What role can DCs play in patient-centered medical homes?

Patient-centered medical homes benefit greatly from DCs.

Patient-centered medical homes benefit greatly from DCs.

In an effort to create a new model for the organization and delivery of healthcare in the U.S., federal officials devised the patient-centered medical home (PCMH), also known as the primary care medical home. Under this model, individuals receive comprehensive care from a network of providers, from nurse practitioners to doctors of chiropractic (DC) to family physicians, all of whom are connected to one another through web based chiropractic software and other modes of communication. 

As practitioners get used to this new way of operating, each may wonder what the organizational structure means for their specialty in particular. For DCs, the advent of PCMHs means more efficient and complete care for the millions of people with chronic back, neck and musculoskeletal problems, as well as those who frequently experience headaches, according to a whitepaper from the Foundation for Chiropractic Progress titled "The Role of Chiropractic Care in the Patient-Centered Medical Home." 

While the new model represents great opportunity in improving chiropractic care across the country, many DCs are not yet on board. According to a recent poll by Dynamic Chiropractic, 23% of chiropractors intend to join a PCMH in their areas, while 19% said they had no plans to do so. Moreover, 58% said they didn't understand the question on PCMH, indicating a dire need for education on PCMHs among DCs. This poll was taken by 117 chiropractors.

Key components of the PCMH
It's important for all types of healthcare professionals to understand the basic tenets of the patient-centered model. One defining feature is that they're always based on teams of professionals, whether they're located in a central facility or connected through a virtual network. The capability for the latter is especially important in rural areas of the country that tend to have a shortage of local specialists. 

It's because the PCMH utilizes healthcare professionals across the gamut that it's able to allow each practitioner to perform at the top of his or her license. This means that DCs and other specialists can optimize the time they spend with patients by limiting their duties to those that require their level of expertise, while delegating less complicated tasks to nurses or administrators. 

The role of DCs in patient-centered care
According to the Foundation for Chiropractic Progress' whitepaper, chiropractors play an integral part in medical homes, providing patients in the network with complete options for their spinal well-being. Within these networks, DCs act as go-to professionals for patients who have musculoskeletal and neuromuscular conditions, which encompass a number of widespread, debilitating illnesses. This underscores the great need and importance for chiropractors in PCMHs. In addition to providing the best care for these problems, ranging from simple checkups to surgery, DCs can also advise individuals on diet and exercise tips that could address the root of issues as well as treat symptoms. 

While it's always been standard practice for general practitioners to give referrals to DCs, people receiving treatment within the Department of Veterans Affairs and Department of Defense may now receive better treatment as primary care physicians within these networks give referrals to DCs for neuromuscular and musculoskeletal care, the whitepaper noted. 

Finally, it's important to underscore the need for chiropractic EHRs and integrated web based chiropractic software, as these technologies help DCs understand patients' full range of care, as well as allow them to communicate with other practitioners in a PCMH. In order for Chiropractors to participate in a patient centered medical home, it will be required that they have chiropractic software.

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