For years, chiropractic has been told: "You only treat six percent of the population." Because there were no solid numbers, the six percent figure was the justification to classify chiropractic as "fringe medicine," to avoid inclusion of chiropractic care as a basic benefit, and even to justify the "orthopractic" concept.
Indeed, the entire rationale for orthopractic is that it will lead chiropractors from six percent to full acceptance. In his exclusive interview with "DC," Dr. Murray Katz made this claim five times!
Consider this statement by Dr. Katz in that interview:
"Chiropractic has gotten stuck in treating five or six percent of the population. Becoming orthopractic affords chiropractors the opportunity to move into the mainstream of medical science, expand the number of people they'll be treating, work cooperatively and scientifically with a group of doctors, and I am proud and happy to help any chiropractor who wants to do that -- to reach out, to reach back to them."Or this comment made in a recent internal memo by Ron Slaughter, DC, national executive director, National Assoc. of Chiropractic Medicine:
"The majority of the chiropractic profession still are not able to accept the simple fact that the overwhelming majority of the public do not believe nor or (sic) willing to accept the chiropractic hypothesis for their health care delivery. Fully 94 percent of the consuming public has rejected this hypothesis for 100 years."Now we all know how orthopractic claims to be scientific. But how is it they failed to notice a report on chiropractic utilization in the June Spine Letter? Over a month before Drs. Katz and Slaughter made their comments, the front page of the Spine Letter stated:
"According to a recent study in North Carolina on Prevalence of Back Pain and Care Seeking, when back pain becomes functionally limiting, people will seek care regardless of whether they have health insurance -- and 33 percent of the time they will seek care from chiropractors (DCs) not physicians (MDs)."Enough with this six percent horse manure! Let's do something very non-orthopractic and look at the data.
As stated in the Spine Letter, Dr. Carey discovered that "485 people -- in almost 11 percent of all households surveyed -- currently had been experiencing acute back pain." This means that a little over 6 percent of the population experiences limiting (debilitating) back pain each year.
Depending on which study you look at, up to 80 percent of the population will experience low back pain in their life.1 If you also included cervical pain, nearly 100 percent of the population would be affected.
If we apply Dr. Carey's results, we discover that of those who experience back pain: 61 percent do not go to any provider; 24 percent seek medical care; 13 percent seek chiropractic care; and two percent seek some alternative provider. Of the 39 percent seeking care, chiropractic sees one-third of those (13 percent of the 39 percent, or 33 percent of those who seek care).
This is a much larger segment than originally thought. Obviously, this profession is enlarging its share of the market beyond what our detractors wish the world to know. But this still doesn't answer all the questions!
We still don't know what percentage of the population seeks chiropractic during their lifetime. Some informal surveys show overall chiropractic utilization as high as 61 percent. Could it be that more than half the people in the United States have utilized chiropractic care when they felt it was needed? This calls for us to do our own study. This is critical information -- figures we need when we are talking to politicians, insurance companies, hospitals, and the public.
Chiropractic has made its own place in the health care arena and the scientific community is just beginning to wake up to how extensive that is. Just wait until they discover just how many patients we have seen over the past 10 years or more.
The question for us is: How do we address the needs of the 61 percent who don't see any provider for their back pain? What does the chiropractic profession need to do to reach them?
Perhaps Dr. Carey will conduct another study ten years from now and discover that 24 percent of the population continues to seek medical care, 37 percent seek chiropractic care, and we still have another 37 percent to reach. Imagine what would happen to this profession if we went from seeing 13 percent of the population to 37 percent. Imagine what would happen to your practice.
There is still 61 percent of the population waiting to hear from you.
1. Nachemson A: A critical look at the treatment for low back pain. Scand J Rehabil Med, (11):143-147, 1979.
DMP Jr., BS, HCD(hc)
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
