Courting Chiropractors : Buena Park Doctors Hospital Gingerly Breaches Barrier and Adds Practitioners to Its Staffin Effort to Carve a Niche in Market and Straighten Out Its Faltering Fortunes

Chiropractor Gary Tanner has been manipulating his patients’ necks and backs in an unusual setting lately--a hospital.

Barred for years from such surroundings, Tanner and other chiropractors have benefited from a horrible hospital industry slump by gaining entrance to hospital staffs that once treated them as heretics.

In Tanner’s case, the hospital is Buena Park Doctors Hospital, a small, 58-bed facility that has struggled financially in the past few years. The hospital’s average occupancy rate has been below 25% for the past few years--far worse than the 45% rate for hospitals countywide in 1990.

Looking for a market niche that would distinguish the investor-owned hospital from its larger competitors, Hospital Administrator Robert J. Trautman two years ago established contact between a team of physicians from his medical staff and a contingent of chiropractors from Los Angeles Chiropractic College.

“Our MDs had no idea what a chiropractor did,” Trautman said. “But we had that exchange, and a comfort level was there.”

For decades, the American Medical Assn. denounced chiropractic treatment as quackery and cultism, and in 1967 declared it unethical for physicians to associate professionally with chiropractors.

But in 1987, a federal judge in Chicago ruled that the AMA had mounted a 24-year campaign to destroy the practice of chiropractic and issued an injunction ordering the association not to interfere with a physician’s right to consult or work with chiropractors.

Since then, more than 100 U.S. hospitals have admitted chiropractors to their staffs, said Rand Baird, a Torrance chiropractor who is on the staff at Pacific Hospital in Long Beach.

“There’ve been a couple hospitals where there was some conflict,” Baird said. “The chiropractors felt all the referrals were going one way: The physicians weren’t sending any patients to them, and there were some ill feelings.”

At Buena Park Doctors Hospital, the talks between physicians and chiropractors led to a change in the hospital’s bylaws, which now allow chiropractors to join the hospital staff and, with the consent of a physician, co-admit patients to the facility.

“It just took a lot of homework,” Trautman said. “The medical staff was worried about everything from what their colleagues would think to liability. But the bottom line is that no one has come right out and opposed it.”

Trautman said he wanted to begin a similar program a few years earlier at Doctors Hospital of Santa Ana, but the situation was not quite right.

“I think that hospital was a very viable hospital, and there was really no need to go out and take the risk of doing something like this,” Trautman said. “Here, we weren’t really as viable an operation. The medical staff was smaller and easier to work with.”

At first, most of the new business generated by chiropractors was in the form of magnetic resonance imaging tests and CAT scans--tests that reveal physical abnormalities that might not show up on routine X-rays.

Last fall, however, the hospital decided to add a new program that had been tried at just a handful of U.S. hospitals. Called MUST, for Manipulation Under Sedation Treatment, the program allows chiropractors, with the help of an anesthesiologist, to treat mildly sedated patients while they remain in the hospital for three to five days.

In September, a team from Texas Chiropractic College, where the program originated, came to Buena Park and certified several local chiropractors in the treatment. The first local chiropractors began providing the therapy at Buena Park Doctors Hospital in December.

The benefit of the program, said La Mirada chiropractor Tanner, is that patients whose pain has interfered with traditional treatment can be more easily manipulated if they are sedated.

“When you relax, you get more movement,” Tanner said. “It (sedation) takes away the unconscious guarding. It’s not a cure-all or panacea, but we’ve seen patients make a good improvement, and the benefits are lasting.”

Ramesh Patel, a Buena Park cardiologist and chief of the hospital’s medical staff, called the program “an experimental tool” and said the jury is still out on its value.

“It might be good for selected cases, but it’s not good for everybody,” Patel said. “If I had a patient who is an ideal candidate, one who has muscular-skeletal pain without any anatomical abnormalities, they’d been treated by physical therapy and were not getting any better, I might consider it. . . . I’m open to anything good, but we have to be careful. We have a moral responsibility to provide good care.”

About 25 patients have been treated during the first six months of the MUST program, and the hospital has not gone out of its way to publicize the therapy, Trautman said.

“We’ve been very quiet about it,” Trautman said. “We wanted to make sure that it was safe, profitable and beneficial to the patient.”

The treatment costs $10,000 to $12,000--two to three times cheaper than back surgery, and with a much shorter recovery period, Trautman said.

Chronic back pain--caused by indications such as bulging disks, nerve entrapment, failed back surgery syndrome and muscle spasms--may respond well to the treatment, Trautman said, but patients with more serious ailments such as ruptured disks, acute fractures or acute arthritis would not be considered good candidates.

“We’ve been tracking patients, and they’ve had varying degrees of success,” Trautman said. “No one was worse off. In many cases, their range of motion was better and their pain was less.”

Buena Park Doctors is not the first Southland hospital to put chiropractors on staff, although it is the only hospital with the MUST program. Canoga Park Hospital introduced a chiropractic program--mostly out of financial desperation--in 1989, shortly before it went out of business.

Pacific Hospital in Long Beach, however, has had a chiropractic program for three years--and not simply for financial reasons, Torrance chiropractor Baird said.

“Financially, they don’t need us,” Baird said. “But they’re interested in comprehensive care. . . . They wanted all disciplines represented.”

The hospital already had experience with osteopathic doctors, podiatrists, clinical psychologists and nurse-midwives, Baird said, so admitting chiropractors was no big deal.

“We were just the latest addition, and we’ve got a real good program now,” Baird said. “The medical staff has essentially welcomed us with open arms.”

Gerald McCann, a Santa Fe Springs orthopedic surgeon who helps coordinate the Buena Park hospital’s chiropractic program, said he expects that other hospitals will admit chiropractors to their staffs once such programs have proved themselves.