4th Quarter Journal 2014 - Arizona Association of Chiropractic

Arizona Association of
Chiropractic
October-November-December
Journal
2014
1
Executive Committee 2013 - 2014
President
David Sheitelman, DC
[email protected]
623-214-7600
Vice President
James Bogash, DC
[email protected]
480-839-2273
Immediate Past President
ReneeAnn Haberl, DC
[email protected]
480-941-2454
Treasurer
Secretary
Jennifer Polk, DC
[email protected]
480-941-1555
Executive Delegate
Kurt vonRice, DC
[email protected]
602-493-8700
District Delegates 2014 - 2015
Delegate
James Sieffert, DC
[email protected]
480-205-9447
Delegate
Terese Farrar, DC
[email protected]
623-975-4057
Delegate
Kurt vonRice, DC
[email protected]
602-493-8700
Delegate
Michael Stone, DC
[email protected]
520-490-9827
Delegate
Melissa Myhr, DC
[email protected]
623-878-0475
Delegate
A. Allen Gentry, DC
[email protected]
520-745-0545
Delegate
Don Dearth, DC
[email protected]
480-756-6044
Delegate
Joanne Siebert, DC
[email protected]
720-206-9906
Delegate
Marc Widoff, DC
480-688-1894
2
Contents:
Pg. 4-6: Dr. Bogash’s Monthly Rant
Pg. 7-9: 2014 NACA Meeting - David M Morrison, ESQ
Pg. 10: Ginger ~ A great complement to Chiropractic Care - Dr. David Seaman, DC
Pg. 11-14: Calendar of Events
Pg. 15-19: Ten Tactics Insurance Companies use to Deny Claims
Pg. 20-24: Busting Through Breast Cancer Myths - Dr. Veronique Desaulniers
Pg. 26: Notes from the political and policy trail - Barry Aarons
Pg. 27: First Impressions are Lasting Impressions - Dr. Rosalind Canham, DC
Pg. 28: Lateral Lower Leg Pain - Dr. Rick Boatright, DC
Pg. 31: Classified Ads
BOARD COMPLAINT?
I CAN HELP!
David M. Morrison, P.C.
Attorney
Representing the Chiropractic
Profession for over 20 years!!
Call for free consultation
Phoenix: (602) 277-6996
Statewide: 1-800-446-7473
The AAC Journal is the official publication of the Arizona Association of Chiropractic,© copyright 2011. All rights reserved. Articles and advertisements in the journal are subject to screening
review at the publication committee. However, the AAC does not necessarily endorse or approve advertising or statements of fact or opinion made in the Journal.
3
Chiropractic & the Injured Worker
~Dr. James Bogash, DC - Lifecare Chiropractic - Mesa, AZ~
As a practicing chiropractor here in sunny Mesa I can tell you that seeing injured workers in my office is a rare event.
Even rarer is a patient who was injured at work who was sent in by his or her HR department to my
office for care. Almost always it is a current patient who was injured at work and wants to be seen
in our office for care because they know how effective we are.
It is rare for me to get frustrated over anything, but having a representative for a patient’s workman’s comp insurance tell me “we don’t refer to chiropractors” just irks me to no end. Even worse
is an existing patient who comes in for care of a work injury and then is told, ILLEGALLY, that they
can’t come into our office for care. The worker is scared to go against his or her employer, even after
assurances by us that they can see us for treatment.
Here in AZ, with a few self-funded exceptions, patients all have a right to see the provider of their
choice. They may be required to make a single visit to a provider that is chosen by the employer,
but that is all they have to do. However, once they have seen a provider twice, that provider controls all care for the course of the injury.
So the patient sees the provider that the employer requires. That provider (which is almost always
one of the two larger occupational or urgent care clinics that use PTs for treatment) then coerces the
patient to come back for another visit under one pretense or another and they get them back in
quick. Frequently the next day.
The patient ends up falling into the scheme and is NEVER given his or her rights, which would be to
see a chiropractor if he or she chose to.
I would just be whining and complaining in this article if it weren’t for one important fact…
It’s a very, very bad idea to NOT see a chiropractor first or at least have one on the care team as
soon as possible. Why? Here are a few of the reasons:
1. The alternative is far more costly.
2. Patients take longer to get back to work and are more likely to become disabled.
3. Medications that actually promote chronicity are more likely to be used.
4. Patients are generally not as happy with the care they receive.
As a chiropractor one would think that I’m just being petty and biased. But regular readers of the
“Rantings” know that I can back up everything that I put in writing. This is no exception.
