Chiropractor vs. MD for Lower Back Pain: Let the Evidence Decide

One of the positive things coming out of health care reform is that health care providers are going to have adhere to “evidence-based practice guidelines.” That means, if clinical studies provide evidence that one thing works better than another for a certain condition, doctors should advise patients about the thing that works better. An example would be, if eating cherries cleared up gout just as well as an expensive prescription medication, patients should be advised to eat more cherries. Perhaps you too chuckle at the thought of your medical doctor whipping out a prescription pad and prescribing fruit. But Title 4 of the Health Care Reform Act of 2010 contains provisions to improve the quality, delivery and outcomes of patient care. Over a billion dollars (wow!) has been earmarked for what’s known as comparative effectiveness research.

It comes as no surprise to me that a recent study called the Chiropractic Hospital-based Interventions Research Outcomes Study, published in the December 2010 issue of The Spine Journal, confirmed in yet another study what chiropractic patients have known all along: “patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little to no improvement with the usual care they receive from a family physician.” Using evidence-based practice guidelines, the family physicians should therefore be referring patients with acute low back pain to chiropractors. Just imagine how simple common-sense changes, like letting the evidence decide, will change how health care is delivered in the near future.