Breaking Down Barriers: Chiropractic Collaboration in Healthcare

In this episode of 'Ask the Chiropractor,' Dr. Brant Hulsebus from Rockford, Illinois, discusses a recent research paper on strategies for treating lower back pain, emphasizing the effectiveness of chiropractic care over invasive medical treatments. The research paper, published in eClinicalMedicine, argues for movement-based care rather than pharmaceuticals or aggressive imaging. Dr. Hulsebus stresses the importance of chiropractor-medical doctor collaboration, sharing his experience in interdisciplinary settings, and explores why such partnerships are rare, often due to systemic politics and financial interests within healthcare systems. He encourages viewers to seek chiropractic opinions for back pain treatments.

www.rockforddc.com

Transcript

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Hello, Dr. Brant Hulsebus here, and welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is my little podcast that I do when someone has a question about chiropractic or chiropractic care, I try to answer. I'm a chiropractor here in Rockford, Illinois. I'm a proud graduate of Palmer College of Chiropractic, and I'm happy to be the team chiropractor of the Rockford Icehogs. Let's dive into it. Today I'm going to talk about a research paper again. This one's called The Effectiveness of Strategies for Implementing Guideline, Coordination, Care, and Lower Back Pain, Assistant Medical Review of the Mental Analysis of Randomized Control Studies. This was published at eClinical Medicine, 2024, November 13th. I'll put a link on the bottom of this. And again, this is a PubMed article. For those of you who don't know, PubMed articles are some of the most highest research papers that exist. They go through multiple levels of scrutiny to make sure the information on there is correct and accurate. Not just simply somebody doing one study and trying to publish it, it has gone through tons and tons of scrutiny. If you want to know more about that, go to my topics on my podcast and look up research and I will tell you all about PubMed there. Let's talk about this article. This article talks about they take all the information out there on lower back pain and spinal stuff and they try to figure out some strategies for implementing a guideline for this, meaning that they said that the use of opiates and different pharmaceuticals and different treatment plans that currently exist for lower back pain is not the best protocol for lower back pain. They're saying today when you're acute lower back pain, number one thing you can do is movement based care. What is movement based care? That's what chiropractors do. We get in there and make things move again. So something that chiropractors have been doing for decades, a century, over a century, is going in there and doing spinal adjustments. We find one or two vertebrae that are misaligned. We will use our hands most of the time. We will find the fixation. We will go in and do a chiropractic adjustment, making the spine move again. And the goal of freeing up the spine is not only for the biomechanics of the spine and the acute swelling of the spine, but also to help the neurology that comes out of that vertebral level to function the way it's supposed to and designed to function. That's what we do as chiropractors. And so the study is saying that today when you go to the doctor, the medical doctor, you might be prescribed an opiate, you might be prescribed a heavy pharmaceutical, and that might be followed up with some aggressive imaging like an MRI. And today they're saying that maybe this isn't the best course. From everything we look at, this is not the best course. This is not the best way of going about things. The best way of going about things are some simple x rays and then some movement based care. Again, what us chiropractors do. And the problem with this is they're saying that, yes, this research has been out there. We know all about this research. We agree with you that it happens. But this paper is trying to figure out why. Where's the disconnect from everybody understanding this and it actually happening? Which is why I made this podcast. The idea of this podcast is I'm trying to get you the information you need to know to make your decision because I've told you several times if you ask any other health care provider, whether it's a dentist, medical doctor, orthopedic doctor about chiropractic care, they'll usually give you an uneducated answer about chiropractic. I'm not saying they're uneducated. I'm saying they're uneducated about chiropractic. They do not understand what we do, nor have they tried to learn what we do. Now, the paper talks a lot about how we can reestablish these connections between the chiropractor and the medical doctor. Now, myself, I am the team chiropractor for an AHL hockey team, the Rockford Icehawks. In the locker room, we have multiple medical disciplinaries, whether it's family physician, ER physician, general surgeon, and orthopedic surgeon. This is typically the audience that I work with. We have discussed many times about different things chiropractors can do. They actually had the benefit of watching me lay the player on the adjusting table and doing the chiropractic adjustment. And I predict exactly what I'll see in the player before and after I do the adjustment. And the player typically tells the doctor exactly what I predicted. So they get to see it first hand, it happening in action. And why aren't these things like, becoming like a ton of referrals to me, working with doctors in different healthcare systems? There's many different reasons. One reason is politics. Meaning that if I am a doctor at one healthcare system, I have agreed to only refer patients to doctors within that healthcare system. So if I'm part of the healthcare system, I'm just going to say Jones. I can only refer to other people in Jones healthcare. Even if there's another hospital in town, we'll call Smith. I'm not allowed as a Jones medical doctor to refer to Smith medical doctors. And because I'm outside of their system, they no longer refer to me. So me being me, I applied to all the systems. And of course I was denied because I don't have any intentions of working with a chiropractor. Even recently, I