A Letter Released to Chiropractic Physicians
on August 10, 2006

DC / MD
Co-Management of Severe Conditions

The concept and practice of chiropractors and medical doctors co-managing conditions has grown considerably over the past decade. Many medical authorities trace the popularity of the co-management concept to a 1993 article in the New England Journal of Medicine titled “Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use.” This article highlighted the growing popularity of treatments outside of those provided by MD’s and called for MD’s to do a better job of understanding and working with the “alternative medicine” field.

While other prestigious journals have published many similar articles over the past 13 years, they consistently group chiropractic in a category of approaches labeled “CAM” – complimentary and alternative medicine. “CAM” serves as a misnomer underscoring a difference in philosophy that can interfere with truly cooperative DC / MD co-management. For instance, if an analgesic provided by an MD provides pain relief with no curative value while the manipulative and physiologic therapeutics provided by a chiropractor work towards fixing the underlying problem, it is the analgesic that should be labeled “complimentary.” Furthermore, the term “alternative” hints too strongly that allopathy needs to be the core of all healthcare while physical medicine needs to play a subordinate role. Such a disposition can interfere with the peer-to-peer collaboration of two or more physicians. This, however, is not intended as an argument against the primary care physician model. The current healthcare model wherein patients choose a long-term, primary care provider who serves as a referral consultant for specialist care can provide enormous benefit for the average patient.

When you have chiropractic patients who may benefit from an MD assessment and medical treatment, please consider a referral to Neal S. Taub, MD, ABPM&R. Dr. Taub’s physiatry training provides him with a broader perspective of the respective roles for allopathic treatments, manipulative treatments, and physiologic modalities. As a doctor board certified in pain medicine, Dr. Taub can expertly and responsibly provide treatments designed to compliment and/or progress chiropractic care. The services Dr. Taub can provide to your chiropractic patients include: prolotherapy, facet blocks, analgesics, injections for chronic headaches, medical acupuncture, or physical therapy management where physical therapy is not provided by the chiropractic practice. As a physiatrist, Dr. Taub’s referral based practice provides focused treatments for specific patient complaints. Patients remain under the general care of referring practitioners.