Chiropractic + Naturopathic Doctor

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Surviving with the Help of Technology


March 21, 2013
By Stephane Laverdiere DC

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Technology is replacing the livelihood of millions of labourers worldwide.

Technology is replacing the livelihood of millions of labourers worldwide. Harnessing information from a report of the Bureau of Labor Statistics, Wall Street has identified jobs that will lose the largest percentage of human labourers over the next decade. That list includes watch repairers, camera and photographic equipment repairers, computer operators, desktop publishers, drilling machine operators, postal service mail sorters and semiconductor processors, to name just a few. Everyone has been affected, or knows someone who has been affected, by technological advancements in various industries.

WHAT ABOUT TECHNOLOGY IN THE HEALTH-CARE FIELD?
For more than 150 years, medical doctors have routinely prescribed antipyretic drugs like ibuprofen to help reduce fever – any fever. A 2005 study conducted by researchers at the University of Miami, Florida, studied 82 intensive care patients.1 The study subjected patients to antipyretics in two control groups. The first group received antipyretics if their temperature rose beyond 101.3 F, which is a standard treatment. The second group received antipyretics if their temperature reached 104 F. To chiropractors, the results are of no surprise – seven people died while receiving the standard treatment, while only one death occurred in the group of patients allowed to have a higher fever.  The study was stopped, since the researchers thought it would be unethical to continue to give patients the “standard treatment” that would result in more deaths.

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Since the guidelines for using something as simple as antipyretics hadn’t been challenged for 100 plus years, we must question what else is being missed.

Another study conducted at Johns Hopkins found that as many as 40,500 patients die in the ICU in the United States each year due to misdiagnosis.2 With more than 10,000 diseases available to diagnose, and thousands of drugs that may be mis-prescribed, the next health-care error is just around the corner. In the meantime, programs that have been coded to analyze data are gaining popularity and usage in health care. Much of what physicians do – examinations, testing, diagnosis, prescription – can be performed better using sensors, passive and active data collection, and analytics.

Computers can take on much of that diagnosis and treatment and even do these functions better than the average doctor while considering more options and making fewer errors. In fact, computers with the right programming are better at balancing patient symptoms, history and environmental factors to arrive at a diagnosis. So, will these digital solutions eventually replace a high percentage of medical doctors?

Doctors aren’t supposed to just measure and collect data. They’re supposed to digest all the data, consider it in the context of the latest medical research and the patient’s history, figure out the proper diagnosis and arrive at treatment that is suitable for the particular patient in question while remaining an approachable and compassionate caregiver. In other words, there are some things computers just cannot do – they can, however, function in a supportive role for those doctors who know how to harness their benefits.  Therefore, the doctors – medical and otherwise – who will survive the ushering in of a new era of technology will be those who embrace, and work with, the technology. 

The health-care field will undergo an evolutionary change – and it might be slow, with a few bumps along the way – for which 40 million uninsured Americans and out-of-control health-care costs in North America will be a strong catalyst.

None of us can predict the future but we know that technology is being pushed to its limits, for example, by new legislation on EHRs (electronic health records) and standardization of record keeping. 

HOW DOES THIS AFFECT CHIROPRACTIC?
Chiropractic is a unique profession and defines itself through work that is, by definition, done by the hands. Even though instruments are used in many offices to deliver the adjustments, computers will never be able to perform the delicate tasks of palpation and determining the area of subluxation (or restriction). While tools such as X-ray and various scans are useful, the hands are the gold standard of instrumentation in our profession. Further, we value the many healing properties of a caring smile and the power of human touch when palpating the spine and delivering the adjustment – we see these as being truly irreplaceable. 

Chiropractic will not be replaced by technology, but we must embrace the various technologies available to us for improving patient care, increasing office efficiency and helping us to comply with our respective chiropractic college regulations.

For instance, one of the most neglected areas of practice is record keeping and documentation. I recently received a visit from a peer, for an assessment regulated by the College of Chiropractic of Ontario (CCO). This experience is certainly not frightening, especially if you are using technology to help you with your documentation – the technology is programmed to keep your records in compliance. If being busy seeing patients affects your ability to record a good SOAP note, you need to consider electronic health record (EHR) software. One great element of an EHR is its ability to create a fully compliant SOAP note in seconds. It will drastically speed up your note taking, allowing you to see more patients in less time while still recording superior notes.

The CCO simply states, “A member shall, in relationship to his/her practice, take all reasonable steps necessary to ensure that records are kept in accordance with this regulation.” It is up to all members to read the six pages of regulations and ensure that their practices are compliant. 

But, simply having an EHR system in your practice is not adequate – it needs to be used and used properly. (Quality of input in equals quality of input out.) One of the most memorable phone calls I have ever received was from a chiropractor who was being assessed by a peer in one week’s time and was frantically asking for help in order to achieve health record compliance in time for the review! Don’t allow yourself to be caught in this situation.

We advocate receiving chiropractic care to relieve stress on the spine and spinal cord, yet many chiropractors practice with a stressful, disjointed and non-efficient office system. Make it your goal in 2013 to remove the stress in your practice – compliance, in fact, survival of your practice, can be easy if you allow the appropriate technology to support you in what you do.

REFERENCES

1.Schulman CI, Namias N, Doherty J, et al. The Effect of Antipyretic Therapy upon Outcomes in Critically Ill Patients: A Randomized, Prospective Study of Surgical Infections. Winter 2005, 6(4): 369-375.doi:10.1089/sur.2005.6.369.

2. Winters B, Custer J, Galvagno S, et al. Diagnostic errors in the intensive care unit; a systematic review of autopsy studies. BMJ Qual Saf doi:10.1136/bmjqs-2012-000803.


Dr. Stephane Laverdiere is a 1995 graduate of the National University of Health Sciences in Lombard, Illinois.  He is president and co-founder of Atlas Chiropractic Systems, a paperless office solution.  He is also founder of the Internet video marketing company, ChiroVMail. He can be contacted at 877-602-8527 or slaverdiere@atlaschirosys.com.  Please  visit www.atlaschirosys.com and www.chiroVMail.com for more information on digital solutions for your practice.


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