It has been just over a year since many in the chiropractic profession first learned that the American Chiropractic Association (ACA) joined more than 80 medical specialty society partners to participate in an initiative that is sponsored by the American Board of Internal Medicine Foundation. This initiative’s mission is to “promote conversations between clinicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” It is called the Choosing Wisely campaign¹ and it has generated more spirited discussion among doctors of chiropractic than I can recall since release of the Mercy Conference Proceedings in 1993.

According to ACA Senior Scientific Advisor Christine Goertz, DC, PhD, the most common issues raised by those outside the chiropractic profession relate to the quality and consistency of chiropractic care delivery. The second most commonly asked question invariably pertains to the costs associated with chiropractic care. While there is no definitive answer and more research is needed, Dr. Goertz reveals what the evidence we have to date tells us about the costs associated with chiropractic.

In her open letter to the National Center for Complementary and Integrative Healthcare, ACA Senior Scientific Advisor Christine Goertz, DC, PhD, offers suggestions to NCCIH on how to meet some of today's pressing healthcare challenges and, in particular, how complementary and integrative health care can play a role. She writes, "We desperately need a healthcare delivery system 1) that is able to consistently provide evidence-based, patient-centered care to the right individual at the right time, 2) for which the patient care trajectory for chronic conditions begins with the safest, most conservative, effective option available and, 3) that empowers patients and providers with the knowledge and tools they need to make informed decisions that are deeply rooted in disease prevention and health promotion. Much work lies ahead in identifying how CIH practices can best contribute to this effort."

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.