On Tuesday, I found myself going to Florida to visit my mom who was just hospitalized for the second time. While I will not get into her health issues, the second time was due to intense pain in her legs aggravated by Gabapentin, a drug that appears to be given to everyone for pain regardless of the cause. Ironically, the doctor knew so much about her other issues but did not ask the staff who takes care of my mother about her leg pain which has commonly felt improved for months by gentle massage and elevation by her caretakers. While I could not get better information from them on what was causing the pain, comfort care should have been used rather than a drug for pain when the problem needed a physical solution. Physical solutions require you evaluate the patient manually and apparently, this does not fit their protocols which makes little sense. While the doctors and the staff followed medical protocols, my mom needed someone to look at her and the mechanism making her legs hurt, rather than someone who needed drugs and charting. Hospital culture includes a dizzying amount of medical providers, nurses and other support staff. If you have already my previous blog on The Pitt on HBO Max, on how your chiropractor relates to the show and how patients receive care which from what I have read comes close to a typical day in the ER, In the hospital, we had my mom with a caretaker to make sure she was advocated for. When I spoke with the doctor, he had not idea why her legs were hurting or why her skin itched, but offered Gabapentin and another prescription medicine for itching. Both medications made my mom feel worse. Here’s what I saw. .They ordered a brain MRI that was totally unnecessary on a 99 year old patient. My brother who had also flown in the prior day vetoed this test. They gave her a pain killer for a condition that improved by elevating her legs and massaging them according to the staff that regularly care for my mom. While the staff did not understand why this helped her, they had seen it before and the medical staff never asked the right questions. In the chiropractic profession, manual evaluation skills help us help patients avoid much of this. Hospitals need chiropractors because other than the nurses, the doctors read charts, make orders and never touched my mom other than notice the skin on her heels which was in pain. When I arrived, I checked her pulses, I could not lift her leg as it was so tight, and the other leg was tight laterally. The caretaker for the day, a skilled LPN watched me evaluate and treat the tight fascia on her leg, loosen her left ankle and her ability to have her legs improved as well as the pain. Her right heel pain which they were wrapping to protect it was painful due to plantar fasciitis and what looked like irritation at the heel. These are conditions that are easy to improve and when the legs are tight, it affects sitting and standing, two things my mom had not been able to do for a couple of weeks due to pain in the back.. I shared this with the in the hospital doctor who was listening carefully to what I explained to him. Medical providers need to understand the musculoskeletal system better and must be required to learn how to do this during continuing education, something we all must do yearly. Everything is a protocol. The problem is, the patient is not a protocol. In the world of musculoskeletal medicine, a primary care approach works best along with manual evaluation skills. There are case managers that are provided by the hospital who can help you manage someone like my mom provided by the social worker in the hospital and rehab centers often are just in patient rehab where someone waits for hours to get therapy when it may be best offered in their homes. A lack of skilled care often is why patients are readmitted shortly after discharge. What I learned If we want to reduce the cost of care and improve patient satisfaction, chiropractors should be on the staff of every hospital. They can reduce testing and offer an alternative to medication for pain which is a poor band aid. Patients with musculoskeletal problems worsen over time without appropriate care. Patients benefit from hands on care and evaluation from painful problems. Pain medications will delay needed care and may make them worse or cause other problems. Mechanical problems require mechanical solutions. Chiropractors are the best since they are body mechanics. Hospital doctors must regain the manual skills to evaluation patients and not always rely on protocoled tests. The musculoskeletal system is 55% of the body. Pills do not treat problems but they may mask symptoms and make conditions that are ignored worse over time. Lack of manual skills to evaluate the musculoskeletal system leads to to poor clinical judgements In patient rehab while less costly is just warehousing patients with nurses and doctors on staff. While some may do well there, most should go home into their regular environments and have visiting staff. Far better for most patients. Hospital culture has a problem with overprescribing pills and under prescribing hands on solutions to help patients. Chiropractors often are the best choice and having them in hospitals is logical and ethical. The doctor needs to look at the patient. I looked at my mom and knew from experience what caused her leg pain. It also helped that I had also asked the staff who cares for her. A hospitalist should understand how to do this and more. The system has 55% of the body blind spot caused the musculoskeletal system. Knowledge, manual skills and on staff chiropractors may be the solution for many patients in the hospital. Hospital systems are the largest driver of healthcare costs. Chiropractic care in the hospital can reduce tests, unnecessary procedures and drugs and offer more appropriate care for what the medical profession needs to better understand; the musculoskeletal system.