By Source Detroit Free Press
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Dylan Womack recovers a spine model from Skagg’s Chiropractic in Joplin, MO., Monday, May 23, 2011. / The News Leader / AP PHOTO
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U.S. Navy Names DC to Musculoskeletal BoardSOURCE: Dynamic Chiropractic With his appointment to the board, Dr. William Morgan continues building bridges for the chiropractic profession. William Morgan, DC, has been appointed to the United States Navy’s Musculoskeletal Continuum of Care Advisory Board (MCCAB), an entity created to address the prevalent musculoskeletal injuries sustained by U.S. armed forces personnel during active-duty operations. Dr. Morgan, who also serves on the spine subcommittee within MCCAB – members of which include orthopedic surgeons, sports medicine physicians, physical medicine and rehabilitation physicians and physical therapists – will serve as the sole chiropractic representative to MCCAB, the Bureau of Medicine and Surgery (BUMED) and the U.S. Navy. The spine committee will develop care algorithms for treating musculoskeletal and spinal conditions and in so doing, help determine the future of musculoskeletal management in the U.S. armed forces. Addressing Musculoskeletal Health Issues in the Armed Forces
The leading cause of medical evacuation from forward-deployed units is musculoskeletal complaints, not combat wounds, with a high percentage of the complaints being back and neck pain. The MCCAB intends to develop guidelines for best practices in the management of musculoskeletal conditions through collaboration between professions, standardized metrics/outcome measurements, evidence-based practices and increased access to care. William Morgan This is a big step for chiropractic in the armed forces. Never before has a chiropractor been on a military medical board that will have this level of strategic planning and implementation of ideas. This advisory board will make decisions about the future direction of health care within the Navy and the Marine Corps (the Navy provides the medical care for both the Navy and the Marines). The development of the board and Dr. Morgan’s appointment to it suggests the Navy’s open-mindedness in addressing the need for better management of musculoskeletal conditions.
Continue reading … Pressed About Skeletal Injuries, Army Chief Cites Soldiers’ Poor HealthSOURCE: The Hill ~ The Congressional News Paper By John T. Bennett The Senate’s top appropriator is concerned about injuries spawned by the weight of gear soldiers carry into combat, but Army brass say the poor health of America’s youth is to blame also. As the Army and other military services have fielded more and more advanced combat gear — especially electronics equipment — U.S. troops have been instructed to strap more and more weight to their bodies. That means injuries, which does not sit well with Senate Appropriations Committee Chairman Daniel Inouye (D-Hawaii), a decorated World War II Army veteran. He said his combat pack and gear never weighed more than 25 pounds. The average Army trooper’s gear now approaches 125 pounds, Inouye said, noting a 2001 Army Science Board study recommended no soldier should carry more than 50 pounds at a time. During an Appropriations Defense subcommittee hearing Wednesday, Inouye told Army leaders he was “shocked” by a recent Johns Hopkins University study that found musculoskeletal spinal injuries are now “double that of combat injuries.” What’s more, “musculoskeletal injuries have increased tenfold in the last four years,” Inouye said. “The cost of medical benefits or disability benefits exceed annually $500 million.” Army Chief of Staff Gen. Martin Dempsey replied that the matter is a “constant issue” for service leaders, and one that crosses his desk at least once a week.
Continue reading … Reflections on the Opportunity of a Lifetime:
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 Dr. Lance Cohen on the job at the National Naval Medical Center in Bethesda. |
Lance Cohen, a 2009 graduate of Cleveland Chiropractic College–Los Angeles (CCCLA), was the first chiropractic student to participate in one of the most prestigious health care fellowships in the nation, at the National Naval Medical Center (NNMC) in Bethesda, MD.
A second generation chiropractor (his father is CCCLA alumnus Dr. Nathan Cohen), Dr. Cohen had the opportunity to work under Dr. Bill Morgan at NNMC, providing care for injured veterans (many of them from the conflicts in Iraq and Afghanistan) at the nation’s premier tertiary care hospital. This experience afforded him unparalleled learning opportunities, which he describes in this Health Insights Today interview. Dr. Cohen now practices in Tahoe City and La Jolla, California.
