chiro presentation on higher cost of PMR directed care

[AndyDufrane]

had a hospital meeting , there was a presentation on spine care, and presented by chiro, basically slide after slide indicating chiro treatment in the acute care phase for low back pain is superior, and PMR physician directed care is more expensive, I need some ammunition to refute that claim, I am just aware of Andy Haig's study that supports PMR getting involved early on with spine related pain, are there other studies or resources I can use to help me with a presentation.

---

Members don't see this ad.

 

[Fiveoboy11]

On slide 1 put:
No matter what physician care is superior for everything

2:
Chiros are glorified PT's, not real doctors

3:
Chiro is dangerous and medical care is safe

4:
Patients get unnecessary care only with chiropractic

On a serious note may want to advocate for changes in practice patterns that actually make sense and do not waste money. Just admit the standard of care or typical practice patterns among physicians for acute LBP is a joke.

 

[AndyDufrane]

On slide 1 put:
No matter what physician care is superior for everything

2:
Chiros are glorified PT's, not real doctors

3:
Chiro is dangerous and medical care is safe

4:
Patients get unnecessary care only with chiropractic

On a serious note may want to advocate for changes in practice patterns that actually make sense and do not waste money. Just admit the standard of care or typical practice patterns among physicians for acute LBP is a joke.

Yeah those slides sound like a good start , but I think I will do a presentation st the next meeting refuting the chiropractor claims, I could also give anecdotal cases I have seen of vertebral artery dissection and subsequent stroke from chiropractic treatment

 

[nvrsumr]

see attachment

the michigan study on lower cost with pmr directing back care is a good start too

 

[lobelsteve]

Might want to full on attack stupidity of chiropractic care.

Www.quackcast.com

Several podcasts from Dr. Crislip on science based medicine review of dc.

 

[jadedphysiotherapist]

had a hospital meeting , there was a presentation on spine care, and presented by chiro, basically slide after slide indicating chiro treatment in the acute care phase for low back pain is superior, and PMR physician directed care is more expensive, I need some ammunition to refute that claim, I am just aware of Andy Haig's study that supports PMR getting involved early on with spine related pain, are there other studies or resources I can use to help me with a presentation.

......Well, because it is usually for acute LBP.

Look at data from physios in other countries in which patients walk in.

Yeah those slides sound like a good start , but I think I will do a presentation st the next meeting refuting the chiropractor claims, I could also give anecdotal cases I have seen of vertebral artery dissection and subsequent stroke from chiropractic treatment

You're planning on using "anecdotal" cervical manip accidents as a pitch....when the subject matter is acute low back pain....which doesn't even warrant cervical manips for tx.....to try and refute an economic statement?

Try something with data instead of red herrings.

Good luck on the presentation

 

[jadedphysiotherapist]

On slide 1 put:
No matter what physician care is superior for everything

2:
Chiros are glorified PT's, not real doctors

3:
Chiro is dangerous and medical care is safe

4:
Patients get unnecessary care only with chiropractic

On a serious note may want to advocate for changes in practice patterns that actually make sense and do not waste money. Just admit the standard of care or typical practice patterns among physicians for acute LBP is a joke.

Not positive, but I think this person thought your advice was serious.

 

[pmrmd]

On a serious note may want to advocate for changes in practice patterns that actually make sense and do not waste money. Just admit the standard of care or typical practice patterns among physicians for acute LBP is a joke.

That's an odd statement considering the SOC for physicians for acute LBP is NSAIDS and P.T. referral.



Sent from my iPhone using Tapatalk

 

[pmrmd]

What Steve said.

Also, a random approach produces average outcomes. Chiro is a random approach. A generic exercise program is a random approach. That -unfortunately- is the SOC and it's expensive.


Sent from my iPhone using Tapatalk

 

[Fiveoboy11]

That's an odd statement considering the SOC for physicians for acute LBP is NSAIDS and P.T. referral.



