During the winter months of 2006 and early 2007, the Foundation for Chiropractic Education and Research (FCER) newly conceived a role in which the foundation could broaden its service to the chiropractic profession.During the ensuing months, a great amount of labor has been poured into the development of this new role, while maintaining the current role the foundation has traditionally filled as the primary funding source for chiropractic research. At a more recent August meeting of the FCER Board of Trustees in Orlando, Fla., the "birthing process" began.
I am writing this article in late August before an official launch date has been set, so consider this a preliminary perspective of what is to come. I think you will get as excited as all those who have been working on the project. I will attempt to share some insights and whet your appetite just a little.
We are in an era where the accepted mantra is evidence-based health care. Yet, we all know that a paucity of randomized controlled trials (RCT) affects the practice of medicine as much as chiropractic. Everyone is feeling the blows of third-party payers hiding behind the skirt of evidence-based health care as a vehicle for cutting payments to providers.
So when Dr. Practice gets a phone call saying his services were denied because the need for care has not been documented, what is to be done? One option would be to shut down the office for the day and go to the local medical library and hunt for the evidence to support your claim. In today's modernity, one could simply get on the Internet and search for the needed evidence. In fact, there are several searchable (for a fee) databases where information has been stored only for such purposes - the Manual and Alternative Natural Therapy Index System (MANTIS) being one popular in chiropractic.
However, unless one is experienced at navigating these databases, a great deal of time could be spent with very few results, or so many articles could be found that it will be difficult to know what to do with all the information obtained. In either case, there will be a significant time loss from practice.
Evidence-Based Resource Center (EB-RC)
The FCER intends to help fix this problem for the practitioner through the creation of an international collection of chiropractic-relevant literature into a single database housed in our resource center. The plan is to make this the largest and most complete resource in the world available to the chiropractic profession.
In using a database, those experienced in searching and culling the literature will have that same opportunity but in a much larger collection of the literature relevant to chiropractic than found anywhere else.
To those not experienced in literature search and retrieval, such as many busy in practice, an added feature in this EB-RC will be the distillation of the information contained in the database, by appropriate experts, into a format that will be easily accessible, readily understandable and clinically relevant to the needs of the doctor and the patient.
We envision the EB-RC to be a continuum of education and research expertise and information resources that will deliver advisory services, management/technical support, education and training. And, as already noted, the center will provide ready access to information on research and evidence-based care. This global access to information will benefit chiropractic patients, the research community, practitioners of chiropractic and manual therapy, colleges/faculty, associations, agencies, regulatory bodies and other stakeholders.
The primary delivery vehicle for this information will be DC Consult, an Internet-based, professional networking Web site and electronic library, housing all the published research relevant to chiropractic.
No doubt many questions and perhaps some skepticism already are racing through your mind; such was my first impression when exposed to this project. However, as I have watched it unfold and participated in its development, I am more excited about what this is and what this can become than anything else in the profession.
We are in the early phase of "beta" testing this resource center and, therefore, I don't have the answers to many of the questions you may have. I simply wanted you to know that the FCER has breathed new life after going through a series of adjustments. Speaking colloquially, our innate is on the move again. Health and vitality are flowing through our nervous system. If one stops long enough to ponder the immensity of what is being developed, it becomes overwhelming. The EB-RC is more than just a repository for research minds to plow through endless articles to hone their theories and test their hypotheses, although it will definitely meet this need.
Just imagine current clinical information substantiated by the most recent literature no more than a couple of mouse clicks away. Information that can so easily be accessed becomes another tool in the daily practice of a busy practitioner in working with his or her patients. No more will you need to wonder which diagnostic test you should use, what does a certain test mean, or what does this skin rash suggest, and the list can go on. Readily accessible, user-friendly knowledge is power in today's world. The FCER plans on putting this information at your fingertips in a fashion that will meet your patients', as well as your needs.
But don't let your imagination stall at this point. Such a database of information can become an invaluable source to our educational needs across all institutions around the world. Students and faculty alike will benefit. Regulators and legislative folks will have need of this information as well. This database even can be designed for patient use and use by the general public.
So the sky is the limit - not that a few extra bucks wouldn't help to move the process along more quickly. In just a few short months, more information will be unveiled and actual use of this resource center will be pilot tested. So hang on to your hats, because we have a barnstorming experience awaiting all of you in or affiliated with chiropractic.
Editor's note: As of 2008, Dr. Phillips will discontinue his "The Next Century" column and begin writing for the "FCER Forum" column. Dr. Phillips is vice president of the FCER and chairs the foundation's research division (EB-RC).
Click here for previous articles by Reed Phillips, DC, PhD.