tried to make an appointment where my general practitioner moved away, my family doctor, and he took a lot of referrals from me over the years, and I attempted to find a new doctor to refer my patients to, and I was told by one of the healthcare systems that we have no interest in working with a chiropractor. So your chiropractor is ready and willing to work with your doctor most of the time. However, the healthcare system is not ready to work with the chiropractor. I'm not picking on healthcare doctors, I'm picking on healthcare systems. The healthcare system, they do not simply want to work with chiropractors. Now, one of the reasons might this be is, maybe it's purely financial. Maybe they don't want to see their income leave their healthcare system and go to a different system. It could purely be financial. Back in the old days, we had Chester Wilk, he sued the AMA, that's the old days, the 1990s. And he was able to show the AMA was purposely trying to contain and eliminate chiropractic. Because of this, of almost a decade, or essentially almost a century of belittling chiropractic and spreading falsehoods about chiropractic, perhaps there's still many professors that still believe this is true. Because they believe what they were taught. Maybe they don't see the paper where they made it all up about chiropractors and that those professors are teaching that and the students are learning that and this prejudicism continues to exist. I don't know. I never went to med school. So I went to chiropractic school. So that's a possibility there, too. So when you go to ask your medical doctor more and more about whether or not you should go see a chiropractor for this situation, you have to understand there's a couple things that the doctor is up against. One is they're ignorant to what we do because they were never taught what we do. Number two, the health care systems. Maybe they send a contract that says I'm part of Jones's health care system. I can only refer internally to Jones. So you're better off to just ask a chiropractor whether or not you should go to chiropractic. Now myself, I work with medical doctors a lot. I try to share with them case notes of what we're doing. I try to show them benefits we've gotten. I literally email them research papers showing the benefits of what we do. And it's amounted to nothing over the last, I'd say, 15 years. We continue to try to educate them what we do. We continue to offer to work with them. Myself, I'm the president of my state association and I'm the rep, national rep of the ICA, our national association and I have offered to go meet with the medical society here in town to try to educate them a little bit what we do, try to make some friendships and relationships and my phone calls and my emails always fall on deaf ears. So there is an attempt for chiropractors to work with them, but since we do not have that and that does not exist, we continue to talk to you, which is why I made this podcast. So if you had a question about chiropractic or chiropractic care, you could ask the chiropractor. So again, somebody with lower back pain, the evidence is overwhelming. The number one choice, the smartest choice would be chiropractic. The most effective care would be chiropractic. That's not me saying that. That's the research and the studies for the last 10 to 15 years have been proving this more and more again. Not only does it prove what we do is safe and effective, but it also continues to show that the other things that you might be prescribed or might be given aren't the smartest idea. You've heard me say it before, steroid shots in the spine were never FDA approved for the spine, and they were not recommended by the manufacturer because the spinal musculature is different than the rest of the musculature. NSAIDs, non steroidal anti inflammatory drugs, have been proven with chronic use to create chronic lower back pain and headaches, the very things you take them for to relieve. Opiates. I don't think we need to talk much about opiates. Everyone knows what happens with opiates. They're very addictive. They lead to bad things. They can ruin your life. Chiropractors have fought hard to get people off opiates, probably over the last 10 15 years, showing everyone that we're another choice. So there you have it. Chiropractic. So we also, we don't tend to do a lot of MRIs. Now we can do an MRI if you have a stubborn case, but they talk a lot in this research paper about the over utilization of advanced imaging. That would be MRIs. We pretty much can figure out what we need to do with an x ray. Now given, if we take an x ray, we do a standard care plan based on your x ray and your exam findings, and we find that you're not improving, you're not getting well, then that would warrant an MRI. Just like a typical medical procedure, if the typical procedure wasn't working, then we would want to do more advanced testing, including imaging. So that logic stays the same. However, You're more likely to get an MRI faster with lower back pain at a medical clinic than you ever would at a chiropractic clinic because we think that we need a couple of weeks of adjustments in order to make it better. The medical doctor might order the MRIs within the first three or four visits right away. And the articles here in the paper say that maybe that's a little too aggressive. There you have it. Another paper, another research thing talking about the benefits of chiropractic care. This one kind of highlights though The problem that we know that exists is the lack of communication between your medical and your chiropractor and the lack of referrals to the chiropractor for proven safe effective care that just don't exist. Not that the effort on behalf of the chiropractor, not on behalf of the effort of research just don't exist. I gave you my reasons. All right. If you have a question about chiropractic or chiropractic care, Feel free to leave a comment or a post wherever you're listening and seeing this and I'll be happy to get back to you. Again, if you have questions about chiropractic care, the only person qualified to answer that would be a chiropractor. And I'll be happy to give you my opinion, my answer, based on the research papers that I read and the evidence that I have. Thanks very much.