Podcast episode (Jan 8, 2018) hosted by Dr. Jeff Langmaid reviewing a 2017 BioMed Central randomized controlled trial titled "Patient Centered Professional Practice Models for Managing Low Back Pain in Older Adults." The host summarizes that the trial compared medical care alone, dual care (medical + chiropractic), and shared care (medical + chiropractic with enhanced communication), and reports that dual and shared care produced greater perceived benefits and higher quality of life over 12 weeks compared to medical care alone. The episode emphasizes patient-centered, evidence-based practice and the importance of collaboration and referral relationships between chiropractors and medical providers.
Welcome to the Evidence Based Chiropractor, providing you with elegant and efficient research based content to help your practice prosper and succeed. Now get ready for a variety of dynamic communication tools designed for immediate growth courtesy of your host, Dr. Jeff Langmaid.
Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Langmaid and I hope you have kicked off 2018 well and I hope you checked out last week's episode which was the best of 2017. And this week we are kicking it right back into research mode. So we are going to look at a randomized controlled trial, an rct. You know, that's the top tier of research that came out in 2017. It is brand new and I am pumped to get to it. I think it's going to deliver a lot of value that you can utilize in conversations starting today. But before we dive into that, I will say a few words as I do each and every week about Rock Tape. Rock Tape is revolutionizing the soft tissue world again with new Rock blades Mohawk. Featuring three tools in one, a surgical stainless steel hand polish tool in in two attachments silicon sleeve and an ABS comb. Mohawk unlocks never before seen treatment protocols to reduce pain, improve mobility and address issues like nerve glide and neuropathy. It's 175 bucks and you can learn more and explore educational courses featuring mohawk@rocktape.com mohawk and as we touched on at the top, it is back to the research. This week the paper that we are going to look at is titled Patient Centered Professional Practice Models for Managing Low Back Pain in Older Adults. A pilot randomized controlled trial. This was put out by Biomed Central in 2017. Couple words to take note of in that title. It starts out with what we love to hear, patient centered and it ends with what we love to hear, randomized controlled trial. So these researchers basically were looking at patient centered professional models for care. So when people have low back pain, what are the best models that are patient centric, patient focused and then what are the outcomes from those models? And the results I think are gonna be exciting to you for sure. So as we know, patient centered care within an evidence based model is truly the future of healthcare, undoubtedly. And and new research has showcased why clinical decisions should be framed by a combination of our clinical experience, the currently available research, patient preferences and expected outcomes. To me that is really where we look at evidence based care and we look at a patient centric model. It really needs to include all of those facets of care. Right. It should have some combination of your Experience your clinical judgment, you're a professional, it should look at or take a nod from the currently available research. Patient preference is important, doesn't mean the patient dictates all. But understanding what a patient's goals and expectations are and really their preferences for care is definitely important. And then third or last, in this case, we're talking about the outcomes themselves. You wanna do things that not only make a patient happy, not only does the evidence support, not only do you feel comfortable with your experience, but the outcomes are there to support it. So in this research paper that the researchers examined the use of medical care, what they're calling dual care, which is medical care and chiropractic, and shared care, which is medical care and chiropractic, but with enhanced collaboration and communication. So again, the researchers in this study looked at three groups of individuals that got treatment for low back pain. One group only got medical care. The next group got medical and chiropractic, but kind of siloed the, that was what they called dual care. And the third group received shared care, which was medical and chiropractic care, but with the addition of what they're calling enhanced communication, essentially the practitioners, the healthcare providers were working side by side. Great note. Taking great sharing of things back and forth, which is what we promote and help with, with all members of the evidence based chiropractor. So you can understand why I take this study to heart. I also love it because a lot of our people that are coming, a lot of our patients, they come in, they're probably seeing medical doctors as well. So this is again what I consider to be a very accurate representation of what's going on in the marketplace. And what's exciting was they found that patients who experienced shared or dual care had greater perceived benefits and a higher quality of life after the conclusion of the 12 week study. So collaboration and communication are absolutely clutch. That's what we'll talk about in a moment. But I'm gonna pull out three quotes from this paper that I thought were very, very important. So quote number one, from this research paper, the researchers had or found systematic reviews advocate the use of spinal manipulation for the management of low back pain. Several clinical trials have demonstrated