What first kindled your interest in chiropractic?
Who’s Asleep Over at MedScape?
In general, I find the reporting at MedScape to be top notch, but I have significant problems with their 4-20-11 essay titled: “The Potential Complications of Chiropractic Therapy”.
Answer this question:
If I sneeze, and there is a car accident across the street,
have we discovered the *cause* of car accidents?
The scientific method would propose that we sneeze a hundred times, and count the car accidents.
That’s how you begin to determine if there is an actual relationship between one event (like drinking milk) and it’s potential consequences (like developing cancer).
The Bone and Joint Decade Task Force was appointed by the World Health Organization (WHO) to look at the causes of, and treatments for neck pain, and after years of review, they published their results in the prestigious Spine Journal. One of the most relevant articles (to this conversation) was titled:
“Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-based Case-control and Case-crossover Study”
Spine 2008 (Feb 15); 33 (4 Suppl): S176–183
CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.
There was an association between chiropractic services and subsequent vertebrobasilar artery stroke in persons under 45 years of age, but a similar association was also observed among patients receiving general practitioner services. This is likely explained by patients with vertebrobasilar artery dissection-related neck pain or headache seeking care before having their stroke.
This Blog (and our website in general) has published regularly on this topic:
WARNING: Conducting an Orchestra Can Cause Vertebral Artery Dissection and Stroke Continue reading …
http://www.chiro.org/wordpress/?p=5005
Landmark Legislation Passes In The Texas Senate
SOURCE: Texas Journal of Chiropractic
The Texas Chiropractic Association reports that on Thursday, April 14, 2011, the Texas Senate passed Senate Bill 1001. Says the Texas Chiropractic Association:
“This landmark legislation is significant for two reasons: It allows chiropractors to form professional associations with medical doctors, and it ensures that chiropractors will be treated fairly by insurance companies that decide to cover services that can legally be provided by chiropractors and other types of practitioners. …We have been trying to pass this type of legislation for more than 20 years.”
The Senate Journal reflects that “Senator Carona offered the following amendment to the bill”: These amendments include:
“A COLLABORATION BETWEEN PHYSICIANS AND CHIROPRACTORS. a person licensed under Subtitle B, Title 3, and a person licensed under Chapter 201 are authorized to: (1) collaborate with each other in providing services to a client ….”
Title 3 is the Health Professions portion of the Occupations Code.
Subtitle B relates to Physicians.
Chapter 201 of Subtitle C relates to Chiropractors.
“ASSOCIATIONS. (a) a person licensed under Subtitle B, Title 3, and a person licensed under Chapter 201 of this code may form a partnership, professional association, or professional limited liability company according to the requirements of this section and any other applicable law.
Continue reading …
Chiropractic Physicians Meet with Congress
SOURCE: ACA News
As health care reform implementation begins, making the case for chiropractic inclusion on the federal and state levels remains a priority.
Nearly 500 chiropractic physicians, students and supporters converged on the nation’s capital Feb. 14-15 as part of the American Chiropractic Association’s 2011 National Chiropractic Legislative Conference (NCLC) with the Chiropractic Summit. Those in attendance listened to speeches from government leaders, received advocacy training and urged elected officials to support pro-chiropractic measures that seek to provide patients, veterans and active-duty military personnel with greater access to the essential services provided by chiropractic physicians.
While last year’s conference focused on the first phase of health care reform, congressional debate surrounding the Patient Protection and Affordable Care Act (PPACA), this year’s meeting concentrated on the next phase, implementation of the law.
Among the speakers this year, Iowa State Sen. Jack Hatch (D-Des Moines), a member of the White House Legislative Working Group on Health Care Reform, stressed that While the work being done on Capitol Hill to expand patient access to chiropractic care is vital to improving health care for all Americans, at this stage important work is also being done in every state capital. “This is both a challenge and an opportunity,” he said.
