Health care reform is all the rage these days. No one really knows what is going to happen. Therefore, professionals are scrambling and grasping at straws. Some think that there is a panacea for the chiropractic industry which is faced with many dangerous trends — health care reform being only one of them.
That panacea is called “Medical Home Model”. I’m not saying there is anything wrong with this, however, the way I interpret it, there are two problems that will be discussed in a minute. But first let’s understand what it is.
This program has been passed into law in Iowa. The premise behind it is better communication between the DC and other health care providers. That’s a good thing! It allows DC’s to be primary care physicians. I’m not sure what that means; I have classified my DC to be not only my primary care physician, but my only physician for the last seven years.
The philosophy is to promote patient wellness by treating the whole body including mind and spirit. That’s a great philosophy which I agree with, since my DC has been providing this for me and my family for the last seven years. The way this is to come to pass is with DC’s working hand in hand with the MD’s.
The thought behind why this is the panacea for DC’s is that with the electronic health records (EHR) system that the government is demanding you have, the MD’s will work with you and refer you patients and vice versa. After all, you are already going to be working “hand in hand” with them.
My question is, “Why is a MD who does not see the benefit of chiropractic, all of a sudden going to start sending you referrals just because you are hooked up to the EHR?”
Here are the two concerns that I see with this model:
1. This model wants you to work hand in hand with the MD’s. I have no problem with this. I would love to have MD’s see and understand the good that chiropractic does for people. However, one of the main concerns with bringing 40 to 50 million new patients into the system is how can the system handle the new influx of patients?
Here comes the Medical Home Model wanting to get chiropractors involved. I think the long term outcome of this program is to make you the DC the new physician assistant. We already know there is a shortage of nurses and other providers. You are the perfect solution with the trends you’re facing.
2. The second concern that I see with this program, once health care reform passes, is what is going to happen if there is a government sponsored plan (which is the case right now)? You have just committed your practice to be more dependent upon government insurance. You now get the opportunity to play the same game as Medicare and Medicaid of having the government tell you what they will pay you for your services. Currently Medicare only pays 71 to 81 cents on the dollar. Is that what you want?
Now I’m not telling you to avoid this program, I’m sure there are benefits to using it. However, I would encourage you to study it with an open mind and ask a lot of questions before getting to deeply involved in it. Maybe if this was the only dangerous trend the chiropractic industry was facing it would solve all your problems. NOT! However, there are other things you need to be concerned with for this program to be your panacea.