Working Together To Get Patients Better, Chiropractors and Medical Doctors

As long as chiropractic care has been around, there has been a challenging relationship with mainstream medicine and medical doctors. If one looks at 50 years ago, chiropractors might have been thought of as quacks, voodoo doctors or “not a real doctor.” These days we are seeing more and more back pain and neck pain patients getting help from chiropractors or medical doctors, and often times the patient is getting treatments from both.

Dr. Hamel has been a practicing chiropractor in Kingwood, Texas for over 20 years. Here is his view of why chiropractors and medical doctors don’t always get along and the differences in philosophy in treatment techniques:

1. While a chiropractor knows a little bit of what happens at a medical doctor’s office (because most have been a patient with an MD at some time or another), most MDs do not know what chiropractic care is and how it works. This is an education issue. If the MD took time to learn more about postural stress, spinal misalignments and how chiropractic adjustments can alleviate a lot of pain, muscle spasm and dysfunction, they may view the care differently.
2. Legally, medical physicians can do a lot more than chiropractors when it comes to back pain treatments, such as pain shots, prescription medicines, and surgeries. This might seem like in the eyes of a patient and medical doctor that the chiropractor is inferior or in a way not a “real doctor.”
3. In general, both chiropractic doctors and MD’s have an oath to help the patient using their scope of practice, and if they can’t, they should refer the patient to someone else who can help. Dr. Hamel believes sometimes a medical doctor referring to a chiropractor, in their mind, means they will lose that patient, and vice versa for a chiropractic doctor referring to an MD.
4. A higher percentage of sick people, (meaning any ailment), are going to see a primary doctor or specialist MD compared to a much smaller percentage of people seeking out chiropractors. Again, this might seem like the chiropractor is a second choice and inferior to an MD.
5. With medical doctors, there is a whole mainstream medical system, with MD’s referring to specialists, prescribing medicine to a pharmacy, sending a patient to an imaging center for an MRI or CT scan and sending the patient to a lab for bloodwork. Chiropractic is kind of a stand-alone profession. Anyone can go see a chiropractor. They do not need a referral from a medical doctor, and they don’t even have to have insurance. There is a big difference between the two and may be another reason that an MD would like to not refer outside of the mainstream medicine model.
6. When addressing neck and back pain, chiropractors take a natural, more holistic approach while medical doctors mostly use a pain relief, treat the symptom model. Ideally the chiropractic doctor wants to find the root cause of a patient’s back pain and then give them treatment to help fix the problem; chiropractors believe that the body can heal itself if it is given the right therapy. Mainstream medicine on the other hand has been in the news for pain medicine and opioid over prescribing due to the fact that they are trying to help the patient feel better (understandably), by just treating the symptom which is pain or inflammation. The problem with pain medicine is that it is not fixing the problem (such as spinal compression, nerve irritation, postural imbalances, muscular imbalances), so the problem is not going away, but the patient is relying more and more on the pain medicine to help. Chiropractors cannot prescribe medicine, but they also must realize there is a time and a place for their patients to take it, ideally for a short time to be able to function, drive or go to work instead of being miserable with pain.

Even though all of these reasons can affect the relationship between chiropractors and medical doctors, we are seeing more cases of patients going to both DCs and MDs to try and deal with their back and neck pain more comprehensively, according to Dr. Hamel. In his office, Kingwood Chiropractic, Dr. Hamel sends a letter to each of his patient’s medical doctor, DO, PA, Nurse Practitioner or specialist, letting them know what they are coming in with, what kind of treatment will be given and what kind of outcome is expected. This helps to connect both Dr. Hamel and the medical doctor, letting them know they have a mutual patient and that they should work together to get the patient well.

A prime example that a chiropractor might refer to an MD or specialist is when a patient has chronic neck pain, back pain or Sciatica that is not going away, even after a month of treatment. Dr. Hamel says that sometimes a patient is stuck in an inflammatory response that just keeps on hanging around no matter the treatment or exercises. This is a good opportunity to refer out to a MD or pain management doctor. In this case an MD can give a cortisone shot to help substantially decrease inflammation with chronic neck pain, back pain or Sciatica. The cortisone shot itself cannot fix a problem, but indirectly it causes inflammation relief, and that can now allow the body to be able to heal and repair more effectively. This is a prime example how a patient can benefit much more from chiropractic therapy after they have received a cortisone shot from an MD. 

When it comes down to it, it is really the best interest of the patient, and both MDs and chiropractic doctors should learn to work together to get their patient’s better more quickly by using the least invasive methods possible according to Dr. Hamel. If a back pain patient only goes to a chiropractor and gets no relief or only goes to an MD and gets no relief; it makes sense to try something else. Both MDs and chiropractors can make a better effort to let their patient’s know that there are other treatment alternatives when the patient is stuck and not seeing results.

On the flip side of things, as patients, we deserve the best in medical treatment and should be able to access all of the treatment options out there. Sometimes we have to speak up, tell the chiropractor or MD that this isn’t working and find out what else they recommend. There is so much out there today in terms of medical treatments, both mainstream and alternative, that are helping people get over neck and back pain. Just take a look at how patients are being helped by PRP therapy, Stem Cell, ozone therapy, acupuncture, massage, IV therapies, cold laser, nutritional supplementation and more. It’s your body, you have the right to get healthier and explore some of these other treatments, and don’t stop until you find something that works.

As a chiropractic doctor for over 20 years, Dr. Hamel is a car accident chiropractor seeing many whiplashed injured patients from the Kingwood and Houston areas.  Dr. Hamel has a great referral system to helps his patients including imaging centers, car accident attorneys, neurologists, pain management doctors, orthopedics and more.  Working together to get the patient out of pain and healed up is the key to building a reputable practice.