Equilibrium is proud to be an evidence-based practice. Our owners, Chiropractors Nicole and Shireesh Bhalerao, are vocal advocates for the necessity of evidence-based care to improve patient outcomes. Where this mission is concerned, they walk the walk. With a Masters in Clinical Research, Dr. Shireesh created TULIP (Turn Learning Into Practice) Seminars to provide small group, hands-on, evidence-based continuing education for chiropractors. He was also instrumental in OHSU Rheumatology Department’s recent collaboration with select local chiropractic clinics, furthering research to improve detection and treatment of Axial Spondyloarthritis.

What does it mean to be evidence-based?

Evidence-based practice is the integration of research evidence, clinical experience and patient needs and values. These key components are each valuable on it’s own, but a practice is not truly evidence-based until they are combined.

Evidence-based practice helps a practitioner deliver the most appropriate care to each patient, care that is based upon the most up-to-date and appropriate scientific clinical evidence, the doctor's knowledge and clinical experience, and the values of the patient. Evidence-based practice requires that the doctor takes an active role in healthcare decisions and delivery. This means that EBP is a good fit for practitioners who are critical thinkers and have the best interest of the patient in mind. EBP is antithetical to a cookie-cutter, one-size-fits-all-approach and financial focus instead of a focus on what is in the best interest of the patient.

Best Evidence

• Sound scientific evidence from reputable sources (e.g. peer-reviewed journals)

• The study design and level of evidence is the best available and most appropriate for the clinical situation.

• The practitioner evaluates the evidence for accuracy and applicability, making sure the evidence applies to the patient in question.

Patient Values

• The patient’s values, needs, and wishes are addressed. Patient values include: culture, gender, age, religion, spirituality, socioeconomic status, and psychological factors.

• The practitioner recognizes that each patient is unique

• The focus in on what is best for the specific patient, putting the patient’s needs first.

Clinical Experience

• The practitioner has current, quality academic and clinical training

• The practitioner is able to clinically reason and apply knowledge

• The practitioner is able to critically appraise the literature

• The practitioner actively participates in clinical decision making