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Can the first person you see for an injury determine the outcome?

3/4/2016

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​The simple answer is yes.  Research published in the spine journal in 2013 suggests that the health professional you see as a first point of contact can play a role in determining the outcome.  The study showed that approximately 43% of workers who saw a surgeon as their first point of contact had surgery within 3 years.  In contrast, of those who saw a chiropractor first, only 1.5% ended up in surgery.  This is an amazing difference.  Continue reading to see the full results and what to make of the study.
The key points from the study are:
  • “42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor.” (The surgery was within 3 years).
  • “There was a very strong association between surgery and first provider seen for the injury, even after adjustment for other important variables.” (Such as symptom severity).

What to make of this study?
To me this is a fascinating study. In my eyes surgery should always be the last treatment option once you have exhausted all other possibilities.  Of course surgery is going to be required on occasion, but if you can reduce the numbers of surgeries through different treatment approaches it can make big cost savings to the health system, time off work, rehab etc.  

This study has used chiropractic care and compared it to a surgeon.  It would be interesting to see a similar study with other health care professions too.  I am a chiropractor, so I can see how the results of this study could be possible, but I wonder if comparing surgeons to physio's or acupuncturists etc, will have similar results?  It will be interesting to find out.

When I first read this I thought that the people that were going to see a surgeon first were likely to be in a lot more discomfort and hence more likely to get surgery as there injuries were 'worse'.  However the research showed that this wasn’t the case, as the second key point above shows.
 
Within reason, I think that when you have an injury, try the natural, non-invasive approaches first.  If they aren't working, then you can look at more invasive approaches.  If you are able to get over a problem without surgery, your body will thank you for it.
 
References
  • Keeney BJ et al. Early predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State; Spine; May 15 2013; Vol. 38; No. 11; pp. 953-964
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