Yourvoice

yourvoice
strength through unity with diversity
October 2013
Volume 21 Number 5
News Bulletin for the
Chiropractors’
Association of Australia
(Victoria) Ltd
2013 AGM
2013 Awards
Straight Teeth at what price?
MRI of the knee
Congratulations to
Dr Michelle Kotzman,
Victorian Chiropractor of
the Year 2013
yourvoice
Chiropractors’
Association of
Australia
(Victoria) Ltd
Contents
ACN 050 191 967
Victorian Branch
Contact Details
Postal: PO Box 13163, Law Courts VIC 8010
Street: 40 Dudley Street, West Melbourne VIC 3003
Ph (03) 9328 4699
Fx (03) 9328 2966
E: [email protected]
Web www.caavic.asn.au
Office Hours
Mon to Thurs: 9:00 am — 4:00 pm
Fridays: 9:00 am — 2:00 pm
Next Deadline: November 15 for December 2013 edition
Print Post Number 100001433
Editor: Dr. Bruce Ellis
Tel: (03) 5428 2669
Fax: (03) 5428 1500
E: [email protected]
Editorial
4
President’s Report
5
Professional Standards
6
CAAVIC News
8
Women in Chiropractic
10
Occupational Chiropractor
11
AGM - Recap
12
AGM - Media, Marketing & Mythbusting
13
AGM - Awards
14
Clinical Review - MRI of the knee
17
Clinical Jottings - Straight Teeth at what price?
18
Health Wellness & Lifestyle
20
World Congress of Chiropractic Students 21
Marketing Plan - Part 24
22
Big Thank You to Back to Sleep
23
Locum List
24
CPD Calendar of Events
25
Classifieds
26
‘Your Voice’ is published by the Chiropractors’ Association of Australia (Vic) Limited and may contain confidential information. Opinions or other
material (including advertising) expressed therein are those of the contributor and do not necessarily reflect the opinions of the Editor, CAA (Vic)
Ltd nor the policy of the Association, unless otherwise stated. Acceptance of advertising material in no way implies that it has the endorsement of
the Editor or CAA (Vic) Ltd.
editorial
Dr Bruce Ellis
It was interesting to attend the
Victorian Branch AGM the other
day. We had several marketing
presentations beforehand and much of
the information was about using social
networking.
I find this new electronic age
fascinating. We can now pass gossip
(and other even less reputable stuff )
around so much more easily. In fact, I
seem to recall some comment about
some huge proportion of people using
‘facetwitter’ or some similar program
every day. And we were encouraged
to place good quality information
out there on a regular basis. I believe
we were encouraged to check our
social media accounts several times
a day. I presume the purpose of this
is to maintain the conversation. Also,
we were encouraged to make the
conversation about things that other
people might find interesting – I mean
this is “social” media, not just marketing
– so we need to broaden the footprint.
Here’s where I reflect on being a
dinosaur. It was ever thus.
When I graduated, Dr. Tony Hart told
us to go out and join a service club or a
church - or both, to go and talk to local
groups and to get involved in our local
communities, interacting with people.
He said this was his best tip for getting
a good practice going.
The concept is still valid. It’s just that
in this modern age by sitting in a semi
foetal position tapping on a keyboard
(as I am doing now), we might touch
base with more people.
Unfortunately, that contact is
somewhat two dimensional and, in
gaining the new, we might just have
lost something important.
Recently one of the doctors from my
practice went to Sydney to attend
a seminar on the marketing of
chiropractic to the medical people.
He came back with a lot of really good
material and - does this sound familiar?
- one of the points that came out of
that seminar was to be seen to be part
of your community.
Another was to create a community
of health care practitioners who could
work together to support the patient –
something that CAANational’s surveys
have shown to be a VERY high priority
with the survey group. “Integrative
Medicine” is the term that National
CEO Andrew McNamara highlights in
a recent report to the profession. It’s
seen as an integration of healthcare
practitioners to provide better patient
care.
However, let me return to the wider
form of the concept of community.
The poet John Donne said it well when
he wrote “No man is an Island” some
400 years ago. We are part of our
continent, he said, and the message is
that not one of us is self-sufficient. We
are social beings (thus the success of
‘facetwitter’), and we have a need to
mix in. From a professional point of
view, this is your best way to introduce/
market yourself as well. I need to add
some more of that research stuff here,
apparently we (chiropractors) are seen
as less trustworthy than osteopaths,
physiotherapists, medical practitioners
and dentists. Apparently, we would be
perceived as more trustworthy if we
had 5 year degrees. Oops... Heard that
one before. I wonder if that is why in
my clinic we have a “brag wall” so that
everyone going to and from our offices
passes metres of framed degrees,
plaques, certificates etc, all indicating
that lots of our collective lives has been
spent in formal education?
