John Wiens DC

The Supreme Court’s health care decision: What it does—and does not—mean

By John Wiens DC|June 28, 2012|Health Care|

Anthony Komaroff, M.D., Editor in Chief, Harvard Health Publications

The passage of the Patient Protection and Affordable Care Act (which I’ll just call the Law) in 2010 was regarded as a landmark event in U.S. history. Today’s ruling by the Supreme Court, which largely upholds the Law, should also be viewed as a landmark event—whether one agrees with it or not.

Why? Three reasons: Everyone wants health care when they need it. Everyone wants to be spared financial devastation from the cost of that care. And health care accounts for 17% of the total U.S. economy, and is growing at a faster rate than the rest of the economy—putting the rest of the economy under enormous strain.

Before the Law was passed, I saw two huge challenges facing U.S. health care. The first was the fact that so many people did not have health insurance. The second was the high cost of health care.

For decades, the percentage of Americans with health insurance has been lower than in other developed nations. Passage of the Law did not immediately change things. At the time of a survey by the National Center for Health Statistics in 2011, 46 million Americans—15% of the population—had no health insurance. These people lived an automobile accident, a heart attack, or a stroke away from becoming destitute.

Who are they? Relatively few are unemployed adults. People who are chronically unemployed have often been able to get health insurance through Medicaid. In fact, most of the uninsured are working adults whose employers did not provide health insurance. Many are children—often, the children of employed but uninsured adults. A smaller fraction are adults under the age of 65 who are out of the labor force.

Another group of people without health insurance are healthy young adults who have simply decided not to pay for health insurance—and to take their chances. They know that if they become seriously injured or ill, they will receive health care somewhere—effectively paid for by the insurance payments that other people are making. They are “free riders.” In passing the Law, the President and Congress basically said to them, “That’s not fair.” (more…)

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Chiropractic Dominates The Spine Journal Downloads in 2011

By John Wiens DC|June 12, 2012|Research|

Source Dynamic Chiropractic

The Spine Journal recently announced its “Top 25 Hottest Articles” for 2011. These are the most downloaded articles for the year. The 2011 list is surprising in that 13 of the 25 articles have at least one author who is a doctor of chiropractic.

In addition, 10 of the 25 papers include content relating to spinal manipulation, cervical manipulation or chiropractic; six of those include the terms in their title. Papers that discussed these topics were found to be very popular, ranking first, third, fourth, sixth, 10^th, 14^th, 15^th, 17^th, 23^rd and 24^th.

The top-ranked paper for 2011 is “Efficacy of Spinal Manipulation and Mobilization for Low Back Pain and Neck Pain: A Systematic Review and Best Evidence Synthesis.” Authors include Gert Bronfort, PhD, DC, Mitchell Haas, DC, MA, and Roni L. Evans, DC, MS, representing Northwestern Health Sciences University and the University of Western States. (This was not their only paper in the top six.)

Simon Dagenais, DC, PhD, currently working with Palladian Health in West Seneca, N.Y., led a total of 17 doctors of chiropractic who authored most of the Top 25 Hottest Articles. Here is the list of the chiropractic authors, along with the number of papers they authored in The Spine Journal and where the papers placed on the Top 25 list:

Paul B. Bishop, DC, MD, PhD – one paper placing 15^th
Gert Bronfort, PhD, DC – three papers placing first, fourth and sixth, respectively
Simon Dagenais, DC, PhD – six papers placing third, sixth, eighth, 17^th, 21^st and 24^th, respectively
Roni L. Evans, DC, MS – three papers placing first, fourth and sixth, respectively
Michael D. Freeman, PhD, MPH, DC – one paper placing 24^th
Ralph E. Gay, DC, MD – one paper placing 24^th
Mitchell Haas, DC – three papers placing first, sixth and 14^th, respectively
Scott Haldeman, DC, MD, PhD – three papers placing third, eighth and 17^th , respectively
Eric L. Hurwitz, DC, PhD – two papers placing seventh and 20^th, respectively
Greg Kawchuk, DC, PhD – one paper placing sixth
Michele J. Maiers, DC, MPH – one paper placing fourth
John Mayer, DC, PhD – two papers placing 2^st & 24^th, respectively
Edward F. Owens Jr., MS, DC – one paper placing fourth
David Peterson, DC – one paper placing 14^th
Joel G Pickar, DC, PhD – one paper placing 10^th
Jeffrey A. Quon, DC, PhD, FCCSC – one paper placing 15^th
Craig A. Schulz, DC, MS – one paper placing fourth

The majority of papers investigate conservative care versus surgery. Two of the papers that examined “catastrophic complications” and “adverse reactions” in surgical procedures included Eric L. Hurwitz, DC, PhD, as one of the authors. If the Spine Journal‘s 2011 list of the most downloaded papers is any indication, the focus in spine care has clearly moved away from surgery toward more conservative care. This refocus is not only reflected in the research community, but also in the minds of the health care-consuming public and the business community paying the bills.

This trend toward conservative care is likely to continue for the foreseeable future. The cost of surgery, surgical failure rates and the subsequent additional costs continue at unacceptable levels. It has apparently taken an economic crisis to wake people up to the nightmare that is the surgical model.

