This post is going to be more of a rant than informative. Patients come into the office with numerous complaints and everyone in a healthcare field can relate to things like this, the problem that I have with this is what exactly does your insurance cover.
There are certain insurance that cover only spinal complaints, I am okay with that for the most part, heck I have even reached a point that if these people come in with a shoulder, knee, elbow, or wrist complaint I will tell them to seek care elsewhere for these complaints as their insurance will pay for such services.
At our office we are perfectly capable of taking care of a wide variety of musculoskeletal complaints, including extremities, ultrasound, electric stim, diathermy, and acupuncture/dry needling are available to patients that desire such services.
The main reason that I write this post: early this week, I had a patient that has tennis elbow, lateral epicondylitis is the more formal term, she has been going to physical therapy for the condition. Don’t get me wrong, I have no problem with her seeking care with another provider, but when I asked what services that she was receiving, she indicated that she was icing, ultrasound, and stretches along with a brace that she is supposed to be wearing while at work.
I got to thinking …I can do all of these services in my office. I refuse to get into the argument of which profession you should use because I send a fair share of patients to physical therapy for things that I do not have the knowledge or time to take care of in our office.
Chiropractic is an ever evolving profession but at what point will we finally determine that extremity care is well within our scope of practice and most chiropractors are perfectly capable of handling these types of complaints and should be reimbursed by medical insurances.
Now I understand that there are chiropractors out there that do not have the knowledge or belief that they can help with these conditions. I am not appealing to those individuals, I am appealing to those people that have a say in the insurance industry to allow chiropractors to perform services that are well within the scope of practice and are taught on an extensive basis in chiropractic school.
At my alma mater, we learned things that I may never use: labs, pelvic exams, and prostate exams. I don’t plan on using these services because I feel that there are other professionals that are more experienced with these services. I know how to spot a concussion but I don’t know enough about the protocol to determine if someone is safe enough to return to activity.
If there are chiropractors that are educated and experienced in these services by all means, they should be covered and encouraged to provide these services. But insurance companies need to get up to date on what different professions actually are knowledgeable and educated in.
As I said earlier, I am not discouraging other professions from continuing to provide the services that they are allowed to provide but chiropractors need to start to get on the same page so that the profession can move forward to provide services that most chiropractors know how to treat but are not reimbursed for from different insurance companies.
Another quick thought that will enrage some people in my field of work: I believe that chiropractors should have a very limited medication list that they are able to prescribe, mainly a muscle relaxant that will allow some patients to get a little relief as opposed to running into the clinics or urgent care to get medications, where most of the providers roll their eyes and send people on their way, but proper education and training needs to be available.