Frank M. Painter

Acupuncture and Chiropractic Care Utilization

By Frank M. Painter|November 9, 2015|Acupuncture, Chiropractic Care|

Acupuncture and Chiropractic Care: Utilization and Electronic Medical Record Capture

SOURCE: Am J Manag Care. 2015 (Jul 1); 21 (7): e414-21 ~ FULL TEXT

Charles Elder, MD, MPH; Lynn DeBar, PhD, MPH;
Cheryl Ritenbaugh, PhD, MPH; et. al

Kaiser Permanente Northwest,
Center for Health Research,
3800 N Interstate Ave,
Portland, OR 97227
Charles.Elder@kpchr.org

This recent study, published in the American Journal of Managed Care, underscores why so many chiropractic patients have to go “out of network” in order to get the care they need: Managed care appears to be be effectively locking them out. This study reviews chiropractic and acupuncture utilization by adults with chronic musculoskeletal pain at Kaiser Permanente Northwest, an HMO.

Evidently, physician referral for acupuncture is strictly limited to chronic pain complaints, while referral for chiropractic benefits is limited to acute pain. This is why 43-54% of those individuals who sought chiropractic care had to seek “out-of-plan” (aka out-of-pocket) care.

Physician referrals within this Kaiser program was tipped in favor of acupuncture, with 55% of them being referred for care, versus only 9% of the chiropractic patients.

Thanks to Dynamic Chiropractic for their brief review of this study!

OBJECTIVES: To describe acupuncture and chiropractic use among patients with chronic musculoskeletal pain (CMP) at a health maintenance organization, and explore issues of benefit design and electronic medical record (EMR) capture.

STUDY DESIGN: Cross-sectional survey.

METHODS: Kaiser Permanente members meeting EMR diagnostic criteria for CMP were invited to participate. The survey included questions about self-identified presence of chronic musculoskeletal pain, use of acupuncture and chiropractic care, use of ancillary self-care modalities, and communication with conventional medicine practitioners. Analysis of survey data was supplemented with a retrospective review of EMR utilization data.

RESULTS: Of 6068 survey respondents, 32% reported acupuncture use, 47% reported chiropractic use, 21% used both, and 42% used neither. For 25% of patients using acupuncture and 43% of those using chiropractic care, utilization was undetected by the EMR. Thirty-five percent of acupuncture users and 42% of chiropractic users did not discuss this care with their health maintenance organization (HMO) clinicians. Among chiropractic users, those accessing care out of plan were older (P < .01), were more likely to use long-term opioids (P = .03), and had more pain diagnoses (P = .01) than those accessing care via clinician referral or self-referral. For acupuncture, those using the clinician referral mechanism exhibited these same characteristics.

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Chiropractors Included in New Danish Muscle and Joint Health Research Team

By Frank M. Painter|November 6, 2015|Chiropractic Research|

Chiropractors Included in New Danish Muscle and Joint Health Research Team

The Chiro.Org Blog

SOURCE: WFC Quarterly World Report 2015 (Sep) (see page 5) ~ FULL TEXT

A team of leading researchers, including chiropractors, have founded a new research institute that aims to become a top centre for musculoskeletal health.

The researchers, from the University of Southern Denmark, have founded the
Center for Muscle and Joint Health.

With a stated aim of reducing the burden of musculoskeletal health, investigators will look at pain and functional loss in joints.

Research has previously shown that a Dane loses an average of seven years of good quality of life due to pain and functional problems related to the musculoskeletal system. Muscle and joint disorders now constitute the major cause of functional impairment of populations in Europe – larger than other common disorders like depression, dementia and heart disease.

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Where the United States Spends its Spine Dollars

By Frank M. Painter|November 5, 2015|Low Back Pain, Neck Pain|

Where the United States Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

The Chiro.Org Blog

SOURCE: Spine 2012 (Sep 1); 37 (19): 1693–1701 ~ FULL TEXT

Matthew A. Davis, DC, MPH

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA.
matthew.a.davis@dartmouth.edu

STUDY DESIGN: Serial, cross-sectional, nationally representative surveys of noninstitutionalized US adults.

