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 www.palmerbeacon.com. . 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.

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.

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.

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.

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.

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 www.MaineInsuranceReg.org; 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.

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: http://www.acatoday.com/government/other/candidates_endorse.shtml 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

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:

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

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.

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 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.

At its meeting on December 8, 2003, the Commission on Colleges of the Southern Association of Colleges and Schools (SACS) denied reaffirmation of accreditation, continued accreditation, and continued the probation for another year. For failure to comply with Criteria Section 1.4 (Condition of Eligibility Thirteen—Finances) and Section 6.3.1 (Financial Resources). SACS's will provide written confirmation, probably by the end of next month. According to a story in Atlanta Journal-Constitution, the school officials see it as a small victory in a tumultuous few years. Life University, is located in Marietta, Georgia

Life’s lost its accreditation in June 2002 and has since suffered a huge decease in enrollment. Life got their accreditation back, but due to bad public relations their image was hurt and enrollment has remained low. With so few students, the university can no longer pay back its debts, totaling $30.7 million. The SPSU foundation plans to take on Life’s debt, buying the campus for a fraction of it’s appraised worth. The foundation plans to take on Life’s $30.7 million debt, which comes out to be a $2.7 million annual payment. This is a great deal since the campus was appraised for $52 million. The foundation intends to pay the debt with bonds, which they will subsequently pay off with monies from rent to be paid by Life University, SPSU, and possibly the Georgia Public Library Service. Life will rent back 50% to 60% of the campus (four or five buildings). SPSU will also pay the rent for the portions of campus they use. Since SPSU’s budget is already tight, Dr. Rossbacher is trying to get the Board of Regents (BoR) to take over SPSU’s rental costs. On November 18, the BoR approved the foundations proposal to begin planning for the purchase of the land. Early next semester, when planning is finished, Dr. Rossbacher will give the formal proposal requesting that the BoR take on SPSU’s rental costs. Unfortunately, even if the BoR does approve the proposal, they cannot legally guarantee that the money will be available every year. Dr. Rossbacher commented that the BoR does not make rash investments so if they approve the money, she asserted that they will most likely make the money available every year. Along with the acquisition of the campus, the foundation will also buy the apartments located on Life’s campus. The foundation plans to finance these apartments in the same way as the University Courtyard on SPSU’s campus – the foundation will sell bonds to pay for the apartments up front and use rent for the apartments to pay off the bonds. Unlike the University Courtyard, Life’s apartments are going to be used for married couples that attend SPSU, Life, and possibly Kennesaw State University. The apartments will add 128 units with some apartments having 1, 2 or 3 bedrooms. The merging of the SPSU and Life’s campuses will add a lot of space to SPSU. SPSU is 226 acres now and the addition of the Life campus will add another 89 acres, plus a few more with the apartments. There would be an additional 12 buildings with a total of 433,000 square feet of space. One of the buildings SPSU will be getting is the “Tree House,” which was built before the 1900’s and was the house of the old caretaker of Marietta’s water supply. This building has a big commercial kitchen, a dining room, and many meeting rooms. Dr. Rossbacher hopes that it can be used as a fundraising tool and for campus events since the student center has become very popular and SPSU organizations and faculty sometimes cannot get space for events. The 1415 building on the far end of Life campus would be used for classrooms if the Georgia Public Library Service doesn’t rent it. Most of the other space on campus is good for seminars rather than classrooms, except for in the gymnasium. The gym has classroom space along with basketball courts and athletic facilities. Another addition is going to be a well-manicured soccer stadium and two rugby fields. The foundation, in addition to the purchase of Life’s campus, plans to give SPSU $5 million to renovate both campuses. Two plans for this money are to convert the old gym on SPSU’s campus into studio space and tear down the I-building. The two campuses will also be connected with a road. The road that runs in front of the utilities buildings, which almost connects the campuses, most likely will be extended to unite SPSU and Life. Another place for suitable for a road has not been identified. Walkways, foot bridges, and maybe bike paths will be put in. Further, the fence that now separates the campuses will be taken down. Right now, Life is under Southern Association of Colleges and Schools (SACS) accreditation review. On December 6-9, Life is sending a delegate to represent them at the annual meeting of the SACS board in Nashville, TN, where the board will reveal its decision on Life’s accreditation. Dr. Rossbacher is confident that even if Life is unable to rent the property from the foundation, SPSU will figure out a way to keep the campus. Rossbacher stated that there are other parties that are interested in renting parts of the campus and added that the foundation has been looking at Life campus for a long time, which she emphasized makes her confident that they would look at all situations seriously in hopes of acquiring the property. Life University will be added to SPSU by July 2004 if everything goes as planned. The BoR must approve the proposal for final planning and financing of the acquisition. This means that by fall semester next year, Life will likely be part of the campus. Life’s lost its accreditation in June 2002 and has since suffered a huge decease in enrollment. Life got their accreditation back, but due to bad public relations their image was hurt and enrollment has remained low. With so few students, the university can no longer pay back its debts, totaling $30.7 million. The SPSU foundation plans to take on Life’s debt, buying the campus for a fraction of it’s appraised worth. The foundation plans to take on Life’s $30.7 million debt, which comes out to be a $2.7 million annual payment. This is a great deal since the campus was appraised for $52 million. The foundation intends to pay the debt with bonds, which they will subsequently pay off with monies from rent to be paid by Life University, SPSU, and possibly the Georgia Public Library Service. Life will rent back 50% to 60% of the campus (four or five buildings). SPSU will also pay the rent for the portions of campus they use. Since SPSU’s budget is already tight, Dr. Rossbacher is trying to get the Board of Regents (BoR) to take over SPSU’s rental costs. On November 18, the BoR approved the foundations proposal to begin planning for the purchase of the land. Early next semester, when planning is finished, Dr. Rossbacher will give the formal proposal requesting that the BoR take on SPSU’s rental costs. Unfortunately, even if the BoR does approve the proposal, they cannot legally guarantee that the money will be available every year. Dr. Rossbacher commented that the BoR does not make rash investments so if they approve the money, she asserted that they will most likely make the money available every year. Along with the acquisition of the campus, the foundation will also buy the apartments located on Life’s campus. The foundation plans to finance these apartments in the same way as the University Courtyard on SPSU’s campus – the foundation will sell bonds to pay for the apartments up front and use rent for the apartments to pay off the bonds. Unlike the University Courtyard, Life’s apartments are going to be used for married couples that attend SPSU, Life, and possibly Kennesaw State University. The apartments will add 128 units with some apartments having 1, 2 or 3 bedrooms. The merging of the SPSU and Life’s campuses will add a lot of space to SPSU. SPSU is 226 acres now and the addition of the Life campus will add another 89 acres, plus a few more with the apartments. There would be an additional 12 buildings with a total of 433,000 square feet of space. One of the buildings SPSU will be getting is the “Tree House,” which was built before the 1900’s and was the house of the old caretaker of Marietta’s water supply. This building has a big commercial kitchen, a dining room, and many meeting rooms. Dr. Rossbacher hopes that it can be used as a fundraising tool and for campus events since the student center has become very popular and SPSU organizations and faculty sometimes cannot get space for events. The 1415 building on the far end of Life campus would be used for classrooms if the Georgia Public Library Service doesn’t rent it. Most of the other space on campus is good for seminars rather than classrooms, except for in the gymnasium. The gym has classroom space along with basketball courts and athletic facilities. Another addition is going to be a well-manicured soccer stadium and two rugby fields. The foundation, in addition to the purchase of Life’s campus, plans to give SPSU $5 million to renovate both campuses. Two plans for this money are to convert the old gym on SPSU’s campus into studio space and tear down the I-building. The two campuses will also be connected with a road. The road that runs in front of the utilities buildings, which almost connects the campuses, most likely will be extended to unite SPSU and Life. Another place for suitable for a road has not been identified. Walkways, foot bridges, and maybe bike paths will be put in. Further, the fence that now separates the campuses will be taken down. Right now, Life is under Southern Association of Colleges and Schools (SACS) accreditation review. On December 6-9, Life is sending a delegate to represent them at the annual meeting of the SACS board in Nashville, TN, where the board will reveal its decision on Life’s accreditation. Dr. Rossbacher is confident that even if Life is unable to rent the property from the foundation, SPSU will figure out a way to keep the campus. Rossbacher stated that there are other parties that are interested in renting parts of the campus and added that the foundation has been looking at Life campus for a long time, which she emphasized makes her confident that they would look at all situations seriously in hopes of acquiring the property. Life University will be added to SPSU by July 2004 if everything goes as planned. The BoR must approve the proposal for final planning and financing of the acquisition. This means that by fall semester next year, Life will likely be part of the campus.

President Bush on Monday signed into law the most far-reaching changes in Medicare in nearly four decades.(H.R.1 an act to amend title XVIII of the Social Security Act to provide for a voluntary prescription drug benefit under the Medicare program and to strengthen and improve the Medicare program, and for other purposes) most sweeping changes to Medicare since its creation in 1965. Included in this sweeping legislation in Sec 651 is a provision for DEMONSTRATION OF COVERAGE OF CHIROPRACTIC SERVICES UNDER MEDICARE. To read Sec. 651 view page 436 of the link below.

Letters to the Editor Crain’s New York Business 711 Third Ave. New York, NY 10017-4036 Re: Samantha Marshall: More chiropractic visits put strain on employers File: P - 1 Dear Editor; The article by Samantha Marshall, “More chiropractic visits put strain on employers,” carried in the November 10, 2003 issue of Crain’s New York Business, is factually wrong and is more worthy of the kind of tabloid journalism one might expect to find at grocery market checkout counters. Mashall squarely puts the onus for any pending increases in Workers’ Compensation premiums on increased utilization of chiropractic care. Although as an absolute number, chiropractic utilization may have increased over the last few years, in terms of cost, the total amount spent on chiropractic is still a mere fraction of a percent of the $4.27 billion employers paid in workers' compensation premiums of under the Workers’ Compensation system. If there is any increase in Workers’ Compensation premiums, it likely parallels the escalating costs of health care in general, none of which have been attributed to chiropractic care. As studies conducted by forecasting firms, Hewitt Associaties1, Kaiser Family Foundation2, the California Healthcare Foundation3, Price Waterhouse Coopers4 and others illustrate over the last four or five years, health care costs have spiraled upward reaching the double digit stratospheres reminiscent of the early 1990s. However, forecasters place the blame for most of the increases squarely on rising cost of hospitalization and drugs,5 not chiropractic. Ms. Marshall’s statement that, “Costs have begun to rise recently in New York, where blanket coverage of chiropractic care is relatively new” is factually wrong. While chiropractic care has been covered service under the Workers’ Compensation system since 1975, the coverage Marshall refers to is not “blanket” or “new.” In fact, in New York, chiropractors are probably the lowest paid of all providers in the entire Workers’ Compensation Reimbursement system. In contrast to other providers, under the Workers’ Compensation fee schedule, chiropractic rates are capped at a reimbursement level equivalent to fifty percent (50%) of ninety-five percent (95%), or roughly 47.5% overall of the rate paid to a general practitioner, and significantly lower than the rate paid to medical specialists, a situation that has prevailed in New York since 1975. In addition, pursuant to the Workers’ Compensation fee schedule chiropractors are not reimbursed at all for many treatments and procedures they are entitled to perform by law. In addition, any cases controverted by insurers and employers are sent to a Workers’ Compensation Practice Panel for adjudication, as they are for other classes of provider. Ms. Marshall’s contention that “a bill introduced into the Assembly this summer, which has a good chance of passing in the next legislative session, would allow chiropractors to expand their fee schedules,” misses the mark. Bills have been introduced for several years that have had as their intent making the reimbursement of chiropractors equitable with other providers in the Workers’ Compensation system. This is a question of equity and fairness, and given the fact that the Legislature has thus far been unmoved, Ms. Marshall’s intimation that this bill “has a good chance of passing in the next legislative session” and “would allow chiropractors to expand their fee schedules” smacks of an appeal to emotional sensationalism, and is not genuine, professional, journalistic reporting. Ms. Marshall also has her facts wrong concerning the impact of the 1997 chiropractic Insurance Equality Law (effective 1998). Marshall states that, “The 1997 Chiropractic Care Act mandated that injured workers eligible for workers' compensation could receive almost unlimited chiropractic care.” (underlining added). Had Ms. Marshall actually bothered to take the time to read the Insurance Equality Statute she would have discovered that the Insurance Equality Law was an equity statute designed to give patients the same access to and equivalent coverage for chiropractic care in health insurance plans as they would receive for medical care provided to physicians. The 1997 Insurance Equality Law had nothing to do with and had no impact whatsoever on Workers’ Compensation Law, Workers’ Comp carriers or plans or employers. To suggest that the 1997 Insurance Equality Law allowed “the New York workers' compensation system [to] create the perfect climate for excessive use of chiropractic services,” is patently false. It calls into question Ms. Marshall’s ability to be fair, objective and balanced in her reporting. Likewise, Marshall incorrectly states that “chiropractors successfully sued several major insurers two years ago for more equitable coverage.” Had Ms. Marshall actually done any sort of investigation she would have learned that the courts had dismissed the suit holding that chiropractors had “no private right of action” to assume the responsibility for enforcing a law that was completely within the ambit of the State Insurance Department. Finally, Marshall and Crain’s reference to Dr. Daniel Quatro, President of the New York State Chiropractic Association as “Mr. Quatro” is an insult. The Federal government and State governments nationwide extend the courtesy of referring to doctors of chiropractic as “Dr.” in recognition of their extensive educational attainment, which studies show, is on par with other health care providers, including physicians.6 This disrespect is antediluvian and reflects, perhaps, part of the “lingering effects” a federal court found when it held organized medicine guilty in 1987 of a “long-term,7 systematic,8 successful,9 and unlawful”10 attempt to “contain and eliminate”11 the “chiropractic profession”12 by any means, legal and unlawful. In 1987, the Federal Court concluded a permanent injunction against organized medicine was necessary because “[t]here are lingering effects of the conspiracy”; because organized medicine “never acknowledged the lawlessness of its past conduct . . . ”13; and because the 'lingering effects' [of organized medicine’s campaign] still threatened plaintiffs with current injury.”14 Unwittingly perhaps, Crain’s contributes to that legacy. Crain’s does its readers a disservice by communicating information in this article that is just plain factually wrong. This type of shoddy reporting leaves the impression that Crain’s plays fast and lose with the facts and that its attitude is decidedly cavalier, perhaps intentionally so. Crain’s would do well to make sure that its reporters and writers have a firm grasp of the facts before putting any article to press. If this sort of shoddy reporting and editing one can expect from Crain’s, it certainly does not reflect well upon Crain’s, its reporters, editors or its other publications. Sincerely, Karl C. Kranz, DC, Esq. Executive Director New York State Chiropractic Association 1. Hewitt Associates. “Health Care Costs Continue Double-Digit Pace, But May Start Moderating in 2004,” Lincolnshire, IL, October 13, 2003. 2. Kaiser Family Foundation and Health Reserach and Educational Trust. Employer Health Benefits, 2003 Summary of Findings, September 2003. 3. California Healthcare Foundation. Trends & Analysis: Insurance Markets – Health Benefit Costs: Employers Share the Pain, July 2003. 4. Price Waterhouse Coopers. The Factors Fueling Rising Health Care Costs. April 2002. 5. Ibid. 6. Cherkin DC, Mootz RD. Chiropractic in the United States: Training, Practice, and Research. Agency for Health Care Policy and Research (AHCPR), Department of Health and Human Services (DHHS), Publication No. 98-N002, December 1997. Grant number HS07915 AHCPR. 7. Wilk v. AMA, 671 F.Supp. 1465, 1488 (Dist. Ct. N.D. Ill. 1987) 8. Id. 9. Id. 10. Wilk v. AMA, 895 F.2d 352, 357 (7th Cir. 1990) 11. Wilk v. AMA, 671 F.Supp. 1465, 1473 (N.D. Ill. 1987) 12. Wilk v. AMA,895 F.2d 352 (7th Cir. 1990), cert denied, 496 U.S. 927, 110 S.Ct. 2621 (1990). 13. Wilk v. AMA, 671 F.Supp. 1465, 1488 (Dist. Ct. N.D. Ill. 1987). 14. Wilk v. AMA, 895 F.2d 352, 357 (7th Cir. 1990))

A new study debunking the long- held belief by many that firm mattresses are beneficial for low-back pain should prompt some consumers to re-think their choices in mattresses, according to the American Chiropractic Association (ACA). A study published in the November 15 issue of The Lancet found that people who slept on mattresses of medium firmness were twice as likely to report improvement in low-back pain symptoms than those who slept on firm mattresses. Doctors of chiropractic have long counseled patients that "comfortably supportive" mattresses are superior to very firm "table board" mattresses, said George McClelland, DC, chairman of the board of the American Chiropractic Association. "A medium-firm mattress will more readily adapt to the natural curvatures in a person's spine," he explained. Dr. McClelland and the ACA recommend the following tips for choosing mattresses: If you're not in the market for a new mattress, and your current mattress is too firm, you can soften it up by putting a 1- to 2-inch-thick padding on top of it -- usually available at mattress and bedding stores. A mattress should provide uniform support from head to toe. If there are gaps between your body and your mattress (such as at the waist), you're not getting the full support that you need. Every few months, turn your mattress clockwise, or upside down, so that body indentations are kept to a minimum. It's also good to rotate the mattress frame every so often to reduce wear and tear. If you're waking up uncomfortable, it might be time for a new mattress. There is no standard life span for a mattress; it all depends on the kind of usage it gets. Be aware that changes in your life can signal the need for a new mattress. For example, if you've lost or gained a lot of weight, if a medical condition has changed the way you sleep, or even if you have changed partners, it could mean that it's time to find a new mattress that will accommodate those changes and help you sleep more soundly. When you're purchasing a mattress, don't be embarrassed to actually lie down on it at the store to check its fit and comfort. Don't just sit on it to test it.

When appealing a claim denial from an ERISA health plan, it is important to determine the extent of the plan's chiropractic benefits as well as who made the decision to deny the claim and why, said Karen L. Handorf, deputy associate solicitor in the Plan Benefit Security Division of the U.S. Department of Labor (DOL). All of this information is available to patients, and doctors acting as patient representatives, under new DOL regulations. Employers with ERISA health plans are also obligated under the new rules to follow specific steps in the appeals process. Handorf, whose DOL division is responsible for providing litigation and advisory legal services under ERISA, participated in an Oct. 24 teleconference on new ERISA-related court rulings and Labor Department regulations hosted by ACA for chiropractic attorneys and state association representatives. She told the group that, at present, individual doctors and their patients are better off going through a plan's appeal procedure to obtain benefits rather than filing a lawsuit. If you have to file a lawsuit in federal court, the plan's decision is usually reviewed under an "arbitrary and capricious" standard; you are limited to the evidence that was presented to the plan administrator, and you will not be able to obtain anything more than the benefits that were promised. States can regulate insured plans through their state insurance laws, and the courts are interpreting ERISA preemption language to allow for more expansive regulation of insured plans by the states. ERISA, the Employee Retirement Income Security Act, was passed in 1974 and intended to encourage large multi-state employers to provide pension, health care and other compensation to their employees by shielding them from various state laws governing pension and insurance laws and instead requiring compliance with one set of federal laws. The law, however, also made it difficult for individuals to get relief for denied claims or botched treatment. About 80 percent of workers not covered by a government-based health plan receive their health care through an ERISA-protected plan. In response, the DOL this year issued new claim appeal procedures effective for all health benefit plans subject to ERISA regulations. It includes a specific time frame for filing an appeal, spells out the rights of the plan participants and responsibilities of the plans, and requires the plan to indicate why and on what basis a claim was denied. Handorf told participants that the first course of action should be to obtain the health plan's "SPD" or summary plan description, which describes-in plain, understandable terms-what a beneficiary is entitled to and what his or her rights are under the plan. From this, doctors and patients can determine if the denial is based on limitations allowed in the SPD. "It all comes down to how a plan is written..." says Handorf. "I would think that most plans that provide chiropractic benefits would be pretty specific about it." If a claim is denied for reasons of medical necessity, doctors and patients have the right to know the identity of the reviewer (who should have appropriate training and experience in the specific health care field involved) and the reasons for the denial. Once this information is known, doctors should submit any additional evidence supporting their treatment decisions to the health plan to be included in the official administrative record. Attention to such details of the appeals process is essential; otherwise, evidence may not be admissible further down the line.