Clinical Compass

🏥 What role can chiropractic care play in Federally Qualified Health Centers (FQHCs)?

A recent publication explores how chiropractors may help address one of the most significant challenges facing primary care today: providing effective, accessible care for spinal and musculoskeletal (MSK) conditions.

Why does this matter?
Spinal and MSK disorders are among the leading causes of disability worldwide and remain a major contributor to healthcare utilization and opioid prescribing.

Key takeaways:
✔ FQHCs serve millions of underserved patients across the United States.
✔ Current primary care models often struggle to meet the growing demand for MSK care.
✔ Chiropractors are well positioned to serve as embedded spine and MSK specialists within integrated healthcare teams.
✔ Medicaid reimbursement appears to be a key factor supporting successful chiropractic integration.
✔ Alternative payment models—including value-based care, shared savings, capitation, and grant funding—may create additional opportunities for sustainable implementation.

The authors draw parallels to the successful integration of dentistry, podiatry, and optometry services within FQHCs and suggest chiropractic care may offer a similar pathway to improving access to nonpharmacologic pain management.

As healthcare systems continue to prioritize value-based care, interdisciplinary collaboration, and opioid reduction strategies, this paper provides an important framework for understanding how chiropractic services may contribute to improved outcomes and reduced downstream healthcare utilization.

📖 Reference: https://doi.org/10.1177/27683605261444627

What opportunities do you see for chiropractic integration within primary care and safety-net healthcare settings?

🤝 Friends of Clinical Compass

At Clinical Compass, our mission is to advance evidence-informed chiropractic care through research, education, and collaboration. We are grateful for the many leaders and organizations who support that mission and recognize the value of rigorous scientific inquiry.

We're honored to share these words from Dr. Lisa Kouzes, Vice President of the Federation of Chiropractic Licensing Boards:
"Clinical Compass played an integral role in demonstrating the safety and efficacy of chiropractic care through rigorously vetted scientific evidence and expert testimony. Their team's responsiveness and dedication to clarity strengthened informed decision-making and ultimately led to service in the best interest of the public."

Partnerships like these help ensure that healthcare decisions are guided by the best available evidence, supporting patients, providers, regulators, and the public alike.

Thank you, Dr. Kouzes, for your leadership and support of evidence-informed chiropractic care.

📚 New Publication

What does the evidence say about spinal manipulation for older adults with chronic spinal conditions?

A newly published systematic review evaluated randomized controlled trials involving adults aged 55 years and older with chronic low back pain, chronic neck pain, and lumbar spinal stenosis.

The authors reviewed 7 randomized controlled trials (9 reports) including more than 1,200 participants to better understand the role of spinal manipulative therapy (SMT) in this growing population.

As the prevalence of spinal pain continues to increase with age, understanding safe and effective nonpharmacologic treatment options is becoming increasingly important.

Over the next few posts, we'll highlight some of the key findings from this review.

💰 What does the evidence say about student loan debt in the chiropractic profession?

A recent survey of 1,455 U.S. chiropractors explored educational debt, income, loan relief opportunities, and perceptions of the value of chiropractic education.

Key findings:
📊 Median student loan debt at graduation: $185,000
📈 Median current student loan debt: $240,000
💵 Median gross income: $76,000
❓ 87% reported being ineligible or unsure if they qualified for loan relief programs
📉 More than half disagreed that their chiropractic education provided a positive financial return on investment
🔄 65% reported they would not choose a chiropractic career again

While many respondents reported positive non-financial benefits from their training and careers, the findings highlight ongoing challenges related to educational debt and professional sustainability.

These results raise important questions for educators, institutions, professional organizations, and policymakers:
• How can the profession better address educational debt?
• What strategies may improve financial sustainability for future chiropractors?
• How can we preserve the value of chiropractic education while improving accessibility?

Evidence-informed conversations about the future of the profession are essential.

