Global Courant
Healthcare reform is all the rage these days. Nobody really knows what’s going to happen. That’s why professionals scramble and grab straws. Some think there is a panacea for the chiropractic industry facing many dangerous trends – health care reform being just one of them.
That panacea is called “Medical Home Model”. I’m not saying there’s anything wrong with this, but as I interpret it, there are two issues that will be discussed in a moment. But first let’s understand what it is.
This program is enshrined in Iowa law. The starting point is better communication between the DC and other care providers. That’s a good thing! It enables DCs to be primary care physicians. Not sure what that means; I’ve classified my DC as not just my family doctor, but my only doctor for the past seven years.
The philosophy is to promote patient well-being by treating the whole body, including mind and spirit. That’s a great philosophy that I agree with as my DC has been providing this for me and my family for the past seven years. The way this should be done is by having DCs work hand-in-hand with the MDs.
The thinking behind why this is the panacea for DCs is that with the electronic health record (EHR) system that the government requires you to have, the MDs will work with you and refer your patients and vice versa. After all, you will already be working “hand in hand” with them.
My question is, “Why does a doctor who doesn’t see the benefit of chiropractic suddenly refer you just because you’re connected to the EHR?”
Here are the two concerns I see with this model:
1. This model wants you to work hand in hand with the MDs. I have no problem with this. I would love for GPs to see and understand the good that chiropractic does for people. However, one of the main concerns of bringing 40 to 50 million new patients into the system is how will the system handle the new influx of patients?
Here comes the Medical Home Model that wants to involve chiropractors. I think the long-term outcome of this program is that you become the new physician assistant. We already know that there is a shortage of nurses and other healthcare providers. You are the perfect solution with the trends you are dealing with.
2. The second concern I see with this program is what will happen with a government-sponsored plan once health care reform is passed (which it is now)? You just committed your practice to becoming more dependent on government insurance. You now have a chance to play the same game as Medicare and Medicaid, which is that the government tells you what they will pay you for your services. Currently, Medicare pays only 71 to 81 cents per dollar. Is that what you want?
Now I am not saying that you should avoid this program, I am sure there are benefits to using it. However, I would encourage you to study it with an open mind and ask lots of questions before you get deeply involved. If this were the only dangerous trend facing the chiropractic industry, it might solve all your problems. NOT! However, there are other things you need to worry about if this program is to become your panacea.
Chiropractic panacea?
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