Case Studies Tell Chiropractic’s Story

Case Studies Tell Chiropractic’s Story

Chairman's Message

Author: Richard Bruns, DC/Friday, January 8, 2016/Categories: September 2015

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By Ric Bruns, DC

It is clear that reimbursement models are going to change over the next few years. Hardly a day goes by that we don’t hear from third-party payers that they’re going to go to a pay-for-performance model based on evidence and outcomes. This includes Medicare and Medicaid.

The professions that have the strongest research and evidence will be the clear winners. The good news is that there is a lot of research being done that crosses over from one profession to another. The chiropractic profession will absolutely have to take advantage of applying those sources of evidence to the broad scope of chiropractic physician services. Our profession also has some very strong evidence for the neuro-musculoskeletal component of our practices, which will provide a big advantage going forward. However, this does not abdicate our responsibility to continue our own research and to establish our positive patient outcomes in the evidence, including the broader scope of services that we routinely provide.

We all know that chiropractic is a comparatively safe, cost-effective treatment method with quality outcomes and high patient satisfaction. We know this because we live and breathe it every day in our practices. With the advent of new payment models, it will be imperative that we continue to prove our performance in the evidence and data that will be generated and utilized not only by all third-party payers but even patients who will be researching their best choices.

Many DCs have said to me, “Ric, I am not a researcher; I am a chiropractic physician functioning in a direct access primary care capacity in a solo practice. I am committed to treating human conditions and health promotion with complementary and alternative healthcare. I don’t have time for anything else.” Some of us have a more narrow focus. Some of us aspire to being defined even more broadly. Yet we all understand the need to tell our story.

The bottom line for all of us is that we will have to prove the effectiveness and positive outcomes of our interventions in the evidence. We need to prove that our treatment plans should be the first choice for third-party payers and patients alike. We will need to prove this in our documentation and ultimately, in the evidence. We also know that in documenting our care “if it isn’t written down, it didn’t happen.” The same is true in the evidence. Therefore we must write down types of treatments, advice, consultations and referrals that we administer and document those results.

We do not all have to be researchers to provide a simple case study. In this edition of ACA News, you will learn how to produce a case study (see Page 26). Can you imagine if all of the practicing chiropractic physicians in this country submitted a case study next year? That would amount to tens of thousands of case studies and help define the profession in the evidence. Even though case studies are one of the lower weighted forms of evidence, they often stimulate broader research and research dollars for future studies.

Can you imagine if all students in chiropractic colleges produced a case study? There would be thousands of additional sources of evidence in the literature. We have a responsibility to our patients, profession and each other to tell the chiropractic story and all of us can produce a case study next year. Let’s all commit to documenting one interesting case and submitting it.

I’m sure ACA News and other sources could commit to regularly publishing these case studies. We could all benefit from the lessons to be learned from the day-to-day practice of chiropractic. Maybe we could also open some skeptical eyes in the research community and generate some badly needed research dollars. Remember, part of being a healer is also being a teacher. Let’s continue to tell others about our remarkable results by publishing our story in case studies. 
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