the efficacy, safety and acceptance of this form of chiropractic care in older people. So this is a great statement because the researchers are putting it out there. They're saying, hey, systematic reviews advocate for the use of spinal manipulation or adjustments for low back. That's great. I mean, at this point it's nearly a given. So that's not Even a question. I know back maybe five, ten years ago there were questions of, hey, is there any even research to support chiropractic care? It's great that now the papers are saying, hey, that's the foundation. There is no question about that. And the researchers are saying there's several clinical trials that demonstrate the efficacy, safety and acceptance of this form of chiropractic care. So I love all of that. Again, this is from BioMedCentral, not exactly a chiropractic focused journal. Research has also found, quote, persons with low back pain often select conservative care treatments over surgery, analgesics or opioid medications, citing concerns with treatment safety, side effects, costs and clinical outcomes. Another great statement, it gets back to the fact of patient preference. Many people don't want surgery, they don't want medications, and they're concerned about safety and side effects. Especially when we look back at 2017 and the opioid crisis or epidemic kind of coming to the forefront of the consciousness of our country, this is a very opportune time to talk about the natural healthcare that you provide as a chiropractor. And finally, the researchers found, quote, participants who received chiropractic care reported greater perceived benefits in secondary measures of low back pain, global improvement, overall health and quality of life compared to the medical group. Difficult to ask for more than that. Again, they found participants who received chiropractic care reported greater perceived benefits in secondary measures of low back pain, global improvement, overall health and quality of life compared to the medical care group. So a couple things in that statement that I find personally exciting. Global improvement's important. That's really function to me. Overall health and quality of life, that's what we're after, right? I mean patients come in to see us often for aches or pains, but our goals I think are not only to decrease their ache or pain and get them on their way, but certainly to improve their quality of life, perhaps open their eyes to what they can achieve function wise that they may not be aware of otherwise. Basically improving patients quality of life. What chiropractic care is all about. And again, this study was from BioMed Central in 2017, brand new and it was titled Patient Centered Professional Practice Models for Managing Low Back Pain in Older Adults. A pilot randomized controlled trial and studies like this I find to be very, very interesting and important because this gets to the heart of building referral relationships with other healthcare providers. I know that there's a lot of and we put this out our member brief, all members of the evidence based chiropractor Received a research brief with this paper in December of 2017. So right when the research came out, we got right out to our members to make sure that they got out to the other physicians in their community that they're bridging the gap in building those referral relationships with. But I think there's many chiropractors out there that maybe have had a bad experience reaching out to a doctor in the past or they think it's going to be a lot of work, or they think they have to be charismatic or quite honestly, sometimes there's fear. Fear of the unknown. It's new, it's something else. And it can be intimidating to get into somebody else's practice or to talk about chiropractic outside of our patient base and outside of our four walls. But that is exactly why the evidence based chiropractor membership exists. It is all about making it easy, it's about making it systematic and it is about getting results. So we've had docs that doubled their MD referrals, we've had docs that got two and three MD referrals within the first few weeks. And some of them been a slower burn. And then as time has gone on and they've worked the process simply and easily, they've seen that return on investment. But more importantly to me now, I love it when the docs in the program are getting high return on investment. That's great. But I view it from even a bigger scope. And I say when we don't have relationships with medical doctors in our communities, quite often patients that go in to see that medical doctor are not gonna be exposed to chiropractic care and they're gonna go down the path very quickly of medications, potentially opioids, maybe injections and ultimately surgery as they fall down that cascade of options that are not very effective at taking care of their issues. And that to me is the heart of the evidence based chiropractor. When you bridge that gap, you not only get more patients in your front door, potentially more revenue in your pocket, but you are truly changing people's lives. And that is what it is all about. So one other thing I'd ask of you today, if you have the opportunity to leave rating or feedback on itunes, you can do it right from the itunes app. If you're listening to podcasts on your iPhone, please leave us ratings or review. That's how more and more chiropractors find the evidence based chiropractor. I am looking forward to an awesome 2018. If you have any questions, any feedback regarding the show. You can always reach me Jeff at the Evidence Based Chiropractor. I hope you have a fantastic week in practice and I will talk to you soon.
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