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Growing medical costs seen as No. 1 workers comp trend

BOSTON (Nov. 10, 2003)-The most important nationwide trend affecting workers compensation this year has been increases in medical costs, according to panelists speaking during the recent Business Insurance's Workers Compensation and Disability Management Conference. This "most critical" trend means that the cost of caring for injured workers' medical needs is now a larger part of each workers compensation claim dollar, said Nancy Schroeder, assistant vp-workers compensation for the National Assn. of Independent Insurers in Des Plaines, Ill., who addressed the conference late last month in Boston. According to data from the National Council on Compensation Insurance, "medical claim costs are alarming, with double-digit increases the last two years. In 2002, medical severity increased by 12%, even greater than the 2001 increase of 10.7%." Yet it is important to remember that comp care "represents only 3% to 4% of total health care expenditures," said Keith Bateman, vp and director of the Alliance of American Insurers in Downers Grove, Ill. Several factors contribute to the increasing health care costs of workers comp claims, Mr. Bateman said. While costs are up for inpatient hospital stays and specialists' fees, the increased cost and utilization of prescription drugs makes that the key contributor, he said. What's particularly troublesome for workers comp insurers is that many of the tools available to control drug spending in group health plans, such as worker co-payments and the ability to direct an employee to a particular pharmacy, are not available to them (BI, Oct. 20). In addition, employers and insurers are grappling to cope with the growing use of the painkiller OxyContin. The drug, which was originally intended for people suffering from severe long-term pain, has become one of the most popular drugs prescribed for workers comp claimants. The concern with the drug stems from its addictive nature and how some users are abusing it. Some claimants who use it become addicted while recovering from their injuries and then must go through a detoxification program before they can return to work, Ms. Schroeder said. In addition, the slow-release medication can produce a heroin-like high when consumed after being ground up. It has a street value of 10 times its cost, which may entice some workers to make money by selling it, Ms. Schroeder said. But rising medical costs are not the only national trends that have emerged this year, Ms. Schroeder said. Another trend concerns federal impingement on state workers comp programs, she said. That "is an increasing and disturbing trend," said Bruce C. Wood, assistant general counsel with the Washington-based American Insurance Assn. One of the most serious examples of that is the federal Medicare program's "far more aggressive stance" in protecting its status as "the secondary payer" of benefits to previously injured workers, he said. Consequently, Medicare is requiring employers to establish trust funds to pay the medical costs of older injured workers to help ensure that employers and their workers comp insurers primarily pay such costs, so that they are not left to Medicare, he said. The Medicare secondary-payer issue "has been increasingly disruptive" and is expected to continue because Medicare is going broke at the same time Congress is expanding the drug benefit Medicare offers under its program, Mr. Wood said. Lobbying efforts heretofore have not resolved the problem, so the next step is to get Congress to step in and define Medicare's appropriate interest in a state-based workers comp system, he said. Another example of federal impingement is a bill (H.R. 1562) approved by the House Veterans' Affairs Committee that could allow veterans to receive medical care for workers compensation claims through the U.S. Veterans' Administration. It also would permit that entity to recover full charges for any such medical care, which could increase workers comp costs, Mr. Wood said. Despite those infringement issues, some progress has been reported in resolving workers comp payers' concerns about their continued access to claimants' medical data, following enactment of the Health Insurance Portability and Accountability Act earlier this year. Payers need access to such data to resolve claims and had been concerned that physicians might respond to the privacy requirements by denying information to them, although the law's preamble expressly excludes applying those provisions in the case of workers compensation claims, Mr. Wood said. While there have been pockets of problems, the education effort appears to be succeeding, Mr. Wood said. Another national trend concerns various types of activity involving state-specific funds, which generally exist at least to provide a source of workers comp coverage, if none is available elsewhere. Developments this year include concerns about the solvency of the competitive California state fund, which, if declared insolvent, could "take down" private insurers linked to it by guaranty funds, Mr. Bateman said. Meanwhile, the Arizona state fund is suing legislators who sought to use its accumulated assets for general expenses, he said. In several states, though, there have been proposals to allow a fund to write others lines of insurance, such as medical malpractice insurance in Oregon, he said. Finally, workers comp insurers continue to be concerned about state funds that seek to write workers comp insurance outside their borders while still maintaining their federal tax exemption, he said. That exemption reduces their cost of operation relative to their private insurers, who have complained that their entry into the marketplace constitutes unfair competition. This information is reprinted with permission of the Business Insurance. Copyright 2004. To learn more visit Business Insurance website:


Palmer alumni cast vote of no confidence in board

Eighty-five percent of the Palmer College of Chiropractic alumni who responded to a Web-based poll supported a vote of no confidence in the institution’s board of trustees. This information is reprinted with permission of the Quad-City Times. Copyright 2004. Of the 665 alumni who filled out a questionnaire at, 569 cast their ballot in favor of the vote. Twenty-three voted to support the board of trustees. Non-alumni and chiropractic students also responded the poll, which was prompted by the resignation of Palmer president and chancellor Guy Riekeman on Feb. 5. A total of 1,257 people responded. The response shows there is concern beyond Riekeman’s resignation, said Mary Flannery, the alumnus who organized the effort. Specifically, several of those who responded cited problems with the structure of the board. “A lot of the alums are saddened and unhappy about Riekeman leaving,” she said. “But the loss of Riekeman is a symptom of a much larger problem.” Palmer officials asked that alumni continue to support the school in order to maintain the school’s “107-year tradition of excellence.” “We recognize that alumni and students still have questions about Dr. Riekeman’s resignation,” a statement from the school said, noting that Palmer is conducting an audit which “may provide additional information relevant to this matter. We would again ask that all alumni continue to support Palmer both financially and by referring students.” Riekeman resigned his position as president of Palmer College and as chancellor of the Palmer University System about three weeks ago. He had been president for five years, chancellor for eight months. The board and Riekeman acknowledged that he resigned because of resolutions passed by the board, namely the requirement for board approval of hiring and salary increases and the employment of Larry Patten as a consultant to gather information for the board. Patten resigned after the 1997 vote of no confidence. The number who cast their vote of no confidence is about the same as those who cast ballots of no confidence in the school’s administration during 1997, Flannery said she was told. The 1997 vote was organized by Palmer’s alumni association. Palmer officials said the 665 who responded “represent a small percentage of Palmer’s more than 20,000 alumni worldwide.” The board and Riekeman also say he supported an audit requested by the board. They agree there was a communication problem between them. Almost 700 people said they would stop referring students to Palmer, while 45 said they would continue to do so. More than 350 said they were donors to the college and would discontinue their support, while 32 said they would continue their financial investment. Todd Spieles, a 1970 graduate who attended Palmer with Riekeman, said Palmer is the epicenter of chiropractic and “we just had a big earthquake.” “There is a firestorm brewing amongst the alumni,” he said. Two hundred of the students who responded called for a restructuring of the board to include a student representative. Seventy-seven students said they are considering transfer to another school, and five said they would transfer. Thirteen students voted in support of the board, with 16 saying there was no negative impact on their education. All of the respondents who supported the board “reviled the negative press surrounding this crisis and felt it was better to either trust the board or wait for more information to become public before judging,” the poll summary says. It continues: “Many expressed a personal distaste for Dr. Riekeman and his vision. The other comments in support of the board applaud the perceived return of less philosophy and more musculoskeletal science to the curriculum.” Those who supported the vote of no confidence, the summary says, “expressed extreme anger and incomprehension toward the board and toward (Palmer board chairman) Vickie Palmer. “A frequent comment lamented the financial damage and loss of Palmer pride likely to remain if no satisfactory statement or rectification of the situation is evident,” it continues. “Finally, many comments praised Dr. Riekeman and what was characterized as the unique leadership qualities he brought to the school.” Flannery hopes that, in the end, the vote will open communication between all parties interested in the future of the college. “One of my primary goals is to have the board, the alumni association and some people who are not in the alumni association sit down and have an open dialogue,” she said. This information is reprinted with permission of the Quad-City Times. Copyright 2004. Ann McGlynn can be contacted at (563) 383-2336 or [email protected].


