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Chiropractors as Primary Care Providers

Dynamic Chiropractic, Jun 4, 2007 by Vivo, Meghan

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These reports confirm that an integrative medical model which combines conventional and CAMoriented treatments, supervised by a licensed health care professional with expertise in both areas, is a new approach with great potential. Other research by AMI has suggested that the integrative medical strategies "seem to be generalizable to other populations, such as Medicaid/Medipass and targeted disease states in a more classic disease management model."

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While the authors note several study limitations, including lack of randomization, lack of statistical analysis and potential bias, they concluded: "The IPA model presented here is correlated with a decrease in clinical utilization and cost outcomes, compared with conventional medical strategies, over an extended period and in a safe and highly regulated environment. The consistent decrease in cost and care utilization achieved by AMI's integrative medical management strategy over a 7-year time frame warrants larger independent third-party funding for multicenter, randomized controlled trials."

Comments From the Principal Authors

In 2004, Dynamic Chiropractic interviewed Drs. Sarnat and Winterstein following the publication of their initial research. Their observations are as relevant to the follow-up research as they were to the original study.

When asked what he hoped members of the chiropractic and medical professions would take from the study, Dr. Sarnat, a medical doctor, commented:

"The study really shows the enormous power and benefit of two things: 1) the utilization of chiropractic in a primary care setting; and 2) the magnitude of outcomes, both clinical and cost, that can be achieved when all members of the health sciences work together as a team for the betterment of the patient, putting aside all professional rivalries. Hopefully, these results are so dramatic that they will 'wake up' the health care system (or lack thereof) to the immediate need for true integration among all qualified health care providers."

In response to the question, "Comparing the AMI model to the other HMOs in the analysis, what was the most surprising outcome of the study - reduced hospital stays, fewer surgical procedures, reduced use of pharmaceuticals, or something else?" Dr. Sarnat said:

"I have always believed that the overutilization of pharmaceuticals and surgery, and the underutilization of more natural healing techniques, such as chiropractic, has been the cause of great suffering. Yet, I had no idea that the magnitude of both clinical improvements and cost effectiveness would approach 50% in both cases. Previous studies have shown these types of savings when chiropractic has been used as a first-line treatment for NMS ailments, instead of conventional medical care. But to see this level of effectiveness across the board for literally all types of clinical presentations within a primary care setting is surprising to me, and good news for the rest of the world."

Dr. Winterstein, president of National University of Health Sciences, was asked to what extent he could envision doctors of chiropractic as a true gatekeeper of other CAM therapies. He replied:

Health Care Industry

Chiropractors as Primary Care Providers

Dynamic Chiropractic, Jun 4, 2007 by Vivo, Meghan

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