An Interview with Dr. Christine Goertz

When I was a chiropractic student, I interviewed one hundred chiropractors for the DC2Be Revolution YouTube channel and podcast. This article is about the insights I gained from Dr. Christine Goertz. PhD. She is a professor in Musculoskeletal Research at the Duke Clinical Research Institute and was Vice Chancellor of Research and Health Policy at Palmer College of Chiropractic for 11 years.

  1. Do multidisciplinary research.

Dr. Goertz: Palmer College of Chiropractic received a grant from the National Institutes of Health in September 2018. At that time, it was the largest NIH grant that has ever gone to a chiropractic educational institution. The grant is a multidisciplinary effort that includes investigators from Yale, the University of Iowa, the VA health system, and the Palmer Center for chiropractic research. We are researching dosing.  Even after 25 or 30 years of comprehensive research in chiropractic regarding low back pain. We still don’t know enough. We do not know how many times a patient needs to see a chiropractor to have the best outcome.

This is a really important question for doctors, patients, policymakers and payers. In this study we are going to be randomizing veterans to receive either six treatments or twelve because those are the numbers that are out there in the real world. Most payers cut chiropractors off at about twelve visits and ask for some sort of additional review. We want to answer that question in a rigorous way.

The NIH, DOD and VA have committed about 80 million dollars over the next six years to study non-drug therapies to chronic pain and this is a small piece of that money.

  1. Learn to work in a multidisciplinary collaborative environment.

Dr. Goertz: I believe that it is going to become increasingly difficult for a chiropractor to graduate from chiropractic school and open up a solo practice. The environment is moving towards collaborative care. Payment systems are moving towards models that look at how much does it cost for a group of practitioners to care for a particular population. This will incentivize Doctor of Chiropractic towards integrative care and multidisciplinary practice settings. This will incentivize those centers to consider chiropractic as they look at how to implement conservative care as a first line of treatment for neuro-musculo-skeletal conditions. Non drug therapies are becoming the first line of defense for patients with low back pain and other spine related conditions. The next generation of chiropractors must be prepared for this change.

  1. Know the Evidence.

Know the evidence that supports Chiropractic treatment. Know what the evidence does and doesn’t show. There is nothing in medicine that is completely evidence-based for a couple of reasons. The first one is that there are gaps between what we know and don’t know regarding treatments of lots of musculoskeletal conditions. An absence of research doesn’t mean it isn’t working, it just means that we don’t have research for that specific condition. We need to know where there’s research and where there isn’t.

  1. Work with Medical doctors.

A couple years ago we did a study of collaborative care between medical doctors and Doctor of Chiropractic for patients over the age of 65. That paper was just published in JMPT. We found patients were really excited about it. They expect their practitioners to know each other and be able to have conversations and refer to each other. Patients are more savvy consumers then they have ever been.

To watch the entire interview, you can go here.

Noah Volz, DC is the author the The Master Student: Book 1: Mindset: The Ultimate Guide to Success, Enjoyment and Productivity as a Chiropractic College Student.