Chiropractic and Medicare - Solution or Perpetual Colloid?

The entire conversation about Medicare documentation brings up the basic conflict between Chiropractic and the realities of medical insurance.  The truth is that there are two types of chiropractic practice. One is a medical approach in which every patient is being treated for a medical condition through the correction of subluxation. The other is the chiropractic approach wherein the only condition being addressed is subluxation so that healthy function can be optimized through the release of a person's inborn capacity to heal through natural healing processes. No, I am not a stump thumping straight, quite the mixer actually.  But then again, I'm not opposed to medical care just because I am a chiropractor, either.  I just prefer to stick to what I was trained in and leave the heroic chemical infusions and surgical excisions to the boys and girls in the white coats. 

No, the problem that I see is that Medicare (and all insurances for that matter) are, first and foremost, vehicles to finance the delivery of symptomatic medical care.  But there were enough people who wanted a holistic approach, that their cries for alternatives eventually could be ignored no longer. These people realized that non-medically focused care when applied to all the rest of the people who weren't desperately sick yet, could bring about a greater level of health and function in our society than what was erroneously being called "health care". And these people, convinced that they were never going to let themselves get sick that way, insisted that the monies that they were paying into the sick care system should be redistributed in a way that could help to pay for these alternative approaches as well, among them chiropractic. 

But the powers that be, would not let go of their insistence that the medical care monies were for medical care.  So, legislators eventually stepped in to resolve the impasse by observing that chiropractic care works perfectly well in a medical context.  After all, look at how well that sprain/strain did without a medical doctor even involved. See, so let's let chiropractors have a crack at these medical conditions.  But of course, we won't let the chiropractors diagnose anything but musculoskeletal diagnoses. And of course, when it comes to Medicare, we won't pay the chiropractor to examine, diagnose, image or anything other than manipulate.  

And so, the golden 80's came to pass when the square chiropractic peg was legislatviely jammed into the round medical insurance hole, and chiropractors were allowed into the previously exclusive medical billing processes and it was like a kindergarten class in a candy shop... their faces were just smeared with sugar schmutz from ear to ear.  And the medical community hated it.  The money never amounted to anything real significant but the menace had to be contained nonetheless.  And so they decided that the chiropractic profession should be forced to accommodate the billing processes that equated every procedure to a medical diagnosis or else they should be sent back to their pre-inclusion days of cash only practices.  And with the promise that they were going to be paid from the same coffers as the medical doctors, teh chiropractic profession happily did whatever they had to do.  

But in the real medical world, there is no room for "art".  There is no room for "feel". So, in reality, the chiropractors continued to practice chiropractic, but they started to bill physical medicine. If a diagnosis is what they wanted, then by God, a diagnosis is what they would get. Fast forward to today where we find ourselves at another crossroads.  We are being called out on the carpet not based on our results.  We still rank huge in patient satisfaction and outcomes.  The dollars spent on chiropractic care are still spit in the health care bucket of water. No, we are being taken to task because we insist on practicing chiropractic and not physical medicine.  

In my opinion, this doesn't come down to a question of who are the good guys and who are the bad guys.  That is way too simplistic.  What we need to decide is whether our government wants to pay to provide chiropractic and medicine or just medicine.  We are not medical doctors.  We will never be medical doctors.  Let's just lay the cards out and let them fall where they may. Chiropractic will not disappear because insurance doesn't pay for it. But to try to continue to deliver chiropractic in a medical model is not doing the medical community any good, the chiropractic community any good nor the patients any good.  And in the end, Medicare is just another medical insurance company that is going broke.  The problem is that this particular insurance company has the force of the Federal Government behind it.  And this company is using public money and can legislate whatever it wants if it waits until things get desperate enough.  I'm just not sure that I am going to allow myself to get desperate along with them.  How about you?