Seeing a chiropractor first reduces the cost and duration of workers compensation injuries according to the Journal of Occupational Rehabilitation The Journal of Occupational Rehabilitation just published a study on the cost and duration of care for a lower back problems (1) that shows, as many other studies have that the type of provider the patients see first will influence the cost and duration of care, as well as possible future episodes of pain. A large cost driver for Occupational Health departments is the time the patient is out of work. Chiropractors according to this study gets them back to work faster, reducing the overall cost to the system. This is something that has been shown by many studies over the years and also by Bottom Line Personal as well as Consumer Reports who now routinely gives doctors the highest satisfaction ratings when compared to primary care of physical therapists. This is a huge problem in New Jersey, where insurance companies are allowed to pick and choose who a patient can see, and chiropractic is seldom utilized. My brother in law who works for a Crawford, a health management company specializing in workers compensation works with chiropractors in NY all the time yet in NJ, chiropractors are rarely used and often discouraged by the workers compensation carriers. With this information, there is more proof that chiropractors should probably be the gate keepers for back problems at minimum, and perhaps many of the musculoskeletal problems workers present with. Perhaps it is the way chiropractors are taught to make the care more personal, and help by understand and looking at them first, and then the problem they presented with, rather than the symptom, and addressing the symptom, while missing the problem. Today’s system has developed many diagnostic tracts that doctors are taught to use to fit patients into their diagnostic criteria. In many cases, this fails miserably, while resulting in quick referrals to the wrong types of providers and the ordering of too many tests that are of little value. Many chiropractors are beginning, as we have done for years to use active evaluation and treat test treat protocols. According to a doctor who was teaching us how to properly use orthopedic tests for the shoulder this past Tuesday, our current methods are wasteful, doctors can diagnose better if they examine better (something doctors are woefully underpaid to do, so they take shortcuts such as tests), and doing diagnosis and treatment like we do is actually what we should be doing. I hope our legislators in NJ are reading this blog and reading this study since it is time for a change from business as usual in the workers compensation industry. As a patient, you do have a choice, and some patients do choose their chiropractor, while alternatively being denied this care from their employer. When they improve from the chiropractors work, the workers compensation doctor unfortunately gets the credit. There are exceptions, including Johnson and Johnson who does allow chiropractors to treat their employees and have had us in the past as a panel doctor for carpal tunnel syndrome and some lower back problems. You can read more about this study here. The bottom line is, with lower back pain and workers compensation injuries, see a chiropractor first for the most cost effective and shortest duration episode of care and disability. Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain. Blanchette MA1, Rivard M2,3, Dionne CE4,5, Hogg-Johnson S6,7, Steenstra I6,7.