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Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
September, 2009, Vol. 9, Issue 09
By Elaine Stillerman, LMT
I always felt that the case of Meador v Stahler and Gheridian would have made a terrific case for the award-winning television show "Boston Legal." I could just picture Alan Shore (brilliantly portrayed by James Spader) eloquently and passionately representing his client while educating the rest of us about our legal rights as patients.
Not familiar with this case? Let me explain. In 2005, a Massachusetts woman, Mary Meador, sued and won a $1.5 million award against her obstetricians for performing a C-section she made clear she didn't want. She didn't claim that the procedure was negligently performed or that her postsurgical complications (which left her bedridden and unable to work for a number of years) were foreseeable. The merits of her claim were that the doctors had misrepresented the risks and dangers of her birth choice -- a vaginal birth after a prior C-section (VBAC) -- and that they ignored her repeated pleas and requests for a vaginal birth.
The doctors were brought up on charges that they failed to obtain Meador's informed consent, which constituted substandard, negligent medical care. The forensic psychiatrist who testified at the trial established a link between the lack of informed consent and the physical and emotional toll it took on the patient and her family by forcing her to undergo a procedure she did not want and did not medically need.
When it comes to labor and childbirth, a woman's emotional vulnerability and physical discomfort makes it difficult for her to stand up for her rights. She needs to focus on her labor and not be engaged in an argument about what she is entitled to. According to the Childbirth Connection's "Rights of Childbearing Women" brochure2 (www.childbirthconnection.org), "Every woman has a right to accept or refuse procedures, drugs, tests, and treatments and to have her choices honored." (For a free copy of this important pamphlet, send a SASE to Childbirth Connection, 281 Park Avenue South, 5th Floor, New York, NY, 10010.)
Fifteen years before the Meador case, Congress passed the Patient Self-Determination Act (PSDA) as an amendment to the Omnibus Budget Reconciliation Act of 1990. It became effective in December 1991. Basically, the PSDA requires that Medicare and Medicaid providers (hospitals, nursing homes, hospice programs, home health agencies, and HMOs) give competent adult individuals, at the time they are admitted or enrolled in the program, information about their rights under state laws governing advance directives. These rights include:
The PSDA also prohibits institutions from discriminating against a patient who does not have an advance directive or a plan of care.
All hospitals that receive federal funding (nearly 80 percent of hospitals in the United States) must conform to the Center for Medicare and Medicaid Services (CMS) Conditions of Participation (CoP) which requires that hospitals honor patient rights as expressed by the PSDA, the Consumer Bill of Rights and the EMTALA (Emergency Medical Treatment and Advanced Labor Act) law to be fully informed of the risks, benefits and alternatives of any proposed treatment and to participate in all treatment decisions. Hospitals that fail to uphold this practice run the risk of receiving stiff fines and/or losing their right to qualify for Medicare or Medicaid funding.
In New York, we have the Public Health Law, Section 2503, passed in 1978 (see my March 2006 column "The Truth About Pitocin" ), that requires all doctors and midwives to fully disclose and require informed consent from laboring women, regarding the use of all drugs during labor and delivery. The Joint Commission on Accreditation of Hospitals (JCAHO) accredits 80 to 85 percent of American hospitals, and one of their standards for accreditation is patient rights. Complaints about patient rights violations can be made to them at www.jacho.org or (630)792-5800.
In my May 2005 column "'V-Back' to the Dark Ages," I addressed the political environment surrounding VBACs and the increased medical denial of this choice, so I am not going to go into the benefits and risks of VBAC again. Instead, I want readers to know that we and our clients have choices and responsibilities when it comes to our health care. Informed consent can only be provided if the patient is truly informed, and by regularly conceding this right to our care providers, it proves how rare and improbable this practice is. The onus of education, the burden of learning the facts, options, alternatives and side effects of procedures and drugs must be the responsibility of the patient. That is the only way, regrettably, that the patient will learn all the facts. Patients don't have to be powerless about their rights.
This is neither a war against individual doctors, or hospitals and their care, nor a diatribe against the medical community at large. It is a wake-up call to those patients who have remained passive about their own health decisions for too long and who have merely accepted the choices that are made for them by others. Only when patients and their care providers can openly discuss, debate and compare options based on shared evidence-based information can we really have a partnership, a team, dedicated to a person's total health care. Alan Shore would have fought -- and won -- for these rights. We can too.
Click here for previous articles by Elaine Stillerman, LMT.
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