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Legislation Would Include Chiropractic Physicians in U.S. Public Health Service

Arlington, Va. - A new bill in the U.S. House of Representatives would improve the quality of America's health care infrastructure by further integrating doctors of chiropractic (DCs) into the nation's official delivery and research networks. H.R. 3851, introduced by Rep. Gene Green (D-Texas), calls for the appointment of chiropractic physicians as officers in the U.S. Public Health Service (USPHS) Commissioned Corps. 

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Q&A with the NY State Board of Chiropractic Education

1) What is the role of the Chiropractic State Board?


The New York State Board for Chiropractic serves as the regulatory body for chiropractic in New York and serves in an advisory capacity to the Board of Regents. There are over 50 different state boards that the Office of the Professions has established through the New York State Education Department. The primary role of these state boards is to protect the public by ensuring that complaints that are filed by consumers are investigated and dealt with fairly and in an unbiased nature. These complaints can be quite varied and can range from scope issues, boundary violations, fraud and any other aspect of unethical practice.

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Update from the NYS Board of Chiropractic Education

Our July meeting at New York Chiropractic College in Seneca Falls was a “twopart” meeting. After Executive Session (in which no disciplinary cases were discussed), Drs. Nicci and Mestan offered a presentation about the efforts that the College has recently put forth to advance the profession. These efforts involve the opening of new community outreaches as well as efforts to improve clinical experiences as graduates move on to treat a more diverse population. Also, within this presentation was a description of the changing demographic of chiropractors themselves, showing dramatic increases in the number of women and minorities following the chiropractic path. New Board members, Dr. Mark Craft and Dr. Elaina Pirro-Lombardi were officially welcomed.

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It is All About Scope

Keynote Address By David Herd DC, ACA Vice President at the NYSCA 2015 Spring Convention at Mohegan Sun

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National Chiropractic Health Month 2015: Pain Free Nation!

Hosted by the American Chiropractic Association (ACA), National Chiropractic Health Month (NCHM) is a national public awareness and education campaign held each October. NCHM strives to teach health care consumers about the benefits of chiropractic services and to promote the expertise of doctors of chiropractic (DCs) in helping their patients reach optimal levels of health and wellness.

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DCs Call for Conservative Treatments for Pain Management Amid Prescription Painkiller Epidemic

Arlington, Va. - During National Chiropractic Health Month (NCHM) in October, the American Chiropractic Association (ACA) will work with thousands of doctors of chiropractic (DCs), chiropractic assistants (CAs) and chiropractic doctoral students nationwide to bring attention to the public health crisis caused by pain, and in particular the overuse of prescription painkillers, with this year's theme #PainFreeNation. The campaign is part of the profession's ongoing efforts to educate the public about the value of exhausting conservative forms of care for both acute and chronic pain before resorting to higher risk options, such as opioids.

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ACA Statement on NCCIH's New Report on Pain in the United States

 

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Study: Chiropractic Care and the Risk of Vertebrobasilar Stroke

Abstract

Background

There is controversy surrounding the risk of manipulation, which is often used by chiropractors, with respect to its association with vertebrobasilar artery system (VBA) stroke. The objective of this study was to compare the associations between chiropractic care and VBA stroke with recent primary care physician (PCP) care and VBA stroke.

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A Systemic Analysis for the Global Burden of Disease Study 2013

The Global Burden of Disease 2013 study was published online in the Lancet. Musculoskeletal disorders account for 20% of disability worldwide and back pain is the biggest single cause of disability worldwide. Neck pain is also a major cause of disability. It has been covered by several news services. You will see that the paper highlights the lack of policies and priorities for these common disabling conditions. For some of the coverage see:

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JLTF Alert: Calling All Members to Support A4391

 

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ACA Presses Federal Government to Encourage Use of Conservative Forms of Pain Management

 

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Chiropractic Physicians Urge Conservative Approach to Pain Management

 

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The Specialized Soft Tissue Instrument used in ConnecTX Therapy is Granted a U.S. Patent

 

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ACA's NCHM 2015 Theme Announced: Pain Free Nation!

 

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Clinical Compass Releases Low Back Update

Clinical Compass, powered by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP), has posted an update to the "Clinical Practice Guideline: Chiropractic Care for Low Back Pain." This document is online and available for public review and comment. 

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APHA Public Health Event: The Global Burden of Spine Pain

 

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Scope policy and College of Pharmacology and Toxicology

During the American Chiropractic Association’s (ACA) annual House of Delegates meeting in February, delegates passed resolutions supporting key elements in scopes of practice and the creation of the ACA College of Pharmacology and Toxicology. Based on membership responses, these policy resolutions have proven quite positive. To no one’s surprise, however, other organizations and special interest groups have associated these policies with “incorporating drugs into the scope of chiropractic practice and promoting the term chiropractic medicine.”

