Implementing Evidence Based Health Care Within the Chiropractic Profession

1
Implementing Evidence Based Health Care Within
the Chiropractic Profession

• APHA
• Philadelphia, 2006

2
What is EBHC?

• EBHC

3
The ComplexitiesCHC Traditions

• Most CHC systems (chiropractic, acupuncture,
  homeopathy, etc.) developed by offering
  alternative explanations of health and disease
  predicated upon novel physical and biological
  laws and methods of investigation.
• Vitalism (Innate Intelligence, Chi)
• Novel Mechanisms
• Subluxation
• Meridians
• Law of Infinitesimals
• No evidence that these are valid
• These beliefs remain salient to varying degrees
  among the different CHC professions.

4
The ComplexitiesThe Evidence

• There are very few definitive answers provided by
  the scientific literature
• There is never proof or certainty, only levels of
  certainty or uncertainty
• For many of the procedures/systems under
  consideration the evidence is minimal or entirely
  absent

5
The ComplexitiesThe Imposition of Limits

• The implementation of EBHC inevitably limits
  patient and provider choices
• These limitations affect both patient
  satisfaction and provider incomes.

6
The ComplexitiesThe Default Defense

An absence of proof is not a proof of absence.
7
Successful Programs

• Education
• Private Practice
• Government
• Third Party Payer