There are many organizations that the American Chiropractic Association (ACA) works with and prioritizes relationship-building within health care and policy. Regarding policy and legislation, we often look to Capitol Hill. We also impact policy through interactions with many other groups that work with Congress and our legislators on budget and healthcare reform. As a member of the ACA Health Policy and Legislative committees, I am always searching for ways to expand our influence. Earlier this year, I had the opportunity to work with the Patient Centered Outcomes Research Institute (PCORI).
PCORI is authorized by Congress to research patient affordability and healthcare effectiveness. As chiropractors, we are familiar with how our work compares with other areas of health care, but often lack the data to support what we see in practice. PCORI helps to create some of this language and to assess what is really working well in health care. They refer to this as clinical effectiveness research (CER).
PCORI held a clinical roundtable event earlier this year, where they invited one ACA member to attend a conversation around key research and care issues. There were a number of healthcare providers there from various backgrounds. It is always a great opportunity to be the only chiropractor in the room to discuss new ideas about collaborative-care teams.
While there were many topics covered at the roundtable, mental health—and particularly the issue of burnout—was on everyone’s mind. Addressing healthcare shortages and minimizing problematic cultures where individuals need to “put in their time” or “pay their dues” before being respected at higher levels were mentioned as strategies to improve burnout levels immediately. This comes down to the micro-cultures within organizations, as well.
Mentorship was also identified as a way to combat this “us vs. them” thinking. ACA has created mentorship programs in the past, and I look forward to seeing how they continue to grow with more bi-directional relationships that enable real conversations along the way. What is encouraging is that the things we face as chiropractors are not nuanced; instead, they are largely systemic challenges in health care that the collective is working to better.
Social determinants of health (SDOH) also remain a big topic around policy opportunities. There are countless factors that influence our patients’ lives, some systemic, some internal, some external. These are often referred to as SDOH. The challenge in policy is that we do not have a “normal” or “baseline” human experience to use as a comparison. Borrowing the cliche, we are comparing apples to oranges. I look forward to data from that comes out of future SDOH research that incorporates this.
It was a highly impactful day, and I look forward to seeing what changes around funding and language in health care come from this, among many other conversations. The leadership present at the roundtable, from nurses, therapists, and members of federal organizations, was inspiring. I know the dialog we had will last long beyond the day itself. In the words of Sheryl Sandberg, “Leadership is about making others better as a result of your presence and making sure that impact lasts in your absence.”
PCORI Opportunities
PCORI provides awards for dissemination of research as well as merit-based programs. They not only fund the studies, but also provide opportunities for funding to host events around CER. PCORI is often looking for merit reviewers to work with its organization to help determine what research is funded. They also have a number of advisory panels. Learn more about their organization and opportunities here.
Dr. Totzke-Hitzeroth serves as Virginia’s alternate delegate in the ACA House of Delegates.
