How Doctors of Chiropractic Are Helping Patients During This Pandemic
F4CP - April 28, 2020
By: Sherry McAllister, DC, MS (Ed) CCSP and Executive Vice President Foundation for Chiropractic Progress (F4CP)
Here’s a welcome glimmer of hope: New CDC data indicates that the overall hospitalization rate for Americans with COVID-19 was less than five per 100,000 patients over four weeks in March. This means the effects on the majority were mild enough for them to recover safely at home.
Meanwhile, federal and state health officials across the U.S. have urged Americans to avoid visiting the emergency department (ED) unless they feel they are having a true health emergency. As such, EDs across the country have noticed a decrease in patient traffic.
Because of this, care delivered through telehealth – typically online video visits with a doctor or advanced practice clinician – has skyrocketed. Several analyst reports estimate that the telehealth industry is expected to grow 15-25% per year until 2026, with an 80% boost alone in 2020 due to the pandemic.
Doctors of chiropractic (DCs) are contributing to the increase in telehealth use, the decrease in ED visits, and likewise, reducing the risk of spreading the deadly virus. That is because unspecified pain–not of the chest or head–is the sixth most common reason for an ED visit and symptoms related to the back are the eighth most common reason, which are both managed by DCs. In some instances, those conditions can be effectively diagnosed and assisted through telehealth.
Wide Range of Services
In most states, chiropractic care is considered an essential service, so clinics are doing their best to serve their community. However, many patients are choosing to stay home and have canceled appointments. While some DCs have had to temporarily close their offices or handle a reduced patient load because of COVID-19 restrictions, other DCs have turned to telehealth due to patient demand. Will telehealth use in chiropractic care continue post-pandemic? I believe so and here’s why:
DCs can evaluate, diagnose and manage disorders of the neuro-musculoskeletal system, including low back and neck pain and headaches, as well as offer other services through telehealth. For example:
· Diagnosis: Although hands-on assessments are impossible, DCs can help narrow or fully diagnose a patient’s problem, especially if they are an established patient with conditions that the doctor is already managing.
· Range of motion: Determining the cause of a patient’s limited range of motion is highly feasible through video-based appointments. Often the DC will be able to spot the cause after having the patient perform some basic movements and answering questions.
· Posture evaluation: With more patients working from home for the first time for an extended period, they may not have created an ideal home-office environment, which can lead to posture problems. Through telehealth, the DC can assess the patient’s posture and offer corrective actions, recommend exercises to improve posture and suggest ergonomic changes to the patient’s home office to prevent exacerbation.
· Functional evaluation: Similar to a range-of-motion evaluation, DCs can review patients’ ability to perform a certain function during telehealth. They can then offer advice on improving patients’ functional outcome measures to improve and assist in their activities of daily living.
· Nutritional counseling: In stressful times and with easy access to our kitchens, some of us may not be making ideal nutritional choices. DCs are highly trained and qualified to counsel patients on their eating and hydration habits.
· Therapeutic exercise: Stretches and exercises can be demonstrated and recorded for the patient through telehealth to do at home. DCs can also recommend non-pharmacological pain management options deemed appropriate such as heat, ice and/or taping.
Worth the Effort
Due to COVID-19, the federal government loosened restrictions on delivering care through telehealth to Medicare patients, but all doctors need to stay within their scope of practice and maintain the same standards of care they would deliver in-person within their clinic.
State laws and reimbursement rules for telehealth also vary widely but are worth the effort for most DCs to learn about and comply with to maintain income during these challenging times. Patients, especially those who are elderly with limited mobility will appreciate the ability to use telehealth with their doctors.
As my colleague Daniel Lord, DC, CCSP, physical medicine program manager at Fortune 500 employer healthcare provider at Crossover Health says: “More than ever, our doctors of chiropractic are using virtual care with great success. It is a highly advisable option for now and a great adjunct to in-person practice in the future.”
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