4
Chiropractic & the Injured Worker
~Dr. James Bogash, DC - Lifecare Chiropractic - Mesa, AZ~ Continued from page 4
In this particular study, researchers looked at 14,787 injured workers over the course of 8 years to
evaluate care patterns for low back pain. They identified 5 distinct patterns of care for the injured
workers:
1. Information and Advice (59% of injuries): The first 6 weeks basically consisted of information
gathering or advice seeking but no overriding pattern. This included simple office visits, laboratory
tests, emergency department or hospital visits, talk therapy, or visits involving imaging (x-ray, ultrasound, CT, or MRI) but no other procedures.
2. Complex Medical Management (2% of injuries): Included more than a single visit to a physician
for nerve blocks, surgeries, or comparable procedures. This is expensive and fragmented care and
runs completely contrary to the way low back pain should be managed.
3. Chiropractic (a paltry 11%): Self-explanatory. Used by the most intelligent injured workers
(ok…so I made this part up).
4. Physical therapy (11%): Self-explanatory.
Dabble (17%): Workers who had one visit to a non-chiropractic physician, chiropractic physician or
PT, or at most one visit to two or more of these categories.
Overall, being good at math, it looks like 89% of the injured population were not under the care of a
chiropractor. Keep this in mind as we go through the rest of the study. I know that here in AZ, this
low percentage is likely a result of steerage by the insurance company, HR employees who do not
understand how effective chiropractic care is, as well as the schemes played at the patient’s expense
by other providers that treat injured workers.
After identifying the 5 patterns, researchers looked at well accepted guidelines for the treatment of
low back pain that is backed up by medical research. There were 11 guidelines that were used to
evaluate the 5 treatment patterns, but here are some snippets to think about:

Early use of (MRI) has been linked to prolonged disability, higher medical costs, and greater use
of surgery at the same time finding no benefit on health or disability outcomes for low back pain.

Chiropractic has been shown to lead to lower likelihood disability recurrence over non-
chiropractic physicians and physical therapists.
5
Chiropractic & the Injured Worker
~Dr. James Bogash, DC - Lifecare Chiropractic - Mesa, AZ~
Continued from page 4 & 5
 In addition, chiropractic care with shorter duration (likely meaning more effective chiropractic
care that seeks to get the patient better ASAP) also leads to shorter disability duration.
More frequent and stronger dosages opioids leads to longer claim durations. Worse, the likelihood
for a catastrophic claim (total cost of $100,000 or more) when spinal surgical procedures were performed increased 10-fold when treatment included opioid use.
It goes without saying that chiropractic care is the antithesis of opioid use.
With all this in mind, here are a few snippets from the study:
 Care to injured workers that was in line with 10 of 11 guidelines led to lower total costs.
 Of the five patterns, complex medical management followed the guidelines the worst in regards
to imaging, surgeries, and medications as well as having the highest total costs.
 Complex management was also linked to the highest rates of prescriptions for four of the seven
drug classes—opioids, other pain medications, SSRI/SNRI/tricyclics, and anxiolytics/sedatives/
hypnotics.
 The PT group was highest in NSAIDs, muscle relaxants, and oral steroids.
 Chiropractic care was on the opposite end of the spectrum, leading to the most alliance with
accepted guidelines, lower total costs and the lowest prescription rates in all seven classes of
drugs.
Previous treatment choices by injured workers influenced future choices for another injury. This
means that, if someone did NOT choose chiropractic care for an initial work injury, if they got injured again they were not likely to seek chiropractic care for the second episode.
There is really not much more to say. Except that maybe all of this information is not new and is
consistent with the findings from a large handful of other studies. Hopefully you can understand
my frustration with the care of injured workers here in Arizona, as well as the extreme confusion
when it comes to chiropractic care being treated as the red-headed stepchild of healthcare when, in
reality, we really rock when it comes to doing what we do.
By avoiding or discouraging chiropractic care for injured workers here in AZ, workers are not getting the best and most cost-efficient care possible. That, quite frankly, is a travesty.
Please contact the Arizona Association of Chiropractic at 602-246-0664 or [email protected] if you have contacts
within HR Departments. We can work with you to set up fully prepared presentations of data demonstrating how
the company can save money by using Chiropractors in Workman’s Compensation Injuries.
6
NACA Meeting Notes June 27-June 28, 2014
David M. Morrison, Esq
The NACA 2014 meeting was attended by representatives from 14 states and the attorney for the
American Chiropractic Association. In addition, we invited a representative from ChiroHealthUSA
to discuss their membership and discount program.
The ChiroHealthUSA presentation revolved around offering a discount program to members. Members are defined as patients of Chiropractic Physicians. This model is being used in several states to
allow for discount programs to patients and to avoid any legal issue with multiple fee schedules.
This presents a way for Chiropractic Physicians to offer discounted services when they are not covered by a health plan or when their patients reach maximum benefits status for chiropractic services.
