Over a hundred years ago DD Palmer the founder of Chiropractic presented his hypothesis, that there was a relationship between the function of the nervous system and wellbeing, while we now know his "bone out of place" theory was wrong, the hypothesis is as relevant as ever, and is well articulated in the Vertebral Subluxation Complex: A "theoretical model" of vertebral motion segment dysfunction, that incorporates the complex interactions (innate), of pathologic changes in nerve, muscle, ligamentous vascular and connective tissues that affects adaptability to physical, chemical and emotional stresses and compromises general wellbeing.
Improving the fuction of the nervous system should be our contribution to the "Health of the Nation". If that helps people stay healthy great. If that helps someone with back pain great, if that helps someone with asthma great, if that helps someones hearing or vision great. If that gets more people off medication and helps with other debilitating conitions that chiropractors are reluctant to offer help with for fear of being accused by the GCC of missleading their clients, great! However its not good enough to just believe in chiropractic we have to improve the way we explain it to the consumer and be able to measure its effects on wellbeing objectively if we are going to be taken seriously by other professions. Its no longer tenable to measure your sucess on "patient visit average".
Chiropractic is separate and distinct from medicine and physiotherapy, in my oppinion it is a mistake to follow the lead of biomedical chiropractors who want to limit chiropractic, to battling with physiotherapy over who treats back pain better. Its for us to help empower the consumer so they can set their own health agenda.
Read the GCC vision of "The Practice of Chiropractic in the UK and its contribution to the health of the nation" (below). Remember Margret Coats is the GCC Registrar and only the messenger on this, if that’s her understanding of chiropractic she has recieved it from chiropractors and it is up to chiropractors to provide her with a broader vision of what our profession has to offer.
"Will we be treaters of musculoskeletal pain syndromes, or will our legacy be to champion the reform movement so desperately needed in health care." Christopher Kent 1995
INFORMATION NOTE from the general Chiropractic Council
THE PRACTICE OF CHIROPRACTIC IN THE UNITED KINGDOM AND ITS CONTRIBUTION TO THE HEALTH OF THE NATION
Chiropractic is a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal manipulation or adjustment (WorldFederation of Chiropractic, 1999).
The Chiropractors Act 1994 established the General Chiropractic Council (GCC) as the regulatory body and since 14 June 2001 it has been a criminal offence for anyone to call themselves a chiropractor if they are not registered with the GCC. The GCC sets the standards for the education, conduct and practice of chiropractic in the UK.
Chiropractors are autonomous primary care practitioners who take an integrated and holistic approach to the health needs of their patients, considering physical, psychological and social aspects. They provide care and support by reducing pain and disability and by restoring normal function to people with neuro-musculoskeletal disorders.
Chiropractors provide care for patients of all ages, who present with a range of acute and chronic conditions. As well as advice about self-help, exercise diet and lifestyle, chiropractors often provide support for pain management, sports injuries and active rehabilitation.
In considering the contribution that chiropractic can make to the health of the nation and its place within the UK system of healthcare, the focus must be on
• safety
• efficacy
• cost effectiveness
• social impact
Safety
Clinical evidence has consistently demonstrated the safety and effectiveness of spinal manipulation. Serious sequelae following spinal manipulation by a chiropractor are extremely rare.
Pre-registration education and training includes the following medical sciences:anatomy; physiology; biochemistry; microbiology; pathology; orthopaedics;neurology, and differential diagnosis.
Chiropractors are trained to evaluate the overall health status of their patients and identify signs of serious or life-threatening medical conditions that require referral to a GP or a hospital.
They also have extensive training in psychomotor skills for the delivery of safe and effective treatment.
Efficacy
Research published by the Medical Research Council in the 1990s showed that chiropractic treatment for managing low back pain was 30% more effective than hospital management, mainly for patients with chronic or severe back pain. The researchers also concluded that patients with low back pain treated by chiropractors derive more long term benefit and satisfaction than those treated by hospitals.
A report by the government’s Clinical Standards Advisory Group on Back Pain in 1994 emphasised the need for early intervention (within the first six weeks) to prevent chronic pain and disability. It included in its recommendations
• Manipulation provided by appropriately trained practitioners (including chiropractors) should be available to NHS patients with back pain.
• A shift of resources in primary care to support the provision of active rehabilitation and patient education.
• psychological and social aspects should be included in the assessment and management of back pain
It is quite clear that chiropractic care meets all of those recommendations.The Royal College of General Practitioners first published guidelines in 1996 thatthere is strong evidence that manipulation is an effective treatment for people who have acute or sub-acute lower back pain. These guidelines were revised in 1999. The College also stated that there is a high level of patient satisfaction with the outcomes of treatment provided by chiropractors and osteopaths.
Cost effectiveness Back pain is frequently referred to as “an epidemic” that places an enormous financial burden on the NHS in terms of
• multiple visits to GPs
• the costs of drugs
• hospital care
Chiropractic care can contribute to a reduction in all of these costs.
Social impact
There is a significant social impact from the back pain epidemic
• on individuals, from persistent pain which can result in unresolved distress,
reduction in social participation, loss of self esteem and loss of work
• on the state, in terms of the need for payment of unemployment and incapacity
benefits
• on industry, where the cost of days lost because of back pain has been calculated
as over £5 billion.
Timely access to chiropractic care can prevent chronicity and thereby reduce the
impact on individuals and the state.
Again, early intervention through chiropractic care can reduce the length of time that
people are absent from work as a result of back pain.
Margaret Coats
Chief Executive and Registrar
General Chiropractic Council
August 2004
This note is an extract from the GCC’s Five Year Corporate Plan August 2004.
The full text can be read on the GCC’s web-site www.gcc-uk.org
