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General Health, Wellness, and Chiropractic Care

By Frank M. Painter|September 18, 2011|Maintenance Care, Wellness Care|

General Health, Wellness, and Chiropractic Care

The World Health Organization defines health as being “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”.

Given this broad definition of health, epistemological constructs borrowed from the social sciences may demonstrate health benefits not disclosed by randomized controlled trials.

Health benefits, such as improvement in self-reported quality-of-life (QOL), behaviors associated with decreased morbidity, patient satisfaction, and decreased health care costs, are reported in the following articles, and they make a compelling statement about the effects of chiropractic on general health.

Despite the historic emphasis on treatment, prevention and health promotion are receiving increased attention within the US health care system. These same health promotion tasks are considered by the National Academy of Science and others as essential components of health services delivered by primary care providers. Chiropractors are viewed by many as capable of and actively delivering prevention and health promotion in addition to providing other primary care services. (more…)

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Redefining the Rules: The CCE Changes Its Standards From Quantitative to Qualitative

By Frank M. Painter|September 14, 2011|Education|

Redefining the Rules: The CCE Changes Its Standards From Quantitative to Qualitative

The Chiro.Org Blog

SOURCE: Todays Chiropractic

By Randy Southerland

Early next year, chiropractic colleges across the nation will adopt a new set of accreditation standards. Significantly, this will be the first wholesale rewriting of the standards in more than three decades.

Set by the Council on Chiropractic Education (CCE), these rules define what programs must do to gain or maintain CCE accreditation. In a marked departure from past years, the standards will now allow greater freedom in how D.C. programs admit and educate students, while requiring more accountability for producing competent professionals. “It’s a change in the way institutions go about delivering education,” says Dr. Brian McAulay, executive vice president and provost at Life University.

The new standards, which take effect in January 2012, are less prescriptive, with fewer demands that programs offer specific courses or use particular teaching methods such as requiring D.C. students to deliver 250 adjustments. Rather, the standards reflect an emerging focus on setting and measuring learning outcomes for students. It’s a trend that has become commonplace in higher education nationally, but is only now being adopted by the chiropractic profession, according to McAulay.

“Rather than focusing on credit hours and the amount of time a student spends in a seat, an outcomes approach asks ‘What has a student actually learned?’” he explains. “This approach is about holding institutions accountable for being very clear on what the student is expected to learn, and then being very good at measuring and assessing whether that learning has taken place.”

The U.S. Department of Education charges accrediting agencies such as the CCE with periodically reviewing standards to ensure they reflect best practices in the profession and in the broader field of education. A team comprising personnel from CCE-accredited programs began this process in the summer of 2006. Its mission was to look at every aspect of the agency’s accrediting standards, and then bring them more in line with current thinking and practices in higher education. (more…)

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Is “Expanded Practice” our Pandora’s Box?

By Frank M. Painter|September 13, 2011|Editorial, Expanded Practice|

Is “Expanded Practice” our Pandora’s Box?

The Chiro.Org Blog

SOURCE: A Chiro.Org Editorial

I just read a Press Release from the Foundation for Vertebral Subluxation (FVS) this morning, titled “Chiropractors Lash Out in Massive Campaign Against Accrediting Agency“.

Previous press releases from this group have denounced (perhaps rightly) any movement to include prescribing rights for DCs, and this Blog has published extensively about both sides of that debate in the past. [1–15]

Personally, I think that seeking prescription rights is a bad idea because of the political and legal turmoil it will invite from Organized Medicine. The authors of the Foundation typically paint the “Pro Drug” movement as an attack against the idea of the Vertebral Subluxation and of the profession’s historical foundation, as one that does not use drugs and surgery to accomplish our goals.

It’s now time for the Profession to determine if this is “Chicken Little” paranoia,
or if the FVS has a valid concern that MUST be addressed.

According to their Press release, there is a “massive and historic outpouring” of dissatisfaction by “at least 6000 chiropractors” via “Facebook, Twitter and e-mail“. The author goes on to state that “At issue is the systematic remaking of the profession by these groups into a branch of medicine.” OK, that got my attention.

