Federal Agency to Develop Practice Guidelines for Low Back Disorders

AHCPR Forming Clinical Practice Panel

By Editorial Staff

One of the tasks of the Agency for Health Care Policy and Research (AHCPR) is to "facilitate the development of practice guidelines and measurements of quality care" (please see "Chiropractic Cost Comparisons Presented at AHCPR Conference" in the March 1, 1991 issue). The U.S. Congress created the AHCPR within the Department of Health and Human Services in an effort to improve health care and reduce costs. To that end, the agency seeks to ascertain what types of treatment are most effective in terms of costs and results.

Congress has allocated the AHCPR a very large annual budget, part of which will go towards the sponsoring of research and panels that will develop practice guidelines. Ultimately, this endeavor will dictate what types of treatment will be acceptable and reimbursable for specific ailments.

Fortunately, within the chiropractic profession, a few individuals and a number of chiropractic organizations are in-step with Congress in the development of practice guidelines. That is why the Conference for the Establishment of Guidelines for Chiropractic Quality Assurance and Standards of Practice (the Chiropractic Quality Assurance Conference) has been formed and sponsored by almost every major chiropractic organization in North America (please see "Chiropractic Practice Guidelines" in the July 19, 1991 issue). And just in time.

The Chiropractic Quality Assurance Conference will take place on January 25 - 30, 1992. This means that the chiropractic profession will tackle the issue of practice guidelines AFTER the AHCPR holds their panel. The knowledge that the chiropractic profession is sponsoring its own panel may aid in the AHCPR's consideration of chiropractic care in their panel on low back disorders.

Although a member of the chiropractic profession sitting on AHCPR's panel would be a logical and appropriate choice, it is not presently known if a DC will be invited. If we're included, it will only be because of the diligent efforts of a few members of our profession in the area of practice guidelines. The Quality Assurance Conference may just be the extra added credibility that the chiropractic profession needs to be invited.

This is a very critical part of the challenge facing the chiropractic profession today. Without serious work and development of chiropractic practice guidelines, we could be effectively "panelled" and "guidelined" out of the health care arena.

The AHCPR panel on low back disorders will tend to greatly influence how chiropractic care is included (or excluded). It is important that each member of the profession support the very critical work currently being conducted by the Consortium for Chiropractic Research, the RAND study and the Quality Assurance Conference in the area of practice guidelines.

This is obviously one area we can't afford to ignore.