OBJECTIVE: To examine expenditures on common ambulatory health services for the management of back and neck conditions.

SUMMARY OF BACKGROUND DATA: Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

METHODS: We used the Medical Expenditure Panel Survey to examine adult (aged 18 yr or older) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

RESULTS: Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008). Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. During the study period, the mean inflation-adjusted annual expenditures on chiropractic care were relatively stable; although physical therapy was the most costly service overall, in recent years those costs have contracted.

There are more articles like this @ our:

The Low Back Pain Page and the:

Chronic Neck Pain and Chiropractic Page

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Chiropractic Management of a Patient With Breast Cancer Metastases to the Brain and Spine

By Frank M. Painter|November 3, 2015|Cancer, Chiropractic Management|

Chiropractic Management of a Patient With Breast Cancer Metastases to the Brain and Spine: A Case Report

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc 2015 (Sep); 59 (3): 269–278 ~ FULL TEXT

Ismat Kanga, BSc, DC, FCCS(C) 1 and Igor Steiman, MSc, DC, FCCS(C) 2

1 Private Practice,
Mumbai, India.

2 Professor, Division of Undergraduate Studies,
Canadian Memorial Chiropractic College,
Toronto, Ontario

Cancers of the breast, kidney, lungs, prostate and thyroid metastasize to the musculoskeletal system in the majority of patients with malignancy. This report chronicles the case of a 65-year-old female with a known history of breast cancer who presented to a chiropractic clinic. Once metastasis was ruled out as the cause of her complaint, the patient was treated with manual therapies and exercises. As the patient’s treatments progressed and her pain improved, she presented with a new complaint of ‘pressure’ in her head. Advanced imaging revealed metastasis to the brain and subsequently to the spine. The aim of this case is to heighten awareness of the presentation of metastasis to the brain and the spine in a chiropractic patient, and to demonstrate the benefit of chiropractic care in the management of such patients.

KEYWORDS: brain metastases; breast cancer; chiropractic; chiropractic care; spinal metastases

From the FULL TEXT Article:

Introduction

There are more articles like this @ our:

Cancer and Chiropractic Page

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We Moved!

By Frank M. Painter|November 2, 2015|Announcement|

Moving Day Has Come and Gone

The Chiro.Org Blog

SOURCE: The Chiro.Org Oracle

Greetings from the Chiro.Org Staff

Dear Chiro.Org Friends and Readers

We moved during last weekend to a new, more secure and much faster server. YIPEE!

Now is a good time to remind you that ALL our various sections of the website are constantly updated with new information.

All those sections of our website remain easily available to you from the left-hand toolbar, under Resources.

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Chiropractic As Spine Care: A Model For The Profession

By Frank M. Painter|October 26, 2015|Chiropractic Care|

Chiropractic As Spine Care: A Model For The Profession

The Chiro.Org Blog

SOURCE: Chiropractic & Osteopathy 2005 (Jul 6); 13: 9 ~ FULL TEXT

Craig F Nelson, Dana J Lawrence, John J Triano,
Gert Bronfort, Stephen M Perle, R Douglas Metz,
Kurt Hegetschweiler, and Thomas LaBrot

American Specialty Health, and
Palmer Centre for Chiropractic Research,
Palmer College of Chisopractic,
1000 Brady Street
Davenport, IA 52803, USA

BACKGROUND: More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care.

OBJECTIVE: To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care.

DISCUSSION: The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach.

CONCLUSION: This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.

From the FULL TEXT Article:

Background

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About Frank M. Painter

Acupuncture and Chiropractic Care Utilization

Acupuncture and Chiropractic Care: Utilization and Electronic Medical Record Capture

Chiropractors Included in New Danish Muscle and Joint Health Research Team

Chiropractors Included in New Danish Muscle and Joint Health Research Team

Where the United States Spends its Spine Dollars

Where the United States Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

Chiropractic Management of a Patient With Breast Cancer Metastases to the Brain and Spine

Chiropractic Management of a Patient With Breast Cancer Metastases to the Brain and Spine: A Case Report

We Moved!

Moving Day Has Come and Gone

Chiropractic As Spine Care: A Model For The Profession

Chiropractic As Spine Care: A Model For The Profession