Increased Access to Chiropractic Care Linked with Lower Healthcare Costs and Better Outcomes

Increased Access to Chiropractic Care Linked with Lower Healthcare Costs and Better Outcomes

As many avid blog followers already know, I am a Baltimore Chiropractor who spends the majority of my time utilizing chiropractic care to treat headaches, neck pain, and back pain in Baltimore, MD. Whether it be the weekend warrior type, the blue-collar worker, of a Baltimore auto accident injury patient, I have been a licensed chiropractor for almost 8 years and have been helping patients with these conditions since graduation from Chiropractic College in December of 2008.

A recent study highlighted by U.S. News sheds light on what I have long believed and understood, that access to Chiropractic care can not only lower healthcare costs (a burden we all share) but can lead to better outcomes for those patients receiving the care.

A while back I shared the story of how I initially became a chiropractic patient. The short version of it is that I injured my lower back when I was about 18 or 19. I tried the typical regimen of care – stretching at home, over the counter drugs, physical therapy, and consultations with orthopedic surgeons. I was a “failed” back pain patient who was told at 19 that I would need surgery or that I would need to learn to live with the back pain for the rest of my life. At my mother’s recommendation I decided to see her chiropractor. I thought that it probably wouldn’t help but that if there was a chance it could help, it was a chance I had to take. I had nothing to lose. As the story goes, I was about 80 percent improved in about four treatments. I couldn’t believe it. Why did no one tell me that Chiropractic care was an option? Why did “main stream medicine” convince me it was surgery or learn to live with it?

The article in U.S. news points out that I was not alone in my journey to heal my back pain. According to the article Americans as a whole spend nearly $300 billion a year on treatment for pain including musculoskeletal disorders. As you might imagine a lot of this financial burden is spent trying to help people with neck and back pain. That’s where Chiropractors come in.

The article notes a study by the Mercatus Center at George Mason University that examined how medical occupational licensing laws are affecting the health care market. They found that the broader the scope of practice for chiropractors became and the more their incomes rose, the better the outcomes for patient care and satisfaction became and the less costs there were as a whole. Now why is this?

Generally speaking, family physicians and internists only can practice what they know and what they were trained on. They know medicine and intervention such as surgery. So, when a patient comes to them with these complaints, it is natural for them to recommend medications and then eventually surgery. This leads to increased costs and decreased patient satisfaction. Tied in the with the fact that medical care and interventions are so expensive compared to chiropractic care, its no wonder that healthcare costs are skyrocketing.

Another thing to consider is that typically if paid through health insurance, many primary care physicians need to control care and make referrals. While it is likely that they want what’s best for their patients, they are more likely to keep a patient in their system and buying healthcare services from their colleagues than it is that they will refer them to “non main stream” chiropractic providers. That view is largely changing and we are seeing a shift where primary care physicians are referring clients for chiropractic care. Furthermore, in states such as Maryland it is very easy for prospective chiropractic patients to bypass their medical providers directly and have “direct access” to chiropractic evaluation and treatment. It appears as if the monopoly that medicine has had on controlling how patients access care has had a significant impact on healthcare costs and therefore outcomes.

The U.S. News article goes on to state that while allowing a broader scope of practice to Chiropractic care has lead to a measurable effect on the market (as seen in terms of decreased costs and increased health outcomes) the same can not be said for a broader scope of practice for physical therapy.

As a Baltimore Chiropractor I am an advocate for patients getting whatever treatment they need to help with their neck and back pain. In most instances, a short course of conservative chiropractic therapy is appropriate and will bring about resolution of their conditions. In some instances, as I have pointed out in previous blog posts, patients do not improve as expected and are referred quickly and appropriately to other specialists for evaluation and treatment. I believe that it is imperative that my chiropractic colleagues and I spend more time educating the medical professionals in our community of the value that we provide to our patients. If there’s evidence that we can help decrease patient suffering while lowering healthcare costs then it is something that we need to do for the good of humanity and the financial solvency of this nation.

If you, or someone you know, has neck or back pain and would like to speak to a Baltimore Chiropractor, please call (443) 842-5500. We would be happy to help!

