Although millions of people visit a Chiropractor every year, many people have never been to a Chiropractor’s office, and haven’t the faintest idea what they do, or how they help. Most think chiropractors work solely on the neck and back, either with deep massage, manipulation, or adjustment using controlled, sudden force.
Although Chiropractors are most often thought of as “back doctors,” they also treat a variety of other problems and complaints, such as migraine headaches, pinched nerves, carpal tunnel, sports injuries, arthritis and whiplash. What most people don’t realize is that Chiropractors can also treat ear infections, asthma, allergies, learning disorders, stress, colic, and constipation, among many more ailments.
Nearly one in six people, at some time in their life, will seek out a Chiropractor for treatment of pain, or some related problem or complaint.
What is a Chiropractor?
Chiropractors are health-care professionals who use hands-on manipulation, and other alternative or non-surgical treatments to diagnose and care for their patients. Their primary focus is treating neuro-musculoskeletal disorders — problems with the nervous and musculoskeletal systems — usually affecting the back and neck. When needed chiropractors will refer patients to medical doctors or other health-care professionals for treatment, and typically work closely with spine specialists. Unlike medical doctors, chiropractors don’t typically prescribe medication or surgery to treat patients. Instead, they use such treatments as physical therapy and massage, and make suggestions regarding diet and exercise to treat their patient’s conditions.
Each year, it's estimated that nearly 30 million people visit a chiropractic office. Most people are seeking relief for back pain from an accident or sports injury, while others are seeking treatment for other afflictions. Today, chiropractors make up the largest group of health-care providers in the US, next to medical doctors and dentists.
Chiropractic is known to be one of the oldest forms of treatment among all forms of pain management. What is not commonly known is that early in the 20th century, when chiropractic medicine was first established, people only came to chiropractors for infectious diseases, such as Scarlet Fever. It wasn’t until a deaf man got his hearing back after a Chiropractor adjusted his spine, that people realized the additional benefits from this form of alternative medicine.
Even so, for many naysayers in the medical community, as well as many insurance carriers, chiropractic treatment is quackery, and nothing more.
Chiropractors and Insurance - HMO
For years, Health Maintenance Organizations, or HMO’s, considered chiropractic care and other alternative remedies, as unorthodox. In fact, before chiropractors earned a Doctor of Chiropractic (DC) degree and gained licensure, some were jailed for practicing medicine without a license. A lot has changed. Even so, many chiropractic treatments are not covered by insurance, or only partially covered, and people are still left to dig deep in their pockets to pay for chiropractic services.
Yet today, some medical doctors are referring patients to a chiropractor, and vice versa. This is in part because research has validated the effectiveness of manipulation and adjustment — as less like quackery, and more like remedial treatment. Some doctors even view manipulation as a rational approach to certain conditions, when surgery or minimally-evasive treatments are thought to be more aggressive than necessary. In addition, healthcare journals have started publishing chiropractic research, and many health-care publications have dropped their anti-chiropractic bias.
Yet, some insurance carriers, and most HMO’s have not yet jumped on the Chiropractic bandwagon. The Health Maintenance Organization (HMO) is an organization that provides managed care for health insurance, individuals, self-funded benefit plans, and other entities in the US, while acting as a liaison with hospitals, doctors, healthcare organizations, retirement homes, etc., on a prepaid basis.
Because HMO’s most often require a member to select a primary care physician as the first point of contact to prescribe treatment, many, if not most, chiropractic services are not covered. However, in recent years, as more and more insurance companies, including HMO’s, are looking for ways to promote good health and preventive care, the rules have changed — a bit. A few HMO’s even now are permitting their members to choose a chiropractor as their primary care physician.
Back as early as 1967, Chiropractors began pushing for “insurance equality” laws to be passed in each state. These state-mandated laws affect what chiropractic services, if any, an insurance carrier will cover. These laws were needed because so few companies covered chiropractic services. It must be noted, however, that these mandates typically only apply to conventional group policies. Most states still exempt HMO’s from complying with these mandates.
As States began enacting these laws, two types of authorized benefits for chiropractic treatments were established:
There are currently 74,697,310 members enrolled in HMO’s in the US.1 Even so, many HMO’s still have a negative public image due to their restrictive policies, such as only contracting with providers who meet certain criteria. Unfortunately, this makes it difficult for health-care professionals, such as chiropractors, who don’t meet these criteria to appeal to patients because of pricey, out-of-pocket expense.
Some chiropractors are doing all they can to ensure their patients receive the care they need. For example:
For the most part, most HMO’s still consider chiropractic care as an “out-of-network,” or “out-of-pocket” expense. That said, there are things a patient can do to ensure their HMO will allow treatment by a chiropractor, prior to an office visit.
Career Options - HMO
It seems that more and more chiropractors are deciding to side-step private practice, due in part to — high operating cost, understanding the ever-changing compliance issues and medical documentation, keeping up with cutting edge treatments and therapies, limited oversight and support by other professionals, the list goes on.
Some aspiring chiropractors are instead opting to join an HMO network. An HMO network contracts with local hospitals and in-patient clinics to provide medical services. This network usually employs two or more independent groups of physicians to provide health care, and looks much like a standard hospital, with an emergency room, reception area, nurses stations, and offices. The group is paid a set amount per HMO enrollee, per month.
In some networks, physicians and chiropractors will be HMO employees. There are many advantages to this arrangement, such as:
Chiropractic is certainly making inroads into HMO medical coverage policies and benefits, with patient-demand leading the way. A recent survey in Dynamic Chiropractic states that chiropractic treatments appear to be more and more mainstream, and less and less considered as alternative treatments by 52 percent of HMO respondents. The message is clear patients appreciate the many benefits of chiropractic care, which in turn, is having an enormous impact on HMO enrollment, and ultimately the addition of chiropractic care into every HMO in the US.
That said, job opportunities in all areas of practice look very promising for chiropractors, with an expected increase of 28 percent between 2008 and 2018. This is much faster than the average growth for all occupations. In fact, Chiropractic was recently ranked at #11 in best jobs, by CareerCast.
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