Seeking Chiropractic's Fit Among the Medical Home
By Emily Mullin
October 23, 2012
The healthcare accreditation organization URAC announced in October that it will partner with the Foundation for Chiropractic Progress for a pilot project that will look at how chiropractic care models can best achieve the principles of the patient centered health care home, or medical home.
While chiropractors are not currently recognized as primary care providers in the medical home model, they are eligible to participate and could have a valuable role to play as a part of the patient’s multidisciplinary medical team.
“This will establish a dialogue in hopes of securing a mechanism for acquiring accreditation for chiropractors under the URAC Patient Centered Health Care Home model,” said Dr. Gerard Clum, a founding faculty member at Life Chiropractic College and the first and former president of Life Chiropractic College West. Clum is also a member of the Foundation for Chiropractic Progress.
The Foundation for Chiropractic Progress is a nonprofit organization dedicated to raising awareness about the value of chiropractic care.
URAC defines a health care home as a quality-driven, interdisciplinary clinician-led team approach to delivering and coordinating care that puts patients, family members, and personal caregivers at the center of all decisions concerning the patient’s health and wellness. A PCHCH provides comprehensive and individualized access to physical health, behavioral health, and supportive community and social services, ensuring patients receive the right care in the right setting at the right time.
Evaluating Pilot Programs
Select URAC PCHCH program standards consistent with state-specific chiropractic scope of practice will be evaluated to determine how chiropractic care models can best achieve the principles of patient-centered care.
Clum said the purpose of the pilot project will be in part to document where there are differences between the typical medical home model and those with a chiropractor within the medical home. Additionally, Clum said the project will help identify whether URAC’s existing PCHCH accreditation guidelines provide a good framework for chiropractic physicians within a health care home.
Clum believes that chiropractic physicians should be included within the emerging medical home and PCHCH models. Having chiropractic physicians on the staff of a medical home has the potential to improve care and drive down costs, especially in areas like prescription drug utilization.
Chiropractic health focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. It is used most often to address neuro-musculoskeletal complaints, such as back pain, neck pain, and pain in the joints of the arms or legs, and headaches.
“The question here is, would the chiropractor be entering the system on a specialty basis or more of on a primary care basis?” Clum said.
With many patients visiting their primary health provider about musculoskeletal complaints, especially back pain, Clum said that having chiropractors in a medical home setting could help provide therapy as well as patient support for encouraging healthy and clinically appropriate behavior. According to 2009 data from the U.S. Centers for Disease Control and Prevention, knee, back and headache or head pain symptoms are all top principal reasons why patients visit their primary care physician.
“Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling,” URAC president and CEO Alan P. Spielman said in a statement. “The ultimate goal of URAC’s PCHCH program is to coordinate all aspects of a patient’s care, so it is important to evaluate how chiropractic health care can best support that goal.”
Patients could benefit from having a chiropractor in a medical home because chiropractic physicians emphasize prevention and a non-surgical, non-drug approach to treatment whenever possible, Clum said.