RYE - On Wednesday, February 11, 2004, NYSCA District 8 Members were honored to have the Honorable Ronald Tocci, New York State Assemblyman representing the 91st Assembly District representing residents of the Sound Shore Communities, which consists of the Town of Rye (Village of Port Chester, Village of Rye Brook and Rye Neck), the City of Rye, the Town of Mamaroneck and a major portion of the City of New Rochelle be the guest speaker at their monthly meeting. Assemblyman Tocci updated members on the legislature that was passing through the Assembly now and on upcoming legislature. He discussed the recent property tax increases in Westchester County and enlightened us on his opinions as to how to make up for some of the multibillion deficit that New York State is currently facing. Mr. Tocci is a longtime proponent of chiropractic care and a friend to our profession. NYSCA District 8 members were very appreciative of Assemblyman Tocci's presence at our monthly meeting. Assemblyman Tocci was first elected to the Assembly in November 1984. On the State level, he is the prime sponsor of more than 100 Chapter laws which include: the law that increased the availability of the Tuition Assistance Program (TAP) as well as increased the amount of the awards; the law requiring home improvement contracts to be in writing and establishes a private right of action against a contractor for financial loss; and he also sponsored the law that allows residents of small cities to vote on school budgets. Born on April 19, 1941, Assemblyman Tocci is a lifelong resident of Westchester where he was educated in the public school system and at Iona Prep. He studied Architectural Engineering at the New York Institute of Technology and currently serves as a full-time legislator. Mr. Tocci is a member of many civic and fraternal organizations including the Knights of Columbus, American Legion, Disabled American Veterans, Vietnam Veterans of America, Elks, Foresters of America, Court Sons of Italy, Calabria Society, and Heritage Lodge. Assemblyman Tocci served in the U.S. Army as a paratrooper in the 82nd Airborne Division from 1966-1968. After receiving an Honorable Discharge, he returned to Westchester County where he began his public career. Assemblyman Tocci resides at 138 Emerson Avenue in New Rochelle with his wife Patricia (the former Patricia Etzler), his son Ron, and his daughter Cara. For more information on Assemblyman Ronald Tocci, click on the link below:


University moves forward on land deal with SPSU, but president says college keeping its options open

MARIETTA - Life University in Marietta, once the largest chiropractic college in the world, has taken another step in what schools officials hope may be a chance to save the school from its financial and accreditation woes. The Life University Board of Directors approved a written agreement Monday spelling out the details of the exchange of Life's land to the neighboring Southern Polytechnic State University Foundation in return for relieving Life of its $30.7 million in debt. The plan was originally announced in November 2003. "The board voted and agreed yesterday to approve the agreement that they've been working on," Life spokesman Will Hurst said. "It's a reaffirmation. It changes nothing." Now the Georgia Board of Regents must approve the contract. They are scheduled to meet again in March, said Dr. Chuck Ribley, Life board of trustees chairman. The agreement calls for the transfer ownership of the school's 89-acre campus to the fund-raising foundation of neighboring SPSU. Life would still be able to operate as a university and lease back some of its current classroom facilities. Life University officials made the announcement that the board was continuing to move forward with the SPSU Foundation deal at an all-school assembly called Tuesday. During the assembly, university President Dr. Ben DeSpain told students that over the past year the school has been pondering about "three dozen plans to secure and guarantee the financial future of Life University." He said working out the Life's issues is very complex, more so than he anticipated. He said the reality of the situation is that he shares the frustration with students and faculty that have stayed at the school, but that Life is making progress. "There are two, maybe three, strong possibilities to keep this beautiful university intact," he said. During the assembly, he raised the possibility of exiting the agreement with the SPSU foundation. He said that there is a clause in the agreement that would allow either side to back out before July, if necessary. If Life were to back out, they would be responsible for covering the SPSU Foundation's costs of entering the agreement, such as legal costs. After the assembly, he elaborated on his statements and said that the University is still examining other options that are coming forward. "It is not that we want to be unfriendly neighbors, but we want to do what is best for us," he said about the ability to get out of the agreement. "We want to try to look out for what we have a fiduciary responsibility to do." Life, which once had the largest chiropractic program in the world, was stripped of its accreditation by the Council on Chiropractic Education in June 2002. A court has since restored Life's accreditation temporarily, but the school must reapply for permanent accreditation in January 2005. It is still on probation with the Southern Association of Colleges and Schools. Because of its accreditation woes, Life lost a significant number of chiropractic students, which made up the majority of the student body. Enrollment in the chiropractic program has dropped by about 2,000 students in the past two years, from more than 3,000 to about 1,300. DeSpain said officials from Life also called Tuesday's assembly to clear up recent campus rumors. "There was a rumor we were going to get a deal signed on the 28th," he said. "People have fertile minds so we wanted to put some specifics out there (today)." One of the most recent rumors was a buyout by the Keiser Collegiate System, a private college management company, based out of Ft. Lauderdale, Fla. DeSpain said there are no written proposals drafted for that option and that it has stalled in the last few weeks because negotiators from both parties have fallen ill. Faculty who attended the meeting said they were glad to hear that there have been options in a venture that at times looked bleak without all the information. "It was somewhat helpful," said Mo Braum, clinic faculty. "I got some sense that we are working together, but the details of what we are working on is a little obscure." He said rumors about potential financial deals at the school have been rampant. "Everybody has a different one," he said." You hear lots of them." Chuck Ribley encouraged students to stay positive. "Will Life University be here next year? The answer is yes," he said. "Don't listen to the rumors out there that the sky is falling. Nothing is falling we are rising." DeSpain said the university would be going out into the community soon to do a tour of civic clubs, laying out what is going on with the future of Life. University officials reaffirmed their pledge to raise the $3 million required to balance the University's annual budget and the student recruitment campaign they are conducting across the country. Student reaction seemed positive for the most part at the assembly. Most of the audience provided DeSpain a standing ovation when school officials presented DeSpain a token of their appreciation for leadership during the university's rough times. This information is reprinted with permission of the Marietta Daily Journal. Copyright 2004.

