Clinical strategies for controlling costs and improving quality in the primary care of low back pain

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Back pain is a pervasive problem which ranks only behind cold symptoms as a reason for all physician visits. Among persons with back pain lasting at least two weeks, 85% will seek the care of a health professional. These patients obtain care fromprimary care physicians (Family Medicine, Internal Medicine, and Osteopathic physicians), but also see a variety of specialists, including physiatrists, rheumatologists, orthopedic surgeons, and neurosurgeons. Since any of these specialties may evaluate patients early in their course, it is important to adopt a systematic and rational early approach to back pain. This discussion emphasizes recent data suggesting that such an approach would include a parsimonious diagnostic evaluation, careful attention to patients’ concerns, and careful choice of proven effective treatments. Specifically, we propose five strategies that may help to reduce costs of care while maintaining quality: 1. Avoid premature or unnecessary diagnostic tests. 2. Avoid patient deactivation. 3. Avoid ineffective or unproven remedies. 4. Prescribe effective therapy in a cost-conscious manner, and 5. Emphasize lifestyle changes and patient self-efficacy.

Original languageEnglish (US)
Pages (from-to)1-13
Number of pages13
JournalJournal of Back and Musculoskeletal Rehabilitation
Volume3
Issue number4
DOIs
StatePublished - 1993
Externally publishedYes

Fingerprint

Low Back Pain
Primary Health Care
Back Pain
Costs and Cost Analysis
Osteopathic Physicians
Family Physicians
Self Efficacy
Internal Medicine
Routine Diagnostic Tests
Life Style
Patient Care
Medicine
Delivery of Health Care
Physicians
Therapeutics

Keywords

  • Back pain
  • Diagnosis back pain
  • Lifestyle change
  • Strategies for back pain

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine

Cite this

@article{df483c3f78e0494993c4b1f78edf8f55,
title = "Clinical strategies for controlling costs and improving quality in the primary care of low back pain",
abstract = "Back pain is a pervasive problem which ranks only behind cold symptoms as a reason for all physician visits. Among persons with back pain lasting at least two weeks, 85{\%} will seek the care of a health professional. These patients obtain care fromprimary care physicians (Family Medicine, Internal Medicine, and Osteopathic physicians), but also see a variety of specialists, including physiatrists, rheumatologists, orthopedic surgeons, and neurosurgeons. Since any of these specialties may evaluate patients early in their course, it is important to adopt a systematic and rational early approach to back pain. This discussion emphasizes recent data suggesting that such an approach would include a parsimonious diagnostic evaluation, careful attention to patients’ concerns, and careful choice of proven effective treatments. Specifically, we propose five strategies that may help to reduce costs of care while maintaining quality: 1. Avoid premature or unnecessary diagnostic tests. 2. Avoid patient deactivation. 3. Avoid ineffective or unproven remedies. 4. Prescribe effective therapy in a cost-conscious manner, and 5. Emphasize lifestyle changes and patient self-efficacy.",
keywords = "Back pain, Diagnosis back pain, Lifestyle change, Strategies for back pain",
author = "Deyo, {Richard (Rick)}",
year = "1993",
doi = "10.3233/BMR-1993-3404",
language = "English (US)",
volume = "3",
pages = "1--13",
journal = "Journal of Back and Musculoskeletal Rehabilitation",
issn = "1053-8127",
publisher = "IOS Press",
number = "4",

}

TY - JOUR

T1 - Clinical strategies for controlling costs and improving quality in the primary care of low back pain

AU - Deyo, Richard (Rick)

PY - 1993

Y1 - 1993

N2 - Back pain is a pervasive problem which ranks only behind cold symptoms as a reason for all physician visits. Among persons with back pain lasting at least two weeks, 85% will seek the care of a health professional. These patients obtain care fromprimary care physicians (Family Medicine, Internal Medicine, and Osteopathic physicians), but also see a variety of specialists, including physiatrists, rheumatologists, orthopedic surgeons, and neurosurgeons. Since any of these specialties may evaluate patients early in their course, it is important to adopt a systematic and rational early approach to back pain. This discussion emphasizes recent data suggesting that such an approach would include a parsimonious diagnostic evaluation, careful attention to patients’ concerns, and careful choice of proven effective treatments. Specifically, we propose five strategies that may help to reduce costs of care while maintaining quality: 1. Avoid premature or unnecessary diagnostic tests. 2. Avoid patient deactivation. 3. Avoid ineffective or unproven remedies. 4. Prescribe effective therapy in a cost-conscious manner, and 5. Emphasize lifestyle changes and patient self-efficacy.

AB - Back pain is a pervasive problem which ranks only behind cold symptoms as a reason for all physician visits. Among persons with back pain lasting at least two weeks, 85% will seek the care of a health professional. These patients obtain care fromprimary care physicians (Family Medicine, Internal Medicine, and Osteopathic physicians), but also see a variety of specialists, including physiatrists, rheumatologists, orthopedic surgeons, and neurosurgeons. Since any of these specialties may evaluate patients early in their course, it is important to adopt a systematic and rational early approach to back pain. This discussion emphasizes recent data suggesting that such an approach would include a parsimonious diagnostic evaluation, careful attention to patients’ concerns, and careful choice of proven effective treatments. Specifically, we propose five strategies that may help to reduce costs of care while maintaining quality: 1. Avoid premature or unnecessary diagnostic tests. 2. Avoid patient deactivation. 3. Avoid ineffective or unproven remedies. 4. Prescribe effective therapy in a cost-conscious manner, and 5. Emphasize lifestyle changes and patient self-efficacy.

KW - Back pain

KW - Diagnosis back pain

KW - Lifestyle change

KW - Strategies for back pain

UR - http://www.scopus.com/inward/record.url?scp=0343011351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0343011351&partnerID=8YFLogxK

U2 - 10.3233/BMR-1993-3404

DO - 10.3233/BMR-1993-3404

M3 - Article

VL - 3

SP - 1

EP - 13

JO - Journal of Back and Musculoskeletal Rehabilitation

JF - Journal of Back and Musculoskeletal Rehabilitation

SN - 1053-8127

IS - 4

ER -