Mootz R D
State of Washington, Department of Labor and Industries, Olympia 98504-4321, USA.
J Manipulative Physiol Ther. 1996 May;19(4):257-64.
The chiropractic profession has traditionally had little or no direct influence on health policy. Conversely, every chiropractor is impacted daily by health policy decisions promulgated by government agencies, health purchasers, managed care organizations and others. This discussion provides an overview of health policy constituencies important to chiropractors, reviews processes currently being used to assess health care technology and develop policy and offers strategies for the profession to more actively engage in constructive policy development.
Descriptive overview of key issues based on qualitative selective overview of literature and author's observations based on two years employment in a government health policy position.
The chiropractic profession's traditional approach to influencing health policy has focused on public relations, political lobbying for favorable legislation and litigation, which has increased public awareness and resulted in a number of legislative successes. However, for the most part, the momentum of decision-making at agency levels and in policy staff positions continues to occur without involvement of chiropractors trained or experienced in policy-making. This is in contrast with medicine and other allied health fields, whose ranks hold such positions routinely. Additionally, methodology for policy decision-making is increasingly evidence-based. Strategies for the chiropractic profession to more actively participate in this arena are offered.
传统上，整脊疗法行业对卫生政策几乎没有直接影响。相反，政府机构、医疗服务购买者、管理式医疗组织及其他机构颁布的卫生政策决策，每天都在影响着每一位整脊治疗师。本讨论概述了对整脊治疗师而言重要的卫生政策支持者，回顾了当前用于评估医疗技术和制定政策的流程，并为该行业更积极地参与建设性政策制定提供了策略。
基于对文献的定性选择性概述以及作者在政府卫生政策岗位上两年工作的观察结果，对关键问题进行描述性概述。
整脊疗法行业影响卫生政策的传统方式主要集中在公关、争取有利立法的政治游说和诉讼上，这些举措提高了公众意识，并取得了一些立法成功。然而，在很大程度上，机构层面和政策工作人员岗位的决策势头仍在继续，而未接受过政策制定培训或缺乏相关经验的整脊治疗师并未参与其中。这与医学及其他 allied health 领域形成对比，这些领域的人员经常担任此类职位。此外，政策决策方法越来越以证据为基础。本文为整脊疗法行业更积极地参与这一领域提供了策略。
