Exploring Patient Satisfaction with Chiropractic Care for Lower Back Pain & Radiculopathy: A Chiropractor's Perspective

Ask the Chiropractor- 
A recent paper was published about Chiropractic patient satisfaction with the chiropractic care.  The study was on lower back issues.  The average age was 47.  Few things surprised us and a few things did not.   Take a listen and Dr Hulsebus will break it down.  #healthy815 #icachiropractor #palmerproud

www.rockforddc.com

Transcript

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Hi, I'm Dr. Brian Hulsebus, chiropractor, and welcome to another edition of "Ask the Chiropractor.""Ask the Chiropractor" is my little podcast that I do here for if somebody has a question about chiropractic or chiropractic care, that they can come on and ask me the question. Why me? Because I'm a chiropractor. A lot of people, for some reason, ask their family doctor about going to a chiropractor before they go to a chiropractor, wanna make sure their family doctor thinks it's a good idea. And I understand where that logic comes from, but in reality, your family doctor knows nothing about chiropractic. So if you have questions about a chiropractor, or a chiropractic, you should always ask a chiropractor. Just like if I had a question about my teeth, I would ask my dentist, not my family physician. So who am I? I'm a chiropractor. I went to Palmer College of Chiropractic. I have served as the IceHogs team chiropractor, the Blackhawks affiliate hockey team. I've been doing that now, I just signed on to start my 19th season working with the athletes over there. I've worked with lots of other athletes over the years, and I've worked with a lot of pregnant women. I've worked with a lot of geriatric patients, a lot of pediatric patients, just about everything under the sun. So, coming out here, every time somebody has a question, I try to answer it, and I try to use science and research and everything else to get to the bottom of things. Well, I hang out with a lot of friends of mine who are medical physicians, and one of them actually asked me,"Are there any studies or research that's done"on patients satisfactory of chiropractic care"after receiving the chiropractic care?" So they're basically saying,"Hey, if somebody goes to a chiropractor"for a little while," in this case, they're talking about lower back pain with radiculopathy, meaning the lower back hurts, and then the pain travels either down your thigh, down the back of your leg, down to your foot, radiculopathy."What's going on?"Do the patients seem like they get good results?"Do you have any research that shows that what you're doing"is actually working and patients are happy?" Well, most of you know that the majority of the research I do is on PubMed. What's PubMed? PubMed is like the gold standard for medical research. If I want to look up something to see if it's a real research or not, I always go to PubMed. And PubMed is the ncib.gov. That's where they keep it all. But I would just type in, like,"Is chiropractic safe PubMed?" and then the real research shows up. Now, in order to get PubMed indexed, it has to go through scrutiny of research and people retrying it to make sure that what this paper publishes is actually validated. So it takes a long time to get your paper proven enough to be put in PubMed. So recently, and I mean recently, I mean like three weeks ago, a paper was recently released on PubMed in the"Chiropractor Manual Therapy," 2023, for volume 31. This was published online May 19th of 2023. The article is,"Patient Expectations and Level of Satisfaction"in Chiropractic Treatment for Lumbar Radiculopathy,"a Mixed Method Study." So what they did is they found a group of people, the average age was around 47, who have lower back pain and radiculopathy, meaning that the lower back pain, it travels somewhere else. They went around and did a series of interviews before and after the chiropractic care in order to determine whether or not with the chiropractic care, the patient was satisfied. You know, "I went to the chiropractor,"I got care, afterwards, am I happy?" The study was mostly 52% female, obviously 48% male. And all kinds of interesting statistics and information. It's a pretty wide demographic of people they interviewed. The bottom line is, at the end of the day, patients were satisfied. They thought it was good. They were happy with the results they got. Let me pull up the articles here. Yeah, 80 to 90% of them were very satisfied when asked about the first visit, the information, the overall management of their care, where over 50% were satisfied with the treatment effects. Now what does that mean, treatment effects? Well, this is what kind of separates chiropractors from other chiropractors. You come here as my patient, one of the first things we do is we do our examination, we do x-rays, and we get to the bottom of what's going on. We try to explain it to you and show it to you, help you understand what we found, and then we describe to you a little bit how chiropractic works and why we think chiropractic is going to help you. So, in this area, 80 to 90% of them were very satisfied about the original procedure."I came in, the chiropractor went over all my stuff with me,"did a good exam, he definitely was able"to locate the problem and made me feel like he understood"what my issue was and how the chiropractor"could relate back to it." Where patients were not as satisfied was the actual, what we call, care plan that the doctor give them. You know, "It's going to take three times a week"for this many weeks, once a week for this many weeks,"we're going to introduce this on this day"and this on this day." This is where a lot of the doctors and the chiropractors fail. So if you're out looking for a chiropractor and you're thinking about going to a chiropractor, I recommend you find a chiropractor that gives you a game plan. Even if it says, you know what, let's give us 10 visits here, I bet we'll make a great big change, and after that we'll redetermine things. But if it's just, you know, let me give you an adjustment, you come back, tell me how it goes. A lot of times people understand the chiropractor knows what's going on, but basically the chiropractor should tell you what their thoughts are, how to get you better, what it's going to take, how many visits and what the requirements are. And also, realistic expectations at the end. I'm very, you know, here at this office, we try to be very honest with our expectations at the end. If you come to see me, and your spine is all degenerative and it's full of arthritis, and there's a lot of things going on with your spine, I'm going to tell you that we're probably not going to make you feel like you're 18 again, but you should be able to get through your everyday activities relatively pain-free. If you come in and your spine is not that bad, I'll tell you, I expect to make a full recovery on this as long as you follow through with your stabilization exercises