J Manipulative Physiol Ther. 1995 Nov-Dec; 18(9): 626-7.

Integration of chiropractic into managed care in a multidisciplinary setting.

White AH.

San Francisco Spine Institute, California, USA.

The first round of managed care flourished from 1990-1995. As the "economic screws" tightened, all subspecialties of health care lost their unbridled freedom to the primary-care physician. Patients can no longer visit their subspecialists (including chiropractors) of choice. As the public becomes disenchanted with such limited managed care and as new reforms of managed care emerge, the chiropractor and other subspecialists are regaining their rightful position. Centers of excellence can clearly diagnose and treat a patient more quickly, economically and accurately than the bureaucratic, "kicked back" primary care gatekeeper. Enlightened managed care business developers are using chiropractors as primary care health providers and are using centers of excellence that include chiropractors as a major cog in the wheel. The new managed care system directs patients to the least expensive professional who can get the job done most efficiently and accurately. With minimal redirection, the chiropractor is the ideal professional to diagnose and treat the early phases of spinal problems and can easily triage patients to the most appropriate chronic health care providers.