Chiropractors are part of the solution to opioid addiction, high costs of spinal pain treatment and health care collaboration.
The chiropractic profession must take bold, innovative steps forward and collaborate with other professions to make an impact on some of the major challenges and trends in health care, according to speakers featured at the opening session of DC2017 in Washington, D.C., last week. The lineup of thought leaders from both inside and outside the profession challenged chiropractors to examine what they could do as a profession and individually to meet the needs of a society struggling with spinal pain, painkiller addiction and runaway health care costs.
DC2017, a first-of-its kind event for the chiropractic profession, was hosted by the American Chiropractic Association (ACA), the World Federation of Chiropractic (WFC) and the Association of Chiropractic Colleges (ACC). The conference attracted nearly 1,300 participants from 29 different countries as well as many vendors, who exhibited the latest products and services in the DC2017 Expo Hall. Premier sponsors of the event included Foot Levelers, NCMIC and Standard Process.
“[The chiropractic profession] will, and shall be, a part of the solution,” declared Espen Johannessen, DC, president of the World Federation of Chiropractic. “We can make a real difference.”
Growing Awareness of Human, Financial Toll of Spinal Disorders
Speakers pointed to the growing awareness of the tremendous toll spinal pain inflicts on populations worldwide and how chiropractors are uniquely prepared to make a strong impact on this public health problem—particularly since the overuse and abuse of opioid painkillers has brought international attention to past approaches to pain management that have proven unsafe as well as ineffective.
More than one billion people in the world suffer from spinal disorders at any one time, and today back and neck pain have more of an impact than HIV, Alzheimer’s, malaria and other common diseases, said Scott Haldeman, DC, PhD, recipient of ACA’s 2017 Humanitarian of the Year Award and founder of World Spine Care, an organization that seeks to bring quality spine care to underserved populations worldwide.
He noted that an estimated $87.6 billion is spent annually in the U.S. on treatments for spinal pain, which ranks as the third highest health care expenditure. In addition, he added, a patient who has spinal pain in conjunction with other conditions can expect their health care costs to double.
“Spinal disorders are an ignored international health, economical and human tragedy,” Dr. Haldeman observed.
Innovation, Collaboration Is Key for Solutions to Modern Challenges
Susan Dentzler, president and CEO of the Network for Excellence in Health Innovation and former editor of Health Affairs, agreed that better approaches to spinal pain are needed, especially for older populations and those in low- to middle-income areas of the country such as the Rust Belt, which are seeing a rise in disability and death in part because of the use of opioids for musculoskeletal conditions–especially low back pain.
“We need better individual and population health, better quality of care and smarter spending,” she said.
At the same time, Dentzler noted that most things that drive health are outside the healthcare system. As illustrated in the CDC’s Health Care Impact Pyramid, factors such as a person’s socioeconomic status (their education and income), their physical environment and their health behaviors (smoking, drinking, etc.) together have a greater impact than clinical care alone.
“Chiropractic has a clear role to play in ongoing innovation in health care,” she said, challenging the audience to think of ways they could make an impact in their communities, improve overall public health and lessen the need for health care interventions by promoting wellness and prevention strategies. She provided examples of innovation from Kaiser Permanente, which is a leader in the use of technology to enhance doctor-patient interactions, and even Uber, which has created a new division to help facilitate health care appointments.
Dentzler believes increasing collaboration among health care providers is a positive development for the chiropractic profession. “Many organizations are thinking broader and including chiropractors,” she said, pointing to one example, Priority Health in Michigan, which created “spine centers of excellence” in response to the high rate of back injuries in the automobile manufacturing industry. According to the Priority model, the centers must include a chiropractor or an osteopath in the mix of providers.
Chiropractors on the Health Care Team: Spinal Care Experts
Jan Hartvigsen, DC, the recipient of ACA’s 2017 Researcher of the Year Award as well as head of research in the Department of Sports Science and Clinical Biomechanics at the University of Southern Denmark and the No. 1 ranked expert in musculoskeletal pain worldwide by the website Expertscape, also thinks collaboration is key for chiropractic’s future.
“Modern health care is about working together, a team approach, erasing boundaries,” he said.
However, according to Dr. Hartvigsen, there are those in the profession who are reluctant to accept their role in health care collaboration as the “spine care experts” and would rather talk about other things. Yet the fact remains that the vast majority of people—7 out of every 10—see chiropractors because of spinal pain, he said.
Hartvigsen researched historical records and learned that, even 55 years ago, spinal pain was the prime reason for chiropractic visits. He co-authored an article in the Journal of Chiropractic Humanities last year that concluded that despite disagreements within the profession, “the chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care.”
“I think it all lines up for chiropractors,” he said. “Patients like what they get; chiropractors have some of the highest patient satisfaction rates in health care.”
All for One: Working Together
Rear Admiral Susan Orsega, chief nurse officer of the U.S. Public Health Service, told attendees of DC2017 that all providers—including chiropractors—are key to the solution for the opioid epidemic. “There’s not a one-stop solution. It will require all of you to be engineers and think outside of the box and address the opioid epidemic with your patients.”
Orsega noted that only half of those who suffer from opioid abuse receive treatment, but that more and more communities are becoming aware and customizing solutions.
She challenged the audience to get out of the health care sector and into other sectors of their communities—such as events, business and education—to talk to people about the opioid epidemic and what chiropractic can do for them.
“It’s not one [solution] over another. They must all work together,” she said. “Your role cannot be more important. We need your help. We need your partnership.”