The meeting’s keynote speakers were Sen. Tom Harkin (D-Iowa) and Ret. Brig. Gen. Becky Halstead, spokesperson for the Foundation for Chiropractic Progress. Harkin, who was instrumental in the inclusion of the provider non-discrimination language in PPACA emphasized chiropractic’s role in transforming the U. S. health care delivery system.
Continue reading …
Historic Grant for Palmer, Rand Corporation, and Samueli Institute To Study Chiropractic Care For Active-duty Military Personnel
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On Febuary 18, 2011 we reported that the Palmer Center for Chiropractic Research Received a $7.4 million Military Readiness Grant. Here’s an interesting update (4-09-2011) on the proposed study from Dynamic Chiropractic |
On the Front Lines With Chiropractic Research
The Congressionally Directed Medical Research Program has awarded the Palmer Center for Chiropractic Research, the RAND Corporation and the Samueli Institute $7.4 million to conduct a four-year research project featuring members of the U.S. military as study subjects.
The primary area of study: the impact of chiropractic treatment on the military readiness of active-duty personnel. Dr. Christine Goertz, Palmer College of Chiropractic’s vice president for research and health policy, who serves as co-principal investigator of the project, summed up the importance of the award: “The three clinical trials to be conducted at six sites across the country under this grant represent the largest coordinated research effort to date within the chiropractic profession. In one of the trials, we will randomize 850 active-duty military personnel at four of the six sites. This represents the largest clinical trial effort to date evaluating chiropractic care.”
Continue reading …
Source MSNBC
The longstanding advice to “sit up straight” has been turned on its head by a new study that suggests leaning back is a much better posture.
Researchers analyzed different postures and concluded that the strain of sitting upright for long hours is a perpetrator of chronic back problems.
Using a new form of magnetic resonance imaging (MRI), researchers studied 22 volunteers with no back pain history. The subjects assumed three different positions: slouching; sitting up straight at 90 degrees; and sitting back with a 135-degree posture—all while their spines were scanned.
Continue reading …
“Basic physiology books describe the spinal cord as a relay system, but it’s part of the central nervous system and processes information just like parts of the brain do,” explains Dr. Stroman, director of the Queen’s MRI Facility and Canada Research Chair in Imaging Physics.
The technique involves capturing multiple images of the spinal cord using a conventional MRI system. The image capturing is repeated every few seconds over several minutes. During the imaging temperature sensations on the skin are varied allowing areas of the spinal cord that respond to the temperature changes to be detected in the MRI.
During their research, Dr. Stroman’s team was also surprised to discover that levels of attention impact information processing in the spinal cord. By examining the differences in spinal cord functioning in people who were either alert or distracted by a task they were able to see changes in the level of cord activity picked up by the MRI scanner.
“The effect of attention is one of the reasons that when you’re playing sports and you get hurt, you often don’t become aware of the injury until after the game when your attention and focus changes,” says Dr. Stroman. “We already knew that a person’s level of attention affects information processing in the brain, but this finding has made us aware that level of attention has to be properly controlled in research that aims to accurately map spinal cord function.”
Got An Opinion on Tort Reform?
SOURCE: MedScape
NOTE: Registration is free on MedScape
Medscape’s new headline trumpets: “Tort Reform Bill Would Reduce Deficit by $40 Billion”. Sounds pretty intoxicating doesn’t it. Aren’t we all just dying to see the deficit shrivel down to where it was when Bill Clinton was in office? I sure am.
However, after reading several paragraphs, I am horrified to see the unreasonable limits they want to set on noneconomic damages. I have heard too many stories of amputations of the wrong limb to think that a pittance is a reasonable payout for sloppy workmanship. Read on:
Tort Reform Bill Would Reduce Deficit by $40 Billion
By: Robert Lowe
March 11, 2011 — A House bill that caps noneconomic damages in malpractice cases at $250,000 and enacts other reforms to curb frivolous lawsuits against clinicians would reduce the federal deficit by $40 billion from 2011 to 2021, according to the Congressional Budget Office (CBO).