I’ll use an older reference here – the
Book of Romans 10:14 – “And how
are they to hear without someone
preaching?” How do we get the
message out that we are in fact,
trustworthy (that is a presumption isn’t
it?) if people don’t see us, hear from
us, talk to us or meet us outside our
offices? My thought is that the best
way to be seen is to be out there taking
part in some social activity in your local
community.
So, how do you partake in your local
community? As I’ve been sharing
fragments my life with you for the last
14 years in these editorials, you already
know that I took Dr Hart’s advice all
those years ago and became part of
my community. You probably are
aware that I’m a member of a church,
and have been involved in Scouting. I
have to admit that my hobbies have
blurred, and that scuba diving and
scouting have merged in my world
to the point that I wonder where one
ends and the other starts some times.
Professionally, for the last few years,
we have sponsored a page in the local
Gazette. This page is reserved for the
local scouts to tell our community what
they’ve been up to, as like us, they are
not seen or heard from enough.
There are lots of other ways to get
involved. Volunteering yourself, or
better, you and your entire clinic, for
something like Clean Up Australia Day,
the Relay for Life, the Big Morning Tea,
or shaking a can for the Good Friday
Appeal, will get you amongst likeminded individuals in a short term
project. Alternatively, while getting
involved with the local school, a sports
club, mothers club, the Ulysses club,
scouts or similar is a far longer project.
There are still some service clubs out
there and, at a minimum, you should
chat to them, but it would be better to
be member.
I’m portraying this notion of
community involvement as a marketing
tool. It is - and it isn’t. I prefer to think
of getting involved as a life tool, i.e.
something that enhances your life. It’s
cont. pg.22
4
president’s report
Dr Helen Alevaki
Most Australians may remember
September 7th, 2013 as the day they
voted in the Federal Election, however
I will remember it as the day we held
a very successful, entertaining and
enlightening seminar and AGM.
The afternoon was kicked off by
the wonderful Dr Angus Pyke, who
shared with us the secrets of how
to successfully and safely use social
media. As always, Angus reminded me
of the importance of engaging with
our patients in this way. Our very own
Elissa Doxey then treated us with a
Mythbusting presentation. Elissa has
a special interest in industrial relations
and in a very easy to understand format
explained the theory AND practice of
employing CAs and Associates. How
lucky are we to have such a talented
person on board. After the break
another of our own, Tim Winkler spoke
on marketing your practice in an ethical
way. Tim is CAAVIC’s Communications
Manager and founder of Twig
Marketing. He has spent almost two
decades in marketing, corporate affairs
and journalism.
The thing that struck me most was the
enthusiasm felt by the participants,
as evidenced by the questions asked
during the afternoon. I was proud of
the fact that all three presenters are
home grown and part of our team!
CAAVIC has members practising
in every area of chiropractic. We
are fortunate to have a Board
and committees who are able to
reflect all these aspects of practice
and wonderfully professional and
focused office staff that complete the
chiropractic profession’s advocacy and
support team.
Our advocacy is not just for the
professional lives of our members;
we also take very seriously our
commitment to advocacy for the health
of all Victorians.
It has been an honour to be President
of a very active and energetic Branch
over the last 12 months. We have
had many outside challenges to the
profession, which I believe we have
used as opportunities for change. The
idea of and/or need for change has
itself been a challenge for us. However
as we grow and mature as a profession
it is pleasing to see that we recognise
that change is required. It is the nature
of the world in which we live.
I have also been proud of the way our
various committees and staff have
stepped up to meet the challenges
and work through the issues so that we
may best represent and support the
profession and you.
I would continue to urge members to
stay engaged in the activity of your
professional Association. Even if you
are unable to be personally involved in
its work it is important for us to receive
members’ feedback in order for us to
remain both relevant and effective.
Like all registered chiropractors,
members have a responsibility to
keep abreast of any changes which
impact on the way you practice. Your
CAA membership and reading the
information we circulate is the best
way of staying aware of any changes
in legislation, guidelines and any other
information that may impact on best
practice.
As always, it is important to realise that
associations like ours are successful
due to the dedication of a core group,
our Executive members. Every time
we meet, everyone brings their focus
and attention and gives 100%. I thank
each and every one of them for their
unwavering support and commitment.
I would also like to express our
gratitude to Drs Roy Smith, Steve
Bernsten, Peter Farrelly and Steve
Pratt for their contribution to our CPD
Committee, to Drs. Michelle Kotzman,
Rick Ames, Simone Aybar, Anthony
Coxon, Paul Finn, Robert Terrett and
Bettina Tornatora for the wonderful
work on the Professional Standards
Committee and of course Dr. Bruce Ellis
for his marvellous contribution as the
Editor of our magazine Your Voice.