and stuff like that, we should do really good. Also, some of these people are unsatisfied because the chiropractor maybe didn't order an MRI. They thought they needed an MRI right away. I often tell people that an MRI is a great tool, but honestly most insurance companies aren't going to go for their first visit with a chiropractor. We're going to have to do some care for a while, and then if you don't get the results that we're thinking that you're going to get, then we want to do a deeper dive. We want to do a deeper dive and maybe then get an MRI, talk to, you know, maybe a physical therapist can get involved too, and try to really dive into what's happening. So not a lot of chiropractors express that like,"Hey, you know, I'm not getting better."I'm not getting the results that's going on."What's the next step?" So as a chiropractor, what I would tell you is if we did so many levels of care, as well here, we would tell you that we're going to see you this number of times, and after about this time, we should start to experience this. Now I've set the bar like, okay, you've come in eight times, at eight times we should be experiencing A, B, or C. If you're not experiencing these A, B, or C things after eight visits, then we want to do a deeper dive, maybe then order an MRI, or maybe take another x-ray view. I know like in the neck, the cervical spine, a lot of times we'll take just the basic neutral x-rays where you're just standing still from the front and from the back. And if you don't get the results we want, we'll go back and take more images of maybe a flexion extension, meaning that you look down and you look up. And then we have tools here that show us which ones aren't moving. And if you know the ones that aren't moving, then we know those are the ones to adjust. So if you go to a chiropractor and they just do the basic stuff, and you're not getting results, and you're not telling you what the goals or the care plan should be, or the highlight should be, then maybe you just maybe talk to a different chiropractor. Or ask your chiropractor,"Hey, what are my goals here,"what are my expectations,"what should I be feeling after this, or "How often should I be coming in,"how should I follow up?" If you're a new patient to a chiropractic clinic, this stuff's very important to know how to get the results and the realistic expectations you should have. So is this a bad mark on chiropractic? I don't think it's a bad thing on chiropractic. I think it's a bad thing on chiropractors. Some chiropractors that aren't giving the care plan, the schedule. I know we're taught this at chiropractic school, to do this kind of stuff. I don't know why some chiropractors fail to do it. So that's the biggest thing. A lot of patients just assume that if I went to the chiropractor with lower back pain that's radiating to my legs or my thighs, that I would automatically get an MRI. Because in today's world, if I went to the medical doctor, they take x-rays one day, they follow up with an MRI the next day. And that's kind of become the standard for them. But it's not really the standard for chiropractors. And why is this? Well one, we kind of see the results on you because we're going to adjust your head to come back the next day and see how you did. And if we start to see you get better, why spend the more money going through the MRI if it's not necessary? And the second reason, probably the largest reason, is because, you know what, it's just not going to be covered. They're not going to let us x-ray you and do an MRI the next day, because we're not getting the results. Because after one or two visits, they're going to say, "You didn't give enough care." Matter of fact, some people actually try to make us go eight weeks before we dive into an MRI. And that's a real struggle for me. Because if you're miserable for eight weeks, I'm going to do an MRI way before that. So that's just kind of the issue is why you don't always get an MRI when you go with a chiropractor. Because a lot of us, our hands are tied. They don't let us take them, even though we'd like to. Some of the coolest chiropractic clinics I've ever been to have motion MRI machines, where we can actually watch chiropractic care live as it's being performed to you. But those are the exceptions, not the norms by any means. X-rays are the norm. MRI are not the norm getting chiropractic, because we just don't get reimbursed for it. So we don't want to stick you with a big$3,000 bill for an MRI that maybe you needed, maybe you didn't need. But the bottom line is if you're not getting results, we shouldn't investigate further. So I hope this answers your questions about my medical friend who's hopefully watches this. When you chiropractors patients, do you have any research on the results of satisfaction of patients afterwards? Bottom line is patients are really satisfied when they show up the first day and we go over everything, explain everything, identify the problem. But half of them were upset because their chiropractor didn't give them a care plan, or give them goals, or tell them what's going to happen. And the other half, the chiropractors did, and those people were really happy, and they understood what was expected of them and what was expected of their care. So I would tell you that find a chiropractor that takes your x-rays and does your exam, go everything with you, explain everything to you, gives you chiropractic care, and then tells you what the goals and expectations are for your care. If you go to a chiropractor that's not doing this, or if you find someone that's not doing this, ask them to do it, or ask them to refer you to someone who does. So there you have it. Patient expectations and levels of satisfaction in chiropractic treatment for lumbar radiculopathy. Like I said, it came out May 19th, 2023. As I'm recording this, it's the beginning of June 2023. This is a pretty new article, pretty recent article. So if you're watching this article, if you're watching me speak right now, I've popped the article up a couple of times so you can see it. If you're listening to me on the podcast, go check out rockforddc.com, R O C K F O R D D C.com. Underneath the area where it says "Blogs," this is where I post these videos, and I have the information, more information about this. So if you'd like to go out and see more information on this, or read more yourself, please go to the website and read more. Other than that, I'm Dr. Brent Hulsebus, chiropractor here in Rockford, Illinois. If you have a question about chiropractic or chiropractic care, and you'd like to have a chiropractor answer your question, because we actually know the answers, go ahead and ask me. You see, I tend to look up the research and the data before I give an answer, and I try to share it with you the best I can, and I try to make it easy to understand. So if you have a question, please feel free to ask. Other than that, stay healthy, and we hope to talk to you real soon. Bye-bye.