The bill, called the Help Efficient, Accessible, Low-Cost Timely Healthcare (HEALTH) Act of 2011, would lower premiums for malpractice insurance and reduce the number of “defensive medicine” services ordered by clinicians to avoid getting sued, the CBO stated in an analysis released yesterday. As a result of these lower costs, direct federal spending on healthcare would decrease by $34 billion over 10 years.
In addition, lower costs on the provider side would cause premiums for private health insurance to fall, which would allow employers to increase taxable wages for employees. That, in turn, would boost federal tax revenue by roughly $6 billion.
Continue reading …
Chiropractic Cost-Effectiveness
SOURCE: Health Insights Today
By Daniel Redwood, DC
“Doctors of chiropractic are a vital part of our nation’s health care system. Your services have been proven both effective and cost-effective and every day you help countless Americans with a variety of health conditions.”
~ Kathleen Sebelius,
Secretary of Health and Human Services
2011 National Chiropractic Legislative Conference
Health care costs in the United States continue to rise and now account for 17.6% of the economy. In the public sector, Medicare and Medicaid budgets are under continual strain, while accelerating private sector insurance premium increases are pricing millions of American families out of the market each year.
Aside from outlawing pre-existing condition exclusions and providing premium subsidies for those who need them most, the Patient Protection and Affordable Care Act of 2010 (PPACA) empowers the Department of Health and Human Services to take a variety of steps toward controlling costs. But attempts to utilize these powers will trigger strong opposition from groups facing adverse impact to their bottom lines. Further complicating matters, the future of PPACA remains uncertain as opponents seek to vilify, defund and repeal it.
Continue reading …
Are Chiropractic Patients Less Likely To Be Vaccinated?
Influenza vaccination among chiropractic patients and other users of complementary and alternative medicine: Are chiropractic patients really different?
SOURCE: Preventive Medicine 2011 (Feb 4) [Epub ahead of print]
Davis MA, Smith M, Weeks WB.
Center for Health Policy, The Dartmouth Institute for Health Policy & Clinical Practice, 35 Centerra Parkway, Lebanon, NH 03766, United States; Grace Cottage Hospital, Townshend, VT, United States.
OBJECTIVE: Previous studies suggest a possible association between using chiropractic care and lower influenza vaccination rates. We examined adult influenza vaccination rates for chiropractic patients to determine if they are different than those for users of other complementary and alternative medicine (CAM).
Continue reading …
Neck Pain Experienced By Air Force Pilots
Here’s a fascinating study, published in the January 2011 Military Medicine Journal.
This article is of particular interest because the Department of Defense was instructed during the Clinton Administration to start providing chiropractic care through the Department of Veterans Affairs to American servicemen, and even after all these years, chiropractic care is only available at 36 VA facilities across the country. This still leaves (at least) 100 major VA medical facilities without a chiropractic physician on staff. [1]
In this study, therapists at the School of Exercise and Nutrition Sciences in Victoria, Australia designed an 18-question survey to determine type and effectiveness of various strategies used by Royal Australian Air Force (RAAF) fast jet aircrew in self-referral and management of flight-related neck pain. [2]
They provided this questionnaire to 86 eligible RAAF aircrew to determine aircrew demographics, the incidence of flight-related neck pain, and their self-referral strategies to manage these neck complaints. The results are quite dramatic:
Continue reading …
Arnold has been a supporter of chiropractic care throughout his career. Here’s a quote from my favorite Governor:
“We’ve got to let the people know that there is a necessity, it’s not even an option, it’s a necessity to have a chiropractor. As much as it is a necessity to have a dentist, if you have a dentist for the family, you should have your chiropractor for the family.”
The Mythology Of Evidence-Based Medicine
The Huffington Post ~ 2-25-2011
Dr. Larry Dossey, Deepak Chopra and Dr. Rustum Roy
The current healthcare debate has brought up basic questions about how medicine should work. On one hand we have the medical establishment with its enormous cadre of M.D.s, medical schools, big pharma, and incredibly expensive hospital care. On the other we have the semi-condoned field of alternative medicine that attracts millions of patients a year and embraces literally thousands of treatment modalities not taught in medical school.