I also thank Drs Alfie Dimalanta, Brad
Atkinson, Jennifer Luu and Marcus Yeo
for their work on Membership Services,
Drs Warren Sipser, Michelle Ronan and
Steve Bernsten who sit on the Public
Education Committee and Drs Ari
Diskin, Brad Atkinson, Kyle Keenan,
Chris Webster and John Pantazopoulos
who contribute so well to the Political
and Legislative Committee. All of these
people give of their time and energy
above and beyond.
I would also like to thank our office staff
for their dedication to our profession.
Karen, Deb and Elissa always answer
the phone happy to hear my voice
and are wonderful advocates of the
work that we do. Of course, the office
needs a fearless leader and we are
blessed to have Norm Brockley at the
helm. Thank you Norm for all that you
do and continue to do, to support our
wonderful profession.
Again, I must acknowledge the support
and love my family have shown me
in my journey as your President.
Without them, this role would not
be a possibility for me. They keep
me grounded and remind me, even
when the going gets tough, that
communicating from the heart is the
only way to go!
I am humbled that I have been
entrusted in this role and continue to
love and grow with it. It has enriched
my life and those I meet and I continue
to be committed to chiropractic being
a healthcare choice for all Victorians.
5
professional standards
Dr Michelle Kotzman
This will be my last magazine article
as Chair of the Professional Standards
Committee. Over the last almost 10
years I have felt it is a privilege to Chair
this Committee.
I have had the pleasure of working
with past and present Committee
members; Drs. Rick Ames, Simone
Aybar, Paul Bergamo, Miriam Bourke,
Paul Chamberlain, Anthony Coxon,
Paul Finn, Peter McGlynn, Paul Noone,
Lou Rotman, Robert Terrett and Bettina
Tornatora,
The quality of these people are quite
literally some of the best the profession
has to offer.
I would also like to thank Norm
Brockley for attending and
coordinating all our meetings.
His insight into issues facing the
chiropractic profession and guidance
has truly been appreciated.
I have thoroughly enjoyed my role
with the Committee and have learnt
and grown so much during this time. I
have also been extremely gratified at
the support and appreciation I have
received from the profession, it has
been quite overwhelming.
Finally I would like to thank my
husband Dr Paul Wise for his patience,
encouragement and support over the
years.
with patients and potential patients to
build an appreciation of the services
your practice may offer and/or the
benefits of chiropractic care.
Angus Pyke’s excellent presentation
at the AGM clearly demonstrated the
growing use of social media as an
element of professional marketing.
However along with the potential
benefits come some potential pitfalls.
There is already a significant list of
health practitioners from almost every
profession, who have come to the
attention of their particular registration
board due to their inappropriate use of
social media.
Among the pitfalls have been
practitioners discussing patient’s
conditions on Facebook, thereby
breaching patient confidentiality and
other practitioners who have made
statements about care or their services,
which have been assessed as being
false or misleading.
While social media can be
instantaneous it is also permanent in
that it’s very easy for people to trap an
image or a statement and retain it for
later use.
So it is important that you remember
that along with the virtues of social
media there are some potential
dangers. Therefore it is critical that you
ensure that anything you put on social
media, especially in relation to your
practice:
•
•
Social Media – the pitfalls
There is little doubt that social media
can be a very effective way to engage
6
•
does not undermine your
professional responsibilities
in no way discloses any patient
information or jeopardises patient
confidentiality or right to privacy
does not present information on
chiropractic or chiropractic care
in a false, misleading or deceptive
manner.
I often think a simple test for social
media posts is ”would you be happy to
see your post published on the front
page of the Herald Sun newspaper”?
It was recently drawn to our attention
that a well-regarded chiropractor had
posted anti vaccination material on
Facebook. In light of the Registration
Board’s position on this issue and the
recent media witch hunt we need to be
vigilant about posting on contentious
issues.
Patient Modesty – why a policy to
gown patients?
It is the policy
of the CAAVIC
that where a
patients presents
for an initial
examination,
or an existing
patient presents
with a new
complaint the
chiropractor must
have a clear and
an unobstructed view of the relevant
region of the body.
The issue of gowning of patients has
arisen a few times recently.
This policy was adopted many years
ago, as a move to reinforce the
responsibility of a chiropractor, as
a primary contact practitioner, to
fully assess their patients’ presenting
condition, which includes sitting the
area of concern. It was agreed that this
is best achieved by gowning patients.
It is well accepted that the conditions
with which patients present, have
a myriad of causes. They may be
a matter of nerve interference or
muscular strain, but sometimes it can
be something more sinister. A full
physical examination with the patient
gowned provides a good opportunity
Should chiropractors let patients
take radiology films from the
practice?
