I am often frustrated by most people and the problems they face with their back, neck shoulders, knees and other parts of their body that appear to be breaking down as they age. Part of the problem is that our healthcare system has become so specialized, that nobody looks at the person. For example, if you have knee pain, your primary doctor will likely either give you medication or send you to either a therapist or an orthopedic doctor. For some reason, the rarely consider the chiropractor. The person they refer to treats the supposedly injured part and the results are often mixed, leading to more medications or sometimes high tech tests or surgery. On another occasion, this same person, may have a lower back episode. This is likely treated with more pills and if they dont relieve the pain, the patient is referred to either a therapist, orthopedist and sometimes is lucky enough to be given a chiropractic referral. On another occasion, this same person develops shoulder pain. The same thing ensues and they either get pills, therapy, a shot and rarely a chiropractor. During these episodes, the patient sometimes will get relief and that relief may often be short lived.
There is a common thread that runs through all of this. Problems with someones gait (the way they walk which is by the way inherited) will predispose the patient to all of the above types of problems. If we just look at the area of pain, are we missing what is really wrong with the person.
This is where our practice is different. We look at people, then get a list of their symptoms and then try to make sense of what we are seeing. This then leads to more appropriate and effective therapy. Most gait issues are caused by body assymetries that create strain on one side of the body causing chronically painful conditions. The medical literature if you look deep enough actually shows this to be the case.
My point is that as physicians, we are trained in the medical symptom model, not the mechanical function/malfunction model. I often tell people I work in a different paradigm than many of my collegues. The great thing is I help solve many difficult chronic long term pain cases, many that were called myofascial pain syndrome of fibromyalgia.
Our office gets predictable results with neck pain, shoulder problems, knee, hip and back pain for most patients unless there is a more severe problem that requires advanced diagnostics. The good news is that most people do not require advanced diagnostics and we save the system tons of money by avoiding unnecessary tests, MRI's and instead, use that insurance money toward getting the patient better.
I am currently writing a consumer level book discussing our model, why many conditions can get better with the right thought process and debunking myths of many conditions patients often tolerate off and on all their lives and never get resolved. I hope to have the book completed early next year and will be looking for a publisher who wants to have a book of the general public that helps them understand why people are in pain and how to find someone who really understands how to get them out of pain without drugs or surgery.
Stay tuned...
Sunday, August 12, 2007
Friday, June 22, 2007
Self, the stroke threat and other groundless magazine articles
It has been upsetting to me lately to read some of the sensational scare tactic articles that are hitting the news stands. One that came to mind was an article in Self Magazine. The article brought up the issue of the chiropractic adjustment to the neck and the threat of stroke.
That scare unfortunately has hurt many who would have benefitted from chiropractic care and stayed away because of this concern. Reality check...
Chiropractors have among the lowest malpractice rates in the country. Ours is about $1300 annually. Since this is based on risk, and since our rates are about 90 percent less than your family practice doctor pays, one can only assume that what we do in our offices is quite safe.
The article below that you can download talks about the true risks. The truth is that having a stroke at the hands of your chiropractor is a chance of less than 1 in one million adjustments. Considering many patients neck problems are actually in their mid back and lower back regions, especially in our office, we do not manipulate the neck unless absolutely necessary. We take all precautions and prescreen patients for any possible problems. When compared to tylenol which can have serious consequences in as few as 1 in 7500 people taking the drug, chiropractic is a no brainer.
http://www.acatoday.org/membersonly/ChiroRisks_Lauretti_06.pdf
Don't be put off by the scare tactics and sensational headlines that others seek. When compared to medical methods, chiropractic has proven itself over and over to be safe and effective and our patients know we deliver the goods in the absense of drugs and surgery.
I find it funny that athletes cannot get enough of us. Recently, the Mets hired a team chiropractor. I guess it is still up to our patients judgement as to whom they will use for the care of their frame and musculoskeletal system.
Our patients know we are effective and we have research to back it up. For many of us though, our bodies are our own labs. While chiropractic care may not fix all problems over night, our patients not only get relief but are in overall better health with a true sense of wellbeing, not a drug induced facsimile.
That scare unfortunately has hurt many who would have benefitted from chiropractic care and stayed away because of this concern. Reality check...
