Chiropractic 2025:

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Chiropractic 2025: Divergent Futures Community health centers (CHCs)–a type of FQHC–currently provide about 7% of primary care in the U.S., but they are likely to provide a larger portion of primary care as health care reform is implemented. In our research for this report, we found CHCs in Iowa, California, and Connecticut that utilized chiropractors. 201 Generally in these CHCs the CHC leaders have had positive personal experiences with chiropractic care, or they knew local chiropractors they trusted to provide care. In Connecticut and Iowa the CHC established a connection with a chiropractic college and functions as a training site as well. CHCs can prove an important opportunity for chiropractors. At least one interviewee suggested that the percentage of CHCs offering chiropractic care will increase by 2025, as CHCs search for ways to provide low-cost effective care and DCs look to gain business, exposure, and more experience. However, at least one other interviewee suggested that although CHCs may “offer” more chiropractic care, what really determines use and implementation of chiropractic care is method of delivery and payment. Corporate clinics are another important opportunity for inclusion of chiropractors. Leading companies like Google, Microsoft, Cerner, and Cisco are moving to onsite health care that includes chiropractic care. The clinics take a variety of forms, some part of health insurance, some free care. But having chiropractors available at the clinic is increasingly a desired option. Chiropractors, Public Health, and Prevention With increasing societal emphasis on prevention, the PPACA also provides opportunities for the chiropractic profession to go beyond patient care to engage in public health. Section 4001 on The National Prevention, Health Promotion, and Public Health Council has led to the development of the National Prevention Strategy, which was released on June 16, 2011, and aims to guide the nation in the most effective and achievable means for improving health and wellbeing. With the adoption of such national strategies for health and prevention (as well as others such as Healthy People 2020), chiropractors and chiropractic educational institutions (as with all clinical professions and health care systems) will need to clarify their roles in prevention and public health. Collectively many organizations and individual DCs are involved in the “Straighten Up America” Campaign, focusing on activity and posture to promote health. 202 DCs have the opportunity to continue to press patients in their practice to live more healthy lifestyles. They can do more screening with their patients for hypertension, diabetes, smoking, and obesity. DCs can get involved in their communities to encourage exercise activity, and can also support worker safety. This prevention opportunity parallels the community service that many DCs do working with the chamber of commerce or other local groups. Many DCs have pursued an MPH (Master’s in Public Health) Degree and nearly 300 are members of the Chiropractic Section of the American Public Health Association (APHA). This section focuses on public health issues (such as wellness) in the context of chiropractic practices and policies. 203 Looking ahead, some interviewees felt that the number of DCs earning an MPH, joining the APHA, and engaging in public health activities and research will grow over the years to 2025. The PPACA also offers new leadership opportunities for the chiropractic field. Section 4001 on The National Prevention, Health Promotion, and Public Health Council, for example, requires that its Advisory Group include “integrative health practitioners who have expertise in—(i) worksite health promotion; (ii) community services, including community health centers; (iii) preventive medicine; (iv) health coaching; (v) public health education; (vi) geriatrics; and (vii) rehabilitation medicine.” 204 The Board has been established, and although it does not currently include a chiropractor, DCs are eligible to join it in the future as they demonstrate expertise and increase their activities in these areas. The PPACA also requires that the PCORI Board of Governors include a “state-licensed integrative health care 71
Chiropractic 2025: Divergent Futures practitioner.” Indeed, since 2010 the Board includes a representative from the chiropractic community, Dr. Christine Goertz. The legislative provision also states that expert advisory panels will include “experts in integrative health and primary prevention strategies.” 205 Additionally, under Section 5101, the National Health Care Workforce Commission is tasked with providing comprehensive information to Congress and the Administration about how to align federal health care workforce resources with national needs. Congress will use this information when providing appropriations to discretionary programs or in restructuring other federal funding. The language in the bill would insure that the need for doctors of chiropractic will be addressed when considering federal health care workforce programs. However, this Commission has not been funded, so no progress has been made on this front. 206 72
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Chiropractic 2025: Divergent Future
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Table of Contents Abbreviations 1 I
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Introduction Chiropractic 2025: Div
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Chiropractic 2025 Scenarios Scenari
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Scenario 1: Marginal Gains, Margina
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Scenario 2: Hard Times & Civil War
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Page 25 and 26: Scenario 4: Vitalism & Value Imagin
Page 27 and 28: Chiropractic 2025: Divergent Future
Page 29 and 30: Comparative Scenario Matrix Chiropr
Page 31 and 32: DCs practicing in integrated health
Page 33 and 34: IAF Recommendations Chiropractic 20
Page 35 and 36: 2. Accelerate research. Chiropracti
Page 39 and 40: Christine Goertz, DC, PhD Vice Chan
Page 43 and 44: Chiropractic Schools, Education, an
Page 45 and 46: The Figure below identifies various
Page 47 and 48: FIGURE 3 16,000 14,000 12,000 10,00
Page 49 and 50: Tuition and the ROI Story Chiroprac
Page 55 and 56: The 50 States of Chiropractic Chiro
Page 57 and 58: FIGURE 4 Liver Disease Kidney Disea
Page 63 and 64: Percentage of Respondents in the Ch
Page 67 and 68: RARELY SEEN (1-10/year) CONDITION A
Page 71 and 72: Primary Care and Health Care Reform
Page 75: Chiropractic 2025: Divergent Future
Page 83 and 84: 88 Ibid. Chiropractic 2025: Diverge
Page 90: Institute for Alternative Futures 1
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