It is believed by many that if we could control fraud, waste, and improper health care utilization, our nation could afford to provide health care for all Americans.Instead, we spend a large percent of our GNP providing partial care for our senior citizens, and spend more money doing it than any other nation spends giving total health care to all of its citizens. Our society and our government needs to do some serious rethinking and re-evaluating the proper utilization of health care. The American health care system is neither healthy, caring or a system. It is currently inefficient, wasteful, and improper. If we ever try to get a national health care program going under its current direction, it would bankrupt this nation. Some corrective proposals that are being offered are like putting a Band-Aid over a hemorrhage; they simply won't work.
I know that these are strong words, but please read on and I'm sure that you will agree. To support my position, I will quote only the most respected government studies, university studies, a Health Maintenance Organization (HMO) study, a hospital study, and workers' compensation statistics. These are fully-documented cases.
Fraud in health care takes several forms. One form is overutilization with expensive tests like MRIs and CT scans, particularly when doctors have a financial interests in the facilities running such tests. This is not to minimize the importance of clinical tests. It is when doctors ignore other tests or therapies which may be in the better interest of patients that it becomes questionable.
One of the most cruel forms of fraud in health care is fraud by exclusion. If a doctor is aware of the advantages of alternate therapies and ignores them for selfish reasons, the doctor is not being honest with his patients. It reflects a callous indifference toward suffering patients. Doctors are morally and ethically bound to advise their patients of any options which may be safer, better, and more cost-effective.
There are several reputable studies of which you should be aware:
- The RAND Study: RAND, the world renowned "think tank," in conjunction with the UCLA Department of Medicine et al., completed a multidisciplinary study in 1991 and found that spinal manipulation (the specialty of chiropractors) was appropriate for acute low-back pain with no neurological findings or sciatic nerve irritation, and acute low-back pain with minor neurological findings and normal lumbosacral radiographs.1 Shouldn't all "appropriate" treatments be found in hospitals throughout America? Of course they should, but why aren't they? We should be asking these questions and demanding honest answers. It's in your interest.
- The British Government Study: In 1990, the British government completed a major 10-year study and found that chiropractic in some areas of health care was clearly superior by as much as a 2:1 ratio over anything that medicine had to offer.2
- AV MED, HMO Study: The largest HMO (health maintenance organization) in the entire southeastern United States sent 100 of its medically unresponsive patients to its local chiropractor and recorded his results. The HMO found that 86 percent of this group were helped. More importantly, 12 out of 12 previously medically diagnosed cases as needing disc surgery were all corrected within two to three weeks, saving AV MED $250,000, notwithstanding pain, suffering, and the potential complications of surgery.3 This information is in the public record (Wilk et al. vs. AMA et al.). The medical profession is fully aware of these astounding facts, yet continues to drag its feet in establishing closer interprofessional relationships with chiropractic. This is not in the public interest.
Imagine the national impact if the cost savings from this HMO were extended to all 7,500 hospitals and thousands of other HMOs across America. It is mind-boggling for any objective observer to see such incredible disregard for patients.
- University of Saskatchewan Study: World-renowned medical orthopedist Kirkaldy-Willis joined forces with chiropractic doctor David Cassidy in a 1985 research report, "Spinal Manipulation in the Treatment of Low-Back Pain." Two-hundred and eighty-three "totally disabled" patients who had not responded to medical care, were given two or three weeks of daily spinal manipulations. The results: "No restrictions for work or other activities" in 79% of 54 patients with posterior joint syndrome, in 93 percent of 69 patients with sacroiliac joint syndrome, in 88 percent of 48 patients with both syndromes, and in 36-50 percent of the 112 patients with more serious disorders.4
If medicine had any kind of comparable treatment, it would make the headlines. Instead, the medical profession looks the other way. Is this intellectually honest?
- Utah Workers' Compensation Records: A study of over 3,000 workers' compensation cases showed compensation costs were 10 times less under chiropractic care, and chiropractic treatment costs were seven times less.5<.sup> A major concern of everyone is the high cost of health care. The answer is glaring at us but can we see it? We'd better.
- Italian Government Study: The Italian government in 1988 completed a two-year study on over 17,000 patients treated by chiropractors within 22 medical clinics. The university conducting the study found that hospitalization was reduced by 87.6 percent and work loss 75.5 percent through chiropractic care. Imagine the financial impact this would have on America's 7,500 hospitals if they cooperated with chiropractors instead of scandalously dragging their feet.6
- Two Hospital Orthopedic Wards Compared with and without Chiropractic Care: It was found that the hospitals using chiropractic care were able to send patients home seven to nine days sooner than hospitals not employing chiropractic care.7 If we project these figures to 7,500 hospitals in America, the impact on cost and suffering is awesome. Yet, why is it ignored? Currently less than .5 percent of the 7,500 hospitals in America have chiropractors on their staff. This is an intolerable situation and must be firmly addressed and corrected.
The issue is not chiropractic versus medicine. Rather, it is a simple case of using the safest, best, and most cost-effective state licensed therapy without bias or selfish interests. It is an issue of common sense and being able to have a cost-effective therapy without bankrupting this nation or adding to any recession in America.
If you are a chiropractic patient, I urge you copy this message and send it to your legislator with your thoughts. If you are a legislator, I urge you to consider the facts contained herein and act appropriately. Your nation's welfare is at stake. If you are in the media, I urge that you feature this information. I can't imagine a more timely and forceful topic of public importance. Together, we must create public awareness and redirect our health care system into a rational and sensible direction. Our nation's health care and well-being is at stake. Please take action today. It is in your best interest.
- The appropriateness of spinal manipulation for low back pain: Indications and ratings by multidisciplinary expert panel. Shekelle PG, Adams AH, et al. 1991 RAND, Santa Monica, CA Monograph No. R-4025/2 CCR/FCER.
- Mead TW: FRCP, British Medical Research Council, 1990. Randomized control trials and scientifically accepted Oswestry Scale for pain measurement were used.
- Davis H: AV MED HMO Medical Director, Miami, Florida 1982. Silverman Mark.
- Wardwell W: Chiropractic: History and Evolution of a New Profession. Mosby Year Book, 1990:196.
- Jarvis K, Phillips R, Morris E: MBA Workers' Compensation Fund of Utah, 1991. Three thousand sixty two nonsurgical back ailments in records from 1986, 21 days and $68 paid under medical care; three days and $68 paid under chiropractic care.
- Splendori F: Chiropractic Therapeutic Effectiveness -- Social Importance, Incidence on Absence from Work and Hospitalization, Italy, 1988. Survey on 17,142 patients over a two year period. Study used chiropractors in 22 medical clinics in cooperation with leading universities who recorded the results.
- Freitag P: U.S. District Court for the Northern District of Illinois, Eastern Division, May 1987. Testimony comparing JFK Hospital of Chicago (using chiropractic) and Luthern General Hospital of Park Ridge, Illinois (not using chiropractic).
Chester Wilk, D.C.
5130 W. Belmont Ave.
Chicago, Illinois 60641-4206
Tele: (312) 725-4878
Click here for previous articles by Chester Wilk, DC.