The purpose of having ChiroHealthUSA make this presentation revolved around the desire of the
attorneys present to understand how to advise their clients in the implementation of discount programs and avoiding plans that are problematic to patients. Examples of these problems are silent
PPO’s, Opt out clauses, and unauthorized discounts by 3rd party administrators.
As an aside, the patient must be informed and it is recommended that they sign an acknowledgement, that any payments made pursuant to the ChiroHealthUSA plan do not apply to any deductible they have with their health insurance company.
Another discount program was discussed with respect to Groupon. Florida has adopted the position
that Groupon is okay as long as there is a disclaimer that the discount does not apply to any Federal
programs or Federal employees. In addition, it must be made clear that the Groupon discount does
not apply to personal injury cases, workers’ compensation cases or any situation where there may be
a 3rd party payor.
Tom Daly, the attorney for the American Chiropractic Association, led a discussion concerning the
content and effect of Section 2706 of Obama Care. This is the section that provides some requirement
that the Obama Care plan be applied in a non- discriminatory fashion. That is the good news. The
bad news is that the Federal programs are allowing the individual State Department of Insurance to
enforce the plan. If there is not a State Department of Insurance, the Federal agency will get involved. However, as we know, Arizona’s Department of Insurance is not supportive of chiropractic
care and not supportive of enforcing non-discriminatory language. Therefore, it will be a two tier
process to get enforcement through the Federal programs. Doctors and patients will have to exhaust
their State remedies before advancing to Federal remedies.
A discussion was held concerning the tactics of ASH and their attempts to pay physicians based on
tier levels. For example, level 5 gets 12 visits, level 4 gets 8 visits etc. This was considered contrary to
the dictates of ERISA. Attorneys in the room came to the conclusion that because of ERISA, the plan
document would rule over the tier levels of ASH.
Continues on page 8
7
NACA Meeting Notes June 27-June 28, 2014
David M. Morrison, Esq ~ Continued from page 7
Thus, any plan that allowed for 24 visits could not be administered by ASH to only allow 12 visits.
We all felt that ASH could not deny care based on the provider tier level versus medical necessity. It
was felt that as long as the doctor could document medical necessity, ASH would have to allow visits up to amount of the actual plan. It is my opinion that the Arizona Association needs to present a
seminar program that educates its members and/or other chiropractics on how to present a valid ERISA claim. This seminar should cover how to do a valid appeal and should cover how to counteract
the various tier levels that ASH is attempting to impose. (Note: already done. Thanks Dr. Bogash).
A panel discussion was held concerning the issue of informed consent. The interesting piece of information that came out of this discussion revolved around having to update your informed consent. It was recommended that every patient sign an informed consent. However, should the patient’s condition change or should the patient’s symptoms change it was discussed that a new informed consent needs to be signed and acknowledged. The acknowledgement would be that not
only did the patient sign the informed consent but that a verbal discussion was had explaining the
informed consent.
We discussed the creation of an IPA by state associations. The Nebraska model was discussed and it
was decided that this model would not be viable for most state associations under the current climate. Specifically, there are anti-trust issues involved in putting together a collection of doctors and
setting of fee schedules. The South Dakota Association, the Connecticut Association, and the Oklahoma Association were all fined by the Department of Justice for anti-trust violations. Some red
flags that were discussed to avoid anti-trust allegations. Associations want to avoid discussing reimbursement targets or price levels, avoid exclusion of chiropractors that are non-members, and avoid
anything that would be considered anti-consumer. It was thought that an IPA would be allowed to
exist if it were only in place to assist in credentialing and in utilization review. However, it was also
suggested this would require a state association to purchase insurance to avoid expenses should excluded physicians sue the association.
The use of lasers was discussed and it was decided that cold lasers would be permissible and within
the scope of practice for most state statutes covering chiropractic. However, the use of hot lasers was
considered outside the scope of practice and malpractice carriers would not cover any complaints
that come in concerning these hot lasers. The definition of “surgery” was discussed in that it meant
any invasive practice that would destroy tissue. Thus, the use of hot lasers might be considered surgery and, therefore, outside the scope of practice for chiropractors.
Continues on page 9
8
NACA Meeting Notes June 27-June 28, 2014
David M. Morrison, Esq. ~ Continued from page 7
Several discussions were had concerning insurance companies request for records and audits of
chiropractic practices. We discussed various methods for handling these intrusions into the chiropractic office and determined that using ERISA to our benefit is the method of choice. Under no
circumstances was it recommended that a chiropractor actually cooperate with these requests for
access to a doctor’s office and/or records. It should be noted that there is a letter on the AAC website that doctors can use to turn the tables on insurance companies that request to obtain records
and visits the doctor’s office. This letter in essence requests an insurance company to cite their legal authority for their request. Without them citing any legal authority, they should not be allowed access to any doctor’s office.