Palmer problems persist as donors pull funding

The husband and wife leading a $35 million capital campaign at Palmer College of Chiropractic in Davenport have resigned their positions and withdrawn their $220,000 pledge, saying they are “confused and disgusted” by school governing board actions that led to the resignation of president and chancellor Guy Riekeman earlier this month. . Students continued their protests Tuesday, marching down Brady Street to the office of Vickie Palmer, the board chairman and great-granddaughter of chiropractic’s founder. A vote of no confidence sent to Palmer on Friday with 759 signatures will be forwarded to one of the school’s accrediting agencies today, a student leader said. . A Web site designed to gather the thoughts of Palmer alumni on Riekeman’s resignation, as well as to tally alumni votes of no confidence in the governing board, is up and running at . Meanwhile, a handful of students are speaking out in favor of Riekeman’s resignation and the faculty senate is drafting a letter in support of the board. . Faculty senate president Mark Doerrfeld likened the split between Palmer and Riekeman to the divorce of two people who appeared on the outside to have a perfect marriage but really did not. As of Tuesday afternoon, 55 faculty members said they supported the letter and Doerrfeld expected more positive responses to come. The school has 91 faculty members, he said. . Angela Thomas, a Palmer student, joined Doerrfeld in her support of the board. . “The fact remains that Riekeman resigned. He quit. If he is unhappy with that, it’s his problem,” she said. “The students need to refocus on their studies, upcoming finals and becoming qualified, competent doctors of chiropractic.” . Finals at Palmer begin Friday. Graduation is set for Feb. 27. . Riekeman resigned his position as president of Palmer College and as chancellor of the Palmer University System on Feb. 5. He had been president for five years, chancellor for eight months. . The board and Riekeman have acknowledged that he resigned because of resolutions passed by the board, namely a requirement that the board approve hiring and salary increases, and the employment of Larry Patten as a consultant to gather information for the board. Patten resigned in 1997 after a vote of no confidence in the administration. The board said his hiring is on a temporary basis “to ensure that the board has accurate and timely information to make informed and appropriate decisions related to university affairs.” . The board and Riekeman also say he supported an audit requested by the board. They agree that there was a communication problem between them. . Thomas and Mary Ann Morgan chaired the capital campaign that was set to raise $35 million for a learning resource center, operating costs and scholarships. The Morgans hope for Riekeman’s return, but Thomas Morgan said he believes the board is set in its decision. “Past history is that they do what they want,” he added. . In a letter to the board in which he rescinded his own pledge, Morgan wrote: “I simply cannot get up in front of the alumni now and ask for money with a good heart or clear conscience. What I am left with is a sadness for what you have done. On the only positive note I can think of, I can always look back to the past five years and have the knowledge of what power and enthusiasm can be generated from Palmer, when a true leader in the profession is our president.” . Morgan joins several alumni who support Riekeman, said Mary Flannery, a Palmer graduate who is organizing the no confidence vote online at The “polls” will close on Monday. . “The bigger issue is about how the board is not accountable,” she said. “One small group is creating all of the answers.” . Flannery joined more than 100 students who marched down Brady Street, holding signs in support of Riekeman on Tuesday morning. Vickie Palmer was not in her office when students were there, she said, adding that she was meeting off-campus with representatives of the college. . Marc Ott, who is scheduled to graduate in February 2005, said students take offense at Vickie Palmer comparing the loss of Riekeman with a teacher leaving her third-grade class. . “We’re not in third grade. Many of us have children in third grade,” he said. “We didn’t spend $150,000 to go to third grade.” . The vote of no confidence will be delivered to the North Central Association, one of the school’s accrediting organizations, today, he said. And while they want Riekeman back as president and chancellor, students also want to be informed about what is going on at the school, he added. . “This is bigger than a person’s job,” he said. This information is reprinted with permission of the Quad-City Times. Copyright 2004.


Palmer University Board Clarifies Recent Action

DAVENPORT, IOWA -- The Board of Trustees of the Palmer Chiropractic University System today released additional information to clarify their recent actions and reinforce their commitment to the institution they serve. The board outlined the resolutions passed at its January meeting to reassert the board's oversight role of Palmer Chiropractic University System, including: 1. Election of two board members to fill vacant officer positions. Elected were Dr. Trevor Ireland, D.C., as vice chair, and Mr. William Wilke, as secretary. 2. A revised board committee structure to provide the focus on critical topics. The committees now include Executive Committee, External Relations, Curriculum and Clinic, Finance and Operations, Strategic Organizational Development, and Trustee Development. 3. Employment of Mr. Larry Patten, on a temporary basis, to ensure that the board has complete, accurate and timely information to make informed and appropriate decisions related to University affairs. 4. Board approval of all hiring and salary increases across the University System until it is clear that policies and procedures are being followed. 5. A special audit of University System operations conducted by McGladrey & Pullen. "Former Chancellor Dr. Guy Riekeman opposed all of these resolutions except the audit and provided the board with the ultimatum that, if the Resolutions were not removed, he would resign," said board chair Vickie Palmer. "Yet, the first two resolutions -- election of officers and restructuring committees -- are board responsibilities concurrent with good governance, not the domain of an administrator. And the third and fourth resolutions were enacted to ensure administration of the University System was following University policy and administrative guidelines. The board is also concerned about the decline in enrollment." While a number of people have expressed concerns, the board says it is pleased by the support expressed by faculty, staff, alumni and many students. "Seeing these resolutions, it is clear that they are in the best interest of Palmer Chiropractic," said Michael Crawford, the Chancellor who preceded Dr. Riekeman. "I could have lived with the resolutions. Obviously, if that would have happened during my tenure, it would have signaled that I needed to take the initiative to communicate more effectively with the board and make sure that I was carrying out the requirements of my administrative position." The board also countered charges by Dr. Riekeman that he did not have direct access to the board chair and other members. "The board functioned for too long in an information vacuum," said board member Dr. Frank Bemis, D.C. "Hiring Larry Patten on a temporary basis to collect information has been an important step in regaining the board's oversight role of the University System. Mr. Patten facilitated the flow of information between the board and the Chancellor so that it could make more effective decisions. It is also important to note that the alumni, based on what we know today of the University's operations, were mistaken in our assessment of Mr. Patten's past performance as Palmer's Chief Operating Officer. I am confident that Mr. Patten's temporary fact-gathering assistance will speed the transition to better things within the Palmer Chiropractic University System." The board also clarified the terms of Dr. Riekeman's resignation. "He issued an ultimatum," said Dr. Bemis. "And the board could not subvert its oversight role, especially the stewardship of students' tuition dollars. The board had no choice but to accept Dr. Riekeman's resignation, and there will be no negotiation with the former Chancellor. We are moving forward with the business of delivering education based on the Palmer Chiropractic Tenets and Principles." Finally, the board announced that vice president of finance and operations William Jarr and vice president of planning Kevin McCarthy have been released. McGladrey and Pullen continues to conduct an audit of the University System, including Palmer Chiropractic College in Davenport, Iowa. "The Chancellor was not following University policies and was not communicating with the board," said Palmer. "This audit is ongoing and we may release material results as warranted." ABOUT PALMER CHIROPRACTIC UNIVERSITY SYSTEM The 109-year history of chiropractic education began at Palmer College of Chiropractic in Davenport, IA. Started by the profession's founder, Daniel David (D.D.) Palmer, Palmer is chiropractic's college. The science, art and philosophy of chiropractic evolved from D.D., and the institution has sent more than 40,000 alumni out to practice throughout the world. Palmer Chiropractic University System was created in February 1991, bringing Palmer College of Chiropractic and Palmer College of Chiropractic West, established in 1980, in San Jose, Calif., together under the same Board of Trustees. Palmer College of Chiropractic Florida at Port Orange, Fla. was added in 2002. Total current enrollment is approximately 2,400 at all three campuses; total full and part-time employment is 553.

