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 From the Desk of:

William J Owens Jr DC, DAAMLP

#16 "The Chiropractic GOLD MINE"

When working with the medical community, research is CRITICAL.  It is about “validating” what we say we can do and basically translates to PUT UP OR SHUT UP.  It is not about who is right and who is wrong; it is about developing a process that guides practicing doctors to the best way to treat their patients.  The interesting thing is that we actually have validating research and more is coming every day.  This consultation is not about how to craft a magic bullet to get MDs to refer; what it is about is helping you to “get it.”  What I mean by that is simple. As the healthcare community (payers, reviewers, referring doctors) requires more and more validation, those that understand and are familiar with research will not only survive, they will thrive.  The research that I am talking about is peer reviewed, medically indexed chiropractic research.  Research is being done daily and it does no good for it to stay in academic circles.  We need clinicians to be reading, discussing and disseminating these results. 

To start this consultation, let’s take a look at an important opinion paper written by Sackett, Rosenberg, Gray, Haynes & Richardson (1996) and published in BMJ.   This is an important paper, because the authors define evidence based medicine as “...the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systemic research” (p. 1).  They go on to state, “Evidence based medicine is not ‘cookbook’ medicine.  Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients’ choice, it cannot result in slavish, cookbook approaches to individual patient care” (Sackett et al., 1996, p. 2).  This next section is where I, personally, think there is a lot of misunderstanding and in fact, what the authors are about to say next is extremely important for chiropractic research.  “Evidence based medicine is not restricted to randomized trials and meta-analyses.  It involves tracking down the best external evidence with which to answer clinical questions “ (Sackett et al., 1996, p. 2).  In my opinion, it is a shame that the type of research study used to test a pharmaceutical has, to some, become the gold standard of research study design.  The double blind placebo controlled study is not appropriate for every modality and as the authors state, not necessary. 

With that all being said, I will be posting the following research papers in e-course format.  This information is critical to understand and touches on a variety of topics.  Here are the titles of the papers and the year published.  Look for these to be posted on the e-course section of the website over the next 2 weeks.  This information will truly get you caught up on the diagnosis and management of these patient groups.

Chiropractic Management of Low Back Disorders: Report From a Consensus Process - 2008

Best Practices Recommendations for Chiropractic Care for Infants, Children, and Adolescents: Results of a Consensus Process.  2009

Best Practices Recommendations for Chiropractic Care in Older Adults: Results of a Consensus Process. 2010

Management of Chronic Spine-Related Conditions: Consensus Recommendations of a Multidisciplinary Panel. 2010

Chiropractic Care for Nonmusculoskeletal Conditions: A Systemic Review with Implications for Whole Systems Research. 2007

How does this all translate into the GOLD?  This is how you promote your practice to the medical community.  You don’t need to convince the entire medical community in your area, you simply have to use the research that is available to find the MDs that are interested in referring.  That is it…once you can show them that what you do is validated by someone else and is not simple rhetoric, you and your patients win.  Game OVER…This research will also be summarized for the bimonthly fliers so you will have the entire research paper, a series of questions to direct you to what is important and the bimonthly fliers.   

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