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Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
July, 2006, Vol. 06, Issue 07
Is the American Medical Association Trying to Contain Alternative Health Care?
“Partnership” formed to examine education, training and scope of practice.
By Michael Devitt
More than 40 years ago, the American Medical Association (AMA) launched its first attack against alternative health care when it formed the Committee on Quackery in November 1963.The primary objective of the Committee on Quackery was to "contain and eliminate" chiropractic as a recognized health care service in the U.S. (Interestingly enough, the committee's original name was the Committee on Chiropractic, but the name was later changed so as to not lend credibility to the chiropractic profession.) While its efforts were ultimately unsuccessful, the committee's activities are believed to have delayed the full integration of chiropractic into the health care marketplace for several years.1
Now, more than 30 years after the committee was disbanded, and almost 20 years after Judge Susan Getzendanner issued a historic ruling that found the AMA guilty of engaging in a conspiracy to contain and eliminate chiropractic, the medical association appears ready to embark on a new campaign to not only damage the chiropractic profession, but all CAM disciplines. In a move that appears to be aimed at stopping the growth of essentially all health care practitioners except for medical doctors and doctors of osteopathy, the AMA House of Delegates has adopted a resolution that calls for the association, in conjunction with an AMA-supported entity known as the "Scope of Practice Partnership," to study the qualifications, education and academic requirements of "limited licensure health care providers and limited independent practitioners." The resolution, adopted at the AMA's most recent interim meeting in Dallas, also calls for the association to allocate more than $170,000 to help fund and publish the study, and to provide a report of its findings when the House of Delegates convenes at the AMA's 2006 annual meeting in Chicago.2
"While nonphysician providers have been, and will continue to be, important elements in the provision of health care, it is important that our patients know and receive the care that only physicians are uniquely qualified to provide," said Dr. Michael Maves, the AMA's executive vice president and CEO." Maves added that the main purpose for the creation of the Scope of Practice Partnership is "to ensure quality care for patients."3
The AMA's alleged concerns over patient care may stem from the fact that increasing numbers of consumers, dissatisfied with the traditional system of health care in the U.S., are turning to providers other than medical doctors for treatment. According to a 2004 survey, 36 percent of all American adults (an estimated 74 million Americans) used at least one type of complementary and alternative medicine in the past year. The same survey found that 28 percent of people who used CAM did so because they believed that "conventional medical treatments would not help them with their health problem."4
In addition, the number of states allowing for the practice of certain types of CAM has increased dramatically in the past few decades. Thirty-six states, the District of Columbia and four Canadian provinces have all passed laws regulating the massage and bodywork profession, 15 states regulate the practice of naturopathy, 43 states allow for the practice of acupuncture by non-physician acupuncturists, and chiropractic has had scope-of-practice laws in effect in every state in the U.S. since 1974.
The AMA's resolution (Resolution 814), introduced by a delegation from the Texas Medical Association at the Interim Meeting, calls into question the standards for admission, training and testing of limited licensure health care providers on the claim that these standards "are neither well-defined nor generally known by physicians or public members" who evaluate them or review the quality of care they provide. It also questions the education and certification standards of limited licensure providers, and requests that the AMA, the Scope of Practice Partnership and members of the Federation of State Medical Boards conduct a thorough study of such providers.
As for the Scope of Practice Partnership, few firm details about the organization exist on the AMA's Web site; in some instances, it also is referred to as a steering committee or a task force. A search of the AMA's Web site finds the first mention of the partnership in a list of resolutions and report recommendations from the AMA House of Delegates 2004 Interim Meeting. The document notes that the association's Advocacy Resource Center is "actively involved in supporting the federation of medicine's efforts to oppose inappropriate scope of practice expansions that threaten the health of the public," but provides little information otherwise.5
In an excerpt of an Aug. 20, 2005 speech to the board of directors of the American Society of Anesthesiologists (also on the AMA's site), AMA President J. Edward Hill, MD, provides some background information on the organization's creation, saying the association helped to create the Scope of Practice Partnership to counter "various and troubling encroachments on physician practice." Dr. Hill also details some of his feelings about working with allied health professionals.6
"Like you, the AMA respects the health care professionals who work with us in our offices and in hospitals, and who can function as physician 'extenders,' in areas where physicians are in great demand and short supply," Hill is quoted as saying. "In my rural practice, for example, I have worked with midwives with great success. However, the operative word in the previous sentence is 'with,' meaning, 'in cooperation with,' or 'as part of a physician-led team.' However, not all allied health professionals see it this way."
According to Hill, the AMA will house and staff the partnership, and provide a basic level of support, with additional support provided by state and specialty societies. An executive committee will be created and charged with reviewing relevant issues and prioritizing scope-of-practice concerns on a state-by-state basis. The partnership also will fund studies to "closely examine the education and training of allied health professionals, and provide this information as a point of comparison for legislators."
Each of the 12 founding members of the partnership has pledged to contribute $25,000 annually to the entity; the funds will be used "to fund research that helps refute the key arguments allied health professionals use to advance their measures in state legislatures." Funding also will be used to "help medical specialty societies and state medical associations fight expansions in non-medical scope of practice" and to "fund campaigns to stop scope-of-practice legislation in states where such bills appear likely to advance."
While the number of societies involved in the partnership is relatively small at present, APA Medical Director, James H. Scully Jr., MD, expects the partnership to expand to all 50 states, and to establish relationships with every state medical board and association in the U.S. It is believed that such a coordinated effort would send a message to legislators that "scope-of-practice issues are not turf issues for one or another specialty, but are concerns of the profession of medicine."
The results of the AMA/Scope of Practice Partnership study are expected to be presented at the House of Delegates' 2006 Annual Meeting in June.
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