Chiropractors have among the lowest malpractice rates in the country. Ours is about $1300 annually. Since this is based on risk, and since our rates are about 90 percent less than your family practice doctor pays, one can only assume that what we do in our offices is quite safe.
The article below that you can download talks about the true risks. The truth is that having a stroke at the hands of your chiropractor is a chance of less than 1 in one million adjustments. Considering many patients neck problems are actually in their mid back and lower back regions, especially in our office, we do not manipulate the neck unless absolutely necessary. We take all precautions and prescreen patients for any possible problems. When compared to tylenol which can have serious consequences in as few as 1 in 7500 people taking the drug, chiropractic is a no brainer.
http://www.acatoday.org/membersonly/ChiroRisks_Lauretti_06.pdf
Don't be put off by the scare tactics and sensational headlines that others seek. When compared to medical methods, chiropractic has proven itself over and over to be safe and effective and our patients know we deliver the goods in the absense of drugs and surgery.
I find it funny that athletes cannot get enough of us. Recently, the Mets hired a team chiropractor. I guess it is still up to our patients judgement as to whom they will use for the care of their frame and musculoskeletal system.
Our patients know we are effective and we have research to back it up. For many of us though, our bodies are our own labs. While chiropractic care may not fix all problems over night, our patients not only get relief but are in overall better health with a true sense of wellbeing, not a drug induced facsimile.
Hurting our patients and our profession by Judicial means
Many of our patients are appalled that our right to adjust extremities (arms, legs, wrists, elbows, fingers and other such articulations that relate to movement) had been taken away by an appellate court decision. It has hurt all chiropractors and their patients, especially since they are the only ones really qualified universally in NJ to perform these services. Although a chiropractor may still work on these areas, actual adjustments to these joints to reestablish normal movement and free patients of pain has been a mainstay of chiropractic practice for decades.
Our scope of practice had been interpreted by our state chiropractic regulatory board to include the practice which is used across the country, allowing chiropractors a unique solution to many joint problems.
This decision was made during a malpractice case that was won by the chiropractor in question. The attorneys on the other side queried the appellate court as to weather we as a profession can adjust extremities. Of course, they were shown only what the attorneys wanted them to see causing a bad judgement which took away our interpreted practice law since 1991. They over rode our own chiropractic board. Unfortunately, we all fall victims since this was all about legal strategies and trying to win a lost case.
The profession is attempting to overturn this poor decision but also is trying to use the opportunity to also put forth a new scope of practice, which will update NJ's which is from 1954 and it quite restrictive, when compared to other states.
Unfortunately, our attempts to get this passed yesterday, 6/22/07 failed in the hands of the senate. We will again attempt this in September and hopefully, not only will we prevail for the sake of the profession and our patients, but will emerge with a modern practice act which allows us to perform what we learned in school including nutrition.
I will keep you posted
Dr C
Our scope of practice had been interpreted by our state chiropractic regulatory board to include the practice which is used across the country, allowing chiropractors a unique solution to many joint problems.
This decision was made during a malpractice case that was won by the chiropractor in question. The attorneys on the other side queried the appellate court as to weather we as a profession can adjust extremities. Of course, they were shown only what the attorneys wanted them to see causing a bad judgement which took away our interpreted practice law since 1991. They over rode our own chiropractic board. Unfortunately, we all fall victims since this was all about legal strategies and trying to win a lost case.
The profession is attempting to overturn this poor decision but also is trying to use the opportunity to also put forth a new scope of practice, which will update NJ's which is from 1954 and it quite restrictive, when compared to other states.
Unfortunately, our attempts to get this passed yesterday, 6/22/07 failed in the hands of the senate. We will again attempt this in September and hopefully, not only will we prevail for the sake of the profession and our patients, but will emerge with a modern practice act which allows us to perform what we learned in school including nutrition.
I will keep you posted
Dr C
Monday, January 29, 2007
Thoughts for the New Year 2007
Well, it is almost the end of January. This was a strange winter. Not too cold so far, and some unseasonably warm weather. Because of increased demand, we have added Tuesday mornings to our Scotch Plains schedule.
