Part of a series on the chiropractic residency program in the VA health care system
The Department of Veterans Affairs (VA) chiropractic residency program reached an historic milestone in 2016 when each of the five sites received accreditation from the Council on Chiropractic Education (CCE)—they are the first U.S. chiropractic residency programs to be awarded this distinction. The programs were also successful in many VA performance metrics, including recruitment of high-quality applicants, 100 percent graduation rates, high degree of graduate placement in VA and/or other hospital settings, and high satisfaction across multiple stakeholders. Consequently, in early 2017 VA transitioned the chiropractic residency pilot into a standing residency program. Two residents of the program will share their experiences through a new ACA blog post series.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) officially ushered in the value-based model of reimbursement, beginning a change to the payment landscape of American health care. But what does this mean to providers? What does it mean overall for you as a chiropractic physician? First of all, we shouldn’t be afraid of the deck being “reshuffled.” Anytime there is a change in a system – especially a system that has delayed or avoided change – it becomes ripe for an innovative, landmark transformation.
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.
*Member-Exclusive Content* A number of systematic reviews have been performed on spinal manipulative therapy (SMT), although their findings have been conflicting. The current review was initiated with the purpose of addressing the divergent conclusions among studies and to include new trials that have been published since the previous reviews. The review’s objectives were to provide updated estimates of the effectiveness and harms associated with SMT compared with other nonmanipulative therapies for adults with acute low back pain.
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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?
Doctors of chiropractic treating veterans through the U.S. Department of Veterans Affairs' Veterans Choice Program (VCP) received good news on Aug. 1, with Senate approval of the “VA Choice and Quality Employment Act of 2017.” The bill passed without objection on the heels of House action last week, which approved the measure overwhelmingly, 414-0. The legislation directs $2.1 billion to the VCP to keep it operating through January 2018, preventing a disruption of care for veterans in the program as Congress continues to work on a broader overhaul.
*Member-Exclusive Content* ACA’s first Facebook Live discussion, “Women in Chiropractic,” has been viewed by more than 5,000 people to date. The discussion explored the opportunities and challenges that women encounter in the chiropractic profession and celebrated the unique approach and perspectives that they bring to patient care. Viewers were invited to submit questions during the broadcast, and following are answers from moderator Christine Goertz, DC, and featured guests Sarah Potthoff, DC, and Keita Vanterpool, DC.
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Part of the Evidence in Action series by Palmer College of Chiropractic
The concept of caring for the whole patient is not new. As early as the 5th century BC, Hippocrates described the importance of attending to the person behind the disease rather than the disease itself. He described psychological, social and physical elements that variously combine and contribute to a person’s health. Assessing and addressing all three components (biological, psychological and social conditions) contributing to health is called a biopsychosocial approach.
The U.S. House of Representatives on June 26 overwhelmingly approved the “Veterans Expanded Trucking Opportunities Act of 2017” (H.R. 2547), sponsored by Reps. Rob Woodall (R-Ga.) and Julia Brownley (D-Calif.). The bipartisan bill aims to ease the transition of military personnel seeking commercial driver's licenses by increasing the number of health professionals―including chiropractors―serving at U.S. Department of Veterans Affairs (VA) medical facilities who are eligible to conduct physicals for truck drivers.
Publication bias is a growing problem in evidence-based practice. In the hierarchy of evidence, systematic reviews and meta-analyses lie at the top of the evidence pyramid because they are regarded as the most rigorous form of evidence for possible clinical decision-making. But publication bias can color the results of those reviews and meta-analyses in ways not easily seen nor understood.