When making use of radiography,
many practitioners return the film to
the patient and keep a copy of the
radiology report on file with their own
notes.
If chiropractors keep the radiologist’s
report and their own notes, the
question arises as to whether this
will be adequate to satisfy any legal
obligations, regardless of how long it
has been since the x-ray was taken?
The short answer is probably ‘yes’.
Chiropractors are under a legal
obligation to retain patients’ health
information for a period of seven years
from the date on which a patient was
last treated.
Health information is defined
broadly and includes, for example,
an ‘information or opinion’ about
a patient’s health or the services
provided to the patient. A
to view the site of any pain and detect
superficial conditions, eg. a skin cancer
or shingles. Such superficial problems
may be the cause of the presenting
condition or simply an additional issue.
presentation you will have been able
to alert the patient to the underlying
problem.
And while such conditions obviously
need to be referred on, you will have
had a chance to fully assess the patient
for other issues that may require your
attention, or if it was the cause for the
chiropractor’s notes and opinions
about a patient, a report provided by a
radiologist, and radiography itself are
all considered health information.
Ideally all such information should be
retained as part of a patient’s medical
records. However this general rule is
complicated by the fact that unlike
reports and a chiropractor’s notes,
radiography and pathology results will
rarely be the referring practitioner’s
property.
Courts have held that where a patient
is referred to an external service for
receiving pathology or radiography
services, the results of these services
are generally the patient’s property.
This means that a patient is entitled to
request that the pathology results or
radiography be given to them after the
consultation.
As elaborated in the previous
Meridian Lawyers’ article in Your Voice,
radiography forms an important part of
a patient’s medical records. It allows for
other practitioners to properly assess a
patient so that the best treatment can
be provided, and is valuable if further
complications arise and a practitioner’s
diagnosis or treatment is called into
question.
the importance radiography plays in
a patient’s medical record, and that
it ideally should be kept with their
treating chiropractor so it is safe from
loss or damage. However if a patient
desires, a copy should be made and
the patient should be allowed to take
their radiography with them. The
chiropractor cannot be criticised for
failing to retain radiology film in these
circumstances and the absence will
not render the chiropractor’s records
inadequate.
Kellie Dell’Oro, Principal & Practice
Group Leader
Meridian Lawyers
T: 03 9810 6775
E: KDell’[email protected]
Disclaimer
This information is current as of September
2013. This update does not constitute legal
advice. It does not give rise to any solicitor/
client relationship between Meridian Lawyers
and the reader. Professional legal advice
should be sought before acting or relying
upon the content of this update.
For these reasons, it is best practice
for practitioners to explain to patients
7
CAAVIC news
VALE - Oliver Mock
Oliver James Mock was born
3/8/98 at home in Mitcham. Oli
was a beautiful red head baby
boy. He grew up in a loving
family, being the middle child
of Russell and Virginia (Ginny)
Mock and brother to David and
Georgina. He was educated at
the Melbourne Rudolf Steiner
school in Warranwood and lived
in Warrandyte most of his life till
recently living in Bendigo. He
was studying Outdoor Education,
Nature Tourism course at the La
Trobe Uni, Bendigo.
Oli had a fall on the 2/8/13. He
recovered enough to have three
very special days with Russ,
Ginny, David and Georgie, before
tragically dying on 16/8/13.
Oli was a free spirited boy/man
that loved to explore, travel and
experience as many people as
possible. He will be very sadly
missed forever. I personally
will treasure our many chats
and teasing and especially our
last meal together. Oli had just
returned from a trip along the
coast through the Kimberleys with
a local aboriginal mob. He was so
excited about his adventures. He
was in love and full of life. He had a
cheeky smile that was contagious.
Thank you to everyone who have
been supporting the family.
I love you Oli,
Favourite Aunty Lou
(Dr Louise Callaghan)
Our hearts go out to the
Mock family.
8
Important Notice
REGISTRATION RENEWAL & CPD
REQUIREMENTS
We are rapidly approaching registration renewal time. Renewal date for
registrations with the Chiropractic Board (AHPRA) is 30 November. This year
AHPRA will use a variety of modes of communication to alert you to the need to
renew your registration.
It is expected that the Board will start to contact practitioners over the next few
weeks. If you have not been contacted by mid to late October then you are
urged to contact AHPRA on 1300 419 495 to follow up.
What are the CPD requirements?
Under the CPD registration standard, all practicing chiropractors must complete
at least 25 hours of CPD per annual registration period. At least 50 per cent of
these hours (12.5 hours) must be ‘formal’ learning activities. The balance may be
‘informal’ or ‘formal’ learning activities. All practitioners must also hold a current
Senior First Aid (Level 2) certificate or equivalent.