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Terrence Murphy, DC Wins Senate Election

 

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Scientifically speaking— Does chiropractic really help back pain?

Science is hard; good science is more difficult.

When I entered this profession in the late 1970s my naive belief was that since chiropractors were obviously getting people better, all we needed for our ac-ceptance to skyrocket was research showing that chiropractic works.

Flash forward to today. Despite many practice challenges, chiropractic is now far better accepted socially, as well as by other healthcare professionals. It’s been quite a while since I've been called a quack. Last week I went to dinner with six DCs and six MDs- neurosurgeons, neurologists and other NMS docs. The topic of mutual referral underlies many of the conversations, but these collaborations would never have occurred 20 years ago. Plus demand is up, as there’s been a tremendous increase in the problem back pain during the 21st century – a good thing for those treating back pain.

But are chiropractors’ social popularity and success skyrocketing?

Insurance companies continue to tighten the economics of practice as we enter the grand PPACA healthcare system experiment, better known as ObamaCare. Time will tell whether it was bold or foolish, but no one is claiming it is going to fix the growing problem of back pain in an aging, slumped over society.

It seems as though just as physicians and other providers accept us more, the individual practitioner has less ability to steer patients to DCs, because now the MD has become an employee. Medical Homes and other entities with acronyms like ACOs and PCMHs are ascendant, with protocols written by committees of administrators and accountants (as well as some clinicians) who look at the ―scientific evidence.”

And research does show the value of spinal manipulation, but often in less glowing terms than myself and our researchers hoped.

The problem of quantifying back pain

The problem—science is hard. My friends who are scientists continually repeat that the plural of anecdote is not data. They require the use of dimly recalled things from Statistics 101 like chi-square and T tests to determine “statistical significance.” To scientifically and statistically prove something requires showing there is less than one chance in 20 that whatever you are studying happened by chance. Also known as P= <.05, reaching this probability means controlling for all other possible variables.

For back pain, there’s an amazing variance of flavors of patients and their com-plaints. Patient history and the specifics of the problem onset and character is one. Does the pain radiate into the SI joint in the low back only, both SI joints, or going into the buttocks? A really important but often neglected factor is bio-psycho-social, where intertwining of the person's psychological involvement with their pain creates psychological and personal benefits (think more attention or a bigger settlement) and creates a spiral of negative behavior.

The multifactorial nature of back pain is probably the one thing on which all the low back pain research agrees. Regarding spinal manipulation, unfortunately the 200 plus studies currently in the journals don’t fully agree, but new exciting studies are coming out which demonstrate the effectiveness of chiropractic, as well as pointing to a role for the DC in the health delivery system.

Meta-studies draw improved conclusions

A big trend in science is doing a study to look at a number of other studies in a meta-study, which is essentially pooling data to see what works best.

A 2013 study published in SPINE by Goertz looked at eight of these systematic reviews and reported that, indeed, chiropractic manipulative therapy can moderately reduce low back pain and disability.

The study: “Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results of a pragmatic randomized comparative effectiveness study.”

The results: “Chiropractic manipulative therapy in conjunction with standard medical care offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP” care.1

In other words, chiropractic makes medical care better.

A possible suggestion for these researchers’ next study: Compare chiropractic plus medical care to chiropractic care alone. Another even more exciting study was just published in the Annals of Internal Medicine. “Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain” looked at what happens when you add chiroprac-tic to an exercise and posture advice program already shown to improve low back pain.

Bradford’s team at Northwestern University of Health Science Advice taught ge-neric awareness such as, “Patients were also instructed in methods for developing spine posture awareness related to their activities of daily living, such as lifting, pushing and pulling, sitting, and getting out of bed.”

The study’s result: Adding chiropractic gave even better results than the exercise and advice alone.2 In both of these studies, researchers controlled for a multifactorial problem by adding chiropractic to something whose effectiveness was already measured. Both studies’ results counter the arguments that back pain is psychological, or that some improvements occur when you teach people exercises and give them postural advice. In other words, posture training helps and placebo effects may be real…but so are the positive changes seen with chiropractic manipulative therapy.

Chiropractic really does help back pain, as does exercise, as does postural advice. And, when it’s all combined, patients do even better!

But practice is not a research environment. In Bronfort’s study, home exercise and advice were delivered in four 1-hour, one-on-one visits during a 12-week intervention. The main program goals were to provide patients with the tools to “manage existing pain, prevent pain recurrences, and facilitate engagement in daily activities.” And while research is fantastic, in the real world chiropractic practice economics defines what can be done. Especially in these days of third party reimbursements, it’s smart to effectively fit programs into sequenced 8-15 minute encounters, program care to be systematically individualized and progressive, and be able to have different staff reliably and reproducibly teach the exercises and posture awareness.