Riekman’s resignation shakes up Palmer

The groundswell of support for the Palmer president and chancellor who resigned his job is turning into lost financial support for the chiropractic college and outrage toward the board and its leader, the great-granddaughter of chiropractic’s founder. . Meanwhile, the board is conducting an audit of the institution and requiring approval of all hiring and salary increases. It also hired a former chief operating officer — who left after a no-confidence vote in 1997 — as a consultant. . Palmer students sent a no-confidence vote with 759 signatures to Vickie Palmer and the board Friday, with the promise of more action this week if former president and chancellor Guy Riekeman is not reinstated. Alumni are organizing a similar vote. Some have said they have or may take their money out of the school. Others said they will refer future students elsewhere. . And officials from the International Chiropractors Association, founded 78 years ago by B.J. Palmer, the son of the school’s founder, said they are “deeply concerned over the uncertainty at Palmer College and doctors and students in unprecedented numbers are looking for answers in what appears to be a very unfortunate situation.” . The board is not negotiating with Riekeman to bring him back, board chairman Vickie Palmer said in an interview Saturday with the QUAD-CITY TIMES. Palmer understands students and alumni are upset, she said, but added that she hopes the information released by the board Saturday will help “with clarification.” . The man with her during the interview was Larry Patten, who resigned from the school seven years ago — the last time Palmer students and alumni took a vote of no-confidence. . “Conflict clarifies,” B.J. Palmer once said. . Palmer College of Chiropractic is indeed in the midst of a conflict. . The resignation . Riekeman resigned his position as president of Palmer College and as chancellor of the Palmer University System on Feb. 5. He had been president for five years, chancellor for eight months. . The board and Riekeman acknowledged that he resigned because of resolutions passed by the board, namely the requirement for board approval of hiring and salary increases and the employment of Patten. The board said his hiring is on a temporary basis “to ensure that the board has accurate and timely information to make informed and appropriate decisions related to university affairs.” . The board and Riekeman also say he supported the audit. They agree there was a communication problem between them. . William Wilke, secretary of the board and a retired bank chairman from Bettendorf, said the board of trustees ordered the audit because it had concerns about “fiscal prudence.” . Specifically, Wilke said cost overruns at a building project on the Florida campus, the expense of legal services from outside of the area, contracts for consulting services, salary increases, lax accounting controls and the commission of a sculpture will be examined. . The sculpture depicted three generations of chiropractors, the idea of Fred Barge, a well-respected chiropractor who passed away in July, Riekeman said. The artist decided to use the likeness of the Riekeman family — a younger Guy Riekeman, his father (a Palmer graduate) and his daughter (who is attending Palmer) — as a model for the sculpture that was expected to cost $50,000 to $60,000 to create and expected to raise at least $180,000 with engravings from families with generations of chiropractors, Riekeman said. . The board stopped the project, Riekeman said. . He declined to dispute the board’s issues point by point, but said Saturday “all financial issues were approved along the way. Nothing we spent was outside of the approved budget.” . The university system has a budget of about $40 million, according to its 2002 tax forms. Since the 1997-98 school year, the amount of federal funding to the Palmer Center for Chiropractic Research increased from $525,800 to more than $3.4 million this school year, according to statistics from the institution. . The number of members in the President’s Club — the group of people who gave $1,000 or more to the school in a year — rose from 278 members in October 1998 to 590 members in October 2003. A $35 million capital campaign also is underway. The largest previous campaign was for a tenth of that in the 1980s. About $20 million has been pledged or received of that $35 million goal. . Riekeman also is credited with the success of the institution’s annual Lyceum celebration, a continuing education event that replaced homecoming. The event made $190,000 last year. When asked about the continuation of Lyceum, Vickie Palmer said the board is allowing interim presidents to decide how to continue with such programming. . Fall enrollment in 1998 as Riekeman was taking over was 1,695 at the Davenport campus. At its California campus, 711 students took classes, totalling 2,406 in the system. . Enrollment this past fall was 1,750 students in Davenport, 447 in California and 203 in Florida, for a total of 2,400. School officials said they expect 120 fewer students at Davenport in the next trimester. . Patten’s return . Larry Patten resigned from Palmer in 1997 after no-confidence votes. The International Alumni Association was the first to issue its vote, saying it had concerns about declining enrollment, low faculty morale, increased student unrest, mismanaged funds and an atmosphere of “fear and intimidation” that permeated the campus. . Then-chancellor Michael Crawford had a long history with Patten. They worked together at St. Louis Community College in Missouri. Patten also led Vickie Palmer’s for-profit business, Signal Hill. . Patten is again working with Palmer — as a consultant to the Palmer University System board and at the newly created Vickie A. Palmer Foundation, Palmer and Patten said, adding that the two entities are completely separate. . Frank Bemis was the president of the International Alumni Association at the time of the no-confidence vote in 1997. He is now a member of the board. . “The board functioned for too long in an information vacuum,” he said in a statement released by the board. “Hiring Larry Patten on a temporary basis to collect information has been an important step in regaining the board’s oversight role of the university system. Mr. Patten facilitated the flow of information between the board and the chancellor so that it could make more effective decisions.” . Bemis said he has re-evaluated his opinion about Patten. . “It is also important to note that the alumni, based on what we know today of the university’s operations, were mistaken in our assessment of Mr. Patten’s past performance as Palmer’s chief operating officer. I am confident that Mr. Patten’s temporary fact-gathering assistance will speed the transition to better things within the Palmer Chiropractic University System.” . And Crawford added in the statement: “Seeing these resolutions, it is clear that they are in the best interest of Palmer College,” he said of the resolutions that prompted Riekeman’s resignation. “I could have lived with the resolutions. Obviously, if that would have happened during my tenure, it would have signaled that I needed to take the initiative to communicate more effectively with the board and make sure that I was carrying out the requirements of my administrative position.” . Patten said he simply hopes to help the institution. . “I care very deeply about Palmer. If I can be of help, I want to be helpful,” he said. . Alumni no confidence — again . Alumni are organizing a vote of no-confidence in the board of trustees, a challenge to gather because chiropractors are spread across the world, said Mary Flannery of Durant, Iowa, who is organizing the effort. . A Web site will gather opinions on whether chiropractors support the board or Riekeman, she said. The site will be up early this week. . She supports Riekeman’s return, but said this battle is just not about his return. . “This is about direction and lack of accountability,” she said. . The alumni are questioning the board, which is elected by a group of nine people known as certificate holders, including Vickie Palmer. . Janet Cuhel of Cedar Rapids graduated from Palmer in 1993 and is the president of the Iowa alumni. She called Riekeman’s resignation a “very, very unfortunate course of events” for Palmer and the chiropractic profession. . “The board statement has been that everything will stay the same,” she said. “The people that they have put in the position of leadership — their vision is completely different. So all of the phenominal pieces that Dr. Riekeman put in place will not be followed.” . Cuhel practices with 1966 graduate Gene Cretsinger, who said Riekeman “brought vision, integrity and a hope for freedom to practice chiropractic as a wellness and human potential model.” . A member of the President’s Club, Cretsinger has pulled his financial support from the school. . “I want Palmer to have the best leadership that is available in the chiropractic profession,” he said. “That leadership is best expressed through Dr. Riekeman in his abilities to articulate that message and draw people. If Dr. Riekeman is not there, I am going to support wherever he goes with that vision.” . Other alumni contacted by the Times expressed similar opinions, including some who said they cast a no-confidence ballot in 1997 and they are prepared to do it again. The alumni association’s past president’s council has also called upon the association’s executive committee to issue a statement in support of the reinstatement of Riekeman. . Alumni association president Kirk Lee, who previously voiced his support for the board, could not be reached for further comment. . Eric Russell, president of the Texas alumni association, said Riekeman brought a feeling of excitement to chiropractic. The profession refers to it as “spizzerinctum,” Russell said. . Student no confidence . The student no-confidence vote, sent to the board Friday after they did not receive a response to their request for dialogue between the board and Riekeman, contained 759 signatures. It calls for the immediate reinstatement of Riekeman. The document states that the $35 million capital campaign for a learning resource center “is in jeopardy.” It predicts the campaign will fail. . “Student pride in Palmer College will and has dropped; activities and growth will stall and fade,” the document continues. “Student recruitment will fall just as other chiropractic colleges has, a severe financial loss to Palmer Chiropractic University System can be expected.” . The students say the board has made an “abrupt and foolish decision without anybody qualified to even begin to fulfill the standards, knowledge and presentation of Dr. Guy Riekeman’s job.” . Failure to reinstate, the students promise, will “result in further action taken by the students” if their request is not complied with by Wednesday. . A table on the Palmer campus, adorned with posters shouting support for Riekeman, was a gathering place for signatures. Students are wearing purple ribbons in support of him. An e-mail account, [email protected], is receiving student comments. . Students plan to march down Brady Street to Vickie Palmer’s office Tuesday to show their support for Riekeman, according to the Palmer Beacon, the student newspaper. The week of turmoil is documented on the newspaper’s Web site at . They wonder when and if they will meet with Vickie Palmer. . Palmer said Saturday she hopes to meet with faculty and student leaders, but has not set up a time to do so. . The future . Vickie Palmer will be reading the correspondence sent to the board about Riekeman’s resignation this week, she said. An office at the school has been collecting the information. The alumni Web site to collect votes of support for the board or for Riekeman will be up in a couple of days, Flannery said. And students are making plans to continue their protests. . Riekeman believes there are bigger issues to be resolved than whether he is the leader. He hopes, but does not anticipate, that he will return to work at the institution. . “I never thought short of a miracle that they would give me my job back,” he said. . Ann McGlynn can be contacted at (563) 383-2336 or [email protected]. This information is reprinted with permission of the Quad-City Times. Copyright 2004.


