With insurance companies controlling the purse strings and deciding what types of treatments will be covered (or not covered), it’s more important than ever for chiropractors to be able to draw upon a robust body of research that proves the effectiveness of chiropractic treatment. Insurance coverage for chiropractic services peaked in the mid-1980s, when insurance equality laws leveled the playing field between medicine and chiropractic. Although most major health insurance plans available today provide some chiropractic care, patients report paying progressively higher out-of pocket costs.
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Part of the reason may be that managed care organizations are combining data from their claim files with results from prospective outcome studies and controlled clinical trials to assess the cost effectiveness for most therapeutic treatments. As insurers look for services to slash, they’re going to focus on those that aren’t supported by a vast body of evidence.
This means that without sufficient chiropractic research, “it’s going to be harder and harder for patients to get reimbursed by third-party payers,” said chiropractic researcher Cheryl Hawk, D.C., Ph.D. The bottom line, she added, is that the more important research becomes to the profession, the more it falls on chiropractors to build upon the chiropractic evidence base.
Although chiropractic research has expanded tremendously in the past two decades, many aspiring chiropractors still don’t yet realize the professional benefits they could gain from a research-based practice. One study found that many chiropractors lack confidence in their research skills and fail to consistently apply research in their practice. And of the thousands of field practitioners who’ve received chiropractic training, relatively few have earned the credentials needed to secure the funding for serious research.
As a result, today’s chiropractic students face a wealth of opportunities for distinguishing themselves professionally—all while helping to advance their chosen profession.
EVOLUTION OF CHIROPRACTIC RESEARCH
All health-care professions go through a similar maturation process, and chiropractic is no different.
Chiropractic understanding began as a vitalistic philosophy, the idea that the body possesses its own innate intelligence, which it uses to ward off disease. Early chiropractors used this philosophy to justify their practices, which aimed to remove imbalances that interfered with the body’s ability to self-heal. During the first half of the 20th century, the profession entered a period of speculative theory, during which chiropractors theorized about their practices based on either perceived neurological or pathological observations.
Around that time, Palmer graduate Claude O. Watkins, D.C., began vocally advocating for organized chiropractic research at the national level. He argued that all chiropractors should be trained to perform clinical research, as “no one can tell who might discover a promising hypothesis for testing.”
Thanks to Dr. Watkins and others, in 1944, the National Chiropractic Association formed the Chiropractic Research Foundation to help promote and gain funding for chiropractic research.But it wasn’t until the 1990s, when the government issued its first grant for a prospective study of chiropractic outcomes, that the profession saw “greater scientific exploration …with more national scientific discussion of the causes and treatment of spinal problems,” said renowned researcher and Palmer graduate Scott Haldeman, D.C., Ph.D., M.D.
Haldeman predicted that the next decade would require “greater emphasis on social research into clinical effectiveness of treatments, prevention of back pain, patient satisfaction and quality assurance.”
PREPARING STUDENTS FOR CHIROPRACTIC RESEARCH
Since then, chiropractic research has gained steam. More chiropractic schools emphasize research in their
chiropractic training programs than ever before.
Palmer College, for example, houses the largest chiropractic research center in the world. Located in Davenport, Iowa, the Palmer Center for Chiropractic Research has received more than $35 million in external research grants for cutting-edge chiropractic research. Palmer also offers research opportunities for students at all of its campuses, including:
Research Honors Program. Doctor of chiropractic students who want to learn how to perform clinical research can participate in the Research Honors Program, which allows them to design and complete a faculty mentored research project. In the process, students learn about research methodologies and get to explore the possibility of a career in chiropractic research.
Master’s degree in clinical research. For students who want a career in research or academia, Palmer’s 36-credit hour master’s program prepares doctors of chiropractic to become researchers, teach at a chiropractic school or pursue their Ph.D.’s. Students in the program have the opportunity to study with experienced research scientists who have long-standing track records for federally funded research.
Chiropractic research has grown by leaps and bounds, but there’s still much work to be done. By including research in their chiropractic training, students can open up new career doors for themselves while helping to solidify the profession’s status as a critical component of health-care in the 21st century.