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HEALTHBEAT SHOW NOTES .... Episode #35 - Recorded March 10, 2006

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and informational Podcast.

In this week’s news:  We’ll Look At –

• Warning About Offering Free Chiropractic Services

• Updated optional cholesterol goals hard to reach

• Pregnancy and Anti-Depressant Medication

• Chronic Pain and Coping Strategies

• CCGPP Low Back Document Under Construction

• Chiropractic Treatments Improve Kinesthetic Sensibility

• And Finally, Health Corner looks at Hospital Over Charges

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #35, recorded March 10, 2006.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

This week’s Episode is sponsored by DaVinci Laboratories.  Please surf to our web site at ChiropracticRadio.com and click on the DaVinci link for your Health and Nutritional needs.

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And Now for some news ….

Warning About Offering Free Chiropractic Services

A number of chiropractors offer free exams or other services to new patients.  With the new HIPAA legislation, it would behoove everyone to be careful about extending these offers to Medicare patients.

In 2002, the US Department of Health and Human Services issued a Special Advisory Bulletin ruling that providers who offer remuneration—including free or discounted services, with a retail value of more than $10, in order to influence an individual’s selection of a Medicare or Medicaid provider—may be liable for civil penalties of up to $10,000. Specifically included in this bulletin were discounted medical services, which would include exams, adjustments or massage services, among other items.

The full text of this Office of the Inspector General’s Special Advisory Bulletin can be download in our Show Notes - http://oig.hhs.gov/fraud/docs/alertsandbulletins/SABGiftsandInducements.pdf

Updated optional cholesterol goals hard to reach

According to a new study in the February 2006 issue of the Journal of General Internal Medicine, Recently updated ''optional'' goals set by the National Cholesterol Educational Program (NCEP) for ''bad'' low-density lipoprotein cholesterol (LDL-C) are not being met by many millions of Americans.

In all, 30 percent had LDL-C levels beyond those recommended by the NCEP in 2001. For the revised optional 2004 goals, the corresponding proportion was roughly 36 percent.

The researchers estimated that about 25 million people exceeded 2001 thresholds for drug therapy and 46 million exceeded optional 2001 thresholds for drug therapy. For 2004 optional thresholds, the corresponding figure was more than 56 million.

For more information, surf to our Show Notes, and always remember to contact a Qualified Healthcare Professional to discuss all Dietary and Nutritional recommendations - http://heart.healthcentersonline.com/newsstories/updatedoptionalcholesterolgoalshardreach.cfm

Pregnancy and Anti-Depressant Medication

According to the DrKoop.com news site, women who use commonly prescribed antidepressants late in their pregnancies run a higher risk of delivering infants with a serious breathing problem.

A study in the February 9, 2006 issue of the New England Journal of Medicine found that the condition, called persistent pulmonary hypertension of the newborn (PPHN), occurs when a newborn's circulation system does not adapt to breathing outside the womb. This condition has been found to be fatal.

As always, COT’s HealthBeat recommends discussing any change in therapy modifications with a qualified healthcare professional.  No changes to medications should be made without discussing benefits and risks.

For more information, surf to our Show Notes for a link to this study - http://www.drkoop.com/PrinterFriendly/93/530918.html

http://content.nejm.org/cgi/content/extract/354/6/636

Chronic Pain and Coping Strategies

A study in the January 2006 issue of the Clinical Journal of Pain looked at the ways in which people adjust to chronic pain.  The study has been partly attributed to pre-existing personality traits, but most evidence to date is from cross-sectional studies and mainly with arthritis groups.

The results of the study stated that the findings provide partial support for the hypothesis that pre-existing personality traits place some patients at risk for poor adjustment to chronic pain.

An analysis by FCER Vice President George B. McClelland, D.C. stated the following - The closing sentence in the abstract of this article states, "the findings provide partial support for the hypothesis that pre-existing personality traits place some patients at risk for poor adjustment to chronic pain."

While this statement represents the crux of the study the take-home message for the practicing doctor of chiropractic (DC), should be an alert to more carefully evaluate those patients, with chronic pain, that we see in our offices on a daily basis. We need to be keenly aware that some of the patients that come to our offices seeking relief for their chronic pain complaints may have personality traits, such as neuroticism and extroversion, as noted in this study, as well as abnormal pain behaviors such as pain magnification, somatization and chronic pain syndromes.

These comorbidities, which can significantly affect how our patients respond to the management procedures we may provide, also need to be assessed. It is most important that if we place a patient on a long-term program of supportive care for their chronic complaints that we are reasonably assured that our treatments are going to help this patient and not create a dependency that may further complicate their lives and delay their ultimate recovery.

Accordingly, it is important that doctors of chiropractic be familiar with the screening and outcomes assessments instruments or tools (0AT) that will assist the DC in the selection of the more appropriate patients that have a higher probability of responding to their management. There are multiple authors, associated with the chiropractic profession, including Steven Yeomans, Craig Liebenson, Kim Christiansen, etc., that have provided excellent texts and resources that can assist the treating doctor of chiropractic, to better assess and manage their patients with chronic pain.

For more information, surf to the Clinical Journal of Pain and also the FCER’s weekly eNewsletter.

CCGPP Low Back Document Under Construction

As reported in an earlier HealthBeat, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is releasing the draft copy of its first chapter on best practices.

This draft focuses on the lower back.  As part of the ongoing process, the CCGPP is asking stakeholders, including patients, insurers, and in particular, doctors of chiropractic, to review the chapter and take a short survey to provide opinions and feedback.

The draft and survey are not yet available.  For more information, please check the CCGPP web site periodically at www.ccgpp.org

Chiropractic Treatments Improve Kinesthetic Sensibility

A study released in the February 2006 issue of the Journal of Manipulative and Physiological Therapeutics investigated alteration in head repositioning accuracy (HRA), range of motion, and pain intensity in patients with chronic cervical pain syndrome without a history of cervical trauma.

The results suggest that chiropractic care can be effective in influencing the complex process of proprioceptive sensibility and pain of cervical origin. Short, specific chiropractic treatment programs with proper patient information may alter the course of chronic cervical pain.

For more information, surf to the JMPT web site.

Health Corner

A recent episode of the CBS News show 60 minutes, ran a piece concerning the over gauging of uninsured consumers who are in need of hospital care and services.

According to the piece, over 46 million Americans are presently without health insurance coverage.  Most Americans know that if you get sick enough to go to a hospital, it's going to be expensive. But you may be surprised to learn that hospitals all over the country charge their highest prices, by far, to those who can afford it least.

Hospitals charge uninsured patients two, three, four or more times what an insurance company would pay for the same treatment. And, when the uninsured can’t pay, they often find themselves the target of collection agencies or in bankruptcy court.

What follows is a portion of the 60 Minutes piece on Hospital charges followed by an Interview with Dan Rather, the author of the piece.

For more information, surf to our Show Notes for a link to this 60 Minutes episode.

http://www.cbsnews.com/stories/2006/03/02/60minutes/main1362808.shtml

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show. And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

Thank you for listening…. As always, We Want to hear from you.  Please send us emails…. Simply surf to our Web Site at ChiropracticRadio.com and click on the Email link.

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Finally, I leave you with the following quote:

"Reality is that which, when you stop believing in it, doesn't go away." 
- Philip K. Dick  

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

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