Worker’s Compensation Chiropractic Care
The Workers’ Compensation Research Institute (WCRI) recently released the results of its study on the use of chiropractic care to treat injured workers in the United States with lower back pain.
As a chiropractor by training and a long-time practitioner in Ohio’s workers’ compensation and managed care field, I was intrigued by this post. The results themselves are quite interesting and signal that further research into the current landscape of physical medicine is well warranted; however, their primary meaning, in my view, is to highlight the renewed role of chiropractic care in workers’ compensation.
The researchers found that the average costs per claim – both medical and compensation – for lower back pain experienced at work were lower for those treated exclusively by chiropractors, rather than other clinical specialists. Additionally, the injured workers studied who were treated exclusively by chiropractors were significantly less likely to be prescribed opioids or undergo diagnostic imaging tests. (For detailed results, refer to the study report.)
History and background
The 1990s were marked by rapidly rising health care costs. This spike, of course, put a strain on workers’ compensation systems in the United States. Several studies conducted during this decade found that the use of chiropractic was a significant driver of workers’ compensation health care spending – leaving many to question its cost-effectiveness. This skepticism has led a number of states to implement reforms to workers’ compensation policies and cost containment measures limiting the use of chiropractic care in favor of other treatments considered more evidence-based. and economic.
The recent WCRI findings paint a much more encouraging picture of chiropractic care for injured workers than the research findings of the 1990s.
I believe there are a few factors that contribute to the disparate results.
- Patient Empowerment: Historically, patients remained under the care of chiropractors for long periods of time, and progress toward healing depended on adjustments or manipulations administered in the office. (The traditionally extended duration of chiropractic treatment and the cost increases that began in the 1990s are other reasons it has fallen out of favor.) improvement and reduce dependence on office care. They educate injured workers on stretching and strengthening exercises to perform at home, as well as strategies for returning to work safely and preventing further strain, such as proper biomechanics and lifting techniques.
- Continuing education: Many chiropractors now undergo training in complementary specialties and treatment approaches, such as sports injury management, orthopedics, neurology and more. This allows outcome-focused practitioners to leverage knowledge and practices from other areas of physical medicine, as well as interdisciplinary care plans, and provides them with additional tools to help injured workers relieve their back pain. and increase their productivity.
- Multidisciplinary care: Although the recent WCRI study primarily highlighted injured workers treated exclusively by chiropractors, some of the greatest successes I’ve seen recently have involved complex cases that warranted an integrated model of care when patients were not achieving the anticipated evidence-based recovery. measures after chiropractic treatment alone. There is a growing trend of opening multi-disciplinary clinics to treat high-severity musculoskeletal problems – where orthopedists, family physicians, nurse practitioners, neurologists, physiotherapists, chiropractors, massage therapists, surgeons and other specialists work together to provide holistic care under one roof. Rather than assuming that one specialty has all the answers for a given individual, this integrated approach spans a variety of treatment protocols and enables quality collaborative care for complex injuries. However, engaging multiple practitioners can increase the medical costs of a claim. It should therefore be done with caution and only when the seriousness and complexity of the case justify it.
Opportunities in the field of toilets
Many in the field of workers’ compensation, managed care, and employers still cling to the long-held perception of chiropractors as providing care for extended durations without evidence of measurable or functional benefits. As a result, they tend to be reluctant to include chiropractic care in injured worker treatment plans for fear of increasing medical costs with little return on investment and potentially extending lost time from work. While some continue to be wary of the effectiveness of chiropractic treatments, millions of people are getting healing and pain relief through evidence-based care from chiropractors. (The WCRI study pointed out that people with non-occupational back injuries are much more likely to seek chiropractic care than those injured at work.)
In light of growing concerns about addictive painkillers, long-term side effects, and rising pharmacy and surgical costs, chiropractic care offers a non-invasive way to help injured workers improve their quality of life. life and their productivity. Some people respond well to chiropractic treatment, others do not, and particularly complex cases may require multiple treatment approaches. However, chiropractic intervention is a low-risk and relatively inexpensive overall treatment option that merits further consideration.
Workers’ compensation in the United States may present a unique opportunity for optimal utilization of chiropractic care due to the structure of the system. Unlike people seeking treatment for non-work injuries, workers’ compensation patients have a claims reviewer, often a nurse case manager, and others who help coordinate their care. These professionals are trained to handle complex cases, ask the right questions, and facilitate communication and cooperation between healthcare providers. Since workers’ compensation is covered by workers’ compensation, patients don’t have to worry about copayments to multiple specialists and medical plan deductibles. Instead, they and their claims team can focus on finding the right care from the right treatment providers at the right time.
I hope WCRI’s publication opens the door to greater consideration of chiropractic care with physical medicine modalities in workers’ compensation cases and a re-examination of regulations currently limiting worker access. injured in some states to high-quality, evidence-based chiropractic care. .
By David Kesler
Courtesy of sedgwick
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