Evidence-based chiropractic: A catalyst for patient-centered care
by David Marcarian, MA and Nancy Miggins, DC
While the paradigms of evidence-based practice and patient-centered care have been evolving independently over the past decade, the concepts are merging in today’s contemporary chiropractic practice.
Insurance carrier restrictions place more responsibility on health care consumers, forcing them to be well informed prior to arriving at the chiropractic office. It also mandates that health care providers objectively justify the recommended treatment regime, both to prospective patients and their third-party payers. It’s critical to incorporate technology that can meet this challenge and connect evidence-based practice with patient-centered care.
Today’s chiropractor can adapt, migrate, or die in response to this time of crisis and paradigm shift. No longer an option, “status quo” is just slow death.
Unlike previous paradigms that relied upon patients trusting their doctors, evidence-based practice blends the doctor’s clinical expertise and research-proven diagnostic technology, focused on the patient’s goals and preferences. This technology-based practice embraces the individual’s needs while preserving chiropractic integrity.
Society today is bombarded with a continuous stream of information, resulting in sensory overload. Standing out in an endless sea of information is a challenge every industry faces, and particularly in health care where patients now recognize doctors as business people.
The key to credibility is the objectivity of the test. A test is truly objective if it does not require verbal input from the patient.
By objectively monitoring a patient’s progress, treatment protocols can be improved and promoted. The focus of care can be re-directed if necessary and the integration of services coordinated efficiently. Clinical decision-making and corresponding patient communication can be streamlined, promoting not just compliance, but direct involvement by the patient in his or her treatment plan. Results remain the focus.
There are many approaches to providing this evidence. To maintain credibility, it’s crucial to understand the limitations and capabilities of the technology being utilized. There are some simple rules that help achieve this goal:
1. Make certain that independent researchers performed research studies conducted on the equipment. Pharmaceutical research is criticized for its biased nature, and the same standards must apply to tools utilized in chiropractic.
2. Keep up to date on the literature. As an example, until 2005, it was considered acceptable to perform seated Static sEMG exams. A paper published by University of Michigan established the need to perform such tests standing.
3. Prior to purchasing equipment that two tests can be performed in a row with good reproducibility. All physiologic measures should provide fairly good test-retest reliability when performed by the same individual with short temporal separation.
4. Confirm that the physiologic measure can be performed in a timely manner. All too often, a great machine is never used due to the amount of time it takes to perform the test. Typically, if it takes longer than five minutes, the doctor will opt not to do it unless justified by reimbursement.
In this highly competitive health care market, fostering patient-centered care is in the consciousness of most every health care leader. Chiropractors no longer enjoy the luxury of building relationships and trust over time. There is one chance, one opportunity, to make a connection that inspires confidence on behalf of the patient. This connection can be assured by merging the technology of evidence-based practice with the principles of patient-centered care, removing trust from the equation and letting the data speak for itself.
Considered radical concepts not so long ago, today evidence-based chiropractic and patient-centered care are core components of quality health care. The bridge, which brings these two concepts together, is technology. Research-proven, clinically relevant technology. Provide this technology and watch how patients respond to the level of care they expect from all health care providers today.
(David Marcarian, MA, is the founder of Precision Biometrics, and inventor of the revolutionary MyoVision 3G Wirefree PhysioMonitoring System. A former NASA researcher, Dr. Marcarian was awarded a $450K NIH grant to develop the MyoVision. As an expert witness, he established the validity of sEMG in a major State Superior Court Decision. Recently, the AMA selected his 3G Wirefree System as the “tool of choice.” Dr. Marcarian trains doctors worldwide through his comprehensive training course, “MyoVision Team Elite.”
Dr. Nancy Miggins, has more than 25 years clinical experience as a chiropractor. She excelled in the areas of procedures, ethical business practices, and management. After spearheading the development of an integrative health and fitness center, she spent six years as clinic director. Although her focus was in family practice, she has also aided Olympic Athletes and professional cyclists with optimizing sports performance through chiropractic.
For more information or to contact Drs. Marcarian and Miggins, call 800.969.6961 or visit www.myovision.com)
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