Dr. Gulitz

The Most Dangerous Street Intersections in Baltimore City

As a Baltimore Chiropractor that spends the majority of my time treating injured clients involved in Baltimore auto accidents and who have suffered Baltimore auto accident injuries including headaches, neck pain, and back pain, I have long wondered where the majority of the Baltimore City auto accident injuries were taking place. That is, this is a large city with many small windy roads and a large diverse population. I was curious where the majority of the crashes were taking place.

Well fortunately for me, I do not need to look any further. By following a law office’s blog post the information was brought right to the forefront for me. It shows down to the intersection exactly how many injury-reported crashes were made in 2015 for each intersection in Baltimore City. There were more than 9,000 reported injuries in Baltimore auto accidents in 2015. So here are the top 6 more dangerous intersections as of 2015 as measured by number of injury-reported crashes.

1) Gwyns Falls Parkway and Reisterstown Road – 46 accidents

2) Northern Parkway at Jones Falls Expressway (JFX) – 38 accidents

3) Orleans Street at Gay & Enstor Streets – 36 accidents

4) West Cold Spring Lane at Jones Falls Expressway (JFX) – 34 accidents

5) South Monroe Street at Washington Boulevard – 27 accidents

6) West Northern Parkway at Falls Road – 26 accidents

Obviously not all Baltimore auto accident injuries occur on road intersections. There are plenty of parking lot crashes and street crashes. It stands to reason that the streets surrounding these above intersections are also very popular auto accident injury streets. In particular Gwynns Falls Parkway reported over 240 crashes in 2015 and Washington Boulevard reported 130 for the year. I suspect that this has more to do with the fact that these are busy streets than that there is anything really wrong with the design or lay out of these streets.

The Baltimore City Police Districts reported the following number of auto accident injury related crashes in 2015: Northeast District (1,442), Northern District (1,320), Northwest District (1,092), and finally Central District (1,070).

As my company prepares for its expansion into Northwest Baltimore (6810 Park Heights Avenue, Suite C4, Baltimore, MD 21215), this blog post makes it clear that our expansion into the northwest is necessary, as a high percentage of the total auto accident injuries in Baltimore City seem to take place up there. I look forward to providing care to those unfortunate Baltimore City and Baltimore County residents that are injured in auto accidents.

If you, or someone you know, has been injured as a result of a Baltimore auto accident injury and require treatment, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help.

Dr. Gulitz

Some Patients Fail To Improve With Chiropractic Care

By now I am sure that my avid blog followers are aware that I am a Baltimore Chiropractor that treats patients in Baltimore, MD with headaches, neck pain, mid back pain, and lower back pain. These aches and pains can be from overuse injuries, chronic pain from a lifetime of hard work, or they can be acute injuries suffering from Baltimore auto accidents, Baltimore slip and fall injuries, and Baltimore worker’s compensation injuries. Like all business owners I like to highlight my “wins” and showcase the patients who have had favorable outcomes and resolutions with treatment in this office. I had a patient recently who came to the office and asked me about my “losses” – that is, the patients that fail to improve with chiropractic therapy. This patient wanted to know what happens to them? Do they live with their pain? Do they need surgery? I thought that this was an interesting blog topic so I decided to showcase two recent losses, that ended up with positive outcomes.

The first “loss” was a friend of mine who came to see me with neck pain and radiating right arm pain. He is an avid weight lifter and had been having neck pain and radiating right arm pain for about six months off and on. I treated him like I would any other patient – I performed a history and physical examination. Based upon my findings we took an x-ray of his neck to rule out instability and to look for neuroforaminal narrowing. Everything looked good so we began treatment. I saw him twice the first week for therapy. He felt a bit better after the first visit and then worse after the second visit. I told him to come back the next week. His condition had progressively gotten worse over the weekend, so we decided to discontinue further treatment until he got an MRI. At this point he had some grip strength weakness and increased arm pain – all of which we had discussed could possibly happen. After we got his MRI about a week later the bad news was revealed. The patient had a large extruded disc herniation in his neck. Although chiropractic care has a good history of helping patients with disc herniations, this particular herniation due to its size and the fact that it was encroaching his spinal cord was likely a surgical candidate. This was heartbreaking for both me and my friend. I referred him to a local orthopedist for a consultation. About a week later, with understandable concern for his health and well being, he underwent a successful anterior surgical decompression surgery with fusion. This means that the herniated disc was removed and the two bones that it was separating were fused with a metal cage to prevent them from slipping. I followed up with my friend about a week later and he was so relieved. All of his arm symptoms had resolved and his neck pain had decreased by about 80 percent. So did Chiropractic care fail him? No – while it is true that he did not respond favorably to my treatment, part of Chiropractic care is to continually re-assess a patient’s condition and to make changes to the treatment plan based on a patient’s response to therapy. In this man’s case he required an MRI and ultimately surgery to fix his condition. He could not have been more thankful for the treatment and referrals we gave him and made on his behalf, because left to his own devices, he likely would have done nothing for six or more months, and he could have potentially re-injured himself worse at the gym moving forward.

