The Evidence Based Chiropractor Blog

Hundreds of chiropractic marketing and research articles to help you grow.

Jeff Langmaid 6/18/14 Jeff Langmaid 6/18/14

The Facts Behind MD Referrals- by The Evidence Based Chiropractor

A few years ago, BioMed Central produced a wonderful paper which examined the referral habits of Medical Doctors. Specifically, they looked at how PCP's refer amongst themselves, and also how they refer to Doctors of Chiropractic. What they found may be some of the most important information currently available on building interdisciplinary referral relationships.

Over 500 Primary Care Physicians took part in the study. Surprisingly, over 80% of Primary Care Physicians reported that their patients requested information regarding Chiropractic. Additionally, close to 75% had patients request a Chiropractic referral. This is very good news as it shows the public has significant interest in Chiropractic care despite the fact that Chiropractic utilizations stands at a woeful 10% (on a good day).

When referring to other Medical Doctors, the studies participants reported initiating a formal referral 99% of the time. When referring to Chiropractors, the PCP's initiated a formal referral in only 11% of cases. This proves that nearly all PCP's are comfortable making formal referrals, however, they are not making these formal referrals to Chiropractors.

Finally, and most significantly, the researchers found that roughly 25% of PCP's have referred a patient to a Chiropractor. Again, while this number is exceptionally low (considering the research on the safety and efficacy of Chiropractic care), it provides us with the information that-

1) Patients are asking their PCP's about Chiropractic care

2) 1/4 of PCP's have referred patients to Chiropractors

3) Only 10% of these referrals are "formal" referrals

In my opinion this study emphasizes the need for chiropractors to reach out to other physicians in their communities and build referral relationships. The public is inquiring about our services to their most trusted health professionals; their family doctor. The onus is on us to build the relationships necessary for these PCP's to make the referrals to our offices'. We have the research to substantiate our place in the health care world; now its time to reach "across the aisle" and make sure our neighbors are receiving the best conservative care possible.

-The Evidence Based Chiropractor is the leading DC/MD marketing and outreach group in the world. Our service is dedicated to increasing chiropractic utilization by showcasing research. Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals. Join us. Lets grow chiropractic together.

Jeff Langmaid 6/16/14 Jeff Langmaid 6/16/14

Healthcare in the United States: Expensive and Ineffective- by The Evidence Based Chiropractor

The Commonwealth Fund recently released an executive report on the state of the US healthcare system when compared to nearly a dozen industrialized countries. The report places the US last in overall score and first in overall expense. With hospital systems, insurance organizations, and pharmaceutical companies recording record profits; the results of this report are a shameful reminder of the current state of healthcare.

I strongly encourage you to review the full report here- http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

Jeff Langmaid 6/16/14 Jeff Langmaid 6/16/14

3 Trends for the Future of Spine Care- by The Evidence Based Chiropractor

Dani Gordon (Becker Spine) recently reported on the top 3 trends for the future of spine care. These ideas were generated from the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago on June 13th. She reported the top 3 key concepts to be-

"1. Data importance is increasing. Data on outcomes, patient satisfaction and cost of care is not only what drives payer preference but also patient preference.

2. Minimally invasive techniques have become increasingly more popular. Not only has technology paved the way for less invasive techniques, but it has also created a more informed patient. Patients look for technology advancements in anesthesia, shorter procedure times and shorter recovery times. Outpatient support, effective implants and MIS technology were cited as the main focus of the spine industry, usually most prominent in ASCs.

3. Change in healthcare is widely based on IT, cost and quality of care. Although Dr. Hochschuler stresses the fact that healthcare is "fifteen-years behind the IT world," much of what improves customer care and quality is based in IT, especially with regard to education, cost of care and patient satisfaction."

As chiropractors, number 1 and number 3 are of particular importance. Patient satisfaction and cost of care are two areas which chiropractors have historically had great success. As third party payers begin to transition their reimbursement models towards satisfaction, cost, and patient outcomes, chiropractors should be in a good position to maximize reimbursement (with adequate lobbying). Additionally, while some chiropractors still cling to their travel cards, a substantial amount of chiropractors are already using technology to their advantage. Find a list of my top chiropractic iPad applications HERE.

Jeff Langmaid 6/12/14 Jeff Langmaid 6/12/14

The Dangers of NSAID's - by The Evidence Based Chiropractor

NSAID's are taken by millions of Americans each and every day. Below is another great infographic from Mercola which outlines just how dangerous these over-the-counter drugs can be.

Did you know that current research shows spinal manipulation to be a clinically superior treatment option than Diclofenac for spine pain? A few months ago, members of The Evidence Based Chiropractor received a monthly MD Research Brief from SPINE Journal which was a double blind RCT comparing spinal manipulation to Diclofenac. The authors concluded that, "“Final evaluation showed manipulation being significantly better than NSAID and clinical superior to placebo.” Are you a member yet?

Jeff Langmaid 5/29/14 Jeff Langmaid 5/29/14

The Business of Spinal Fusions- by The Evidence Based Chiropractor

Spinal fusions are big business in the United States. In 2013, over 87% of the surgical spinal procedures involved a fusion. The US performs over double the amount of yearly fusions compared to Canada, the United Kingdom, Western Europe, and Australia. Nearly 500,000 fusion are being performed this year (nearly 250,000 were performed in 2001).

Are these procedures providing superior outcomes for our patients? It would appear the answer is no.

In 2006, a Medicare physicians panel found that "it was less than reasonably likely that spinal fusion would provide a long-term benefit for patients suffering from degenerative disc disease." Medicare never translated this finding into their policies, however, other insurers have picked up on the fact that spinal fusion utilization may be far greater than its effectiveness.

Blue Cross & Blue Shield has now excluded spinal fusion as a covered procedure for degenerative disc disease without gross instability. They recommend at least 3 months of conservative spine care. Cigna also has a similar recommendation. Even the International Society for the Advancement of Spine Surgery said “increasing success and optimism may be leading some surgeons to overuse procedures beyond what the current state of medical evidence really supports.” Also of note is between 2006-2009 the cost of a spinal fusion nearly doubled. This is in part due to the surgical implant companies increasing the pricing of instrumentation.

Many health care facilities are building multidisciplinary health care centers. These spine centers include medical doctors, chiropractors, and other allied health practitioners. Preliminary data shows that these spine centers are providing a higher quality of care, with great patient satisfaction, good outcomes, and a model of care based on best practice and evidence based guidelines for spine care. Whether or not a spinal fusion is right for you is a decision to be made between you and your doctor. However, growing evidence would suggest that conservative spine care may be more effective for many individuals.