A recent article in a chiropractic
publication offered advice on how to
choose a chiropractor. [1] The reader
was admonished to "suspect brainwashing"
if wellness or maintenance care was
recommended. The author regurgitated the
tired old bromide that "There is no
scientific evidence..." This claim must
be refuted.
The World Health Organization defines
health as being "a state of complete
physical, mental, and social well-being,
and not merely the absence of disease or
infirmity." [2] Given this broad
definition of health, epistemological
constructs borrowed from the social
sciences may demonstrate health benefits
not disclosed by randomized clinical
trials. Health benefits such as
improvement in self-reported
quality-of-life, decreased health care
costs, behaviors associated with
decreased morbidity, and patient
satisfaction may be evaluated using such
methods.
Blanks, Schuster and Dobson [3]
published the results of a retrospective
assessment of subluxation-based
chiropractic care on self-related
health, wellness and quality of life.
This is, to my knowledge, the largest
study of its kind ever undertaken
regarding a chiropractic population.
After surveying 2,818 respondents in 156
practices, a strong connection was found
between persons receiving Network care
and self-reported improvement in health,
wellness and quality-of-life. 95% of
respondents reported that their
expectations had been met, and 99%
wished to continue care.
Coulter et al [4] performed an analysis
of an insurance data base, comparing
persons receiving chiropractic care with
non-chiropractic patients. The study
consisted of senior citizens over 75
years of age. It was reported that the
persons receiving chiropractic care
reported better overall health, spent
fewer days in hospitals and nursing
homes, used fewer prescription drugs,
and were more active than the
non-chiropractic patients.
Rupert, Manello, and Sandefur [5]
surveyed 311 chiropractic patients, aged
65 years and older, who had received
"maintenance care" for five years or
longer. Chiropractic patients receiving
maintenance care, when compared with US
citizens of the same age, spent only 31%
of the national average for health care
services. There was a 50% reduction in
medical provider visits. The health
habits of patients receiving maintenance
care were better overall than the
general population, including decreased
use of cigarettes and decreased use of
nonprescription drugs. Furthermore,
95.8% believed the care to be either
"considerably" or "extremely" valuable.
Rupert [6] reports that 79% of
chiropractic patients have maintenance
care recommended to them, and nearly
half of those comply. In an online
survey with 3018 respondents by Miller,
[7] 62% responded affirmatively when
asked, "Although you feel healthy, would
you follow your family member's lead and
visit a doctor who focuses on wellness
and prevention just so you can stay
feeling that way?"
Clearly, there is a growing body of
evidence that wellness care provided by
doctors of chiropractic may reduce
health care costs, improve health
behaviors, and improve patient perceived
quality-of-life.
References
1.
Andersen GD: "Food for thought
2002: how to choose a
chiropractor." Dynamic
Chiropractic 2002;20(3).
2. World
Health Organization: The first
ten years of the World Health
Organization. Geneva: WHO, 1958.
3. Blanks
RHI, Schuster TL, Dobson M: "A
retrospective assessment of
Network care using a survey of
self-reported health, wellness
and quality of life." Journal of
Vertebral Subluxation Research
1997;1(4):15.
4. Coulter
ID, Hurwitz EL, Aronow HU, et
al: "Chiropractic patients in a
comprehensive home-based
geriatric assessment, follow-up
and health promotion program."
Topics in Clinical Chiropractic
1996;3(2):46.
5. Rupert
RL, Manello D, Sandefur R:
"Maintenance care: health
promotion services administered
to US chiropractic patients aged
65 or older, Part II." Journal
of Manipulative and
Physiological Therapeutics
2000;23(1):10.
6. Rupert
RL: "A survey of practice
patterns and the health
promotion and prevention
Attitudes of US chiropractors.
Maintenance care: Part I."
Journal of Manipulative and
Physiological Therapeutics
2000;23(1):1.
7. Miller
S: chiroviewpresents.com. Survey
says? 2/6/02.
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