The Manga Report drew national attention for its support of chiropractic treatment for low back pain. This unbiased, independent study commissioned by the Ontario Ministry of Health concluded that chiropractic treatment is cost-effective, safe, has a high rate of patient satisfaction, and is more effective than medical treatment for low back pain. Its recommendation that the management of low back pain be moved from medical doctors to doctors of chiropractic forced legislators, representatives of managed care, and other decision makers to reexamine their positions on chiropractic health care.
When Pran Manga, PhD, selected a US distributor for his groundbreaking study, he turned to FCER. To date, more than 3,000 copies of the 104-page Manga Report and more that 172,000 copies of the Executive Summary pamphlet have gone out to the profession. The unvarnished facts about the benefits of chiropractic as reported by an internationally known health care economist have reached the hands of more than 175,000 people.
There are precious few within the chiropractic profession who have not heard of the RAND study, but many may have forgotten FCER's role in the project. During his tenure at FCER, Steve Wolk, PhD, our former research director, was instrumental in designing and managing the RAND study and made numerous modifications that enhanced the value of this now famous study.
Two studies that were supported and published by FCER have made a major impact on the perception of chiropractors as providers of a primary health care: "
"The role of the doctor of chiropractic in the health care system in comparison with doctors of allopathic medicine and doctors of osteopathic medicine," by Meredith Gonyea, PhD, of The Center for Studies in Health Policy, Inc.Dr. Gonyea's study compared the roles of chiropractors, allopaths, and osteopaths. Her simple conclusion was startling to some:
"The chiropractor as a primary health care provider in rural, health professional shortage areas of the US," by Deborah Callahan, MA, and Arnold Cianciulli, DC, MS.
"The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services."Ms. Callahan and Dr. Cianciulli took Dr. Gonyea's conclusions one step further in their survey report. They found that in medically underserved rural areas doctors of chiropractic are already providing primary care to many of their patients. This establishes an existing pattern of practice and will help to confirm that chiropractors can serve in a primary care capacity to help ease the shortage of primary care physicians in the US. A study is now in progress that will assess patient satisfaction with the services provided by the doctors who responded to this survey.
It was a major coup when Western States Chiropractic College received the first federal research grant ever awarded to a chiropractic institution for research that is being conducted by FCER's "Researcher of the Year," Joanne Nyiendo, PhD. FCER assisted in this important venture by providing funding for one of three pilot studies that supported the feasibility of Dr. Nyiendo's study. We hope the study will pave the way for more federal funding for research on chiropractic.
Chiropractic: A Primary Care Gatekeeper, by Arnold Cianciulli, DC, MS, and Chiropractic: A Review of Current Research, two booklets published by FCER, have been used extensively on Capitol Hill and by state legislatures. Doctors in Florida and New Jersey credited FCER publications with helping them to win their states' bids for primary care status by providing persuasive and credible information to decision makers.
When chiropractic was attacked by the Wall Street Journal, "20/20," and Consumer Reports, FCER didn't stand idly by. Within a week of each publication, a point by point response was prepared. These unemotional, fact-based responses were designed to arm the practitioner with sound information to respond to patient's concerns. They were sent to more than 100 chiropractic publications and are also available free-of-charge for our members upon request.
That's just a sampling of what FCER has done for you, the practitioner, lately. But what are we going to do for you in the future? Plenty more.
- The Vermont study, a collaborative clinical trial on low back pain that was conducted by the University of Vermont and Los Angeles College of Chiropractic, has been accepted for publication in Spine, the prestigious medical journal. This is tangible evidence that the barriers between chiropractic and medical research are breaking down and that chiropractic research can no longer be dismissed by its detractors as "unscientific."
- An FCER-funded study comparing chiropractic treatment with pharmaceutical treatment for tension headaches will be published soon.
- Also soon to be published is a survey of the patients of doctors of chiropractic identified as primary care providers in the Rural Health Care study, which should provide insight into patient satisfaction.
While back pain is the mainstay of many chiropractic practices, these studies will draw attention to chiropractic's expanding role beyond back pain.
On the horizon are a broad spectrum of studies funded by FCER that will have far-reaching impact for the chiropractic profession. Researchers are now exploring chiropractic treatment of scoliosis, migraine headaches, and industrial injuries. A collaborative study with Beijing Union Hospital on low back pain is also in the works.
In 1994 the National Chiropractic Mutual Insurance Company (NCMIC) entrusted the Foundation with a $1 million grant to increase the amount of research funded to support and expand the scope of chiropractic practice. Studies are now in progress that examine chiropractic treatment of carpal tunnel, otitis media, asthma, infantile colic, dysmenorrhea, primary hypertension, cervical pain, and posterior disc displacement. NCMIC is also funding the two-year, $441,000 study, "The Role of Chiropractic as Primary Care Gatekeeper." The project will investigate, develop and test alternative primary care roles for chiropractors in medically underserved areas.
There isn't enough room to go into all that FCER has done for you lately, but if you'd like to know more about being part of these advancements please contact us at 1701 Clarendon Blvd., Arlington, VA, (703) 276-7445 or (800) 637-6244.
Mary E. Johnson
FCER Director of Communications