Three Experienced Researchers Join Palmer Center

The research capabilities of the Palmer Center for Chiropractic Research (PCCR) in Davenport, Iowa, have been bolstered by the addition of three experienced researchers. Maria Hondras, D.C., M.P.H., Dana Lawrence, D.C., F.I.C.C., and Edward Owens Jr., M.S., D.C., joined the PCCR research faculty between November 2003 and January 2004. The PCCR is the world’s largest chiropractic research facility and headquarters of the National Institutes of Health’s Consortial Center for Chiropractic Research. The addition of these three respected research scientists to the Palmer research team comes on the heels of a recent $2.7 million grant from the National Center for Complementary & Alternative Medicine (NCCAM), a division of the National Institutes of Health. The grant allows Palmer to establish the Center for the Study of Mechanisms and Effects of Chiropractic Adjustments, a three-year, collaborative project with National University of Health Sciences, Kansas State University, the State University of New York at Stony Brook and the University of Iowa. “Adding experienced scholars like Drs. Owens, Lawrence and Hondras significantly increases our ability to expand Palmer’s research program, especially in the areas of clinical research and technology assessment. We expect each of these faculty members to use the resources of the center to pursue funding opportunities, conduct studies and publish new data regarding chiropractic theory and practice,” said William Meeker, D.C., M.P.H., vice president for research for the Palmer Chiropractic University System. Maria Hondras, D.C., M.P.H., earned a Doctor of Chiropractic degree from National College of Chiropractic, Lombard, Ill., in 1989, and a Master of Public Health degree in Epidemiology from the University of Illinois at Chicago in 1993. Prior to joining the research faculty at the PCCR as associate professor, Dr. Hondras was a health and safety specialist for the UPS North Illinois District, served as a consultant to the Consortial Center for Chiropractic Research, and was a scholar-in-residence at Western States Chiropractic College. From 1986 to 1998, she served on the research, postgraduate and clinical faculty at the National College of Chiropractic and has maintained a limited home-office practice since 1989. Dr. Hondras has more than 10 years experience with the design, management and oversight of clinical trials in chiropractic and has conducted trial management workshops in North America, Europe and Australia. Since 1995, she has served on the Advisory Board of the Cochrane Collaboration Complementary Medicine Field. She has published numerous research studies in peer-reviewed journals including the Journal of Manipulative and Physiological Therapeutics, Spine and Pain. Dana Lawrence, D.C., F.I.C.C., has more than 24 years teaching and administrative experience in chiropractic education with an emphasis on teaching spinal and extravertebral chiropractic technique and orthopedics. With expertise as a biomedical editor, writer and textbook consultant, he has served as the editor of the Journal of Manipulative and Physiological Therapeutics since 1987, and also is editor of Journal of Chiropractic Medicine and Journal of Chiropractic Humanities. Dr. Lawrence has published numerous textbooks, including “Fundamentals of Chiropractic Diagnosis and Management,” and “Chiropractic Technique: Principles and Practice” (with Tom Bergmann and David Peterson). Dr. Lawrence received his Doctor of Chiropractic degree from National College of Chiropractic, Lombard, Ill., in 1979. Prior to joining the PCCR research faculty in January 2004 as an associate professor, he was Dean of the Lincoln College of Postprofessional, Graduate and Continuing Education at National University of Health Sciences, Lombard, and concurrently served as Director of the Department of Publication and Editorial Review and a professor in the Chiropractic Technique Department. Edward F. Owens Jr., M.S., D.C., received his Doctor of Chiropractic degree from Life Chiropractic College in 1986, and a Master of Science in engineering science and mechanics from Georgia Tech in 1980. Prior to joining the PCCR research faculty as an associate professor, Dr. Owens was director of research for Sherman College of Straight Chiropractic. He served as editor of the Chiropractic Research Journal from 1995 to 1998 and was a member of the research faculty of Life College from 1983 to 1990 and from 1994 to 1998. He also maintained a private practice in Decatur, Georgia, from 1987 to 1998. His areas of expertise are biomechanics and clinical research, with a particular interest in muscle tone changes that accompany vertebral subluxation. He has made many presentations and published numerous articles on these subjects in peer-reviewed journals.


Administrative adjustments don’t sit well with students

Guy Riekeman resigned as president of Palmer College of Chiropractic and chancellor of the Palmer system last week because of conflicts with the board of trustees but would return if those disagreements are resolved. Speaking Monday night to students at a standing-room-only session at First Baptist Church near the Davenport campus, he said the way he was allowed to communicate with the board contributed to his resignation. He also said he has a “serious concern” about the board “crossing the line from governance into management.” He had been presented with board resolutions that would have “stripped administration of all its authority,” said Riekeman, President of Palmer College since 1998 and chancellor since July of the system that includes the school in Davenport and campuses in California and Florida. “It became for me an impossible working environment,” he said during the hour-long session where he received two standing ovations. The school’s enrollment is solid, and its financial situation is good, Riekeman said. But communication with the board has been “difficult” since shortly after he was named chancellor. He could not communicate with individual board members directly and ultimately, communication was through Vickie Palmer’s office only, he said. Palmer is chairman of the board and great-granddaughter of founder D.D. Palmer. Palmer said Monday that it is the job of the chancellor to keep in touch with the board, and that the chairman is the point person for the board. Palmer said the board has several functions, including policy and financial, as well as appointing leadership. “We understand our role very well,” she said. And as for Riekeman’s return, she said: “The board accepted his resignation and I believe that the board stands true to that.” Earlier in the day, students protested over the noon hour at the campus along Brady Street in Davenport. About 150 students carrying signs showed their support for Riekeman while standing in the cold. The signs read: “Keep the good Guy.” “Fledgling chiros unite for Riekeman.” “Palmer’s future needs Riekeman.” One sign, “United we stand for Riekeman” required six people to hold. Bolden Harris, president of the student council, said Riekeman was moving the college and the chiropractic profession in the right direction. “He’s a man of integrity. He’s got a great vision for this school and the profession,” he said of Riekeman as the crowd cheered in the background and a car drove by honking its horn. Interim president Don Kern, while watching the protest from a fourth-floor window, encouraged students to base their opinions on fact, not emotion. He acknowledged that Riekeman had been a “very popular” president but hopes students will concentrate on the work they are there to do. “It saddens me to see them being so distracted from their studies,” he said. Students also passed around two petitions on Monday. One asked the board and Riekeman to talk about his return to leadership. The second was for a no-confidence vote in Vickie Palmer and the board. Riekeman said he is not asking, nor will not ask, students to protest or leave the school, just to follow their own conscience. “I’ve always been known for integrity and responsibility. I don’t want to incite people to do things,” he said. He is asking those contributing to the school’s $35 million capital campaign to continue to do so. Riekeman has received other job offers, but he and his wife, Annie, will not consider anything for at least a month, he said. He hopes to return to Palmer. “I want to go back to work,” he said. “There is no better place to get a chiropractic education.” Ann McGlynn can be contacted at. (563) 383-2336 or [email protected]. This information is reprinted with permission of the Quad-City Times. Copyright 2004.

