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Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
January, 2005, Vol. 05, Issue 01
"Peek-a-Boo, I See You": Obstetric Ultrasound
By Elaine Stillerman, LMT
Expectant mothers ask for it by name. They often can't wait to get to their obstetricians to "see" how their babies are growing. A remarkable diagnostic tool called ultrasound enables mothers and doctors to peak into the mysterious world of the life and growth of the fetus in-utero.But is it safe and accurate? Are women being protected, or are they being offered a false sense of security about the health of their babies? And what about this burgeoning business of keepsake images and videos of unborn babies? Are eager mothers courting danger with this unnecessary exposure to ultrasound radiation?
Originally developed during WWII to help the military detect enemy submarines, this technology wasn't used in clinical obstetrics until the early 1960s. The use of ultrasound has now become a routine practice in prenatal care in most industrialized countries. Ultrasound uses ultra-high frequency sound waves that bounce off internal structures to produce images (sonograms) of organs, tissues, blood flow, or, in obstetric instances, the developing fetus. According to the Food and Drug Administration (FDA), there are legitimate medical reasons to use this prenatal test: to confirm pregnancy, assess fetal age, diagnose any fetal abnormalities or birth defects, evaluate the position of the placenta, and determine whether there are multiple pregnancies. Generally speaking, when a trained professional administers the test, it is assumed that its benefits outweigh any risks; however, some experts feel that even medical application of obstetric ultrasound has not been fully tested and is not without risks.
There is a lack of epidemiological studies on the risk of ultrasound on human fetuses, although animal studies have shown altered growth, low birth weight, diminished immune response and a deviation in genetic material from high doses of ultrasound. Studies on humans exposed to ultrasound have shown some serious side-effects, including pre-term labor or miscarriage, low birth weight, delayed speech, and fewer instances of right-handedness, which is viewed as brain damage to the developing brain. According to some doctors, ultrasound has its place in clinical diagnosis but not during pregnancy. Many physicians are losing their ability to confirm gestational age through a bimanual examination because they rely so heavily on technology, and medical schools rarely teach this palpatory skill.
Other concerns about the medical use of ultrasound include different powers of energy emanating from the equipment itself (the machines are becoming more powerful and there is inadequate data or control on levels of output) and the misreading of these tests by technicians or doctors. A study conducted on the accuracy of ultrasound at a major women's hospital in Brisbane, Australia, showed that ultrasound missed almost 40 percent of fetal abnormalities. Many genetic and physical disabilities, such as Down Syndrome, or heart and kidney disease, cannot be picked up from an ultrasound. False positives (an abnormality is detected when it does not exist) may occur, and uncertain interpretations can be extremely stressful for the expectant couple.
There are other serious considerations. The number of elective scans is increasing as doctor's routinely use the test at many prenatal visits, sometimes exposing their patients - and fetuses - to periods as long as one hour. The traditional transabdominal scan is now being replaced with the transvaginal scan, which probes even closer to the growing fetus. New developments, including the Doppler ultrasound, 3-D ultrasound and even 4-D (moving or dynamic 3-D) scanners are currently available to women.
The 3-D ultrasounds are also referred to as "entertainment scans" and provide clearer pictures of the fetal face and movements. What is of greater concern is that the technicians who perform these entertainment ultrasounds are neither regulated nor certified by the states where they do business. Appealing to their emotions, expectant parents are being courted by a number of new companies who claim that this 3-D technology is safe and can offer them the chance of a lifetime to photograph and video their unborn child (doctors use 2-D imaging.) They claim that these pictures help couples bond early with their babies. For a fee of about $80 for a short session, couples can learn the baby's gender. For $300, a half-hour session (exposure) will record fetal movements on a videocassette or DVD; color photos are included in this package. The recommended gestational age is between 28 and 32 weeks for the "cutest" images.
The FDA strongly cautions against the use of ultrasound for these keepsake memories. They insist that nonmedical use of ultrasound is not a wise idea. The FDA also regulates medical equipment and is trying to crack down on the "entertainment" use of ultrasounds. Along with the FDA, the American Institute of Ultrasound in Medicine and the European Committee for Medical Ultrasound agree that the nonmedical use of ultrasound must be discouraged and that the use of 3-D ultrasound for psychosocial or entertainment purposes is inappropriate and contrary to responsible medical care.
The use of a diagnostic ultrasound during pregnancy may provide some valuable information about the well-being of the fetus. It can also be emotionally comforting to see the fetus' heart beat. But the advance of technology needs to be kept in perspective and in the safe hands of those qualified to use it.
Click here for previous articles by Elaine Stillerman, LMT.
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