Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
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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