This is why the StrongPosture® exercise protocols and PostureZone® framework is a great way to systematically teach exercise and also communicate with patients, the public and other professionals.

The PosturePractice Model

By first engaging people with a picture from an app (see above image), and then communicating concepts of PostureZone© biomechanics, the message can apply to spine care, as well as people with other neuromuscular skeletal issues including extremity concerns, hip to foot and shoulder to hand. Plus, Baby Boomers concerned about hunching over and athletes seeking performance also value posture. And while not clinical, for many a significant appeal of the PostureZone© framework is vanity’s appeal— people who stand tall with strong posture simply look better.

Once people are interested and engaged with posture awareness, the StrongPosture® exercises use the PostureZone© cueing in an actionable framework to systematically strengthen functional postural balance, alignment and motion in a daily posture exercise habit, individualized to for the patient and applicable to multiple demographics.

These posture concepts are receiving increasing coverage in national and local media. Dynamic Chiropractic’s October 1st front page article covered how posture is the DC-MD bridge, and on the general public side the November 2014 issues of SHAPE as well as RealSimple magazines talked about the benefits of improving posture.

Through the trends of both clinical research and media, it has become clear that people are interested in chiropractic care and how our services can help them to live longer, healthier lives. As we venture into a new era of healthcare practices, it makes sense to position the chiropractic profession into a place of value, both in the eyes of other wellness profes-sionals as well as those of the consumer.

About the Author

Dr. Steven Weiniger is an internationally recognized posture expert who has trained thousands of doctors, thera-pists, trainers, and other health and well-ness professionals to help people stand taller with the StrongPosture® exercise protocols.
Dr. Weiniger literally wrote the book on improving posture, Stand Taller ~ Live Longer: An Anti-Aging Strategy, and his team at BodyZone promotes pos-ture awareness with the free Posture-Zone screening app for iPhone. His articles and expertise on posture, anti-aging, exercise, and practice manage-ment have been featured extensively in professional journals and mainstream media.

1—Goertz, C. M., Long, C. R., Hondras, M. A., Petri, R., Delgado, R., Lawrence, D. J., . . . Meeker, W. C. (2013). Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results of a pragmatic randomized comparative effectiveness study. Spine, 38(8), 627-34. doi:10.1097/BRS.0b013e31827733e

2—Bronfort, G., Hondras, M. A., Schulz, C. A., Evans, R. L., Long, C. R., & Grimm, R. (2014). Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: A trial with adaptive allocation. Annals of Internal Medicine, 161(6), 381-91. doi:10.7326/M14-000

 

Dr. Terrence Murphy for NY State Senate

Dr. Terence Murphy, a chiropractor in Westchester, is running for the NY State Senate. His election would be very significant for the chiropractic profession as a voice in the NYS Senate. Please consider giving him your support.

You can get more information at www.VoteforMurphy.com

About Dr. Murphy

Dr. Terrence Murphy’s family originally moved to Yorktown 52 years ago when Yorktown’s mascot, the Cornhusker, was still a common and public sight. Growing up next to Wilken’s Fruit Farm, Terrence enjoyed an incredible childhood which included apple picking and skating on Mill Pond. As the youngest of six children, Dr. Murphy learned at a young age how to stick up for himself. His father Jack, a blue-collar, union man and labor advocate who worked for Con Edison for over fifty years taught him the importance of hard work, dedication, and commitment to community.

Remembering his father’s teachings of the importance of community Dr. Murphy was always willing to help others in need. It was of little surprise to his family when he decided to study chiropractic following his graduation from Yorktown High School in 1984. Terrence’s time away from Yorktown was a blessing in disguise. It allowed him to become an independent individual, traveling the world as a member of a world class rugby team, while reinforcing his love and passion for his home town.

In 1999, Dr. Murphy made his first official mark on Yorktown by opening the Yorktown Health and Wellness Center on Commerce Street. Standing in the same storefront today as then Dr. Murphy has exhibited his father’s lessons of hard work, dedication, and commitment to his community.

Following the passing of his father, Dr. Murphy, opened Murphy’s Restaurant in Yorktown in 2006, with his Mom Deneyse, and older siblings, Colleen, Erin, Sean, Denis, and Pat. As a tribute to their father, Murphy’s stands as one of Yorktown’s largest and most successful businesses and has been recognized twice for providing employment opportunities for the mentally challenged.

Dr. Murphy’s commitment to the Yorktown community does not stop there. For fifteen years he volunteered for the Yorktown High School Athletic Department caring for our young athletes as an on-field medical professional. Terrence served for nearly ten years as a New York State certified EMT and started the watchdog organization Keeping Westchester Safe.

Today, Dr. Murphy continues his chiropractic practice while assist in managing his family’s restaurant. Always keeping family first, Dr. Murphy’s favorite time spent is with this wife Caroline, and children McKayla, Jack, and Kian.