- The effectiveness and cost effectiveness of chiropractic management of low back pain.
- The untested, questionable or harmful nature of many current medical therapies.
- The economic efficiency of chiropractic care for low back pain compared with medical care.
- The safety of chiropractic care.
- The higher satisfaction levels expressed by patients of chiropractors offers an overwhelming case in favour of much greater use of chiropractic services in the management of lower back pain.
"There should be a shift in policy to encourage and refer chiropractic services for most patients with low back pain ... a very good case can be made for making chiropractors the gatekeepers for management of low-back pain in the workers compensation system." (Manga report)
As indicated by Professor Manga in Adelaide, the response by the Ontario government to the report was due to be released in November. The Ontario minister for health, the Hon. Ruth Grier referred the Manga report to a Chiropractic Services Review Committee for advice. This committee has prepared its final report which at the time this article was written had not been publicly released. We await the release of this report with great expectations. It will no doubt have a positive impact on our profession's image in relation to the medical profession.
These same findings were presented by Professor Manga to representatives of the Workcover Authorities in Australia in December 1994. Reaction to this meeting has not yet been publicly released. We eagerly await their comments. The substance and recommendations of his study were also utilised in a joint meeting of the Workcover representatives in Perth in November 1994, and in submissions to the Commonwealth Health and Veteran Affairs Departments. Again, no comments from these government bodies has yet been released on these findings. There can only be a positive reaction, one would think, to a study which so conclusively supports use of our profession in the presence of low-back pain. However, government bodies tend to be extremely conservative and their reaction to the report may be less enthusiastic than we would like. There has been no media attention to the Manga report in Australia or New Zealand. Perhaps once the formal response by the Ontario government and the response by the Workcover Authority is known, our national chiropractic associations in Australia and New Zealand can begin to push for as much media exposure as possible. We have a great opportunity to tell the public and the medical profession what chiropractors have known for a long time: Chiropractic offers the best scientific care available for back pain. Perhaps in this our centennial year the recognition we so greatly deserve, but have been denied, will come to fruition.
Orazio Trevisan, DC, BSc
George Dragesevich, DC, BSc