To check your CPD status, go to the Chiropractors National website - www.
chiropractors.asn.au or call them on 1800 075 003.
CAAVIC news
CAAVIC First Aid
Under the current CPD
accreditation scheme all registered
chiropractors must have a current
first aid certificate, Apply First Aid
(HLTFA301B).
If you sat for your certificate in 2010
it will expire this year! Don’t let this
happen to you!
CAAVIC has again selected
Emergency First Aid Pty Ltd to
deliver first aid training to all our
members, their staff and others
throughout Victoria at a very
reasonable fee. In less than 7 hours
you will be a certified first-aider for
another three years!
If you are doing Apply First Aid
for the very first time – or if your
current Apply First Aid certificate
lapses by more than three months,
you must complete an on-line
training component (around 2-4
hours) BEFORE you attend your
training day. We can organise this
for you.
For a list of dates and venues - and
to register - call the office or visit
our website www.caavic.asn.au and
follow the links to sign up for a First
Aid course.
News in Brief
The proposed Cap on tax-deductible
CPD (self-education) expenses has
been scrapped.
The proposal that would have seen
deductions for self-education expenses
capped at $2000 has been scrapped
following representations from a range
of employer groups and professional
associations including the CAA.
The spinal steroid injections no
better than placebo.
In their article in a recent medical
Journal Prof Ian Harris and Prof Rachel
Bookbinder noted that the number
of procedures involving spinal steroid
injections for low back pain was
increasing despite the lack of evidence
of any benefit.
Heart-attack survivors not taking
the warning
A recent report entitled “To hearts one
future” has revealed that survivors of
myocardial infarction are failing to
heed the warning and make significant
changes to their lifestyle. Accordingly
they are risking the chance of having a
second such event.
GP suspended for changing patient
record
A GP has found to have committed
professional misconduct and been
suspended from practising. The
suspension came following findings
that the GP had changed patient
records to be later used as evidence in
an inquest.
Australian diabetes figures are
alarming
Soft drink bad for knees
A report in the British Medical Journal
has linked the consumption of soft
drink to knee osteoarthritis. The survey
found that men who reported having
one sugar sweetened carbonated
drink had a 56% increased risk of
osteoarthritis and for those having
five or more drinks the risk was nearly
doubled.
New figures recently released show
that one Australian adult over 25 will
develop diabetes every 5 minutes. The
latest Australian Diabetes, Obesity and
lifestyle study shows:
• Obesity was a major factor in
diabetes
• Smoking and lack of exercise were
also contributing factors
• People surveyed significantly
overestimated the amount of their
vigorous physical activity.
• To have impact, obesity education
needed to target young people.
• Diabetics have a 40% increased
risk of mortality
• Depression was 80% more
prevalent in those who were obese
9
women in chiropractic
Dr Bettina Tornatora
Rural Chiropractic
Can you truly claim to be Primary
contact? Can you say that your patients
use you as their first port of call for their
health? Many Chiropractors can say yes to
these questions because they have built
a level of trust and rapport with their
clients.
What if you were the first point of contact
because other services did not exist or
were sparse? How would you manage
that responsibility? Many of the rural and
remote practices face this issue on a daily
basis. This can be challenging, however a
fantastic opportunity to hone skills and
knowledge.
When recruiting chiropractors for
associate roles whilst in practice in
rural NSW often this skill development
opportunity was not considered by
applicants. In particular this was true
of many new graduates. Lifestyle and
social opportunities were often given
move weight in their considerations.
10
While these are significant of course,
the practical development of your skills
needs to be considered.
We lost count of the number of times we
were told: “We have come in to see you
and if you think we need to go to the
hospital we will go”. Often the decision
may mean that the person would drive
home if given the all clear. You may be
thinking, thats no big deal. But home
for some of our clients was up to 500km
away!.
The other factor in considering rural
practice that is often overlooked is
the opportunity to become part of
a community. Direct professional
connections are facilitated by smaller
locations. For example you can meet all
of the nursing mothers groups in one
interaction. Make contact with the local
GPs personally in one afternoon. And
because these professionals also live
in the community, it is likely that you
will interact with them on a social or
community level. This environment may
mean that you are given a more open
and possibly welcoming reception when
making contact. This is a situation that
many working in major cities would be
very appreciative of.
So when investigating the possibilities,
consider rural practice. It may be
challenging however definitely
rewarding. For those about to graduate
or early in their practice years,
consider this carefully. Do you want an
opportunity to test yourself and what
you have learned? Do you want to
have interaction and impact on a local
community? A worthwhile consideration
for anyone interested in putting their
skills to the test and taking your
connections to another level.
occupational chiropractor
Dr Chris Webster
Occupational risk factors for
shoulder pain: a systematic
review.
therefore should be included in any
assessment of the condition.