This is an excellent opportunity to educate patients and their families, friends and co-workers about chiropractic. If nothing else, read the abstracts of The Spine Journal‘s 25 Hottest Articles and share the information with them. As we all know, an educated patient can be an effective source of referrals.

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VIDEO: Chiropractor, waterbeds make cows content

By John Wiens DC|June 1, 2012|Video|

Source Halifax ChronicleHerald

CHILTON, Wis. — Lucky, a 7-year-old dairy cow, had been walking with a limp for several weeks when veterinarian Sara Gilbertson was called. Instead of prescribing painkillers, Gilbertson tried an unusual new therapy — a chiropractic adjustment that included a full-length spinal massage.

Gilbertson rubbed the Holstein’s spine by gently squeezing it from neck to tail, pausing to apply firm pressure to one hip and readjust several vertebrae. The cow stood in calm silence, moving only enough to reach another mouthful of hay. Later, as Lucky reclined on a bed of sand, Gilbertson noted with satisfaction how relaxed and comfortable the animal seemed.

Link to Video

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The Difference Between Scientific Evidence And The Scientific Method

By John Wiens DC|April 23, 2012|Legal Issues|

Source Litigation and Trial

Scientists, even those in the “hard” sciences that are based primarily on empirical observations and mathematical analysis, have their own dogmas, prejudices, incentives, and conventions. That’s of course not to say that science is bad or wrong or useless — the only reason you can read this on your computers is because thousands of scientists over the years came to exactly the right conclusions about electricity, metallurgy, chemistry, mathematics, quantum theory, and information theory — but just to admit the obvious, which is that scientists are people and science happens under many of the same constraints as every other social endeavor. As much as we’d like to trust scientists as objective experts whose assertions should be accepted ipse dixit (a phrase that dates back to Pythagorus and is today routinely used by lawyers trying to discredit their opponent’s expert), the truth is that courts shouldn’t be afraid to look at scientists as people and evaluate them accordingly.

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Nature and Nurture: World‐first Discovery Sheds New Light On Congenital Birth Defects

By John Wiens DC|April 6, 2012|Research|

Hypoxia, or a period of low oxygen during pregnancy, combined with a genetic risk factor of having only one functioning copy of a gene, dramatically increases the chances of a baby being born with congenital scoliosis.

Source Science Daily

Scientists have made a landmark discovery that could help women minimize or even avoid the risk of having a baby born with congenital birth defects. The study is published April 5 in the international journal Cell.

The scientists, from universities in Australia, Japan, Canada and the United States, including Arizona State University, show for the first time how “nature” and “nurture” interact to increase the severity and likelihood of developing birth defects, including abnormalities in the heart, kidneys, brain, limbs and cranio‐facial regions (cleft palate).

They show how hypoxia, or a period of low oxygen during pregnancy, combined with a genetic risk factor of having only one functioning copy of a gene, dramatically increases the chances of a baby being born with congenital scoliosis, a malformation of the spine that affects around 1 in 1,000. (more…)

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Texas says chiropractors shouldn’t treat diabetes, other disorders

By John Wiens DC|April 3, 2012|News|

Source Salt Lake Tribune

Texas is on its way to expressly banning chiropractors from treating conditions such as thyroid disorders and diabetes.

Calling chiropractors who solicit diabetics with “secret” treatments “hucksterism,” the Texas Board of Chiropractic Examiners has been working on new rules since 2010. The questionable ads run by Texas chiropractors were similar to ones currently appearing in Utah, said Yvette Yarbrough, the board’s executive director.

Texas’ new rules may allow chiropractors to co-manage such diseases through nutrition and exercise. But she anticipates that the new rule will ban “outright treatment” of diabetes, thyroid disorders, Attention Deficit Hyperactivity Disorder, asthma and other conditions.

The proposed rule is part of an ongoing battle between the Texas Medical Association and chiropractors. Medical doctors say chiropractors are illegally treading on their turf.

“Everybody wants to practice medicine but nobody wants to go to medical school,” said David Bragg, the medical association’s attorney. “Chiropractors are excellent marketers. … They believe chiropractic is the answer. Texas law doesn’t agree with that.”

Tyce Hergert, public relations chairman for the Texas Chiropractic Association, said chiropractors should be able to help patients through nutrition and exercise.

“As far as sitting down with a patient that has diabetes, going over their diet, [offering] lifestyle coaching,” he said, “we have plenty of training in that.”

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About John Wiens DC

The Supreme Court’s health care decision: What it does—and does not—mean

Chiropractic Dominates The Spine Journal Downloads in 2011

VIDEO: Chiropractor, waterbeds make cows content

The Difference Between Scientific Evidence And The Scientific Method

Nature and Nurture: World‐first Discovery Sheds New Light On Congenital Birth Defects

Hypoxia, or a period of low oxygen during pregnancy, combined with a genetic risk factor of having only one functioning copy of a gene, dramatically increases the chances of a baby being born with congenital scoliosis.

Texas says chiropractors shouldn’t treat diabetes, other disorders