This is the case with the well known Texas Back Institute (TBI). TBI is the largest freestanding spine specialty clinic in the United States. It is proud of its conservative approach and brags: "While we receive the most complex cases, 90 percent of our patients recover from back problems without surgery."
TBI previously limited itself to board-certified orthopedic surgeons (with spine fellowship training), and a host of specialist. They have now recognized the benefits of adding chiropractic care to their health care team. As Dr. Mark Doyne, TBI's director of rehabilitation and conservative care puts it:
"The Texas Back Institute (TBI) believes in the multidisciplinary approach in the management of spine disorders. In order to enhance this team approach, and to better serve our patients, we felt that chiropractors should take their place with other professionals at TBI. Only 10 percent of our patients have surgery; TBI is truly a rehabilitation institute where conservative patient care predominates. We look forward to integrating chiropractic care into the continuum and philosophy of patient care -- a philosophy which emphasizes patient education, patient accountability and ownership of an activity based rehabilitation program, and an early return to functional activities."After an extensive search, TBI chose John Triano, DC, MA, professor and director of the Joint Ergonomics and Research Laboratory at National College of Chiropractic. Dr. Triano has a national reputation for his work with the Agency for Health Care Policy and Research (AHCPR), and the National Institutes of Health (NIH).
TBI Chairman of the Board Dr. Stephen Hochschuler had this to say about why TBI ultimately decided on Dr. Triano:
"Texas Back Institute decided several years ago to search for a chiropractor to be involved with the growth of the Institute. It is obvious that a large part of the American population does seek chiropractic care for their back complaints and that the efficacy of treatment seems to be significant. We had first met Dr. Triano approximately three to four years ago and were impressed by the quality of his scientific endeavors as well as his pursuit of his ergonomic engineering degree and felt his abilities in both the chiropractic world and ergonomic engineering world would be of great benefit for the development of the Back Institute."Dr. Doyne added:
"TBI has had the pleasure of working with Dr. Triano over the last several years. Jay is a renowned scientist, researcher, clinician, and educator. He will continue his important extensive clinical research at TBI; moreover he will add depth, balance, and new approaches to patient care."While Dr. Triano will continue his research efforts on the benefits of chiropractic, this leaves the profession with mixed emotions. We have lost Dr. Triano as a chiropractic college educator, but he has become our ambassador at the Texas Back Institute.
Among the research projects Dr. Triano plans to conduct are persistent extremity pain; the biomechanical meaning of manual diagnostic procedures; clarifying the effects of manipulation on discogenic pain; and a controlled clinical trial on neck disorders contrasting chiropractic care, conservative medicine and surgery. According to Dr. Triano:
"The Texas Back Institute is interested in contributing to expanded knowledge of the spine through recognition of and promotion of the credibility of chiropractic science and art. TBI wants to have available all of the important components related to spine care. Our current challenge is to determine the appropriate mix of treatment options and guidelines for use to yield high quality health care, rapid return to work, and minimum possible expense."As the quality of chiropractic research grows, and the benefits of chiropractic care becomes more evident, it will be increasingly commonplace for federal, state and private organizations (that have traditionally excluded chiropractic) to hire some of our top DCs.
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