Lastly, we held an interesting discussion on telemedicine. The issue to be discussed revolved
around malpractice insurance, whether or not you are licensed in the state of residence of the patient and if a patient can provide a valid waiver so that you can dispense advice over the computer and across state lines. This is a very up and coming area of medicine and there are not real
statutes in place that govern this practice. It is developing and there will likely be statutes proposed, in the future, to govern how a doctor can practice telemedicine. We need to continue to
monitor the legislature to determine how we wish to either support or not support chiropractic
through telemedicine.
- Dave Morrison, ESQ.
Personal Injury Attorney
Thank you Mr. Morrison for your countless hours volunteered to the AAC and its
members, benefitting Chiropractors throughout the state of Arizona.
**Please log into azchiropractic.org for access to the letter regarding recoupment requests.
9
Ginger ~ A great complement to Chiropractic Care
Dr. David R. Seaman, DC ~ [email protected]
When taken in adequate amounts, ginger can be a great adjunct in the treatment musculoskeletal pain. This article
is a summary of a 1992 study that describes the outcome of 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort), all of whom used powdered ginger. Most of the subjects experienced relief in pain and swelling to varying degrees. Ginger consumption ranged from 3 months to 3 years. Importantly, none of the patients reported adverse effects (1).
One subject was an 80 year-old female with osteoarthritis, who consumed 6 grams of ginger per day for the first 6
months, and 2 grams for the following 2.5 years. This subject experienced both the effectiveness and safety of ginger. Years before she began taking ginger, one of her kidneys was removed. As NSAIDs can damage the kidney,
she would have been especially vulnerable if she was taking the medications. However, with ginger, she experienced no side effects, suggesting that ginger may be the anti-inflammatory agent of choice in osteoarthritic patients
in general and especially those with renal and cardiovascular issues.
A 69 year-old female began taking ginger because she suffered from low back pain since she was 17 and later on,
also developed neck, elbow, hand, and knee pain. The use of NSAIDs created gastrointestinal distress for her. She
began taking about 7-8 grams of ginger per day and after two months here knee swelling disappeared. At four
months her spine symptoms improved. The only complaint that persisted to the same degree as before she started
taking ginger was the swelling in her thumb and first finger. After taking ginger 6 months, she stopped taking
NSAIDs.
A 50 year-old male with rheumatoid arthritis began taking ginger one month after he was diagnosed. He consumed 50 gram raw/fresh daily in lightly cooked vegetable and meat dishes. After just 1 month, relief in pain and
swelling was evident and he was completely free of pain and swelling after 3 months of ginger consumption. He
was active as an auto mechanic, and 13-14 years passed thereafter without relapse of symptoms. While he did develop some nodules on some of the joints of his fingers, there was no associated deformity, loss of function, or
pain.
A 49 year-old male physical laborer developed muscular pain and joint pain, which lasted for five years before trying ginger. He was prescribed analgesic medications that irritated his gut. At one point, his condition was so bad
that he was disabled from work. He began taking one teaspoon of powdered ginger a day and within one month
he was completely free of pain. He continued taking ginger for several months more before stopping, at which
time; he was able to work without suffering.
While such outcomes cannot be guaranteed in all individuals, it should be quite obvious that ginger should be
viewed as a key botanical for patients in pain. The subjects in this study took powdered ginger or the root itself.
Ginger root can be purchased in most grocery stores and powdered ginger is available in bulk at most heath food
stores. Supplemental powdered ginger is also available as are the more potent standardized extracts. A great review article published in the American Family Physician is available online and worth reading if you have never
used ginger before (2).
Reference
1.
Srivistava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med
Hypothesis. 1992;39:342-48.
2.
White B. Ginger: an overview. Am Fam Physician. 2007;75(11):1689-91.
10
Events for October 2014
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
1
2
3
SATURDAY
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Executive
Committee
Meeting
19
Personal
Injury Case
Management
Seminar
26
Personal
Injury Case
Management
Seminar
20
21
22
23
24
27
28
29
30
31
25
To get more information about these or our future
events, please visit our website www.azchiropractic.org.
Want your Event listed here? Please contact us at
[email protected].
11
Events for November 2014
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
Neurophysiology of
Stress
BRAINUCATION
2
3
4
5
6
7
Extremity
Adjustment &
Rehab
Technique
Seminar
Neurophysiology of
Stress
BRAINUCATION
9
8
10
11
12
13
14
15
17
18
19
20
21
22
28
29
Extremity
Adjustment &
Rehab
Technique
Seminar
16
Executive
Committee
Meeting
23
24
25
26
27
HAPPY
THANKSGIVING!