One side, mainstream medicine, promotes the notion that it alone should be considered “real” medicine, but more and more this claim is being exposed as an officially sanctioned myth. When scientific minds turn to tackling the complex business of healing the sick, they simultaneously warn us that it’s dangerous and foolish to look at integrative medicine, complementary and alternative medicine, or God forbid, indigenous medicine for answers. Because these other modalities are enormously popular, mainstream medicine has made a few grudging concessions to the placebo effect, natural herbal remedies, and acupuncture over the years. But M.D.s are still taught that other approaches are risky and inferior to their own training; they insist, year after year, that all we need are science-based procedures and the huge spectrum of drugs upon which modern medicine depends.
If a pill or surgery won’t do the trick, most patients are sent home to await their fate. There is an implied faith here that if a new drug manufacturer has paid for the research for FDA approval, then it is scientifically proven to be effective. As it turns out, this belief is by no means fully justified.
The British Medical Journal recently undertook an general analysis of common medical treatments to determine which are supported by sufficient reliable evidence. They evaluated around 2,500 treatments, and the results were as follows:
* 13 percent were found to be beneficial
Continue reading …
Palmer Center for Chiropractic Research Receives $7.4 million Military Readiness Grant
Scientists at the Palmer Center for Chiropractic Research (PCCR), the RAND Corporation and the Samueli Institute have been awarded a $7.4 million grant by the Congressionally Directed Medical Research Program. The grant will fund a four-year research project to assess chiropractic treatment for military readiness in active duty personnel. This is the largest single award for a chiropractic research project in the history of the profession and will be used to conduct the largest clinical trial evaluating chiropractic to date.
Ian Coulter, Ph.D., the Samueli Institute Chair in Policy for Integrative Medicine at RAND Corporation, is the research project’s principal investigator. Co-principal investigator and Palmer College of Chiropractic’s Vice Chancellor for Research and Health Policy Christine Goertz, D.C., Ph.D., will oversee the design and implementation of the three clinical trials funded by this award. The Palmer Center for Chiropractic Research will receive approximately $5.1 million in order to accomplish this task. Samueli Institute Vice President for Military Medical Research Joan Walter, J.D., also is a co-principal investigator for this project.
Continue reading …
Source Chiropractic Economics
The Alabama State Chiropractic Association (ASCA) conducted a survey of member practitioners in 2010 regarding the scope of practice in Alabama. Overall, results indicated that a majority of surveyed chiropractors are in favor of the inclusion of injectable vitamins and nutrients and prescriptive rights in the scope of practice…
Within the group of 255 respondents, 63 percent percent agreed or strongly agreed that chiropractic is a drugless alternative to allopathic medical care, and the same proportion of respondents felt that chiropractic is the detection and correction of subluxations. Seventy-six percent agreed that subluxation is an important cause of disease and correction can restore health.
However, 41 percent responded that the chiropractic profession should abandon the term subluxation and focus on a broader scope of practice in general. A majority were also in favor of chiropractors utilizing injectable vitamins and nutrients (58 percent), as well as prescriptions of certain drugs (60 percent).
Continue reading …
President Obama’s New Budget Proposes A 2-Year Medicare ‘Doc Fix’
SOURCE: MedScape
February 14, 2010 — President Barack Obama’s proposed budget for fiscal year 2012 would delay a massive reduction in Medicare reimbursement for physicians from January 1, 2012, until January 1, 2014, and freeze rates in the meantime.
Released this morning, the budget for fiscal year 2012, which begins October 1, would finance this so-called “doc fix” to the Medicare reimbursement crisis by, among other things, reducing the Medicaid provider tax threshold, reducing Medicaid outlays for durable medical equipment, and speeding new, lower-cost generic drugs to the marketplace. These measures would raise $62.2 billion, which would offset the $54.4 billion cost of the 2-year doc fix and yield an additional $7.8 billion in savings.