Palmer chancellor Riekeman resigns

The president of Palmer College of Chiropractic in Davenport, who also served as the chancellor for the entire Palmer system, resigned this week after just eight months as chancellor and five years as president. Guy Riekeman’s resignation is effective immediately, according to a statement released Friday afternoon. At the same time, the board of trustees announced plans to “realign the university’s administrative team and refocus on critical topics.” Vickie Palmer, chairperson of the system’s board of trustees and great-granddaughter of the school’s founder, said Riekeman requested the board keep the reason behind his resignation confidential. She said the system will be “keeping the same focus in educating the best chiropractic students.” Don Kern, who served as Palmer’s president from 1987 to 1994, will take over again as the leader of the central Davenport campus on an interim basis. Kern promised a smooth transition. “We’re moving ahead with all of the initiatives started under Riekeman,” he said, mentioning in particular the development of the new Florida campus and the continuation of the $35 million capital campaign for a learning resource center in Davenport. Kern received a phone call from the board Thursday, asking him to step into the president’s role again, he said. He also declined to answer why Riekeman resigned. Riekeman could not be reached for comment Friday by the Quad-City Times. Riekeman became the school’s eighth president in the fall of 1998 after the death of then-president Virgil Strang shortly before his retirement. A motivational speaker and creator of several professional development seminar programs, Riekeman is a 1972 graduate of Palmer. He had been an X-ray instructor, dean of philosophy and vice president of Sherman Chiropractic College in Spartanburg, S.C. One year before his presidential appointment, he was named executive director of the Palmer Institute for Professional Advancement. At the time, he said he anticipated chiropractic would become less of an “alternative” form of health care. “There is no question in my mind that in the short term, chiropractic will be a major player and in the long term, it will be a leader in the new definition of health care today,” he said. Riekeman was named chancellor of the Palmer system in summer 2003. He was to oversee Palmer and its two colleges in California and Florida, as well as the Palmer Center for Chiropractic Research, Palmer Institute of Professional Advancement and Palmer Foundation of Chiropractic History. Palmer is 109 years old and is credited as the beginning of chiropractic education, started by the profession’s founder, Daniel David Palmer. It has 40,000 alumni, 550 employees and 2,400 students. Kirk Lee, president of Palmer’s alumni association, said the association supports the college and the board of trustees in its decision. “The president will come and go, but the alumni will always be there,” said Lee, who practices in Albion, Mich. Brent Warner, who will graduate from Palmer in three weeks, said he respects Riekeman for his accomplishments at Palmer, especially his recruitment efforts. A difference of opinion about chiropractic theory led to Riekeman’s resignation, Warner added. Warner’s serves on the school’s student council and says he received several e-mails and phone calls Friday afternoon about Riekeman’s departure as word spread. “It’s a split. There’s a lot of students who aren’t unhappy with this decision,” Warner said. “There’s a lot of students who came to this college because of Guy Riekeman. There are some who really love the guy, some who really don’t.” Ann McGlynn can be contacted at (563) 383-2336 or [email protected]. This information is reprinted with permission of the Quad-City Times. Copyright 2004.


In what many consider a ground breaking move in healthcare education, D’Youville College has announced it will be offering a Doctor of Chiropractic program beginning in 2004. D’Youville will be the first standard accredited multi-disciplinary college in New York State to “mainstream” chiropractic education by offering the Doctor of Chiropractic degree and only the second college in the country to do so. (The University of Bridgeport in Connecticut started their program in 1990.) Canada, a major source of students for D’Youville, has only one school of chiropractic.. The State Education Department approved the program in June and D’Youville is now actively recruiting freshmen students. Previously, students interested in the chiropractic profession had to attend one of 16 single purpose institutions nationwide primarily dedicated to chiropractic education. Now, with D’Youville entering the field, a student will take liberal arts and science courses required for an undergraduate degree with students from other health-related disciplines and then embark on professional level evidence-based chiropractic studies. Chiropractic is a healthcare discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery. It focuses on the relationship between body structure, primarily of the spine, and function as coordinated by the nervous system and how that relationship affects the preservation and restoration of health. The name is taken from the Greek words “cheiros” (hand) and “praktos” (done by) and combined to create “chiropractor” or “done by hand.” “This new program will be the cornerstone of our Integrative Holistic Health Department at D’Youville,” says Sister Denise A. Roche, president. “In addition to our current certificate program in hospice and palliative care, we envision that the department will eventually add future offerings in the areas of acupuncture, integrative healing, and transpersonal psychology.” D’Youville will offer the chiropractic program on two levels: one that will provide the student with the opportunity to complete the Bachelor of Science in Biology degree and the Doctor of Chiropractic in seven years and one for transfer and/or ‘second career students’ who, if they have an undergraduate degree and meet academic requirements, can earn their Doctor of Chiropractic in four years. Students entering the program at the freshmen level will pay undergraduate tuition throughout the seven-year program, according to D’Youville officials. The program will be centered on the fourth floor of the college’s Academic Center where a state-of-the art chiropractic clinic will be built for the clinical training portion of the program. “D’Youville began studying the feasibility of offering academic programs related to complementary and alternative therapies three years ago. The selection of chiropractic as the first program was based on a number of factors, including the fact that chiropractic is both alternative and mainstream as well and the profession has gained popular acceptance” according to Dr. Paul T. Hageman, chair of the Department of Integrative Holistic Health Studies and lead faculty member for development of the program. Also, the fact that the White House Commission on Complementary and Alternative Medicine Policy recommends the integration of complementary and alternative medicine into the mainstream healthcare system encouraged D’Youville’s development of the program. Two-thirds of Health Maintenance Organizations (HMOs) offer at least one form of alternative care with the most common being chiropractic (65%) and acupuncture (31%), according to a study conducted by National Market Measures, for Landmark Healthcare Inc., a company specializing in the development and delivery of management programs for musculoskeletal disorders and rehabilitation services. “The steadily increasing acceptance and use of chiropractic by the public, third-party payers, and the Federal Government indicate that chiropractic is no longer the marginal profession it was once considered to be,” Hageman said. “As part of our feasibility study, we surveyed 1991 licensed chiropractors randomly selected from New York, Pennsylvania, Ohio, and Ontario. Our survey concluded that the demand for chiropractic care at the national, state or provincial levels will continue to increase during the next decade, there are sufficient individuals interested in becoming chiropractors, and the majority of chiropractors support the integration of chiropractic programs into university and college settings,” he said. “Students will focus on human anatomy, physiology, biomechanics, pathology, diagnostic imaging, chiropractic diagnosis and analysis, adjustive techniques and will complete a strong graduate-core research requirement,” Hageman said.. “In addition, they will be integrated into classes in nursing, occupational therapy, physical therapy, dietetics and other health related courses The intent of this integrative and collaborative approach is to facilitate communication among professionals and to bring about an enhancement of patient care.” The college expects approximately 30 students to sign up for the new program in the next academic year. D’Youville’s long history of health care education, beginning in 1942 with the area’s first four-year nursing degree program, was followed by the addition of occupational and physical therapy, a physician assistant program and a dietetics program in the 1980s. Graduate programs in nursing, health care administration, and a number of health related certificate programs were also added. Chiropractic is recognized today as one of the largest healthcare professions in the United States and chiropractors are currently licensed in all states. In 1970 there were approximately 13,000 licensed chiropractors with the number increasing to 81,000 in 2000, according to the Federation of Chiropractic Licensing Boards. BACKGROUND The modern history of chiropractic began with Dr. Daniel David Palmer, a teacher/healer and the person considered the founder of the practice. He was born in Port Perry, Ontario in 1845 and 20 years later moved to Iowa opening his first practice in Burlington. His son, Bartlett J. Palmer, was an early pioneer in radio and owned several radio stations. A firm believer in advertising and mentored in the art by his friend Elbert Hubbard, who established his Roycroft printing plant and furniture factory in East Aurora, Palmer is credited with the growth of the chiropractic profession. “B.J.” helped his father build Palmer College in Davenport, Iowa into one of the largest chiropractic colleges in the U.S. He is credited with establishing the school’s prominence and with helping to have chiropractic accepted by both the public and legislators. Palmer died in 1961. Early history shows “manipulation” described in an ancient text dating back to 2650 B.C. by travelers to Asia in which tissue manipulation was a part of therapy. In 1500 B.C., the Greeks were recording their successes in lower back treatments. In 1983, the American Public Health Association (APHA), after years of research, initiated a policy statement that recognizes spinal manipulation as a safe and effective treatment for certain neuromusculoskeletal disorders, including the treatment of lower back pain. - 30 – Contact: Dr. Paul T. Hageman, chair of the Integrative Department of Holistic Health, D’Youville College. 881-7793 office, 532-5094 home.



