Chiropractic occupies a unique position within the United States health care system. It is both alternative and mainstream (in that it has gained increasing acceptance by third-party payers, patients, and the Federal Government). Chiropractors are becoming more involved in multidisciplinary practices and are increasingly found in managed-care settings. In some cases, chiropractors have established their managed-care organizations. In other cases, they participate in managed-care networks as individual practitioners or in capitated contract agreements with the purchaser of chiropractic services.
Pain can disrupt employees’ ability to concentrate and perform their jobs, whether from work-related injuries or poor posture. Chiropractic services for state workers can help relieve pain, improve mobility, and restore function, allowing workers to return to their jobs more quickly. Chiropractic can reduce pain and disability, increasing productivity, decreasing absenteeism, and lowering insurance costs. In addition, a holistic approach can improve worker morale and job satisfaction. In one study, employees of companies with onsite chiropractors took fewer sick days and were more productive at their jobs than those of similar companies without such clinics. Chiropractors provide patients with a nonpharmacological method to manage pain using spinal manipulation, massage therapy, and exercise. They also can recommend dietary changes to help relieve pain symptoms. Chiropractors often work collaboratively as part of a patient’s circle of care, including in interprofessional clinics, family health teams, and hospitals. They may also be part of onsite health programs at large corporations.
A chiropractor is trained to evaluate, diagnose, and treat musculoskeletal disorders. Chiropractors also have expertise in conservative musculoskeletal management of occupational injuries and illnesses. Stress management techniques include yoga, meditation, controlled breathing, visualization, and guided imagery. These are widely used and can help reduce the effects of chronic stress, contributing to many health risks. The health realization/innate health model of stress argues that the presence of potential stressors does not create stress but rather a person’s appraisal of these circumstances and ability to cope. Chiropractors can help employees recognize their coping mechanisms and teach them how to manage stressors effectively. They can also recommend other stress reduction strategies, such as using biofeedback. This is a unique feature of chiropractic care.
Chiropractic care can be essential in a public health strategy with its noninvasive and nonpharmacological approach to musculoskeletal health. Chiropractors work collaboratively as part of their patient’s healthcare team, often in interprofessional clinics and family health teams and sometimes in hospitals and corporate onsite health centers. They can also link to the broader health community by offering information and resources. Chiropractors work collaboratively with many healthcare team members, often in interprofessional clinics with physicians and allied health professionals such as physiotherapists, nurse practitioners, registered massage therapists, midwives, doctors of chiropractic, and psychologists. They also treat patients in their own offices, as a part of an integrated care team at a community health center, or as onsite support for employees at large corporations. They do not need to have a referral from a medical doctor to see a patient; most people who receive chiropractic treatment pay for it privately rather than through insurance.
Chiropractic services offer a cost-effective treatment option for workers’ compensation patients. This is because chiropractors take a holistic approach to care and address the root cause of the injury. This includes rehabilitative exercises and techniques like spinal manipulation, massage therapy, and relaxation strategies. In addition, chiropractors provide educational materials on musculoskeletal injuries and the workplace. They also consult with primary care, pain management, and other specialty teams to help their patients with their medical needs.
Chiropractic services can be incorporated into prevention programs by offering health education and promoting physical activity, healthy diet, and emotional well-being. Chiropractors also serve as attending and concurrent care providers for injured workers with spine and extremity occupational injuries, providing conservative musculoskeletal management. One study that included onsite chiropractic care limited to a few hours per week at a small local law firm found reduced utilization of health care services (radiology and physical therapy), fewer modified work days, and lower absenteeism rates. In addition, chiropractors can help reduce the known barriers to accessing chiropractic services by working with other health professionals and community service providers, addressing gender-based healthcare disparities, and reducing violence against women. Licensed chiropractic physicians are trained to recognize when patients will not benefit from their services and to refer patients appropriately to other health practitioners.