NOTE: It may be true that this page has 6000 “members”, but MANY of them (like myself) were added to that list without our knowledge or permission. So their claim of 6000 “members” is spurious. Further, even if it WAS true, 6,000 DCs represents less than 10% of our Profession. Hardly a ground swell movement. (more…)

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A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

By Frank M. Painter|September 12, 2011|Guidelines, Whiplash|

A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

The Chiro.Org Blog

SOURCE: Journal of the Academy of Chiropractic Orthopedists 2011 (Mar); 8 (1)

By: Lynn Shaw, Martin Descarreaux, Roland Bryans, Mireille Duranleau, Henri Marcoux, Brock Potter, Rick Ruegg, Robert Watkin, Eleanor White

The literature relevant to the treatment of Whiplash Associated Disorders (WAD) is extensive and heterogeneous.

Methods: A Participatory Action Research (PAR) approach was used to engage a chiropractic community of practice and stakeholders in a systematic Review to address a general question: ‘Does chiropractic management of WAD clients have an effect on improving health status?’ A systematic review of the empirical studies relevant to WAD interventions was conducted followed by a review of the evidence.

Results: The initial search identified 1155 articles. Ninety-two of the articles were retrieved, and 27 articles consistent with specific criteria of WAD intervention were analyzed in-depth. The best evidence supporting the chiropractic management of clients with WAD is reported. For the review identified ways to overcome gaps needed to inform clinical practice and culminated in the development of a proposed care model: The WAD-Plus Model.

Conclusions: There is a baseline of evidence that suggests chiropractic care improves the cervical range of motion (cROM) and pain in the management of WAD. However, the level of this evidence relevant to clinical practice remains low or draws on clinical consensus at this time. The WAD-Plus Model has implications for use by chiropractors and interdisciplinary professionals in the assessment and management of acute, sub-acute and chronic pain due to WAD. Furthermore, the WAD-Plus Model can be used in the future study of interventions and outcomes to advanced evidenced-based care in the management of WAD.

There are more articles like this @ our:

Whiplash Page

The FULL TEXT Article:

Background

(more…)

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How To Use the Evaluation & Management (E&M) Codes Properly: Part III

By Frank M. Painter|September 11, 2011|Evaluation & Management, Guidelines|

How To Use the Evaluation & Management (E&M) Codes Properly:

Part III: Mastering the E/M Guidelines

The Chiro.Org Blog

SOURCE: Chiropractic Economics

By Kathy Mills Chang, MCS-P

Part III: Mastering
the Evaluation & Management
(E&M) Guidelines

Jump to: Part 1 or Part 2

The medical decision making component ties it all together.

Welcome to part three this focus series on the evaluation and management (E/M) guidelines. This will wrap up what you need to know to stay compliant with E/M coding for the Centers for Medicare and Medicaid Services (CMS).

In the last installment, the elements of your patient’s examination were reviewed and you learned how it is the second of the three key elements of the patient’s E/M service. Now, the third part of this E/M documentation series will unravel the final component of the E/M code: medical decision making (MDM). For chiropractors, this is usually the diagnosis and treatment plan.

Three key components of the E/M guidelines:

Patient history
Examination
Medical Decision Making (MDM)

Remember that your patient’s medical record should establish a chronological record of exams, tests and results, and treatments and treatment plans (including the diagnosis and prognosis of the illness or disease). The medical record should corroborate the reimbursement request and is requisitioned by most payers for adjudication of claims when reimbursement is in question. (more…)

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How To Use the Evaluation & Management (E&M) Codes Properly: Part II

By Frank M. Painter|September 10, 2011|Evaluation & Management, Guidelines|

How To Use the Evaluation & Management (E&M) Codes Properly:

Part II: A Closer Look at E/M Guidelines

The Chiro.Org Blog

SOURCE: Chiropractic Economics

By Kathy Mills Chang, MCS-P

Part II: A Closer Look at
Evaluation & Management
(E&M) Guidelines

Jump to: Part 1 or Part 3

Make sure you know how to fulfill the “examination” component. In part one of this series, the components of a patient’s history were reviewed, and you learned how it is the first of three elements that help you justify and document your evaluation and management (E/M) service. In the second part of this series, you’ll learn about the objective information required to properly document the examination.

Remember, the medical record establishes a chronological record of exams; tests and results; treatments; and treatment plans, including the diagnosis and prognosis of the illness or disease. Its job is to corroborate the reimbursement request and is requisitioned by most payers for adjudication of claims when reimbursement is in question.

For this reason, your medical record is a vital piece of the reimbursement puzzle, too. Understanding all the requirements, including those of the examination, is critical.

There are four levels of E/M services that are based on four types of examinations: (more…)

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