Occupational & Environmental
Medicine, 2000. 57(7): p. 433-42.
Van der Windt, D. A., Thomas, E., Pope,
D. P., de Winter, A. F., Macfarlane, G. J.,
Bouter, L. M. and Silman, A. J.,
Abstract
OBJECTIVES: To systematically
evaluate the available evidence on
occupational risk factors of shoulder
pain.
Summary
This article is a review, which seeks to
bring together the information from
relevant research studies undertaken
in this area. The review looked at 29
studies on the topic described.
METHODS: Relevant reports were
identified by a systematic search of
Medline, Embase, Psychlit, Cinahl, and
Current Contents. The quality of the
methods of all selected publications
was assessed by two independent
reviewers using a standardised
checklist. Details were extracted on
the study population, exposures
(physical load and psychosocial
work environment), and results for
the association between exposure
variables and shoulder pain.
Studies included had to pass a basic
screening process for methodology to
be included in this review. The review
looked at how job tasks were analysed,
the types of risk factors included, how
shoulder pathology was assessed
and the statistical analyses used. The
authors also included studies which
measured psychosocial influences
on shoulder pain, such as autonomy,
stress, support and job satisfaction.
Due to the differences between many
of the studies in terms of the methods
they used, strong associations and
trends could not be clearly defined,
but a link was found between physical
load, psychosocial work environment
and shoulder pain.
When the researchers isolated the
studies of high quality methodology,
they found there was a consistent
positive association between shoulder
pain and
•
repetitive movements
•
vibration
•
duration of employment
•
job dissatisfaction.
The authors of this review noted that
the majority of the studies did not
consider each person’s previous work
history or non-work related activities.
They felt that these conditions may
impact on shoulder pathology and
RESULTS: 29 Studies were included in
the review; three case-control studies
and 26 cross sectional designs. The
median method score was 60% of the
maximum attainable score. Potential
risk factors related to physical load and
included heavy work load, awkward
postures, repetitive movements,
vibration, and duration of employment.
Consistent findings were found for
repetitive movements, vibration,
and duration of employment (odds
ratio (OR) 1.4 - 4.6 in studies with
method scores >/= 60%). Nearly all
studies that assessed psychosocial risk
factors reported at least one positive
association with shoulder pain, but
the results were not consistent across
studies for either high psychological
demands, poor control at work, poor
social support, or job dissatisfaction.
Studies with a method score >/=60%
reported ORs between 1.3 and 4.0.
Substantial heterogeneity across
studies for methods used for exposure
assessment and data analysis
impeded statistical pooling of results.
CONCLUSIONS: It seems likely that
shoulder pain is the result of many
factors, including physical load and the
psychosocial work environment. The
available evidence was not consistent
across studies, however, and the
associations were generally not strong.
Future longitudinal research should
evaluate the relative importance of
each individual risk factor and the role
of potential confounding variablessuch as exposure during leisure time-to
set priorities for the prevention of
shoulder pain in occupational settings.
Work above shoulder level and
degenerative alterations of the
rotator cuff tendons: a magnetic
resonance imaging study.
Arthritis & Rheumatism, 2004. 50(10): p.
3314-22.
Svendsen, S.W., Gelineck, J., Mathiassen,
S. E., Bonde, J. P., Frich, L. H., StengaardPedersen, K. and Egund, N.,
Summary
This article aims to show how working
with the shoulder in an elevated
position (above 90 degrees) for an
extended period of time can produce
pathological changes to the rotator
cuff muscles. This was measured by
way of Magnetic Resonance Imaging
(MRI) technology by fully qualified
radiologists. Direct measurements
of arm use were used, as well as
self reported work histories from
questionnaires. These allowed the
researchers to estimate the time spent
with the arm in an elevated position
above 90 degrees, over each person’s
entire working life.
They found that if a person spent a
total of 5 months over their working life
with their arm in an elevated position
above 90 degrees, the risk of rotator
cuff pathology was increased. It was
also found that the risk of having
abnormalities on MRI scans increased
by 15% for every 5-month increment in
lifetime shoulder elevation.
continued on page19
11
2013 Annual General Meeting
Business recap
The following reports were presented
at the AGM:
The President. Dr. Alevaki reported on
Branch activities in relation to
• Political issues, including
WorkSafe/TAC submissions
• Membership Services
• CPD with the new video
conferencing system
• Professional Standards
• Public Education
She also indicated that she expected
the coming year to bring many
challenges, with attacks on the
profession seemingly on the rise
and growing evidence of apparent
discrimination against chiropractic in
some quarters. She was of the view
that it would be critical for the CAA to
be a political force in the coming years.
The President also thanked the
members, the Executive, Committee
members, the Branch staff and her
family for all their help and support
over the past year.
