 Cheryl Hawk, Vice President for Research and Scholarship at Cleveland Chiropractic College, is widely recognized as one of the world’s leaders in chiropractic research. After practicing chiropractic for a dozen years, she pursued a doctorate in Preventive Medicine at the University of Iowa, focusing on epidemiology and program evaluation. Dr. Hawk has excelled at research administration, building departments at Palmer and now at Cleveland, and has also continued to produce research of her own, in collaboration with colleagues from Cleveland and other chiropractic colleges.
In this Health Insights Today interview, Dr. Hawk discusses Cleveland Chiropractic College’s decision to focus on two key research areas: geriatrics and prevention. Realizing that the growth and development of chiropractic research depends on each college choosing different areas in which to specialize, Dr. Hawk and the Cleveland administrative team have targeted these topics for two reasons: (1) they are broadly recognized as areas of increasing importance to society; and (2) they are areas where other chiropractic college research departments have not specialized.
Why is research important to the chiropractic profession?
With the emphasis on evidence-based practice and documenting outcomes, if you don’t have research, it’s going to be harder and harder to get paid (or for your patients to get paid) by third party payers. That’s really the bottom line, and why everyone is realizing that research is important. But we haven’t taken the next step, which is to say that if the evidence is this important, then the evidence base is everyone’s job.
When you say that it’s everyone’s job, I think that most people can see how it’s the research department’s job, I think they can see how it’s the faculty’s job to at least convey the information developed by researchers to students and practitioners …
That should be one part of it.
… but how can the field practitioner, the practicing chiropractor in private practice, help to create and utilize research?
There are two ways. I’m on the executive committee of CCGPP [Council on Chiropractic Guidelines and Practice Parameters], since I’m the chair of the scientific commission. A key part of their role is disseminating information. Field doctors need to know how to use the information with their patients to provide optimal patient care, but they also need to know how to use it with payers if a claim is being disputed. We have people every single day coming to us saying, “I’m in New Jersey (or South Dakota or Ohio) and we’re having problems getting paid. Can you help us? Tell us how to use the evidence.”
How do you respond?
CCGPP has a rapid response team. For instance, United Health Care was refusing to cover chiropractic for children. They were basing it on some findings in certain research studies, and what we (the members of the executive committee) did was to write a letter making an argument for why it was appropriate, even though the evidence is limited. It made a real difference. It was important to make the case that chiropractic helps musculoskeletal problems in adults, that children also have musculoskeletal problems, and that there’s plenty of evidence that chiropractic is safe. So even if there is not much of an evidence base at this time on chiropractic applied to children, one can make a plausible argument that it is appropriate. There haven’t been many medical studies on children either, because there are restrictions on using children as research subjects.
The Foundation for Chiropractic Education and Research is now funding a study that involves a consensus process on chiropractic care for children. Cleveland Chiropractic College has the grant and I am the principal investigator. The idea is that there is not a lot of evidence, and in the absence of higher levels of evidence, a formal consensus process of experts is useful. We will use the evidence that does exist and work to come up with a statement on best practices for chiropractic and children. |
