Chiropractic 2025:

Chiropractic 2025: Divergent Futures
OptumHealth, a major chiropractic network that is a subsidiary of United Health has analyzed United claims and
found that going to chiropractors for back pain saves money. When the patient’s first visit is with an evidence-based
chiropractor, the severity-adjusted total episode cost is 35% lower than the overall average total episode cost for
treatment of back pain. OptumHealth’s analysis of expenditure distribution for treatment of over 290,000 complete
episodes of non-surgical back pain ending in 2005 showed that spinal manipulation and therapeutic exercise only
comprised 16% of total expenses, while over 40% of treatment costs were for services that had little efficacy (e.g.
radiology). 149
Medicare can also provide a major demonstration of potential cost savings from chiropractic care. The Medicare
Chiropractic Services Demonstration Project found that in most sites for the study health care costs did not increase
significantly with the addition of chiropractic services. However this study’s largest site was in Illinois where
chiropractors increased their levels of care for the patients in the demonstration, thus increasing the total cost of care.
The results of the demonstration are thus difficult to interpret, due to questions about the representativeness of the
Illinois demonstration site.
Research on Primary Care By Chiropractors
Some chiropractic colleges consciously train chiropractors to provide primary care. In Illinois chiropractors are
authorized to act as primary care physicians (PCPs) with a wide scope of practice under the administrative rules of
the Illinois Department of Insurance and the Illinois Department of Public Health. 150 Specifically chiropractors are
licensed with full physician status (as a “person licensed under the Medical Practice Act to practice medicine in all
of its branches or a chiropractic physician”). 151 The only distinction between DCs and MDs in Illinois is that DCs
may not use operative surgery or drugs. 152 A study analyzing the use of DCs as PCPs by Sarnat (MD), Winterstein
(DC), and Cambon (DC, PhD) conducted between 1999 and 2002 for Alternative Medicine Integration Group
(AMI), an integrative medicine independent physician association (IPA), showed decreases over a seven-year period
(including the additional three-year update to the original study) of 85% in pharmaceutical costs, 62% in outpatient
surgeries and procedures, 59% in hospital days, and 60.2% in hospital admissions when compared with conventional
medicine IPA performance in the same time frame and geography for the same health maintenance organization
product. 153 High patient satisfaction rates were reported in all years in that study. 154 Dr. Sarnat co-founded AMI,
which in the late 1990s reached a contract with Blue Cross Blue Shield (BCBS) of Illinois to allow BCBS Illinois
members to have the option of choosing an AMI chiropractor as a primary care physician. 155
Vitalism and Epigenetics
Beyond efficacy and cost-effectiveness, there are other important aspects of chiropractic research. Focused-scope
chiropractors promote the idea that their principles, clinically applied concepts, and work on subluxation all enable
the body’s natural healing capacities to be communicated effectively through the healthy spine and nervous system.
This leads some to argue that they are not treating conditions directly, but rather treating conditions by restoring
health. However, when confronted with such chiropractic concepts, including “innate intelligence” or “subluxation,”
many conventionally trained scientific materialists, and many chiropractors, are skeptical. However, there is growing
recognition that important scientific potential exists in the scientific exploration of the nature of health and healing,
seen with the rise in scientific research on prayer, intention, and consciousness in healing as well as investigation of
energy medicine, chi, and other traditionally vitalistic concepts. For example, Taylor et al. explain that chiropractic
adjustments result in changes to sensorimotor integration, and that “emergent signals from optimal sensorimotor
integration may underlie appropriate adaptation of respiratory patterns and homeostasis. This may go some way to
explain some of the beneficial effects of chiropractic care on nonmusculoskeletal conditions.” 156 Taylor et al. explain
that many of the studies analyzed in their publication showed that chiropractic adjustments caused sensorimotor
64