Women in Chiropractic (WIC).
Michelle Ronan gave an update on
Women in Chiropractic programme.
She reported that in its formative
stages the primary objective of the
programme was to guide and support
female chiropractors through the range
of gender specific issues that they can
face in practice. This role would be
ongoing and already a group of female
practitioners had been trained to act in
a first response role and they were now
rostered to take calls from members.
She noted that women were
underrepresented in chiropractic
circles and so the secondary role was
to empower and encourage females to
take a greater role in the chiropractic
arena, whether through education,
research, community activity or
through association involvement.
In conclusion she stated that she was
pleased to see that this wonderful
12
Victorian initiative, was being
considered for adoption by the New
South Wales and Western Australian
Branches.
RMIT. The President gave the following
report on behalf of Dr. Navine Haworth.
RMIT is now led by Drs. Barry Draper
and Navine Haworth in a job share
capacity. They were not able to attend
the AGM however Dr. Haworth asked
that the following points be conveyed
to the meeting:
1. The chiropractic programme
continues to grow and enjoys the
full support of RMIT, despite recent
attacks, which she says have only
served to act as a catalyst for it to
strengthen its resolve in support of
the programme.
2. The programme has a strong
academic complement which
continues to provide a great
education for our undergraduates.
3. The programme has a strong and
active student body, which enjoys
the support of the CAA through
a wide range of programmes
designed to assist them in their
growth and prepare them for
transition into their chosen
profession.
4. RMIT is currently going through a
process of approval to build a new
interdisciplinary teaching clinic
across the road from RMIT
5. That a School of Health Sciences
research hub is currently being
developed at the Bundoora West
campus for collaborative focused
research projects. RMIT has six
chiropractors enrolled as Higher
Degree Research Students (Masters
and PhD).
RMIT kindly acknowledges the long
term support of the CAA, including the
funds raised by CAAVIC to purchase
the Bulleen Clinic, the ongoing support
through funding and the provision
of other resources, for example, the
Practice Management Course run by
CAAVIC.
RMIT is also grateful to the profession
for its support of the students through
M-PIL, which has enjoyed outstanding
level of support this year. It would
encourage members to continue in
their efforts to mentor future students.
We work very closely with the
Chiropractic programme staff and
would like to acknowledge their
amazing efforts, under often trying
conditions to grow the practitioners
of the future and also contribute to
the work of the CAA in advancing the
chiropractic profession.
The President encouraged members
to continue to support RMIT whenever
they had a chance, and if the
opportunity arose to thank the staff for
the extraordinary job they do.
CAANational Report. Dr Tony Croke
(Tas/Vic representative on CAA National
Board) reported on some recent
CAANational activity:
• CAANational move to Melbourne
has been cancelled.
• PE campaign, including the success
of the Spinal Health Week
• Reinforced the need for all
chiropractors to take care with any
professional advertising
• Responses to recent media attacks
on chiropractic
• New chiropractic programmes in
New South Wales
CAAVIC Elections. The results of the
office holder elections were:
• Dr. Helen Alevaki re-elected to the
position of President
• Dr. Peter Farrelly elected to the
position of Vice President
• Dr. Warren Sipser re-elected to the
position of Secretary
• Dr. Michelle Ronan re-elected to
the Executive
• Dr. Kyle Keenan elected to join the
Executive.
2013 Annual General Meeting
Media, Marketing & Mythbusting
Dr Angus Pyke presenting at Media, Marketing & Mythbusting seminar.
Seminars provide path for practices
of the future
Social media has brought us the
Kardashians (if you don’t know them
let’s not start in this august journal, just
Google them later), more electronic
friends than we know what to do with
and a constantly evolving series of
acronyms that leave us staring in mute
bewilderment at our children.
But hold on a minute, it turns out
social media is an important tool for
chiropractors too!
Yes, dozens of smartphone-wielding
chiropractors were lured away from
election day barbeques and the
possibility of a needle-stick injury
on the St Kilda Foreshore to attend
seminars on Media, Marketing and
Mythbusting Industrial Relations law
prior to the CAAVIC AGM and cocktail
soiree on Saturday 7 September at the
St Kilda Novotel.
Dr Angus Pyke, a veteran of timelines,
Tweets and YouTube, provided an
outstanding introduction to the ways
social media can be used as a business
and health promotion tool.
Dr Pyke has featured on the prestigious
international thoughtleaders’ video
channel, TedX and has more than 1000
friends on his Facebook page www.
facebook.com/whatactuallyworks. He
explained a wealth of simple tips to
start building followers on social media
by generating content that is concise,
relevant to people and containing
some information about chiropractic
care amongst other important health
advice.