Continue reading …
Anatomical Connection Found Between the Rectus Capitis Posterior Major and the Dura Mater
A new study, just published in Spine Journal, reports on an investigation of the muscles of the suboccipital triangle and their relationship to cervicogenic headaches.
During the anatomic study of thirteen cadaver specimens, it was discovered that eleven of the 13 specimens had a connection between the rectus capitis posterior major muscle (at C2) and the spinal dura mater. [1]
A previous report by Hack (Spine 1995) [2] discussed a connection found between the rectus capitis posterior minor and the dura mater and its relationship to cervicogenic headache.
Continue reading …
Medical Errors Kill 15,000 Medicare Patients a Month
SOURCE: AOL Health
A new report from the Department of Health and Human Services, Office of the Inspector General reveals that 13 percent of Medicare patients in the U.S. experience an adverse event each month in American hospitals, and some 15,000 of them die as a result. [1]
The news is startling, particularly since the report points out that 44 percent of adverse incidents occurring in hospitals are avoidable. And all-together, these adverse events are costing Medicare more than $300 million a MONTH.
Continue reading …
Who Should Manipulate The Spine?
The World Health Organization (WHO) recently crafted and published the WHO Guidelines on Basic Training and Safety in Chiropractic (FULL TEXT Adobe Acrobat 512KB) in consultation with the World Federation of Chiropractic, the Association of Chiropractic Colleges, and various other chiropractic, medical, and osteopathic groups. [1]
The Guidelines clarify that chiropractic is a separate profession rather than a set of techniques that can be learned in short courses by other health professionals. They also make it clear that medical doctors and other health professionals, in countries where the practice of chiropractic is not regulated by law, should undergo extensive training to re-qualify as chiropractors before claiming to offer chiropractic services. In some countries there have been recent efforts by medical groups to provide short courses of approximately 200 hours in chiropractic technique. The WHO feels this is a bad decision.
The World Health Organization guidelines indicate that a medical graduate should a require an additional minimum of 1800 class hours, including 1000 hours of supervised clinical training, before claiming to offer chiropractic services. [2]
Our Top 15 Stories of the Year
These were our most-read Stories of the Year:
- Starting with Chiropractic Saves 40% on Low Back Pain Care
- New Study Reveals That Back Surgery Fails 74% of the Time
- If Not Chiropractic Care, Then What’s Your Alternative?
- Medical Pushback on Provider Nondiscrimination Law
- Commonly Used Meridian Points
- Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain
- 5 Things You’re Not Supposed To Know About Chiropractors
Trading Backpacks For Rolling Luggage Fails in German Primary School Study
It’s well understood that heavy backpacks are taking a heavy toll (excuse the pun!) on adolescent spines. [1] A recent standing magnetic resonance imaging study by the Department of Orthopaedic Surgery, University of California, at San Diego revealed that: “Increasing backpack loads significantly compressed lumbar disc heights measured in the midline sagittal plane” and that: “student subjects reported significant increases in back pain, associated with increasing backpack loads from 4, to 8, and finally to 12 kgs of carried weight”.
Continue reading …
Chiropractic’s Next Battle: AMA Ownership of the CPT Codes
SOURCE: Dynamic Chiropractic ~ Dec 16, 2010
By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
As 2010 comes to a close, it is important to look ahead to see what we can do as a profession to brighten the future of chiropractic. Among the many bits of information that have come across my computer monitor of late is a very interesting article by John Weeks of The Integrator Blog, “an organizer-writer in the emerging fields of complementary, alternative and integrative medicine since 1983.” [1] The article points out that the American Medical Association (AMA) has owned the current procedural terminology (CPT) codes for more than 40 years.
The benefits of this ownership are probably much greater than you realize. Basically, they amount to the following:
- Control: By owning the CPT codes, the AMA effectively keeps a lid on what doctors of chiropractic (not to mention nurses, optometrists, acupuncturists, doctors of naturopathy, etc.) can be reimbursed for. None of the other health care professions is able to create new codes that are more reflective of what they do (and should be reimbursed for) without saying “AMA, may I?”
Continue reading …
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