Integrated care can have multiple definitions depending on who you talk to. Many people, including myself, would say that integrated care means that all providers (primary care doctor, orthopedist, physiatrist, chiropractor, physical therapist, neurologist, cardiologist, etc.) collaborate in a comprehensive, interprofessional, evidence-based, patient-centered effort to deliver effective and affordable care. This would give patients complete care.
For this to work most efficiently though, there needs to be a system in place where providers are either able to, a) easily send office visit notes to a central location where the provider will actually see them; or, b) simply access the same electronic health record for that patient. This would allow all providers to see the big picture of the care being provided. You have this setup at a large organization such as Providence, Rockwood, Group Health. But chiropractors tend to be in an independent lot usually because the chiropractor is practicing in a private office setting and having all providers in the same space would improve communication. Plus hospitals and big organizations understand the value to them to keep loyal providers within their own system who regular refer patients within that system.
Undoubtedly the greatest advantage of integrated care settings is patient care. However, I feel there is still a lack of effort put forth by many providers to strive for integration. The biggest reason, I believe, is time. Being part of a comprehensive care team requires more time and effort in communicating with other doctors. But I know that doctors who care about their patients will in fact take this time out of their busy schedules to meet their patients' needs. Coming out of chiropractic school I was blessed to work with an amazing chiropractor who modeled the very nature of patient-centered, integrative care. Any additional second he had away from treating patients was spent calling patients or their providers to ensure the best care was being given. This example really made an impression on me. Seeing patients benefit from this approach to their care is a reason I strive to do the same.
Research shows that chiropractic care plays a critical role in pain management programs which reduce the long-term costs of health care. The Department of Veteran Affairs is a group that has seen the inclusion of chiropractic. The reason is the VA is following directives to find safe and effective alternatives to opiates and expensive surgical procedures. This has led to the gradual expansion of chiropractic services offered at the VA. This is great news!
The easiest way I’ve found to integrate my care into a patient’s bigger care picture is simply asking new patients if they would mind me communicating their findings and treatment plan with their primary care physician. This is easily done by faxing initial office visit notes and follow up progress reports. I really think this is where the majority of chiropractors fit into the integrated patient care model. Not every chiropractor will have the opportunity to join with a major organization.
The best part of integration is getting to see patients who never have received chiropractic care and wouldn’t have, for that matter, had it not been for their primary care doctor recommending it as a viable treatment option. If you ever hear a medical professional say, “Oh don’t go see a chiropractor,” I challenge you to ask them why? Writing this blog helps me stay motivated to continue reaching out to other providers, usually allopathic ones, in hopes to build healthy, interprofessional relationships. These types of relationships will help to break down any remaining ugly walls that may exist between the chiropractic and medical professions, reduce health care costs, and lead to patient centered care. Chiropractic care results speak for themselves. Anybody who doubts that can look at the piles of supporting anecdotal and clinical research.
If you have any questions about how chiropractic care could help you, please call Gaitway Chiropractic in north Spokane at (509) 466-1366, request an appointment online, or come by the clinic at 8611 N Division St, Ste A, Spokane, WA 99208.