- Joined
- Sep 20, 2016
- Messages
- 1,802
- Reaction score
- 502
http://www.nejm.org/doi/full/10.1056/NEJM199810083391502#t=article
Old School Deyo article (before Chou was around on this racket) showed that basically an educational packet was superior to both PT and Chiro in terms of cost effectiveness.
Of note: "
We found no significant differences among the groups in recurrences of back pain or in the use of services during follow-up. This casts doubt on the ability of the self-care–oriented McKenzie physical therapy to reduce the utilization of services. The overall costs of care for back pain were lowest in the booklet group, so there was no evidence that the higher initial costs of the physical treatments were offset by later savings.
The relative costs of chiropractic and McKenzie treatments could differ in other settings. The number of visits was left to the discretion of providers (who were aware that both costs and benefits would be measured), and the smaller number of visits to McKenzie therapists (HMO employees) than to chiropractors (in private practice) may reflect differences in practice styles.15"
So all people who come in for LSS should get:
1) Educational Packet
2) Thai Chi Exercises
3) Ibuprofen
4) Yoga prescription
This should all be administered by an NP or better yet LPN and call it a day.
No need for anything further. Any questions?
Old School Deyo article (before Chou was around on this racket) showed that basically an educational packet was superior to both PT and Chiro in terms of cost effectiveness.
Of note: "
We found no significant differences among the groups in recurrences of back pain or in the use of services during follow-up. This casts doubt on the ability of the self-care–oriented McKenzie physical therapy to reduce the utilization of services. The overall costs of care for back pain were lowest in the booklet group, so there was no evidence that the higher initial costs of the physical treatments were offset by later savings.
The relative costs of chiropractic and McKenzie treatments could differ in other settings. The number of visits was left to the discretion of providers (who were aware that both costs and benefits would be measured), and the smaller number of visits to McKenzie therapists (HMO employees) than to chiropractors (in private practice) may reflect differences in practice styles.15"
So all people who come in for LSS should get:
1) Educational Packet
2) Thai Chi Exercises
3) Ibuprofen
4) Yoga prescription
This should all be administered by an NP or better yet LPN and call it a day.
No need for anything further. Any questions?