30
12
Fax this Registration Form
ATTN: Dec 2014 Nutritional Adjustment Seminar
Fax: 602-246-2906
Please complete one Registration form for EACH member
Billing Information for Credit Card (Information Below MUST match Credit Card Billing)
Name: ________________________________________
Address: ________________________________________
City, State, Zip: ________________________________________
Email Address: ________________________________________
Preferred Phone #: ________________________________________
Credit Card #: ________________________________________
(Visa, MasterCard, American Express)
Expiration Date: ____/_____3 or 4 Digit Code on Back
____________________
EARLY BIRD REGISTRATION through December 1st, 2014
AAC Member: $49.00 _____
Non AAC Member $79.00 _____
REGISTRATION AFTER December 1st, 2014
AAC Member: $69.00 _____
Non AAC Member $99.00 _____
Donation to AZ Legislative Fund $ ________
Cancellation Policy ~ No refunds ~ No Exceptions
13
Events for December 2014
SUNDAY
7
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
8
9
10
11
12
13
David
Seaman, DC
2 AZCE
Documentation
14
15
16
18
17
David
Seaman, DC
2 AZCE
Documentation
19
20
26
27
Executive
Committee
Meeting
21
22
23
24
28
29
30
31
25
14
TEN TACTICS INSURANCE COMPANIES USE TO DENY CLAIMS
Provided By: Curiel & Runion (http://www.curielandrunion.com/ten-tactics/)
As new studies come out regarding chiropractic care, our society has turned to this
practice more regularly for issues such as: headache prevention, athletic and flexibility
improvement, relief from allergies and overall health boost. While we are continuously
learning more about the benefits of chiropractic practices, one of the leading reasons to
seek treatment is still due to injuries suffered during car accidents.
During an auto accident, your body is unexpectedly jarred beyond normal limits and
can suffer from a number of effects. No matter how small the fender-bender, it's vital
that car accident victims seek the help of medical professionals whether it's their primary care doctor or a trusted chiropractor. The effects of a car accident aren't always
obvious and these hidden injuries can get worse over time, requiring more and more
rehabilitation, trips to the doctors and as a result - money.
No one should have to choose between their health and their wallet, so it’s important to
know what to do and how to handle your insurance adjuster after an accident. You
may instinctively contact your insurance company to file a claim, but be wary. Dealing
with an insurance company can sometimes be tricky, especially if your injury has resulted from the accident. There are a number of strategies the insurance adjusters use
to deny claims, which can be devastating. The experienced accident attorneys at The
Law Offices Curiel and Runion in Phoenix have seen many insurance companies deny
claims using a variety of strategies. In order to educate their clients and local community, they have identified the top ten tactics most commonly used by insurance adjusters. You can read the article here to find out exactly what to look for and the most common companies that use them.
15
16
17
18
19
~ AAC PLATINUM & GOLD CORPORATE MEMBERS ~
PLATINUM CORPORATE
MEMBER
Farmers Insurance
Jim Kreisman, MBA
480-491-8585
[email protected]
PLATINUM CORPORATE
MEMBER
AAC Corporate Attorney
David M. Morrison
602-277-6996
[email protected]
PLATINUM CORPORATE
MEMBER
Anabolic Labs
Susan Cali
623-377-6011
[email protected]
GOLD CORPORATE MEMBER
ChiroHealth USA
Kristine Hudson
625 Lakeland East Dr.
Flowood, MS 39232
[email protected]
GOLD CORPORATE MEMBER
Law Offices of Broening Oberg Woods
& Wilson
Terrence P. Woods
(602) 271-7705
[email protected]
GOLD CORPORATE MEMBER
Compliance Consultants Intl.
Angela Powell
doctorscompliance.com/index.html
800-680-3540
[email protected]
SILVER CORPORATE MEMBERS
N.C.M.I.C. Group
Michael Whitmer
14001 University Avenue
Clive, IA 50325-8258
1-800-321-7015
www.ncmic.com
ChiroTouch
Robert Moberg
3636 Camino del Rio N. Ste 220
San Diego, CA 92108
(619) 488-9798
www.chirotouch.com
DC Online
Karen Moreau
3578 Hartsel Dr. Unit # E 414
Colorado Springs, Co 80920
Medical Professional Supply
Richard Corcilius
1817 South Horne, #6
Mesa, AZ 85204
(480) 497-6373
[email protected]
SignaPay Ltd.
105 Deck Ct. 650
Irving, TX 75062
(800) 944-1399
Standard Process
Southwest Nutrition, Inc.
Dan Schwerdtfeger
20235 N. Cave Creek Rd. Ste # 104-491
Phoenix, AZ 85024
(480) 231-7700
[email protected]
ChiroBack - Up Services, Inc.
