Outcomes and Costs of Care for Acute Low Back Pain

To the Editor: The excellent study of the outcomes and costs of care for low back pain by Carey et al. (Oct. 5 issue) 1 found that chiropractors charged considerably more than primary care physicians but had higher scores for patient satisfaction. Neither finding is surprising. Although some chiropractors advise patients to stop coming after their symptoms are gone, others urge them to continue coming indefinitely for “preventive maintenance” or to make the spinal adjustments “hold.” 2 Some chiropractic “practice-builders” encourage this and actually give seminars and write about virtually every type of resistance a person might have to “lifetime care.” 3 Practice-builders . . .