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HEALTHBEAT SHOW NOTES .... Episode #66 - Recorded October 13, 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 –  

• October is Breast Cancer Awareness Month

• ACA Blasts Medicare over Proposed Cuts

• New Chiropractic Diagnostic Imaging Guidelines

• Whiplash and Neck Muscle Contraction

• Is Pain Ever "Normal"?

• And finally, Michigan enacts new chiropractic rules

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #66, recorded October 13, 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 ….

October is Breast Cancer Awareness Month

October is Breast Cancer Awareness Month.  For more than 20 years, National Breast Cancer Awareness Month has educated women about early breast cancer detection, diagnosis and treatment.

This effort continues reaching out to women with several key messages, most notably, the importance of early detection through annual mammography screening for women over 40, or earlier for women at increased risk.

COT’s HealthBeat always recommends receiving regular checkups and to always conduct self-breast examinations.

For more information about this effort, surf to www.nbcam.com

You can also do a Google Search on Breast Cancer Awareness Month to see how you can participate in the many fund-raising and education efforts going on thru the month.  Following is an example of some of the news coverage of the courageous people fighting to regain their health.

ACA Blasts Medicare over Proposed Cuts

According to the American Chiropractic Association, Chiropractors could Face 13.1 Percent Reduction in Medicare Reimbursement Rates.

The American Chiropractic Association (ACA) is calling on Congress to halt proposed reductions in Medicare physician payments scheduled to take effect Jan. 1, 2007, that could seriously jeopardize access to care for millions of Medicare patients and would significantly reduce chiropractic reimbursement rates under Medicare.

ACA says that changes recently proposed by the Centers for Medicare and Medicaid Services (CMS) as part of a congressionally mandated five-year review undermine Congress’ goals of preserving patient access and achieving greater quality of care. The association is pressing for a one-year delay in implementation of the cuts to provide CMS more time to assess the negative impact of the changes.

The CMS has proposed to offset an increase in payments to physicians who use higher-level evaluation and management (E/M) services by applying a budget neutrality adjuster across work relative value units (RVUs) for all health care services by 10 percent. This adjuster results in significantly different outcomes depending on the codes a given provider community uses.

In addition to seeking immediate congressional action to delay the proposed rule, ACA is pressing for a fix to the Sustainable Growth Rate (SGR) formula. It is advocating not only for addressing next year’s 5.1 percent payment cut, but also to create a long-term policy solution that would lead to more accurate physician reimbursement.

The American Chiropractic Association is urging its members and chiropractic patients to lobby Congress on this issue before a final rule is unveiled by CMS later this year. Specifically, the ACA is asking doctors of chiropractic to contact their U.S. Representatives and Senators and ask them:

To delay for at least one year implementation of the proposed rule as published in the June 29, 2006, Federal Register.

For more information, surf to the ACA at www.acatoday.org and also to our Show Notes for the full article - http://nysca.com/?id=403

To sign on to the Cardin-Johnson Letter. A letter is being circulated around the U.S. House of Representatives that asks for Congress to take action and prevent the 5.1 percent decrease to the SGR from taking effect. Available on ACA’s Web site is a list of members of Congress who have NOT signed onto this letter as of Sept. 7. If your member of Congress is on this list, please contact him/her and ask them to sign onto
this important bi-partisan letter. If your member is not on the list, please contact them and thank them for their support.

Representatives and Senators can be reached via the Capitol switchboard at (202) 224-3121 or via the ACA Legislative Action Center.

New Chiropractic Diagnostic Imaging Guidelines

A website will be made available for chiropractors to evaluate new imaging guidelines on neuromusculoskeletal disorders in adults. Participants will be asked to provide comments and suggestions regarding various characteristics of the proposed imaging guidelines. Specific characteristics include ease of use; feasibility and desire of implementing these guidelines in practice; and how comprehensive are each of the recommendations, to name a few.

There is an urgent need throughout the health care professions to develop practice guidelines. The purpose of this project is to develop evidence-based diagnostic imaging practice guidelines for neuromusculoskeletal disorders for use by chiropractors.

The expert consensus guidelines will then be forwarded to various chiropractic specialties for further external review and consideration (phase 5). Simultaneously, a ‘’public’’ website will be made available for worldwide chiropractors to consider what is referred to as the Delphi expert consensus guidelines (phase 6).

Upon completion of the second external review and after receiving comments by field practitioners about the ‘’public’’ website, the suggestions and comments will be considered by the executive committee and incorporated into the document for the Delphi expert panel to review (phase 7).

The executive committee will then draft the final version of the guidelines based on consensus opinion. Phase 8 of this project will involve the dissemination and implementation of the international consensus opinion guidelines.

Diagnostic imaging practice guidelines are intended to reduce unnecessary radiation exposure, increase examination precision and decrease health care costs--all without compromising the quality of care.

You may access the guidelines online version at http://www.uqtr.ca/imagingchiroguidelines

…. to start evaluating the proposed imaging guideline between August 1st and October 31st, 2006

Whiplash and Neck Muscle Contraction

A study in the September 15, 2006 issue of the Journal SPINE investigated the effect of neck muscle precontraction in aware occupants in whiplash. Head angulation relative to the 1st Thoracic and facet joint capsular ligament distractions were compared between aware and unaware occupants.

The study concluded that occupants aware of an impending whiplash impact with precontracted neck muscles can markedly reduce overall head-neck and spinal motions. It is our theory that this would reduce whiplash injury likelihood.

For more information, surf to the journal SPINE.

Is Pain Ever "Normal"?

This article analyzes the Pain Terminology adopted by the International Association for the Study of Pain (IASP), noting that most of their pain categories are defined in terms of a reference standard of "normal" pain.

Given the lack of any officially adopted operational definition of the word "normal," the authors argue that the use of this word expresses and maintains a paradigm that drives many clinicians' reasoning about their patients' pain. The authors further offer evidence that this uninterrogated paradigm is being tacitly used to differentiate legitimate pain reports from malingering and drug seeking.

The authors consider this unsubstantiated "folk" sense of "normal" in light of evidence-based, rationalized prototypes based on statistical analysis of empirical evidence. The authors conclude that evidence for consistency in the experience and expression of pain and for clinician accuracy in evaluating the veracity of that pain is lacking; therefore, the logical preconditions needed for a rationalized, evidence-based prototype of "normal" pain have yet to be met.

Further, the authors also conclude that the use of "normal" as a reference standard leads to ineffective and inhumane management of patient pain and to the danger that third parties, such as insurance companies and drug enforcement agencies, will use this unsubstantiated reference standard to arbitrarily limit pain therapy options. The authors recommend that the word "normal" be expunged from the International Association for the Study of Pain, Pain Terminology.

For more information, surf to the October 2006 issue of the Clinical Journal of Pain.

Michigan enacts new chiropractic rules

The state of Michigan has voted to require the NBCE Part IV Exam in 2007, bringing the number of states now accepting or requiring the Part IV to 48. The Part IV requirement is a result of administrative rule changes passed by the Michigan Board of Chiropractic. Michigan's rule for licensure now states that for applications filed on or after January 1, 2007, an applicant shall have Parts I, II, III, and IV of examinations conducted and scored by the NBCE.

If you have any questions regarding these rules, call 517-335-0918.  For more information visit - www.michigan.gov/healthlicense

http://www.chiroeco.com/news/2006/September/NBCE.php

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Finally, I leave you with the following quote:

"Do you want to know who you are? Don't ask. Act! Action will delineate and define you."
– Thomas Jefferson

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

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