The second “loss” was a few months prior to the above example. A young woman who was about 40 presented for care with lower back pain and left and foot numbness. She was a fairly active woman who liked to do yoga and go to the gym, but had stopped recently due to back and leg issues. I told her that we would try two weeks of treatment and re-assess her condition. She was doing well for about 3-4 visits and then her condition worsened. She felt increased back pain and increased leg numbness. These “red flags” made it clear to me that a lower back MRI would be in order. So, we ordered her an MRI. Similar to the example above, the patient had a sizable disc extrusion with lower back nerve root compression. We discussed that it was likely that the disc herniation was compression the nerves going to her left leg and foot. She had a family friend who was a spinal orthopedist so I encouraged her to take her MRI findings to him for an evaluation. As expected based on her response to treatment and her MRI findings, he recommended surgery. Given her age and response to treatment before chiropractic care and after chiropractic care, she elected for surgical intervention. She had a lumbar laminectomy with discectomy. That means that they shaved a hole in her lower back vertebrae and shaved down the offending disc. Less than a week later she came in to “catch me up” on her progress. She was about 75 percent relieved in terms of back pain and 100 percent of her leg numbness had resolved. She admits that it was the best she had felt in almost a year. She was very appreciative of the fact that we had tried to help her with conservative chiropractic therapy and that we referred her to another provider when her clinical condition worsened.

Both of these examples demonstrate how, despite what most chiropractors would like you to believe, we are not magicians or mystical healers. We are neuromusculoskeletal practitioners that are limited in scope, but experts in what we do. In both instances the above patients were referred for MRI imaging and ultimately had to undergo decompressive spinal surgeries. Although surgery and anesthesia are not without risk, both patients ultimately did well with their procedures and their symptoms have improved considerably. When I asked both patients what they thought about the therapy they received, rather than being upset with the fact that chiropractic care could not “fix” them, they were very appreciative that they were referred “downstream” to providers who could ultimately tackle the underlying problems. In fact, both patients who failed with conservative chiropractic therapy have since continued to refer their family and friends to the practice, since they so appreciated the care that we provided to them in their times of need.

I tell all of my new patients that we will begin with a few conservative treatments to see how they will respond to care. Ideally if patients respond favorably as expected, we reduce their treatment moving forward. If they worsen, as in the examples above, we make timely referrals for imaging or to other specialists. To me, chiropractic care is limited in scope. But rather than this being a negative, I look at this is a positive. It means that we can focus on what we do well and we can refer patients to where they need to be quickly so that they can ultimately improve their condition quickly.

If you, or someone you know, has headaches, neck pain, or back pain and are interested to learn if Chiropractic care could benefit you, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

What Is A Lifetime Chiropractic Patient?

As many of my avid blog readers are already aware, I am a Baltimore Chiropractor that spends the majority of my time treating patients using Chiropractic care. Typically this means that we are treating Baltimore auto accident injury patients with whiplash symptoms: Headaches, neck pain, upper back pain, and lower back pain following Baltimore car accidents. But that also means treating weekend warriors with overuse injuries, and regular folks who wake up with stiff necks and stiff backs. As you might imagine as all people are different and unique, so to are the necessary treatment plans to get these patients out of pain and back into the “real-world.”

I recently saw a new patient to the practice. They were interested in coming in for some treatment for an acute neck injury (they “slept funny” the night before.) However, they had previously gone to another Baltimore Chiropractor who tried to convince them that they would need to be a “lifetime” chiropractic patient in order to receive the most benefit of the proposed treatment.

