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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
March, 2013, Vol. 13, Issue 03
Can CAM Help Slow the Growth in National Health Care Spending?
By Kathryn Feather, Senior Associate Editor
A recent report from Health Affairs entitled, "U.S. Spending on Complementary and Alternative Medicine During 2002-2008 Plateaued, Suggesting Role in Reformed Health System," sheds light on some interesting spending trends for CAM.
According to study authors Matthew Davis, Brook Martin, Ian Coulter and William Weeks, CAM is an approximately $9 billion market in the U.S. each year, which they say is equal to three percent of national ambulatory health care expenditures. The authors examined trends in the demand for CAM as reported in the Medical Expenditure Panel Survey during 2002 through 2008. According to the report, the authors believe that, "should some forms of complementary and alternative medicine be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in the new delivery systems such as accountable care organizations could help slow growth in national health care spending."
In terms of national spending on CAM, "inflation-adjusted expenditures on chiropractic care increased 11 percent from $6.2 billion in 2002 to $6.9 billion in 2008. Inflation-adjusted expenditures on acupuncture, massage therapy and other complementary and alternative medicine services were stable." Another interesting finding was the amount spent per patient on specific services. The authors found that "the mean annual inflation-adjusted expenditure per user decreased for acupuncture (from $260 to $325) and other complementary and alternative medicine services (from $301 to $214), while it increased for chiropractic care (from $447 to $582) and massage therapy (from $259 to $305)."
According to the study, the number of CAM users held steady except for one specific service: acupuncture grew by 16 percent from 950,000 in 2002 to 1.1 million in 2008. Overall, the number of adults who visited a CAM provider at least once during the year increased by six percent, from 15.2 million in 2002 to 16.1 million in 2008. "Chiropractic care accounted for 77 percent to 82 percent of total ambulatory visits to complementary and alternative medicine providers from 2002 to 2008, while massage therapy accounted for 10 percent to 14 percent; acupuncture 4 percent to 6 percent and other services, 3 percent to 4 percent."
The authors acknowledge the historically poor communication between CAM providers and providers of other medical services. However, the authors note that new opportunities to stabilize spending could come from including CAM services in accountable care organizations. "Considering that complementary and alternative medicine appears to be relatively inexpensive when compared to allopathic medicine, if medical care providers are willing to collaborate with local complementary and alternative medicine service providers, offering at least some complementary and alternative medicine services could help accountable care organizations achieve their objectives."
In conclusion, the authors believe that, "as health care policy makers, payers and other stakeholders attempt to reduce waste in health care systems, they should recognize that excluding currently covered complementary and alternative medicine services would, at best, produce only meager cost savings. Operating under more free-market conditions, the pricing of complementary and alternative services appears to be more self-regulating than that of the conventional health care sector. This difference suggests that payment systems that encourage consumers to make educated decisions under the constraint of a budget may help constrain health care spending growth.
"Examination of the U.S. complementary and alternative medicine market is useful in understanding consumer response to a more cash-based health care economy, which can inform future benefit design. If certain types of complementary and alternative medicine services are proven to be efficient in managing health conditions, those who provide these services may find opportunities to participate in new delivery system models such as accountable care organizations, resulting in a more collaborative approach to health care delivery."
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