One of the biggest hurdles for new chiropractors is validating the necessity and importance of their care; not only to the insurance industry, but also to the patient, to other treating doctors, and to attorneys. While the marketing management firms may frequently offer new approaches to validation of care, the best answer has always and always remain: evaluate and treat with objective data. This is why Greenville NC, chiropractor Bret Wickstrom is an evidence-based chiropractic practitioner.
Evidence-based Chiropractic reinforces the validity of the care provided in the minds of your patients and for the other providers involved in your patient’s healthcare.
The scientific data collected and used in Evidence-based chiropractic is supported not only by the AMA Guides & the Medicare Carriers’ Manual but also in the new guidelines for PI & Work Comp currently being implemented in California & Hawaii and that have been designed by the American College of Occupational & Environmental Medicine. Within Evidence-based Chiropractic, only one type of functional testing is recognized as the “Gold Standard” by all three references, and that is computerized dual inclinometers.
Patients who come into an Evidence-based Chiropractic practice know, just after the first few visits, that chiropractic is the right choice for them, because a repeatable process is used by the Chiropractor to evaluate and treat their patients, and the process is grounded in hard data – with charts and graphs that document the change in the patient’s condition.
The evidence-based chiropractor already knows that the future success of their practice is secure because the stakes continue to rise for doctors who practice without objective proof of validity.
We must also keep in mind that the legal definition of fraud, once specific to intent, now relies on objectivity versus subjective opinions. The necessity of proving “intent” in order to prosecute a doctor for fraud has been eliminated. If a doctor’s prognosis is found to have been based upon conjecture or personal opinion, rather than established principles of evidence-based health care, it is considered fraud. If the treatment cannot be proven to be “necessary,” it is considered fraud. And “fraud,” against ANY third-party payer, not just Medicare, is considered a federal crime. Insurance carriers, defense attorneys, judges, and adjustors all now have a legal responsibility to report any and all cases of suspected fraud to the State Attorney General’s office and the practitioner’s licensing board.
- Documenting function improvement is not an impossible task, nor is it even a difficult one.
- Many evidence-based systems already exist.
- Integration can take place with minimal effort.
The important factor is to have a system in place which benefits your patient’s health while insulating the doctor from the threat of post-payment reviews, license revocation, and legal action.
Chiropractors need to consider that an initial consultation, a few orthopedic exams, and a set of x-rays may not be enough to accurately formulate a prognosis. The inclusion of evidence-based chiropractic establishes a functional baseline, a “starting line”, an essential requirement to determine MMI – maximum medical improvement. The 5th edition of the AMA Guides for the Evaluation of Permanent Impairment includes normal values for ranges of motion and muscular symmetry for this exact reason. Follow-up functional exams should be performed roughly around the same timeline as interim exams; every 3 months or every 12 visits, whichever comes first. Even more so than Mercy or the Croft Treatment Guidelines, this will justify your care to third-party payers in a manner they can understand, and cannot argue against.
Each and every chiropractor is now faced with a simple choice: will your chiropractic treatment be recognized as evidence-based, or will it be considered evidence-based? The time is rapidly approaching when you must decide to implement evidence-based chiropractic care or fall behind. Objective data is not limited in its application to PI and Work Comp cases any longer; it is a necessity for every practice, whether insurance, cash, or PI/WC based.
The benefits for the doctor are many:
- A repeatable process easily integrated into your practice that enables you to be better informed.
- A greater confidence in the knowledge that your care is compliant with all new regulations in effect and those being considered for implementation.
- Improved healthcare delivery to your patients.
The benefits for the patient are also many:
- Confidence in their treatment plan.
- Undeniable proof that the patient’s condition echoes their testimony.
- Value-added reinforcement for the patients’ health care investment
- Improved patient retention and compliance.
Nothing promotes the chiropractic profession more than a satisfied patient who is armed with a graph demonstrating irrefutable, objective evidence that chiropractic has worked for them. The greatest challenge facing chiropractic in the 21st century will be addressed through scientific verification of the applied principles of chiropractic philosophy.
In the words of Dr. John K. Maltby, president of the International Chiropractic Association, “The best chiropractic philosophy is to have solid scientific backing for what you do.”