Understanding Who Uses Chiropractic and Why (According to New Research) | Podcast Ep. 425

Foreign hello and welcome to the Evidence Based Chiropractor. I am your host Dr. Jeff Langmaid. This week we are back with more brand new research all about engagement in non pharmacological pain management modalities among adults with chronic pain and what are some of the factors that may affect whether somebody utilizes integrative care, chiropractic care, non pharmacological care or whether they turn to medications and opioids. Brand new study, we're gonna highlight it. A lot of take home messages, clinical pearls and items that you can use in the conversations in practice online and in your community. Before we get there, I wanna say a few words about Patient Pilot by the smart Chiropractor. We have done some major updates and upgrades to Patient Pilot over the last month including totally overhauling our reactivation reports so that as a member you are going to see how many people are clicking to schedule and come back into your practice, how many people are engaged opening your emails, how many are you teaching and how many people are on your list. We put that in every single report and at the top of the members area. So if you are a doc out there interested in generating more patient reactivations this year, the really good idea head over to thesmartchiropractor.com again that is thesmartchiropractor.com connect with our team, ask your questions. We would love to work with you as we do over 350 practices around the world. Now as I said at the top, today's episode we're talking research. This is a study that came out in the Journal of Pain Research and the title I'll drop a link down below of course is Engagement in Integrative and Non Pharmacologic Pain Management Modalities among Adults with Chronic Pain. An analysis of the 2019 National Health Interview Survey. Again, I'll drop that link down below if you want to head over and check it out. Great study, lots of interesting bits that they found. This study was written and published to basically examine the factors influencing the use of integrative health and non drug treatments for chronic pain. It's US based and they used a survey type approach and it was the 2019 and 20 National Health Interview Surveys. So from those surveys startling statistic here we know 20.8. So 21% of adults in the United States report chronic pain. That's pain on most days or every day during the previous three months. That's a big deal. We know that the opioid epidemic is a chronic pain epidemic and 20% of adults that's like crazy. So that means you walk into the mall and you see 10 people. That means over two of those individuals are struggling with chronic pain, Right? Then, if you saw 100 people in practice this past week, over 20 of them have chronic pain. If you saw 1,000 patients this year, 200 patients or more than that are struggling with chronic pain. Now they come in to see you, to see me, to eliminate, to reduce, to mitigate that pain and help you get moving. And we do a really good job of it as chiropractors. But it doesn't take away from the fact it's important to remember that is a good chunk of people. Every time you walk into a room, if there's a couple people there, chances are one of them or more is struggling with chronic pain. That is a big deal. That also showcases the opportunity that we have as chiropractors. There is no shortage of opportunity. It's why I say time and time again on this podcast, this is all about communication. If everybody in your town knew who you were, knew how to choose you, and you had good systems and processes in your practice for patient reactivations, you would never want for a new patient again. That is just the truth, because there is no shortage of opportunity. There are a massive amount of people that are struggling just with chronic pain. There are an innumerable amount of people struggling with low back pain. There's a significant amount of people with neck pain, headache. We haven't even gotten to the fun stuff of extremities and performance yet. The opportunity is endless. It's mostly a communication process and systems issue. If you haven't got to the point you want to get to in practice. So opioid use does remain prevalent as well. Bad news among US adults with chronic pain. How much so? Well over 22% of individuals with chronic pain report opioid use during the last three months. Over one in five individuals that have chronic pain. So we know over one in five individuals in the United States have chronic pain. We know over one in five of those report opioid use over the last three months. That's a lot of pills. That's a lot of medication. That's a lot of heartache. And it blows my mind that there is minimal to no accountability to the individuals that are prescribing this medication. It is, in my opinion, beyond criminal at this point, but it continues to go on. So this, and this study looked at over about 32,000 adult participants, and they whittled it down to over 18 years old. And they Whittled that down to a little bit above 7,000 individuals out of the 32,000 that had chronic pain. Defined as saying if you've had pain in the last three months, how often was it? And the answers were either most days or every day qualified for somebody that had chronic pain in this study. So that was A out of 32,000 people, over 7,000 of them said that they had chronic, they had pain most days or every day over the past three months. Talk about opportunity. So what did the statistics tell us as they started to analyze that? A couple things that are really important to consider. One, to consider in your market and then two, to consider if you're looking to expand or grow your market. There are some sharp delineations between individuals who used integrative healthcare, as they say, which include chiropractic and those who didn't. And let's take a look at what some of that is. People who used integrative healthcare were generally younger, about 52 years old as opposed to 57 years old. Those are averages, so don't take it as absolute numbers. But they tended to be younger. They also individuals that used integrative care tended to have a higher family income. They also tended to have more locations of pain. So those are three big factors. So that is key. Now compared to those that are not using integrative care, subjects that engage in more than one integrative modality had a higher rate of being female or identifying as female, higher levels of education and they tended to live in metropolitan areas as opposed to non metropolitan areas. Important to keep in mind. Now among subjects with chronic pain, these were some factors associated with an increased odd of engaging in integrative health. 