Dr Michele Glassman
PO Box 97188
Phoenix, AZ 85060-7188
(602) 389-1171
20
21
7 Specific Cancer Triggers To Avoid
~Dr. Veronique Desaulniers ~
7 Specific Cancer Triggers To Avoid
Cancer statistics are staggering. According to the World Health Organization, 1:2 men and 1:3
women are destined to develop some form of cancer in their lifetime. One in eight women are destined to develop some form of Breast Cancer in their lifetime. These are frightening statistics but,
fortunately, you do have a measure of control by being very proactive about your health
An article in the American Association of Pharmaceutical Scientists stated that “Cancer is a preventable disease that requires major lifestyle changes. Only 5 – 10% of all cancer cases can be attributed to
genetic defects, whereas the remaining 90-95% have their roots in the environment and lifestyle.”
According to the research provided by the Breast Cancer Fund, the evidence is very clear: chemicals
in our environment and radiation exposure are linked to Breast Cancer.
Here are 7 Cancer Triggers to avoid.
Trigger # 1- S.A.D. Food
The Standard America Diet’s acronym (S.A.D.) is so appropriate since it has contributed to a sad
state of health. Processed, packaged and poison foods make up 90% of the grocery store shelves.
Avoid the following:
Sugar
Processed fats and oils
Chemicals and additives
Hormones and antibiotics in meats and dairy
Packaged and processed foods
As well-known Chiropractor and health advocate, Jack Lalane, once stated, “If man made it, don’t
eat it.”
Trigger # 2 – Environmental Toxicity
Environmental toxicity includes all the chemicals we are exposed to in the environment, in our
homes and in our body. Make informed decisions about the products you use around your home, in
your home and on your body. The average person is exposed to over 150 chemicals per day, just
from their personal body care products and cosmetics.
22
7 Specific Cancer Triggers To Avoid
~Dr. Veronique Desaulniers ~ Continued from page 19
Trigger # 3 – Physical and Hormonal Stress
A form of physical stress that occurs in our body is called Oxidative Stress. Oxidative Stress is the
body’s inability to readily detoxify or repair damage from toxins. When your body breaks down
food, or when it is exposed to environmental toxins, it produces free radicals which can cause DNA
and cellular damage. If your liver and detoxification pathways are not functioning at optimal levels,
the chronic exposure of the free radicals can lead to DNA damage and ultimately cancer.
Hormonal stress is caused by many environmental chemicals called Xeno-estrogens. These chemical
estrogens mimic estrogen and are hormone disruptors. If you cannot metabolize or properly breakdown all these foreign estrogens, you get a buildup of the more “aggressive” proliferative estrogen.
An effective liver cleanser like NAC and an estrogen “cleanser” like DIM I3C is a great way to support your body.
Trigger # 4 – Emotional Wounds
Although the complex relationship between “psychology and physiology” is not clearly understood,
scientists are well aware that psychological stress affects the immune system. Negative and stressfilled thoughts can lead to immunosuppression while happy joyous thoughts can boost your Immune System.
Learn to manage your stress response and examine your belief systems about your body and your
health. Daily meditation and journaling are a great way to heal emotional wounds.
Trigger # 5 – Dental Toxicities
I have personally consulted with thousands of patients with compromised Immune Systems over
the years and found that they had a common denominator - dental toxicities. Dental toxicities affect
you in 2 ways: chemically and energetically. The internationally recognized medical researcher, Yoshiaki Omura, MD, has studied the effects of heavy metals on the body and he believes all cancer
cells have mercury in them.
Trigger # 6 – Inflammation
The role of Inflammation and Breast Cancer has become abundantly clear. It has been estimated that
95% of all cancers have a common factor:
Inflammation and a protein complex involved in cellular stress called NF-kB.
Super food nutrition such as broccoli sprouts and supportive supplements such as curcumin can
turn off inflammatory genes and turn on protective genes.
23
7 Specific Cancer Triggers To Avoid
~Dr. Veronique Desaulniers ~ Continued from page 20
Trigger # 7 – Needles & Knives, Lotions & Potions
This last trigger is what is known as iatrogenic or medically induced cancers. What may
come as a shock to many is that the very instruments that are used to diagnose and treat cancer, are some of the very causes of cancer. My heart goes out to the countless women that
are unknowingly coerced into radiation and mastectomies when they are dealing with a benign condition.
According to Medscape News, “The practice of oncology is in need of a host of reforms.” It
is a well-known scientific fact that cancer stem cells that are subjected to radiation and
chemical poisoning actually stimulate the growth of the cancer and make it more malignant.
Do needle biopsies fall into that same category? Absolutely! Here is a statement from the
JAMA Surgery magazine: “Manipulation of an intact tumor by FNA (fine needle aspiration)
or large-gauge needle core biopsy is associated with an increase in the incidence of SN metastases, perhaps due in part to the mechanical disruption of the tumor by the needle.”