Governor George E. Pataki today nominated State Department of Labor veteran David Wehner to be the next Chairman of the New York State Workers’ Compensation Board. His nomination is subject to confirmation by the New York State Senate. “David Wehner’s extensive experience and expertise in labor and other work-related issues make him ideally suited to lead the Workers’ Compensation Board,” Governor Pataki said. “The Workers’ Compensation Board is one of our most efficient, responsive and well-managed agencies, and I am confident that the high standards of excellence set by former Board Chairman Robert Snashall will continue under David’s leadership.” “I also want to commend Interim Board Chairman Jeffrey Sweet for the steady job he did while the search was underway for a new Chairman,” Governor Pataki said. “I’m pleased he will continue to serve on the Board as Vice Chairman, and I know David and Jeff will make an outstanding team.” David Wehner said, “I am honored Governor Pataki has nominated me as Chairman of the Workers’ Compensation Board. Since 1995, there have been many legislative and administrative changes implemented under Governor Pataki, which have greatly improved the Board’s delivery of services across the state. I am looking forward to the opportunity to continue that success.” Wehner, who currently serves as Executive Deputy Commissioner at the New York State Department of Labor, fills the vacancy left by Robert Snashall’s departure as Board Chairman last year. Jeffrey Sweet, Vice Chairman of the Board, has been serving as Interim Board Chairman since Snashall left last August. Mr. Wehner has served as Executive Deputy Commissioner since 2001. As Executive Deputy Commissioner, he has been responsible for the daily operations of a $6.5 billion agency, including 60 local offices across the State and more than 4,500 employees. Mr. Wehner has oversight for the unemployment insurance, employment service, welfare-to-work, job training, Workforce Investment Act, public safety and health, and worker protection programs in New York State, as well as serving as department liaison to the labor and business communities. Before being named Executive Deputy Commissioner, Mr. Wehner had served more than three and a half years as Deputy Commissioner for Administration and Public Affairs. Previously, Mr. Wehner also served as both Chief Special Assistant to the Commissioner of Labor and Director of Communications. In that capacity, he was responsible for policy oversight, intergovernmental relations and the communications functions of the department. --more-- He is a member of the Board of Directors for the National Association of State Workforce Agencies (NASWA), and past President of the National Association of Government Labor Officials (NAGLO). Mr. Wehner is a native of Rochester, and holds a Bachelor’s and Master’s Degree in Communications from the State University of New York at Albany. Mr. Wehner and his wife, Diane Wallace Wehner, live in Guilderland with their two sons, Paul and Kevin, and daughter Allison. As Chairman of the Workers’ Compensation Board, Wehner will earn an annual salary of $120,800.

“C O M M U N I C A T I O N”

Webster’s dictionary defines “communication” as a transmitting, a giving or exchanging of information, messages, etc. Doctors of Chiropractic have a variety of daily opportunities to communicate with patients and the public at large. Some of the ways a Doctor of Chiropractic may communicate include: ADVERTISING: Doctors of Chiropractic commonly use print or electronic media, promotional seminars, or lay lectures to communicate methods of chiropractic care to patients and the public. A responsible Doctor takes care that the presented material is within the scope of chiropractic practice in New York State and is reflective of his or her education and technical expertise. An ethical practitioner is sensitive to advertising that is not in the public interest, i.e., false, fraudulent, deceptive or misleading. PATIENTS: Communication with your patient is paramount, especially that which involves direct clinical interaction in an office setting. Inadequate or ineffective communication may lead patients to misinterpret clinically warranted procedures as “inappropriate” or, worse, “violative”, e.g., placement of the practitioner’s hand or knee or body during an adjustive technique. If a patient files a complaint of a boundary violation or any other alleged act of professional misconduct, the Office of Professional Discipline must initiate an investigation. Making the effort to communicate to your patients about the specifics of clinically warranted chiropractic procedures and techniques is an extremely valuable investment of your time. This is an example of where it is critical as a professional to be proactive rather than reactive. RECORDKEEPING/DOCUMENTATION: Your patients’ files/charts can contain a broad spectrum of consent forms, examination forms as well as daily office entries. In reality, records are vehicles of communication with your patients, other health professionals, lawyers, judges, workers’ compensation board and other third party administrators, peer and utilization review parties, and state regulatory agencies. As a licensed professional, you are responsible for formatting your clinical documentation clearly and accurately, and for securing the confidentiality of your patients’ records. This area of responsibility has been heightened by the promulgation of federal regulations to implement the Health Insurance Portability and Accountability Act (HIPAA). The members of the New York State Board for Chiropractic want you to remember that communication is a platform for information and education, which can protect the public by enhancing the provision of care entrusted to every licensee authorized to practice the chiropractic profession in this State.

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Record Fine against CIGNA Healthcare and CIGNA Behavioral Health

Superintendent of Insurance Alessandro A. Iuppa announced that CIGNA Healthcare of Maine, Inc., and CIGNA Behavioral Health (collectively "CIGNA") have been fined a total of $900,000 for multiple violations of Maine law. The fine, which was assessed as part of a consent decree with the companies, constitutes the largest fine ever levied by the Maine Bureau of Insurance. CIGNA Healthcare of Maine, Inc. holds a certificate of authority to operate in Maine as a health maintenance organization ("HMO"). CIGNA Behavioral Health holds a license as a medical utilization review service that reviews the necessity, use, or appropriateness of behavioral health care services, and as a third-party administrator. The companies were found to have violated Maine law for failing to pay claims on time, failing to pay interest due, failing to keep supporting claim documentation and failing to have adequate procedures for identifying and correcting errors in a timely manner. In addition to the fine, the companies must pay restitution of interest to affected claimants. Both entities must pay combined restitution to affected claimants for interest due for late paid claims of approximately $915, 000 for calendar years 2001 and 2002. For prior years the companies must provide additional unpaid interest for claims processed from September 18, 1999 (the date the present text of Maine's prompt pay law took effect) to January 1, 2001. The companies will have until the end of January 2004 to calculate the additional interest due. The aggregate amount for the four years will be the largest award of restitution ever obtained for claimants by the Maine Bureau of Insurance. In addition to the claims payment issue, the consent agreement resolves a number of other violations. These include: complaint handling, company grievance procedures, records retention, failure to actively market individual health plan coverage, and member notification concerning plan cancellation. One of the most startling findings to emerge from the examination was the fact that CIGNA's own grievance review process overturned initial claim denials, when appealed, a significant percent of the time. The consent agreement requires that the companies file a plan of corrective action for the Superintendent's review and approval that addresses each violation of law listed in the consent agreement. The action plan is due to the Superintendent by December 31, 2003. The Superintendent singled out the grievance process as one area where the Bureau sought reforms. The Bureau of Insurance is part of the Department of Professional and Financial Regulation, which encourages sound ethical business practices through high quality, impartial and efficient regulation of insurers, financial institutions, creditors, investment providers, and numerous professions and occupations for the purpose of protecting the citizens of Maine. Consumers can reach the Bureau through its Web site at; by calling 800-300-5000 in-state; or by writing to Bureau of Insurance, 34 State House Station, Augusta, ME 04333. This information is reprinted with permission of the The Monument Newspaper Copyright 2003.


