Chiropractic Shenanigans

You’d think after illegal cash payments from chiropractors played a large part in the federal prison term of former Speaker of the NC House, Jim Black, that the profession would lie low for a while. No such luck. Chiropractors have a new bill in the General Assembly that would give them a special status among medical specialists – insurance companies would be prevented from charging higher co-pays when patients see a chiropractor. In most health insurance plans, when a patient sees a specialist instead of a primary care doctor the patient pays a higher co-pay. This includes everything from physical therapists to dermatologists. The idea is to get people to see their primary care doctor first for most non-emergency problems.

It always shocks me, but I’ll actually have to agree with NC Blue Cross on this one – this bill is a bad idea for patients and anyone who pays a health insurance premium. This isn’t just about costs either. It’s also about quality of care. Specialists, whether chiropractors or surgeons, often tend to see a patient with health problems through the lens of their specialty. So, someone with abdominal pain who sees a surgeon is likely to hear about the importance of removing the appendix even if they might just need to cut down on the Texas Pete hot sauce. Not only is it more expensive to have your appendix out than to lay off the Texas Pete, but capping the hot sauce bottle is much less dangerous.

In fact, primary care doctors are skilled in what some people think is one of the real arts of medicine, the ability to consider multiple factors that play into a patient’s health and combine those often widely disparate causes to produce an accurate diagnosis. So, not only is it cheaper to see a primary health doctor first, it’s often going to result in better care – even if it turns out a specialist visit is needed. This new chiropractic bill is little more than one more health care special interest trying to get special treatment.