CF 358: First Provider Matters & Neural Mobilization Today we’re going to talk about First Provider Matters & Neural Mobilization But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do.

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You have found yourself smack dab in the middle of Episode #358 Now if you missed last week’s episode, we talked about Utilization and Expenditure of Chiropractic and we talked about Hormone Therapy in Females. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things….. Well, if you’re a regular listener, then you know we have gone a couple of weeks without a podcast. Unfortunately, my mother went through a battle with her health and ultimately lost that battler on January 24, 2025. She had been in the hospital for several weeks prior and every minute before work, at lunch, and after work was spent at the hospital. Not writing podcasts, as I’m sure you all understand. Then, we’ve kind of been in recovery mode. Trying to get my thoughts together and honestly…..just taking a little time to breathe. So, here we are this week. Can I tell you what some time off will do to an evidence-based practice. Day-um…. One word….two syllables….Day-um. Christmas was on a Wednesday which is a week wrecker. Then NYE was on a Wednesday, yes…a week wrecker. Then we had the snow storms and over 11 inches of snow so a couple of days off there. Then my mom’s passing then my mom’s funeral so a couple more days off there. Next thing you know a good Monday for me was 45 patients and I was looking at 28 or so. Not a good thing so fortunately, I’m getting the train back on the track now with 38 this Monday and Wednesday is looking solid as well as Thursday and Friday so I think the ball is back in play. Which takes some stress off. Oh, and while my mom is in the hospital and we don’t know if she’s going to make it, I had to take a quick trip to support my daughter’s cheer team down in Fort Worth, TX. My damn sexy pick up truck died on the way home and has been in a mechanic shop 250 miles away for the last 3-4 weeks. Then, after the funeral, my wife and I got COVID. 2025 is hating on my but we’re winners around here and, like I said, I think we’re already back on track. If you’re a praying person, I’d ask you to include us today. Include us for mom, our clinic’s health, and for a better, stronger 2025. That would be amazing of you. Now, enough woe is me, let’s get to the research.

Item #1

Our first one this week is called, “First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization” by Bise et al and published in Physical Therapy and Rehabilitation Journal in September 2023. Remember, the citations can be found at chiropracticforward.com under this episode. Christopher G Bise, Michael Schneider, Janet Freburger, G Kelley Fitzgerald, Galen Switzer, Garry Smyda, Pamela Peele, Anthony Delitto, First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization, Physical Therapy, Volume 103, Issue 9, September 2023, pzad067, https://doi.org/10.1093/ptj/pzad067

Why They Did It Costs associated with low back pain (LBP) continue to rise. Despite numerous clinical practice guidelines, the evaluation and treatments for LBP are variable and largely depend on the individual provider. As yet, little attention has been given to the first choice of provider. Early research indicates that the choice of first provider and the timing of interventions for LBP appear to influence utilization. We sought to examine the association between the first provider seen and health care utilization.

How They Did It Using 2015–2018 data from a large insurer, this retrospective analysis focused on 29,806 patients seeking care for a new episode of LBP. The study identified the first provider chosen and examined the following year of medical utilization. Cox proportional hazards models were cal...