October is "Oregon Chiropractic Health and Wellness Month"

October is "Oregon Chiropractic Health and Wellness Month"

The Governor of Oregon was an ER doctor before he went into politics. Last month he declared October "Oregon Chiropractic Health and Wellness Month."

The proclamation has the key whereas:

"A seven-year prospective follow-up study analyzing 70,274 member-months of patients managed by doctors of chiropractic resulted in an 85 percent reduction in drug costs, 62 percent reduction in MRIs and surgeries, 60.2 percent reduction of, in hospital admissions, and a 59 percent reduction in hospital stays."

Which comes from an article out of Chicago Clinical utilization and cost outcomes from an integrative medicine independent physician association: an additional 3-year update. It was discussed years ago at SBM.  I suspect the Governor doesn't read the blog, although he seems to like oxymorons.

Combined with the State guidelines that recommend spinal manipulation for low back pain (acute and chronic), the Governor declared that

the Services of Doctors of Chiropractic result in improved health, satisfaction, safety, and reduced per capita costs.

Based on the study I will buy into reduced costs. I would suspect it is difficult to properly evaluate and treat diseases, which is expensive, if you are grossly under trained in primary care as are DC's. The 40% of the patients were either well or with orthopedic problems, but from the paper I would estimate that 60% of the diagnoses were for problems for which DC's have no training. It is scary to think of DC's taking care of diabetes, cancer and cardiac disease.

You have a group of patients who select a DC as PCP and probably less inclined to utilize health care (even if appropriate) and are taken care of by a group that is disinclined towards providing modern health care (even if appropriate, like vaccines) and health care utilization goes down. Surprise.

Patient satisfaction was increased, which in the medical field is associated with increased mortality.

We know nothing about improved health from DC care. Was proper screening done, were immunizations kept up to date, were guidelines followed?  I suspect not. And they were proud that 91% of the DC's did not get a referral, which would suggest most of them were either trying to treat diseases they were not competent to deal with or unable to recognize their medical inadequacies.

And we know nothing about safety, given the issues of chiropractic discussed at length at SBM.

And since the care provided by a DC is often not based on reality and has no efficacy for any process besides manipulation for low back pain, what is the point if it is less expensive? Ignoring disease due to inadequate training hardly seems the best way to control costs.

And as the study notes:

The validity and generalizability of this observation are guarded given the lack of randomization, lack of statistical analysis possible, and potentially biased data in this population

Do not care for patients properly and costs go down. I suppose it is an excellent concept for an insurance company, but not so good for the patient.  I will not celebrate Oregon Chiropractic Health and Wellness Month.

Points of Interest: 09/23/2014
Naturopathic Medicine Week 2014