Six Leading Presidential Candidates Endorse Chiropractic

ARLINGTON, Va -- With just one week remaining before the beginning of the Iowa caucuses, the American Chiropractic Association (ACA) has secured official statements on chiropractic care from each of the six leading Democratic presidential candidates. ACA secured these statements through close cooperative efforts with the Iowa Chiropractic Society and politically active doctors of chiropractic across the country. "Though they may often disagree on other issues, the leading presidential candidates for the Democratic presidential nomination appear to completely agree on the value and benefits of chiropractic care," said ACA President Donald Krippendorf, DC. "The ACA is encouraged by this enthusiastic support and more determined than ever to ensure that it is maintained by our elected leaders long after Election Day." Governor Howard Dean, Congressman Dick Gephardt, Senator John Kerry, Senator John Edwards, General Wesley Clark and Senator Joe Lieberman round out the list of candidates who have submitted statements. To view these statements, visit: The ACA, the largest national organization representing doctors of chiropractic, has taken an active role in the months leading up to the January 19, 2004 Iowa precinct caucuses in evaluating the health care policy positions of each of the announced presidential contenders. This effort has included meetings with major candidates and senior campaign officials, and the use of ACA's specially designed issues questionnaire. "The candidates are recognizing the political clout of Iowa's chiropractic constituency," said F. Dow Bates, DC, ACA Iowa Delegate. "The numbers speak for themselves. Iowa is home to thousands of doctors of chiropractic and chiropractic assistants, tens of thousands of chiropractic patients and the largest chiropractic college in the world. The road to victory in the Iowa caucuses goes straight through the offices of the state's doctors of chiropractic." Providing additional outreach were Keith Overland, DC, ACA Connecticut delegate, who serves as a health care policy adviser to the Lieberman campaign, and Dan Redwood, DC, of Virginia, who helped secure General Clark's statement. Source: American Chiropractic Association

Revised 2004 Medicare Physician Fee Schedule and Extension of the Annual Participation Enrollment Period

It is my understanding that CMS has revised the Medicare Fee Schedule for 2004 and extended the time providers have to decide whether enroll with CMS as a participating provider. Doctors have until February 17, 2004 to consider the new fee schedule before making their 2004 participation decision. The new fee schedule incorporates increases passed by Congress and signed by the President into law on December 8, 2003. Because the law was signed so late in the 2003 calendar year, CMS is back peddling trying to incorporate the changes brought on by the law with the current calendar year. As a result, CMS has extended the time providers have to consider the new fees and whether they want to remain a participating provider or not. As a result Medicare contracted carriers have released the following physician advisory at the behest of the CMS: 1. Providers should stop and contemplate the rate increases authorized by the Medicare Prescription Drug, Improvement, and Modernization Act before making their 2004 Medicare participation decision. If doctors decide to maintain the same participation status in 2004 that they currently have now, they do not need to take any further action. 2. After reviewing the new rates, members should understand the extended timeframes for making their decision and the rules involving their 2004 payments while their decision is being processed, especially if they decide to change their participating status. 3. If members decide to change their participation status, they should be sure to complete the participation agreement that everyone should have received from their respective carrier and submit it to that carrier as soon as possible. The 2004 participation enrollment period has been extended and carriers will accept the agreements postmarked as late as February 17, 2004. For the complete listing of the new Medicare fees, go to MEMBERS ONLY section under INS. & MANAGED CAREE and then select MEDICARE:


Nation's Largest Insurers Meet with ACA To Improve Relations Between Insurance Industry and Chiropractic Profession

Continuing to build an infrastructure between the insurance industry and the chiropractic profession, the American Chiropractic Association (ACA) recently participated in the latest in a series of conferences with leaders of several major insurance groups. Known as the Claims Solutions Work Group (CSWG), the conference was held in Chicago, IL, and featured senior-level executives of the ACA, the National Association of Independent Insurers (NAII), Shelter Insurance, Farmers Insurance, Allstate, national and state BlueCross BlueShield, General Casualty Insurance, AAA, Erie Insurance Group, American Family Insurance and Metropolitan Life Insurance, among others. Hosted by NAII, the largest property/casualty insurance association, the meeting marked the sixth time ACA has participated in a CSWG conference since 1999. Expanding upon breakthroughs achieved from past CSWG meetings, the participants discussed chiropractic reimbursement issues, developed joint projects that will support a better relationship between insurers and doctors of chiropractic, and identified priorities for the coming year. Specific problematic billing codes were also discussed, including extra-spinal CMT, neuromuscular reeducation, testing and measurement codes, massage, hot packs, manual therapy (97140) and E/M codes with CMT. Many insurers agreed to review their practices and those of their business partners as they relate to these codes. ACA President Donald Krippendorf, DC, has noticed continued, dramatic improvement in the communication and cooperation between payers and doctors of chiropractic as a result of the CSWG conferences. "In four short years the participants of the Claims Solutions Work Group have constructed a bridge between insurers and chiropractors that did not previously exist. The ACA is proud to be a part of this most important program." According to Paula Pfankuch, a senior manager with BlueCross BlueShield of Illinois, the meeting "really turned out to be a great day." Pfankuch added that BlueCross BlueShield of Illinois is "on board" and plans to participate in the next Claims Solutions Work Group meeting in the Spring. The next in the series of CSWG conferences is scheduled for March 3, 2004, in conjunction with ACA's annual National Chiropractic Legislative Conference (NCLC) in Washington, DC. Source: American Chiropractic Association

Acupuncture Decreases Somatosensory Evoked Potential Amplitudes to Noxious Stimuli in Anesthetized Volunteers

The effect of acupuncture on pain perception is controversial. Because late amplitudes of somatosensory evoked potentials (SEPs) to noxious stimuli are thought to correlate with the subjective experience of pain intensity, we designed this study to detect changes of these SEPs before and after acupuncture in a double-blinded fashion. Sixteen volunteers were anesthetized by propofol and exposed to painful electric stimuli to the right forefinger. Then, blinded to the research team, the acupuncture group (n = 8) was treated with electric needle acupuncture over 15 min at analgesic points of the leg, whereas the sham group (n = 8) received no treatment. Thereafter, nociceptive stimulation was repeated. SEPs were recorded during each noxious stimulation from the vertex Cz, and latencies and amplitudes of the N150 and P260 components were analyzed by analysis of variance. P260 amplitudes decreased from 4.40 ± 2.76 µV (mean ± SD) before treatment to 1.67 ± 1.21 µV after treatment (P < 0.05), whereas amplitudes of the sham group remained unchanged (2.64 ± 0.94 µV before versus 2.54 ± 1.54 µV after treatment). In conclusion, this double-blinded study demonstrated that electric needle acupuncture, as compared with sham treatment, significantly decreased the magnitudes of late SEP amplitudes with electrical noxious stimulation in anesthetized subjects, suggesting a specific analgesic effect of acupuncture. IMPLICATIONS: This double-blinded study demonstrates that electric needle acupuncture, as compared with sham treatment, significantly decreases the magnitudes of late somatosensory evoked potential amplitudes with electrical noxious stimulation in anesthetized subjects, suggesting a specific analgesic effect of acupuncture.


Advisory panel nixes VA patient self-referral to chiropractors

Chiropractic care at the Dept. of Veterans Affairs could expand dramatically, if the final recommendations of the VA chiropractic advisory committee are followed. "Any provider of care in the VA would be able to refer a patient for chiropractic services," said Warren Jones, MD, a member of the advisory committee and immediate past president of the American Academy of Family Physicians. This would mean that nurse practitioners and rehabilitation therapists could be making referrals as well as orthopedic surgeons and primary care physicians.


Omega 3 fatty acids and cardiovascular disease—fishing for a natural treatment

Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease. This article reviews the evidence regarding fish oils and coronary disease and outlines the mechanisms through which fish oils might confer cardiac benefits.