupational medicine departments, PT offices, allopathic clinics and yes, chiropractic offices.
The new healthcare paradigm is trying to find the true story of health care and outcomes by reviewing the evidence. When combined with the clinician’s best judgment, utilizing the highest level of integrity and honesty, the truth will lead to improved health promotion, prevention and wellness strategies. This will ultimately lead to a healthcare system that is compassionate, effective, civilized and evidence-based. If this profession is to move from treating five to 15 percent of the population to treating 100 percent of the population with safe and effective conservative care approaches, we must tell our story using outcomes-based evidence and clinical integrity.
State governments and the federal government have set up elaborate health-data gathering organizations. Many are using paid claims databases based on claims filed to third-party payers. Eventually there will have to be a deeper analysis focused on review of clinical data and outcomes, combined with research evidence. This will be an evidence-based testimonial, so to speak.
The practice of chiropractic is safe and cost competitive, with high patient satisfaction largely driven by outcomes that are greatly valued by patients. This statement must be confirmed in the evidence. We cannot tell the world of the number of conditions that we treat, services and advice we provide and outcomes we achieve if we don’t write it down.
I tell my allopathic colleagues that I see the same presenting complaints that they do but rarely get credit for them. Far too often, all the details of the patient encounter do not get into the paid claims data due to HCFA limitations, arbitrary limits applied to services rendered and diagnoses that payers accept from chiropractic physicians. Healthcare reform, ICD-10 and EHRs will bring forth the opportunity to tell our story more fully. We need to do a better job of getting this information into the clinical records so that we are recognized for our roles as physicians and for the benefits we provide.
The lesson for chiropractic physicians is to diagnose accurately, code appropriately, document fully and record outcomes for all the symptoms related to us. If we don’t tell our story, others will. Their inclination too often is to limit us to a few diagnoses and a single service.
The ACA is your partner, making website resources available to improve your compliance, documentation and coding and to tell the story of the positive outcomes that we see every day in our offices. Additionally, get to know your local and national legislators on a first-name basis so they know the chiropractic story long before you need to ask them for their help (i.e., become a key contact link). Utilize your new EHR to its fullest to tell the stories of chiropractic successes. Use the new ACA member packet and list of resources and benefits to recruit your colleagues to help you tell the story so that we cannot be ignored and our patients will not face discrimination. Let’s work together at the grassroots level and make a commitment for each of us to recruit one new member this year. Our profession can’t thrive without unity and none of us can tell the full story alone.