The Medical Field & Their Relationship With Chiropractors in 2019

Friday, July 12th, 2019

Traditionally, there has been quite a divide between the chiropractic field of healthcare and the medical field of healthcare with equal amounts of offensive behavior on each end of the spectrum.

There have been times in history when chiropractors were locked up in jail for treating patients and the American Medical Association deemed it unethical to even ACCEPT a referral from a chiropractor. Another way of saying that is if a chiropractor felt he or she was unqualified to treat a patient, the MEDICAL association deemed it unethical for any medical professional to treat a patient that you referred to them! It gets so much worse but it is not worth going into for the purposes of this article. Of course, you would have chiropractors against the medical field when under attack in such a manner.

On the other hand, we have chiropractors dismissing essentially anything from the medical field up to and including treatments like surgery of any kind, high blood pressure medication, vaccines, cancer treatment, and even the handling of babies upon birth. On top of that, you commonly have chiropractors pushing and peddling the newest of anything to make a dime (including multilevel marketing) regardless of the presence of any real research to substantiate the products they push. Of course, the medical field would frown on these things.

As a result, cooperation or collaboration between the two entities has been few and far between. That is until more recently.

As an Amarillo chiropractor, having been in practice for over 20 years at this point, I have seen the tide change. In 2017 the American College of Physicians (ACP) updated their treatment recommendations for acute and chronic low back pain. They now recommend spinal manipulation (chiropractic) as a first-line treatment for acute and chronic low back pain. They recommend chiropractic before even taking aspirin. That is a big deal when you consider that the ACP was once one of the main entities against chiropractic years and years ago.

So, why has your primary doctor not sent you to a chiropractor yet for you low back pain? There are really four main reasons why according to Dr. Tim Bertelsman and Dr. Brandon Steele with ChiroUp, a national company that helps track chiropractic effectiveness among other metrics.

Those reasons come down to:

  1. The Trust Factor
  2. The Substandard Care Factor
  3. The Ignorance Factor
  4. The Over-engagement Factor

We’ll cover each very briefly.

The Trust Factor

It is clear that those in the medical field prefer to refer to and work with only those practitioners that are like-minded: practitioners they know and trust and who treat their patients the way they would treat them. They are keen to protect their patients in their decisions and only send them where they feel they will get optimal results. They feel that a referral puts THEIR reputation into consideration so they want to only make the best referral possible and, for many, chiropractic is still an unknown factor for them. Certainly when you see them advertising on platforms like Groupon for a $20 visit.

Those in the medical field also frown on chiropractors peddling supplements and especially frown on them pushing new supplements every visit. This is not typically done when a patient is going to a more evidence-informed chiropractor.

The Substandard Factor

Those in the medical field are skeptical of saliva testing, hair analysis, and things that are less studied in the literature. They are hearing now that spinal manipulation works but are unsure of many of the other modalities used by some in the chiropractic profession. They also mention that they hear what we are telling their patients and, if a chiropractor is advising them against vaccinations, you will not be seeing any more of their patients. Evidence-informed chiropractors do not typically engage in such discussions.

The Ignorance Factor

If those in the medical field are honest, they do not usually know exactly what chiropractors do or why it works. It just is not something taught in medical school. Just like the fact that chiropractors mostly see the failures of surgery, physical therapy, and pain management, our medical counterparts mostly see the failures of chiropractors. If they’re doing great, they do not need to go back to see the medical doctor. They do not see our successes. Evidence-informed chiropractors should be doing their part to educate and inform their community. That goes for their medical community as well.

The Over-engagement Factor

Medical doctors see themselves as a sort of financial steward for Medicare and similar plans and, if they refer to a provider that runs up a bill from too much care that honestly seems unnecessary, THEY can actually be booted from the system. More than anything, they are looking for reasonable treatment plans, reasonable goals, and an endpoint to the treatment. That should be what you can expect when treating with an evidence-informed chiropractor.

These are the four most common reasons our medical counterparts do not always feel comfortable sending their patients to chiropractors. For them, it is easier to simply refer to a trusted physical therapist they are already familiar with. Why would they have any reason to know the research that shows chiropractors are more effective, less expensive, and have higher patient satisfaction than physical therapists? Again, what they have mostly seen are the failures of chiropractic.

As a result, chiropractors need to step up their education game.

One of the first things chiropractors can do is put down the shovel and quit digging. What I mean is this: many chiropractors need to stop endless visits for the life of a patient. Get the complaint resolved and move on. They will come back to see us when they start hurting again.

Stop claiming to treat things out of the scope of chiropractic. Conditions such as digestive issues, ear infections, and even cancer. Even if a chiropractor has experienced improvement in these things at some point over the years, there is zero research showing the effectiveness and basing recommendations on some anecdotal observations may be irresponsible. Doing so is certainly perceived as irresponsible to those in the medical field regardless of what chiropractors think of it.

Stop subscribing to a philosophy before subscribing to the science and research. I feel there is always room for theory and philosophy to guide further research but, solid research should take the front and center of the stage until further notice. As an added benefit, research just happens to be the language of our medical counterparts.

Stop looking like a circus sideshow snake oil salesman. That means chiropractors need to stop jumping on every little product and supplement. Especially multilevel marketing schemes. Jumping on bandwagons like these simply make the entire profession look awful. Not just you, but everyone associated with your profession. Money is short-lived. It comes and it goes. Reputation is what follows you and is what ultimately matters the most. Protect it and preserve it at all costs.

Stop just getting by. Why do chiropractors not specialize? Chiropractors tend to graduate from chiropractic college and go into practice and essentially just stop learning right there and then. In the medical field, our closest counterparts are general practitioners to an extent. But so many go on to specialize in the medical field. That is why we have neurologists, pediatricians, orthopedic surgeons, and neurosurgeons just to mention a few. Our profession has Diplomates and specialty certifications yet so few actually take advantage of them to continue and further their education. Simply getting 16 hours per year of continuing education because that is what your state demands is no longer good enough. Challenge yourself to do better. Challenge yourself to be the best, most knowledgeable, and most responsible chiropractor in your community.

When chiropractors as a group start showing progress with regard to these recommendations, they will see more trust from the public and from the medical field. As a result, chiropractors will begin seeing more and more referrals from those in the medical field.

The research is there in abundance. Now we just need trust.

Jeff Williams, DC
Amarillo Chiropractor – Chiropractor Amarillo
Host of Chiropractic Forward Podcast