Read the study: https://pubmed.ncbi.nlm.nih.gov/41973683/

What defines quality care in chiropractic—and can we actually measure it?

This national survey of U.S. chiropractors explored both the importance and feasibility of implementing quality measures in real-world practice.

Key takeaways:
✔️ Strong agreement across the profession on what matters most
✔️ Patient safety leads the way (with measures like documenting adverse events ranking highest)
✔️ Quality care isn’t just a concept—it’s measurable and implementable

As healthcare continues to evolve, chiropractic is stepping further into accountability, standardization, and evidence-informed practice.

Read it here: https://pubmed.ncbi.nlm.nih.gov/41904489/

Healthcare costs in the U.S. have surpassed $5 trillion—and a significant portion is tied to inefficiencies and low-value care.

This article highlights how states like Oregon and Washington are addressing this through evidence-based policy and something equally important: including complementary and integrative health providers (like chiropractors) in coverage decision-making.

Why does this matter?
✔️ More diverse clinical perspectives
✔️ Greater emphasis on prevention and whole-person care
✔️ Smarter, more cost-effective healthcare decisions

Representation at the policy level shapes access to care.

Read it here: https://doi.org/10.1177/27683605261436283

We Need Your Input!

Clinical Compass is updating our 2017 best practices for the chiropractic management of older adults. Part of the process is to get public comments to incorporate into the recommendations.

We have just completed an extensive Delphi panel consensus process with a multidisciplinary panel of health care professionals. This works represents of a significant expansion of guidance for clinicians, students, educators, advocacy groups, and policy makers.

The public comment period ends on June 13th, 2026. Please follow this link to provide feedback: www.clinicalcompasscpg.com

What if maintenance care wasn’t for everyone—but exactly right for the right patient?

This RCT is putting that idea to the test using the MAINTAIN instrument—a clinical tool designed to identify which patients with recurrent spinal pain benefit most from ongoing care.

Moving toward:
➡️ Stratified, personalized treatment
➡️ Better outcomes with fewer unnecessary visits
➡️ Real-world implementation in practice

This is where chiropractic care continues to evolve.

Read it here: https://pubmed.ncbi.nlm.nih.gov/41664083/

Big congratulations to Dr. Clint Daniels on being honored as a Fellow of the American College of Chiropractors (FACC)👏

This is a well-deserved recognition of his leadership, commitment to the profession, and dedication to advancing evidence-informed chiropractic care. Honors like this reflect not just individual achievement, but a lasting impact on patients, colleagues, and the future of our field.

Celebrated at the Northeast College of Health Sciences graduation ceremony alongside fellow recipients Lindsay Rae, Chad Buohl, Peter Ferraro, and Karyn Phillips—an incredible group contributing to the profession in meaningful ways.

And a special shoutout to those who helped make the recognition possible, including Zachary Cupler for the nomination.

👏 Congratulations again, Dr. Daniels—this one is well earned.

Recruiting for real-world clinical trials is no small task—especially within large, integrated systems like the VA.

This recent publication on the VERDICT trial (Veterans Response to Dosage in Chiropractic Therapy) takes a closer look at what actually works when it comes to engaging veterans with chronic low back pain in research 👇

📊 Key takeaways:
• Existing clinical referrals were the most efficient recruitment strategy
• Email outreach improved response times compared to postal-only methods
• Multifaceted approaches helped improve diversity and engagement
• System limitations (like clinic capacity) still play a major role in enrollment

What this study highlights is something we see every day in practice: access, communication, and system design matter. Research doesn’t just live in journals—it depends on real people, real workflows, and real-world barriers.

Studies like this help bridge the gap between clinical research and implementation, ultimately improving how we deliver care to complex populations like veterans with chronic low back pain.

👏 Shoutout to the authors for advancing pragmatic research and helping us better understand how to bring evidence into action.

Read it here: https://pubmed.ncbi.nlm.nih.gov/41857686/