A big concern of mine this year is the way insurance companies have abused our patients and are not giving us what we have paid for. Most of us have been continually subjected to higher co payments which is blurring the line between weather to go in or out of network. The truth is, out of network doctors are out of network because the insurance companies are paying them less and less, while charging us more and more. In our case, we are no longer in United Healthcare. There were a number of reasons this happened, but we are finding out that with the higher co payments, the paperwork our patients were required to fill out and the nasty things they were doing to us, and to our patients and to the relationships we have with those patients, out of network was better for everyone. The benefits are as follows: The paperwork has gone away. That is correct, no precert forms anymore. With the loss of participation will be the loss of wondering if they misinformed us about precert, as they did last year and then withheld our reimbursements. Although we in good faith tried to straighten it out and get paid after providing proof, this was ignored and more United Healthcare excuses were given. It turns out many medical doctors felt the same way and more are opting out daily.
Many people have been brainwashed to believe that out of network is unaffordable. The reality is that although some doctors price themselves that way, most of us are priced reasonably and have ways for patients to comfortably afford care. Sure, you may not have the 40 dollar co pay which is becoming more common, but for $55, you can get the care you need, without the referral, the hassle, the angst and everyone is happier.
We have tried to stay in network with most plans, for the benefit of our patients. Most doctors would like to. Today, I met with a medical doctor I am friendly with who just terminated Horizon Blue Cross after many years because they continue to pay him less and less, while his overhead continues to escalate. He was quite upset by this especially when he contacted the representative to question her about their policy and the answer was simple, here is how you can resign from the plan. Here is a well respected physician who is caught between whether to do an appropriate EKG on a patient that he is not being paid for anymore. He told me the allergist friend of his has to fight with a clerk to give a non generic medication.
Out of network does not look so bad after his stories. As a doctor, I am torn between great care, a lousy health plan, can I afford to stay in network and trying to stay in network so more people can access us more easily.
What would you do if you were me? For those that know me, I always go the extra mile for my patients. I will do whatever it takes to help them resolve a problem. As a patient, you need to begin to demand your plan becomes accountable and your doctor needs to be treated with respect, and paid at a level that allows him to feed his family as well. Just my thoughts...
A big concern of mine this year is the way insurance companies have abused our patients and are not giving us what we have paid for. Most of us have been continually subjected to higher co payments which is blurring the line between weather to go in or out of network. The truth is, out of network doctors are out of network because the insurance companies are paying them less and less, while charging us more and more. In our case, we are no longer in United Healthcare. There were a number of reasons this happened, but we are finding out that with the higher co payments, the paperwork our patients were required to fill out and the nasty things they were doing to us, and to our patients and to the relationships we have with those patients, out of network was better for everyone. The benefits are as follows: The paperwork has gone away. That is correct, no precert forms anymore. With the loss of participation will be the loss of wondering if they misinformed us about precert, as they did last year and then withheld our reimbursements. Although we in good faith tried to straighten it out and get paid after providing proof, this was ignored and more United Healthcare excuses were given. It turns out many medical doctors felt the same way and more are opting out daily.
Many people have been brainwashed to believe that out of network is unaffordable. The reality is that although some doctors price themselves that way, most of us are priced reasonably and have ways for patients to comfortably afford care. Sure, you may not have the 40 dollar co pay which is becoming more common, but for $55, you can get the care you need, without the referral, the hassle, the angst and everyone is happier.
We have tried to stay in network with most plans, for the benefit of our patients. Most doctors would like to. Today, I met with a medical doctor I am friendly with who just terminated Horizon Blue Cross after many years because they continue to pay him less and less, while his overhead continues to escalate. He was quite upset by this especially when he contacted the representative to question her about their policy and the answer was simple, here is how you can resign from the plan. Here is a well respected physician who is caught between whether to do an appropriate EKG on a patient that he is not being paid for anymore. He told me the allergist friend of his has to fight with a clerk to give a non generic medication.
Out of network does not look so bad after his stories. As a doctor, I am torn between great care, a lousy health plan, can I afford to stay in network and trying to stay in network so more people can access us more easily.
What would you do if you were me? For those that know me, I always go the extra mile for my patients. I will do whatever it takes to help them resolve a problem. As a patient, you need to begin to demand your plan becomes accountable and your doctor needs to be treated with respect, and paid at a level that allows him to feed his family as well. Just my thoughts...
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