The patient was startled by this. They were told that they were going to need 65 visits and to spend nearly $3,000 out of pocket up front just to help them with their neck pain. And, having completing this plan, they would need to come in at least once a month “forever” to help maintain the progress that was made on their neck. Having never been to a chiropractor before, this patient asked if this approach to care was normal. They asked if it was necessary to become a lifetime chiropractic patient in order to get out of acute pain.

As you all know, I do not believe that lifetime care for an acute injury is necessary. I am more than happy to get a prospective patient what they want- which is to get out of acute pain and to return them to their normal daily activities as quickly and with as little pain and restriction as possible. When I informed this patient that I would be happy to treat them for 2-3 visits and to get them out of acute pain for the cost of their copay (approximately 20 dollars if my memory serves me) they were elated. I saw the patient for about a week and their pain went away. The patient has since stopped treating for this injury since their pain resolved and their range of motion was completely restored.

Then it occurred to me. This patient HAS become a lifetime patient to me and my practice. I gave them what they wanted and needed and I trust that the next time, should there be a next time, that they need any treatment for neck or back pain, they will likely come back to my practice for additional treatment. He didn’t feel “swindled” “manipulated” or “taken advantage of.” But he has become a lifetime patient. If that means that he never has neck or back pain and I never see him again, then for his entire life, he only ever treated in my office for chiropractic care. This makes him a lifetime patient.

So am I looking for lifetime patients? By my definition- yes. I want people who so trust in the quality of care that we provide that they never look further than my practice for relief of their headaches, neck pain and back pain. But by that same token, am I looking to have someone show up weekly forever and pay my rent and put my kids through college? No – because at some point if chiropractic care doesn’t work for a particular musculoskeletal condition then I don’t want to treat that patient. I want to refer them to another provider who can get them well.

A lifetime patient can come in many forms. Whichever form you choose to be, we are happy to take care of you. If you, or someone you know, requires chiropractic care for auto accident injuries, headaches, neck pain, or back pain, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Hovding – New Airbag for Bicyclists Hopes to Prevent Whiplash In Bicycle Accidents

As a Baltimore Chiropractor that spends the majority of my time treating patients with auto accident injuries such as headaches, neck pain, and back pain I see more than my fair share of these injuries following Baltimore auto accidents. As the weather got better this summer I saw a shift towards more non-motor vehicle collision injuries. In particular, we started to see more bicycle vs. motor vehicle injuries and plenty of pedestrian versus motor vehicle injuries.

One of the advantages of being situated in a car if it is in a crash is the number of safety features that have been developed to help to minimize the risk of death and injury. In particular, seat belts and front and side curtain airbags really help an occupant to “ride down” a crash quickly to help absorb energy and minimize trauma to the soft and hard tissues of the body.

The problem when we see patients that are involved in bicycle versus motor vehicle collisions and pedestrian versus motor vehicle collision (hit by a car while walking) is that these safety features do not exist outside of a car. Well, that is until now.

Like many of you I spend a fair amount of my work day watching cat videos on youtube, watching the latest lip sync battles on line and following the latest viral video trends. Sometimes this is actually a useful endeavor and I discover things that are new and trending that impact society and my chiropractic practice.

Recently I came across an interesting produce out of Sweden called Hovding. It is essentially an airbag for bicyclists. It has built in sensors that determine if it believes a cyclist is going to suffer an impending crash and it deploys, in an attempt to function as a car airbag and to protect and cradle the head and neck of the cyclist.

It’s got a very simple design. It has an anchor brace that circles the neck. It has a hood that deploys in case it senses an impending crash, and it has an air tank that fills the hood when necessary that rests on the back the cyclist. It has a series of sophisticated sensors that determine when it needs to deploy. It even records the crash details and collects the data for future product enhancements.

Given the trends towards urbanization and decreased dependence on fossil fuels I see more and more riders taking to their bicycles in the future. An invention such as Hovding could go a long towards decreasing or eliminating concussions, headaches, and neck pain in those that choose to ride bicycles. I think it is a great invention whose time has come. Detractors point to its price point of $300 euros (approximately $335 US as of the time of this blog post) and say that it is too expensive. I personally think that its a small price to pay to help protect the only brain, spinal cord, and neck we will ever have.

If you, or someone you know, has been injured as a result of a bicycle injury in Baltimore, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz