Friday, October 27, 2006

My first cyberspace blog for those who love their chiropractor

This is my first post on my attempt to communicate who I am, what I stand for and to give people an understanding on what goes on in the heart and mind of their chiropractor.

Foremost, most of the chiropractors got into the profession to help others. There are many means for doing so and our profession has been the underdog for many patients whose complaints have gone inadequately taken care of by other methods. Many of those who fall through the cracks of the healthcare system land in our offices, often after spending time and money on health care solutions that plainly just did not work. Many of these approaches may have included care by other chiropractors with a different philosophy, those who spent months in physical therapy with no improvement, those who did pain management and those who their doctor just simply either kept them on medications with their side effects and in some cases, just refused to even allow the idea of them seeing a chiropractor.

What I find interesting is that we help the larger majority of people who come to us with problems such as neck pain, back pain but in my case, I am highly skilled in problems in the arms, and legs such as carpal tunnel and plantar fascitis. Many of the studies show our results superior to other approaches for neck and back pain but many of these studies unfortunately, are short sited because they are from the symptom model. That is the model that most of us learned in school where you come into the office with neck or back pain and the doctor treats the pain, and not the reason for it.

I moved away from this when I realized it plain does not work well in musculoskeletal conditions. If you really look at the literature, you can extrapolate that most back and extremity issues including shoulder and knee problems have to do more with the gait (way someone walks), body style (which is inherited) and overall body symmetry/assymmetry which is part of body style.

The symptom model has cost us dearly. Look at how expensive it is to get care that is clueless (does not understand the problem but attempts to throw therapies at it hoping something will stick). Look at how many MRI's are ordered that are negative. A better understanding of how to evaluate the musculosketal system can eliminate the need for many of these. Instead, insurance companies hire gunmen such as carecore who make us fill out reams of paper and waste time when these tests are truly appropriate. Ask your doctor, I am sure they love this company (sarcasm). Often, care for the problem may cost less from a chiropractor than the test itself. Really, unless I think someone is beyond what we can do conservatively, or unless something does not seem right with a cases progression, an MRI a huge waste of health care resources.

In our profession, there are a variety of approaches, some better than others. I try to stay ahead of the curve and use what will get the job done in the shortest period of time. Insurance companies think that is not short enough. Infact, United Healthcare purchased a company called ACN Group to manage our care for us (since they believe we cannot do this by ourselves). Their meddling in patient care is why our patients need an advocate (me). We constantly need to fight for your right to get the care you need.

Most patients dont know much about this except for these annoying forms we have them constantly fill out. By the way, if they dont tell us you need to be certified and you do, they penalize us for their stupidity and make us nuts (what does that have to do with patient care, I will never know). Lately, they have taken to demoralizing us with threats of expulsion if you dont play by their book and they will likely be looking at a class action suit. There are others that do the same, but pay us less so it does not even pay for us to join those networks. ASHN is one that has singlehandedly demoralized chiropractors in California by flooding them with paperwork, signing contracts with major healthcare plans and then underpaying the doctors. Recently, I saw something that stated that only 47% of the money they made from approx 208 million dollars went to the doctors. The rest apparently went to administration, etc.

Wouldnt this be better spent on treating patients? Paying doctors a living wage?

While this may sound like I am ranting, perhaps I am alittle, but these are the realities of todays doctor of chiropractic. I am on the state societies insurance committee and I am determined to make a difference for our patients, for their chiropractors and for the care of the musculoskeletal system.

Care needs to make sense. If it doesnt, then we are wasting health care resources. We see our healthcare bill go up every year and we get less. Where is that money going? Hospitals, administration, doctor care (insurance carriers have methodically reducing provider reimbursements each year while their overheads continue to rise). Yet you hear about their CEO's taking bonuses and they hire outside companies to limit care, but you pay more. Sounds fishy, doesn't it.

So much for my first post. I will be coming back here periodically to let you know what I think, what happens in my practice life, the lives of our patients, the breakthroughs, miracles and other stuff that goes on in a chiropractors office

Nuff said

DR C