Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
June, 2003, Vol. 03, Issue 06
The World of the Injured Worker
By Vivian Madison-Mahoney, LMT
Author's note: This revised article was originally prepared by myself and Sherry Smith, LMT; it was presented to a three-member panel of the Florida Workers' Compensation Division, which included Insurance Commissioner, Bill Nelson.The panel was in the process of revising its 1997 "Florida Workers' Compensation Health Care Provider Fee For Service Reimbursement Manual" during a time when the workers' compensation system was trying to eliminate massage therapists from the original draft for changes in the system; needless to say, workers' compensation carriers in Florida are still reimbursing us. It pays to fight for your rights!
This article is directed toward those interested in working with injured workers. If you have not considered working with these types of patients, this article may help you understand why accepting some insurance for reimbursement is necessary.
I originally wrote this article with the Florida worker in mind, so some references may not fit the circumstances in every state; still, it is generally the same everywhere. Keep in mind that not all cases or conditions are the same, and this article focuses on cases involving the more serious or catastrophically injured worker. Health-care providers who specialize in work injury cases generally agree that the following summarizes the experiences of a typical injured worker.
The Typical Injured Worker Scenario
The Employee's Continuing Nightmare
At this point, the employee can experience any of the following:
Surveillance of Injured Workers
The insurance carrier's surveillance officer begins to film the employee engaging in activities such as attending a child's baseball game; walking with a cane through a fairground; or swimming.
Consider the following examples:
Injured employees may experience fear knowing that their every move may be filmed. They can't tell whether they are being stalked; are about to be robbed or beaten; if their children are in danger; or if it is just the carrier's surveillance crew filming their activities. This causes undue stress and fear for innocent employees who, through no fault of their own, were injured.
These stories go on and on. Surveillance films (paid for by the carrier) often present a distorted or incomplete report of the employee's activities, or are not even of the patient.
Searching for Normalcy
The employee will try to find some semblance of normalcy by trying to engage in daily activities as best as possible, even though these minor activities can cause undue pain. Unfortunately, the surveillance crew is not present to film this pain or disability. The employee's injury may allow him or her to engage in certain activities for short intervals when there is time available to recuperate. These activities may not allow for repetitive motion but may be necessary to begin the improvement process; however, the employee may not be able to perform on the job without ample rest time between activities. Once again, the insurance carrier's spot surveillance is taken out of context, and the employee is punished for trying to rise above his or her injury by beginning to participate in short and varied activities.
The Employee's Changed World
By now, the employee's world has changed - maybe forever - because of this injury. The employee's disability income does not meet financial obligations; disability checks that were initially on time become delinquent or are cut out completely at the whim of the insurance carrier or adjuster.
The employee's once-good credit rating is lost as bills are turned over for collection. Collectors call the home daily. The employee's spouse works, but can no longer carry the financial or emotional load alone. Family emotions and financial pressures continue to escalate. The employee receives the disability check late, or it is reduced or stopped completely. The utilities are shut off. The adjuster refuses the prescribed treatment plan, including medications, and the employee cannot purchase the prescribed medicines. The employee's spouse is leaving him or her, or contemplating doing so. The employee has no choice except to seek legal counsel. The children suffer from experiencing the discouragement, depression and other sorrows created by the situation.
Employee Seeks Self-Medication
To obtain some relief, the employee begins self-medicating with prescribed medications (if he or she can get them through workers' compensation coverage); over-the-counter medications, alcohol; or all of the above, to cope with the physical and emotional pain. Some employees become addicts.
To keep sane, the employee seeks the help of a mental-health counselor or is referred to one by the attending physician. The employee feels emotionally strung out, despondent, and sometimes suicidal. The system has created the need for these additional services.
And They Wonder Why?
Many months (frequently, more than a year) have elapsed since the employee's injury, and the employee feels as if the world is crashing down. Despite many forms of treatment, the employee's condition has not improved and has often intensified. The employee has begged for something to help him or her deal with the pain and get back to a life that includes work and normalcy. Despite what the employer or insurance carrier may think, the majority of employees do not like watching soap operas, feeling incompetent, and being out of the work atmosphere: It has been forced upon them by the system.
It is my belief that the majority of injured employees would rather work than be supported or made to feel the effects of despair, inadequacy, and self-doubt created by the system and this situation. And they wonder why they can't get an injured worker off of temporary or permanent disability to return to work.
No two cases are alike: Not all carriers defer treatment, and not all employees are completely honest; but there are a few exceptions, and it is those exceptions that get the most publicity. It is my opinion, from my years of observation, that employers and insurance carriers pay a much greater price to avoid paying for the catastrophic legitimate cases, than they lose on those who try to elude the system now and then.
I will be attending the annual Workers' Compensation Educational Conference again for the 19th year. (Incidentally, there are more surveillance exhibits there than other types of services.)
The Employee Finally Receives a Prescription for Massage Therapy
Watch for the continuation of this article in the August issue.
Click here for previous articles by Vivian Madison-Mahoney, LMT.
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