A Health Care System in Transformation: Making the Case for Chiropractic

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SOURCE:   Chiropractic & Manual Therapies 2012 (Dec 6);20(1):37 ~ FULL TEXT

Richard Brown

The Lansdown Clinic,
High Street,
Stroud, Gloucestershire, GL5 1AU,
United Kingdom.

There are a number of factors that have conspired to create a crisis in healthcare. In part, the successes of medical science and technologies have been to blame, for they have led to survival where lives would previously have been cut short. An informed public, aware of these technological advances, is demanding access to the best that healthcare has to offer. At the same time the burden of chronic disease in an increasing elderly population has created a marked growth in the need for long term care. Current estimates for expenditure predict a rapid escalation of healthcare costs as a proportion of the GDP of developed nations, yet at the same time a global economic crisis has necessitated dramatic cuts in health budgets. This unsustainable position has led to calls for an urgent transformation in healthcare systems. This commentary explores the present day healthcare crisis and looks at the opportunities for chiropractors as pressure intensifies on politicians and leaders in healthcare to seek innovative solutions to a failing model. Amidst these opportunities, it questions whether the chiropractic profession is ready to accept the challenges that integration into mainstream healthcare will bring and identifies both pathways and potential obstacles to acceptance.

Keywords: Chiropractic, Healthcare transformation, Healthcare reform


From the Full-Text Article:


A need for transformation in healthcare systems throughout the globe has long been recognised [1-3]. Social reform, improvements in living conditions and the positive impact of public health initiatives have all conspired to enhance quantity and quality of life [4]. As the baby boomers of the post World War Two era move into their twilight years enjoying a range of activities that would have left their ancestors aghast [5], western societies have experienced a steady increase in the size of the ageing population as communities dance, jog, cycle and gyrate their way into their eighties and nineties [6].

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But while we celebrate the achievements of medical science in prolonging and sustaining life, health care systems have been buckling under the pressure [7]. Advances in health technologies have brought about highly sophisticated systems of investigation, surgery and medical care [8, 9]. In nations where health is delivered free at the point of service and where an informed public demands access to the most advanced available care, costs of health provision have rapidly escalated [10]. At the same time, fiscal deficits and global economic crises have resulted in budgets being dramatically reduced as governments struggle to balance the pressures on the public purse [11, 12] whilst at the same time demanding added value. In nations which have seen the cost of healthcare as a proportion of the nation’s GDP rise steeply, in some cases by over seventy per cent [13], it is clear that within such an environment traditional models of service delivery are no longer fit for purpose.


Global health crises

The impact of conflict between forced financial austerity and life-saving, though costly, technological advances in healthcare has been felt across the globe. The starkest example of the need for health systems transformation exists in the United States, where nearly 50 million residents live without insurance coverage [14]. Despite clear evidence supporting the need for change and the efforts of the current administration to put healthcare reform at the top of its agenda [15], political and establishment opposition has meant that progress has faltered to the point of stagnation [16]. Vested interests, notably of a powerful medical lobby and a dominant insurance industry have ensured that the public remain suspicious of any proposals for change. Calls for a synergy between government and large industry to reduce the burden [17] have still to produce meaningful results.

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