1 higher family income 2 higher levels of education 3. Living in large metropolitan compared to non metropolitan areas 44 increased number of pain locations 5 pain that limited work or life activities on some most or every day compared to not at all. So those are some of the key factors we start to extrapolate here and it's important to understand this. Here's what my mind immediately goes to is I start thinking about what's on my website, what are the videos that I'm shooting, what are the messaging I'm putting out on the banners if I'm attending events, what is my marketing message? Because these are the facts of how people are making decisions. So either need to go with gravity and understand who my demographic is ideally, or I can say let me take the opportunity to open up my demographic by knowing there might be some hindrances on some of These categories, the ones you know. In other words, the opposite of what we just discussed, the factors for not using integrative care. Right. And how do I rectify that? So interesting. Alternatively, there were some factors associated with decreased odds of engaging with integrative care. And be no surprise based upon what we just went through. Older age as opposed to younger age, males identifying as male as opposed to identifying as female. And here's an interesting one. Identifying as black or African American as opposed to single, other races or white. That's interesting. And four, using opioids to manage pain every day compared to never. Well, number four, doesn't surprise me. I've been using opioids every day to manage the pain, so I'm gonna continue to do that. You're probably less likely, of course, to use integrative care. No surprises there because you've chosen the opposite. So some really important factors, and I want you to think about who comes into your practice and think about where do they fall on that spectrum? And is your website representative of those individuals? The pictures, literally, the text, literally are the banners, are the flyers that you put out, are the handouts that you utilize. Everything from the reading level, older versus younger, the background of the images, metropolitan versus non metropolitan. Now, of course you want to have it resonate with the audience that you're trying to attract, but it's important to know the audience that's already utilizing services because you can lean into gravity and then you can identify, for instance, identifying as black or African American, you are less likely to use integrative care. There's no reason for that. And they kind of showcase here that they can't really identify a reason for it. They say future studies are necessary, but that might be an interesting place of outreach for you in your community. If you notice there are clearly individuals across all identified races that, that are struggling with chronic pain. And if nobody else is reaching out to some of these patient populations, maybe it's an opportunity for you to be able to reach out, bridge the gap, improve your practice and really change the lives of those individuals that might just not be represented in other practices or maybe even in your practice today. But you can change that moving forward. Those are the interesting things I find in this study. Now, they also took a look in this study and at looking at non pharmacologic only versus opioid only type statistics. And compared to those using opioids only, having less than a high school education, living in a metropolitan area and having pain limit life or work activities every day were less prevalent among subjects using non pharmacological modalities. So probably no big surprises there. So ultimately the findings are, are completely wacky. I mean, there's no other way to say it, which is many of the people with most of these qualifications, the people who need non pharmacological and integrative care most are the ones least likely to use it. And that's a shame, but it's also an opportunity. So we know older adults have higher rates of chronic pain and are more likely to take opioids. And increased age, of course is associated with increased odds of chronic pain as well. And when we look at that being ultimately the increased age associated with the reduced odds of engagement with non pharmacologic or integrative therapies, that's a big deal. Now, chronic pain is also more prevalent in rural areas, yet they found non metropolitan residents was associated with reduced odds of engagement with non pharmacologic or integrative modalities, lower income associated with increased risk of chronic pain and stacking it on again, more likely to take opioids and medications, which is a really, really big deal. As they highlight the association between opioid use and chronic pain, it's well established, there's nothing that we don't know about it. It's generally overlapping and largely the same thing. And they've of course found individuals taking opioids daily were less likely to engage in integrative care. So they highlight the fact that many of the, there's a huge gap here in many of the people that need non pharmacologic and integrative care, the most are the least likely to use it. So again, I just think back towards communication, towards marketing, towards outreach. And how are you bridging that gap? Because it is really, really wild. Those identifying as black African American adults were over 31% less likely to engage in integrative health modalities compared to those who identified as white. So these are all massive opportunities to do outreach into your community, to really take a step back and understand that in many cases when we look at people who are older, people who have lower education, lower income levels, maybe they're in a more rural community, they, they have the highest likelihood to have chronic pain and they're utilizing integrative approaches the least frequently. That is an opportunity for you to get out there. And to me, that is the primary take home message on this study is man, we still have, we've come a long way and we have a lot of work to do. Now if you'd love to bridge the gap with other healthcare providers in your community, of course we'd welcome you to our MD referral program at the Evidence Based Chiropractor. The program is undefeated. As I say, it's 100% successful when implemented and 0% successful when not implemented. So if you're an action taker who wants to get out there and believes you should be receiving more referrals from other healthcare providers, head over to the evansbasedchiropractor.com, get started. It is really easy. It's step by step. And again, program is undefeated. Now before we wrap up today's episode, additionally, if you sell pillows in your practice or if you sleep on a pillow yourself, I'm gonna recommend an Align of Sleep pillow. I love their products. You can head over to aligno sleep.com yeah, that's alignosleep.com sold exclusively through chiropractors. I had the opportunity to meet Dr. Pound over here at my house. He came up I use the pillow in my house. Cannot Recommend it enough. Alignosleep.com, additionally, shockwave therapy I cannot go online any day without seeing questions about Shockwave in a Facebook group. I personally cannot recommend stemwave enough. Go stemwave.com the evidence basedchiropractor if you have any interest in it whatsoever, click the link below or head over to go stemwave.com the evidencebasedchiropractor they support this podcast. I'd love for you to support them. It's what I use in the practice I own. We have an entire practice built upon this technology. Happy to answer any questions as well. But if you head over to ghostenwave.com the evidencebased chiropractor, they can tell you everything you need to know and hook you up with best pricing options available. As a listener to this podcast as a shout out. So thank you for listening to this podcast. If you have not left a rating or review, now it's time to do so. I'd love to hear from you. You can just scroll on down if you're listening on your phone, tap how many stars, maybe leave a little feedback. That'd be awesome. If you ever want to reach out to me, jeff the evidencebasedchiropractor.com I am available. Thank you for listening. Thank you for being a chiropractor. Have an awesome week in practice and I will talk to you soon.

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