Sent from my iPhone using Tapatalk

Doctors’ attitudes and beliefs regarding acute low back pain management: A systematic review - ScienceDirect
Initial Management Decisions After a New Consultation for Low Back Pain: Implications of the Usage of Physical Therapy for Subsequent Health Care Costs and Utilization - ScienceDirect
Primary Care Referral of Patients With Low Back Pain to... : Spine

Looks like referral rate to a PT for all LBP is ~ 7%, and acute ~ 13%
First link says doctors attitudes and beliefs are at odds with guidelines and recomendations for acute LBP management

 

[pmrmd]

Looks like referral rate to a PT for all LBP is ~ 7%, and acute ~ 13%
First link says doctors attitudes and beliefs and attitudes are at odds with guidelines and recomendations for acute LBP management

Your first reference is Oceanic, so forget about it. SOC is local and in AZ -where you are- PT utilization appears to be far more than 15%. Your citations are authored by PTs and I frankly question the accuracy of the data as it does not jive with empirical evidence. You should just type what you really think, that you feel PT is underutilized, that doctors are clueless about back pain, MDs have no idea about PT but you have knowledge of medicine, and you are so able and competent you keep haunting PMR and pain forums because...you're just so darn special.


Sent from my iPhone using Tapatalk

 

[Fiveoboy11]

Your first reference is Oceanic, so forget about it. SOC is local and in AZ -where you are- PT utilization appears to be far more than 15%. Your citations are authored by PTs and I frankly question the accuracy of the data as it does not jive with empirical evidence. You should just type what you really think, that you feel PT is underutilized, that doctors are clueless about back pain, MDs have no idea about PT but you have knowledge of medicine, and you are so able and competent you keep haunting PMR and pain forums because...you're just so darn special.


Sent from my iPhone using Tapatalk

Unless you have journal articles to cite I'll go with what I found and I'll speak up when I feel like it. You can be segregationist and dismissive all you want. Feel free to come over to the PT forum all you want, I welcome it. Unless you feel you're too great. And I don't pretend to be trained or an expert in medicine, especially not in front of patients.

 

[jadedphysiotherapist]

Your first reference is Oceanic, so forget about it. SOC is local and in AZ -where you are- PT utilization appears to be far more than 15%. Your citations are authored by PTs and I frankly question the accuracy of the data as it does not jive with empirical evidence. You should just type what you really think, that you feel PT is underutilized, that doctors are clueless about back pain, MDs have no idea about PT but you have knowledge of medicine, and you are so able and competent you keep haunting PMR and pain forums because...you're just so darn special.


Sent from my iPhone using Tapatalk

.....If you want remote legitimacy among professionals, I highly recommend actually reading material or critiquing data/methods.

^I'm aware of PM&R scope and that they do a lot of good primarily in specific interdisciplinary management...but for this specific thing....your colleague was trying to market and save face without giving relevant info.

 

[AndyDufrane]

thanks everyone for the input, my presentation probably won't happen until the next quarter, so hopefully I will have polished presentation, but I was just kind of caught off guard with the presentation as I didn't expect a chiro to go after PMR in a presentation to other physicians

 

[dr.dexter18]

Look into Dr. McGill's work. He professor of spine biomechanics in Canada and pretty well known in his field from what I can tell. I haven't had much of a chance to dive into his work but from what I have read, he indicates from his research that some specific motions of the back can reduce pain initially by eliciting the stretch receptors. However, this is temporary and often can cause more harm meaning chiro work could potentially be a cause to why a patient needs to return for repeated adjustments. Not sure if he specifically address Chiro work but worth a look.

 

[Kissmyabjj]

Look into Dr. McGill's work. He professor of spine biomechanics in Canada and pretty well known in his field from what I can tell. I haven't had much of a chance to dive into his work but from what I have read, he indicates from his research that some specific motions of the back can reduce pain initially by eliciting the stretch receptors. However, this is temporary and often can cause more harm meaning chiro work could potentially be a cause to why a patient needs to return for repeated adjustments. Not sure if he specifically address Chiro work but worth a look.

I had Dr. McGill for a Skype lecture to my PM&R program. He is a genuine badass!!

 

[truthseeker]

thanks everyone for the input, my presentation probably won't happen until the next quarter, so hopefully I will have polished presentation, but I was just kind of caught off guard with the presentation as I didn't expect a chiro to go after PMR in a presentation to other physicians

If you can get insurance companies to part with the information, it would be interesting to find out how much people spend once they start going to a Chiro. Each individual visit is most certainly less expensive than a PM&R office visit, or PT visit but I know that in our PT clinic, we discharge people on average in under 4 visits. its more expensive but we have little recidivism. Go to the chiro for acute back pain, and they convince you that if you don't come in for maintenance adjustments in perpetuity, you will "never walk again" and other baloney.