Knowledge is power. Now that you aware of the 7 Cancer Triggers, discover The 7 Essentials System™ that is a step by step guide that teaches you how to prevent and heal Breast
Cancer Naturally. Women around the globe are turning their health around by following
this effective and targeted approach.
If you have any questions or concerns about your health, let me know how I can best support you.
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Notes from the political and policy trail
~Barry Aarons ~ The Aaron’s Company~ AAC Legislator
August 26th primary elections:
The primaries were generally good for chiropractic. AAC Legislators of the Year and staunch chiropractic supporters
Rep. John Kavanagh (seeking a vacant Senate seat) and Sen. Nancy Barto (seeking re-election) both won their respective
primary battles. Kavanagh had a serious challenge but prevailed while Barto crushed a generally considered weak challenger. One newcomer that deserves our attention is Dr. Regina Cobb who won her primary in the Mohave and La Paz
counties’ district. Cobb is a dentist and is looking to work with a coalition of chiropractors, dentists and podiatrists to get
AHCCS to cover those services. Cobb is expected to handily win the general
Animal Chiropractic
Recently it was brought to our attention that the Veterinary Board has cited a chiropractor for treating animals. It has
been generally felt that it is permissible for a chiropractor to treat an animal when a veterinarian refers an animal for chiropractic treatment and if the chiropractor has received one of the available animal chiropractic certifications. We have
undertaken a lot of research to catalogue what goes on in other states and have visited with the President and Executive
Director of the Chiropractic Board to see if the issue can be resolved. The Chiropractic Board is scheduled to visit with
representatives of the Veterinary Board to discuss the matter. Nevertheless, Rep. Warren Peterson has told us that if necessary he is willing to run legislation to allow qualified referred chiropractors to continue to treat animals.
AHCCCS Coverage
Now that we will likely have a champion for the dental, podiatric and chiropractic coalition in Regina Cobb and with
Sen. Barto and Rep. Kavanagh leading the Senate effort it is likely that we will renew our efforts to have AHCCCS cover
those services. While we expect insurance companies to balk at the proposal we are confident that we have the necessary
support to help get us over the hump in the 2015 session.
Advanced Practice
The AAC is evaluating whether to renew our efforts to get limited authority for chiropractors to prescribe prescription
strength dosages of ibuprofen, prescription strength dosages of naproxen, methocarbomol, and cyclobenzaphrine. We
went through the sunrise process in late 2013 and in conversations with key legislators it did not seem necessary or advisable to go through that process again. Sen. Barto indicated that she would be willing to consider introducing a bill in
the 2015 session to accomplish this. Whether we move forward has yet to be determined.
Sports Physicals
As noted in a recent email the AAC successfully completed a two year negotiated effort for the Arizona Interscholastic
Association to allow chiropractors that have a sports chiropractic certification to conduct sports physicals for students in
high school athletic programs. The AIA Executive Board passed an emergency measure during the summer to allow for
this following several meetings between AAC representatives and the AIA staff leadership and counsel. This was not a
simple effort but rather an extended meeting of the minds to get it done. This is a huge victory for the chiropractic community and the AAC. The AAC will now work on providing sports certification classed in Arizona to make qualifying
easier for our members.
Chiropractic Board of Examiners’ Proposals
Several years ago, when the recession and budget sweeps had virtually depleted the Board’s funds an effort was made
to allow the Board to set its own fees. You will remember that the AAC opposed this effort as lacking controls, parameters and had the potential affect of converting fees into professional services taxes if the sweeps continued. Now that the
sweeps have been eliminated the Board proposes to set a new fee structure with a statutory ceiling within which the
Board may adjust their fees up or down to reflect the economy. While the AAC has yet to take a formal position this plan
likely provides the controls and parameters necessary to protect chiropractors from unreasonable increases while giving
the Board the funding options to carry out its responsibilities
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First Impressions Are Lasting Impressions
~Dr. Rosalind Canham, D.C.~ Professional Online Education
As an Office Consultant I’ve often been asked, “Why are my numbers down? Why am I getting No
Calls or No Shows.” A few simple tests can help you determine if it’s your receptionist.
1. Check for Personality
Call your office from an unrecognizable number and listen to hear what office image your front desk
is projecting. Does the person on the other end sound Happy? Apathetic? Too busy? Energetic?
Excited? Is your new patient script being used? Is the person answering your phone prepared and
able to answer any questions you ask? The first impression of your office comes across in the new
patient phone call not when they get to your office. Scripting, phone etiquette and tone are essential
in communicating your message.
