November 2007

UHC labels chiropractic for kids 'unproven'

UnitedHealthCare, a major Health Management Organization serving more than 26 million individual consumers, issued a policy statement in September noting that chiropractic for children and adolescents, as well as chiropractic treatment of headaches, are "unproven" services.

The policy will impact chiropractic providers who contract with UnitedHealthCare, putting into jeopardy their right to provide chiropractic care to children or to help patients with complaints about headaches.

The company contracts directly with more than 535,000 physicians and care professionals and 4,700 hospitals nationwide.

The UHC Bulletin stated that the company had "previously concluded that certain services provided as a part of chiropractic care were unproven. A recent review of the clinical evidence in published, peer‑reviewed medical literature leads us to further conclude that chiropractic services for treatment of children and adolescents is unproven and services for treatment of headaches is unproven."

The World Chiropractic Alliance vigorously opposes such a policy and had previously issued a position paper in support of chiropractic for children. According to that paper, the care of children is consistent with recommended chiropractic guidelines, as set forth in the Council on Chiropractic Practice (CCP) "Clinical Practice Guideline Number 1, Vertebral Subluxation in Chiropractic Practice," included in the National Guideline Clearinghouse.

This document, the position paper points out, concludes that "Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth. As with any age group, however, care must be taken to select adjustment methods most appropriate to the patient's stage of development and overall spinal integrity. Parental education by the subluxation‑centered chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is encouraged."

The CCP Guideline clearly provides ample documented evidence that chiropractic care is safe for children and can have beneficial effects on health and fitness from newborn to adult stages.

In addition to the CCP Guideline, two peer‑reviewed journals ‑‑ Chiropractic Pediatrics and the Journal of Clinical Chiropractic Pediatrics ‑‑ disseminate critically reviewed papers in this field. Courses in pediatrics are offered at the professional and postgraduate levels at accredited chiropractic colleges and by the International Chiropractic Pediatric Association.

The WCA paper also notes that, unlike medical treatment and surgical procedures, chiropractic care presents an extremely low risk for chiropractic pediatric patients, as reported by Dr. R.A. Pistolese in "Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient" (Journal of Vertebral Subluxation Research).

"We must make sure UHC, as well as all our patients, have access to information about chiropractic care for children," stated Terry A. Rondberg, DC, WCA president. "They need to read the WCA Position Paper, as well as the CCP Guidelines so they understand that there is substantial evidence to support chiropractic for all people, including our youth."

He noted that the new policy, which echoes similar statements about chiropractic from various insurance companies and the medical establishment, should motivate doctors to break free of insurance and HMO industries that discriminate against them, and support chiropractic research efforts.

"We also must have massive research conducted by credible scientists in order to prevent insurance companies and HMOs from using such policy statements to undermine confidence in chiropractic," Dr. Rondberg noted.