CAM Primary Care Providers Result in Cost Savings, High Patient Satisfaction

Complementary and alternative medicine

Patients visiting chiropractors and other holistically-oriented physicians who serve as primary care providers (PCPs) have lower utilization costs and higher patient satisfaction levels than patients treated by conventional medical doctors, according to a study published in the May issue of the Journal of Manipulative and Physiological Therapeutics that tracked data from a unique Independent Physicians Association (IPA) where chiropractors serve as first-contact, primary care physicians.

"The escalation of medical expenditures remains an urgent problem in the United States and it's becoming quite clear that cost containment strategies by conventional medical providers are failing to achieve even mediocre results," said study coauthor James Winterstein, DC. "This study confirms that integration of allopathic, chiropractic and other complementary and alternative medicine (CAM) providers can positively impact patient quality of care while limiting overall costs. This approach to patient care has great potential to improve the U.S. healthcare system."

Led by Richard Sarnat, MD, researchers directly compared cost and clinical utilization data from an integrative CAM Independent Physicians Association (IPA) with conventional medical IPA data from members enrolled in a traditional health maintenance organization (HMO). The recent report analyzes data from 2003 to 2005 and is a follow up to the original report published in 2004, which compared data from 1999 to 2002.

"Our most recent analysis supports earlier findings that patients visiting CAM-orientated primary care physicians (PCP) " primarily chiropractors " experienced fewer hospitalizations, underwent fewer surgeries and used considerably fewer pharmaceuticals than HMO patients who received traditional medical care," Dr. Winterstein said. "Moreover, doctors of chiropractic succeeded in diagnosing and treating patients at a level nearly equal to medical doctors."

Researchers found that over the course of the seven-year study, patients visiting chiropractors and other CAM-oriented PCPs had 60 percent fewer hospitalizations, 62 percent fewer outpatient surgical cases, and 85 percent lower pharmaceutical costs when compared with total network HMO utilization rates and costs. The chiropractors and other complementary and alternative medicine doctors treated and managed cases ranging from upper respiratory tract infections and allergies to headaches, orthopedic and other medical conditions.

In 2005, the chiropractic PCPs managed 60 percent of their enrolled patients without requiring a referral to a conventional medical specialist. These data mirror the 2001 findings, which also demonstrated that 60 percent of the patient population within the integrative IPA was solely managed by their chiropractic PCPs.

"The most current data from our ongoing study suggests that doctors of chiropractic are well-suited to provide patients with valuable primary-care services," Dr. Winterstein notes. "We have demonstrated that it is possible to deliver CAM-oriented primary care in a highly regulated environment without compromising either quality or safety."

Patients reported on the quality of care they received through the use of annual patient satisfaction surveys. On average, data from patients enrolled between 2003 and 2005 demonstrated a high degree of satisfaction (96 percent, 94 percent, and 91 percent, respectively). These findings were similar to data from 1999 through 2002 (100 percent, 89 percent, 91 percent, and 90 percent, respectively). The integrative CAM patients consistently rated their experiences more positively than did members enrolled within the HMO's conventional medical IPAs.