2. Technology vs. Live Person
Did you roll to an answering machine? Was it last week’s message? Was the message so long you
wanted to hang up? Or did it roll into an automated system? Did it take forever to navigate to a
live person? Did you follow the prompts and never get to a live person and did you leave a message? How long does it take for your CA to call you back to schedule? Nothing is as frustrating as
just being dumped into a mail box to leave a message and waiting for a call back that doesn’t come
for hours.
3. Ensuring that you’re equipped
Did the phone ring busy or roll to a fax line. If the new patient is getting a fax squeal in their ear
that is enough for most to hang up and call the next DC on their list. This is corrected simply by
adding another phone line. That will cost you about $30.00 a month and one new patient would pay
for it.
If your front desk clerk is a Girl Friday and is busy at work in the back office and has the phone going to message on purpose. This is a perfect fit for another simple fix; get her a head set.
4. Check for under staffing.
Personal interaction is very important. If your staff is too busy to pick up your incoming calls it may
mean you need more staff. Ask them why they weren’t able to get to the phone. Determine if these
were legitimate reasons for missing the call and how often this is happening. How many new patients would it take to make up the salary of adding one part time employee during your busy
hours?
I believe that a strong chiropractic team comes from training, implementing and reassessing. Your
staff will learn this and more when they go through their CA training. For information about live or
online CA Training courses Email me at: [email protected]
Rosalind Canham D.C.
Chiropractor and Educator
www.ProfessionalOnlineEducation.com
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Lateral Lower Leg Pain
Dr. Rick Boatright, D.C.
During my first year in practice, in Lincoln City, Oregon a man presented in the office in severe
pain. He had difficulty walking even though he was on crutches. With certain movements, he
experienced severe, temporary cramping in the lateral lower leg. The cramping would last for
several seconds. In fact, it scared me at the time. I was convinced that I’d have to send him to the
hospital.
I took the history, did the consultation and performed an examination. He reported mild low
back discomfort, but it appeared nearly insignificant compared to his leg pain. Palpation of his
sciatic nerve at the piriformis muscle, even with deep pressure, failed to elicit a pain response.
It was rather confusing at the time. I remembered the professors telling us that if back pain radiated into the buttock, it was a somewhat mild form of sciatica. If it extended down to the knee, it
was moderate sciatica. If it went all the way to the ankle, it was severe sciatica.
Medical doctors seem to follow the same diagnostic criteria, although neither my findings nor my
understanding of neuro-anatomy validate this concept.
At that time, I had already mastered the Activator technique and had taught it at Life West for
over a year. One of the tests in the advanced protocol was for a posterior head of the fibula.
Remember that the peroneal nerve wraps around the head of the fibula then descends the lateral
lower leg to the outer ankle. Even mild irritation of the peroneal nerve can make it exquisitely
sensitive.
The Activator testing protocols revealed very little in the lumbar spine or the sacro-pelvic complex to indicate sciatic involvement. However, checking for a posterior fibular head in the sore
leg, elicited an immediate and profound response.
Of course, the correction for a posterior fibular head is a simple posterior to anterior thrust, opposite to the line of subluxation.
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Lateral Lower Leg Pain
Dr. Rick Boatright, D.C.
After completing the adjustment and advising him of possible residual pain for a day, I advised him
on using ice, warned against using heat, and scheduled him to come back the following day for his
report of findings. The patient carried his crutches out of the office at his side, even though he still
exhibited a slight limp.
The following day, entering the office, he had no crutches, no cane, no limp and he reported that the
pain was completely gone!
I’ve seen hundreds of cases similar to this over the past 20+ years, even though his was the most dramatic.
This is a common subluxation and too often it’s misdiagnosed as sciatica.
The Activator test for a posterior fibular head is to stroke from anterior to posterior on the fibular
head and look for a leg length change. A positive indicates a subluxation in that direction.
For a manual adjustment approach, one might test for a subluxation by palpation, looking for a tenderness response along the peroneal nerve. With the fingertips or the thumb, press firmly into the
tissue in the space between the medial surface of the fibula and the lateral surface of the tibia. Moderate to severe tenderness in the first three inches inferior to the fibular head is a good indicator of a
probable subluxation. The correction would be from posterior to anterior with the fibular head as
your contact point. Speed is far more important than force or audibles. It’s a sensitive joint.
Patients with a posterior fibular head typically resolve quickly with this correction. And since it’s so
commonly misdiagnosed and subsequently fails to be treated, it can lend the astute doctor an added
degree of credibility.
When you see pain in the lateral half of the lower leg extending from the knee to the lateral ankle,
check this. It’s a great move to have in your bag of tricks.
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CLASSIFIED ADS
Miscellaneous
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Call Dr. Robin O’Neal ~ 520-403-0563
STATEWIDE TEMPORARY OR PERMANENT OFFICE COVERAGE
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Large selection of licensed and insured chiropractors. We can help with your coverage and
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www.mmachiropractors.com
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