Elissa Doxey
Following Dr Pyke, CAAVIC Project
Officer Elissa Doxey attempted to bust
some of the misconceptions and myths
surrounding employment law. Elissa
presented an overview of existing
employment laws and how they related
to chiropractic practices, citing a
range of precedents and issues that all
chiropractors need to be aware of.
Tim Winkler
Finally, after a well-earned tea break,
CAAVIC Communications Manager
Tim Winkler provided an overview
of communications trends and ways
to market chiropractic practices in
2013-14 and beyond. Tim presented
a range of advertising concepts and
an overview of the latest research into
perceptions of chiropractic.
Each mini-seminar generated a wide
range of questions from the floor and
appeared to be highly successful in
delivering relevant insights to Members
free of charge.
Draft Minutes of the CAAVIC 2013 AGM
are available on request from the Branch
office.
Our special trade display was made up from members who run businesses complementary to the Chiropractic profession.
Our thanks go to - Ollie Owl, Forage Foods, Back to Sleep, Posture Pole and Synaptic Design. Thank you all very much for
giving up your Saturday and helping to make the 2013 AGM very memorable and educational.
13
2013 Annual General Meeting
AGM Awards
The AGM Awards are the culmination of our year, providing us with an opportunity
to recognise some of the many people who have contributed to our profession.
Victorian Chiropractor
of the Year
Michelle Kotzman
Michelle has worked
tirelessly for the
profession, serving
some ten years
on the CAAVIC
Executive, the last
three years as Branch
Vice President.
She has also been Chair of the
Professional Standards Commitee for
nearly 10 years, during which time she
was instrumental in producing many
practice guides and articles to lift the
performance, guide and assist the
Victorian members.
She has served six years on the Branch
Audit Committee, overseeing the
governance of the Branch and four
years as Victorian Representative to the
national Council of Representatives.
She was elected to Chair of COR last
year and has been highly commended
for her work in this role.
Outstanding Service Award
(alphabetical order)
Paul Finn
Paul has been a member
of the Branch Executive,
the Public Education
Committee, and was a
founding member of the
Professional Standards Committee, on
which he still sits. He has volunteered
his time to lecture to students as
part of the Practice Management
Programme for RMIT. He has mentored
too many students and practitioners to
number.
14
Simon Floreani
Simon has served
on the CAAVIC’s
Executive and PE
Committees.
He has also served on the CAA National
Board, of which he was elected as
President National Board. Simon has
also represented the profession on
numerous Committees and other
bodies.
Andrew Lawrence
Andrew is another
long term CAA
member whose
service to the
profession has been
outstanding, even
before he once again threw himself
back into the fray for another term on
the National Board.
Andrew has contributed many years to
the National Board, has been President
of the National Board. He has served
on the RMIT programme advisory
committee and on a range of CAA
Committees. He has always stood
ready to help out wherever he can.
Troy Miles
Troy has been a tireless
supporter of Spinal
Research and has run
DG Experience for four
years in Melbourne as
well as being one of the co-ordinators
of DG Congress.
With his partner Georgia, he was
instrumental in getting over 100
students to DG Melb. He teaches at
SOT conferences and spends weekends
to support the seminar attendees.
Troy is instrumental in running the
jumpstart programs for students.
Robert Terrett
Robert has been a tireless
worker for the profession.
He has been a member
of the CAAVIC Executive.
He Chaired the Peer
Review Committee, before it became
the Professional Standards Committee.
He was a founding member of the
Professional Standards Committee, on
which he still sits.
Robert started the Clinical Challenge in
the CAAVIC magazine, before it became
a feature of The Australian Chiropractor
magazine. He continues to be a
regular contributor to the Your Voice
magazine, in particular the clinical
jottings section.
Meritorious service
RT (Tom) Sims
Tom has been a leader
in the chiropractic
profession for many years
since setting up practice
in Dandenong in 1962,
he continues to practice in the same
suburb and has been a mentor for
many Chiropractors over his long
career.
Tom graduated from Palmer
Chiropractic College in 1961. He
returned to Dandenong and initially
joined in practice with Dr Bob Jeffries.
After a while Tom set up his own
practice and has been in Dandenong
for the last 51 years. Tom in the late
60’s and 70’s, served on the association.
Over this time, he has had many
chiropractors come to practice with
him and a common thread we note is
the respect and responsibility that he
has a Chiropractor.
2013 Annual General Meeting
AGM Awards
Fellow of the International College of Chiropractors
Brett Jarosz – A Special Presentation
The award went to one of your
colleagues, who has made some
excellent contributions to his
profession in a very short time.
In 2008 Brett was awarded:
• CAA Graduate of the Year (RMIT
University)
• CAA Excellence in Chiropractic
Science award (RMIT University)
• RMIT University Chiropractic
Diagnostic Radiology award
CAAVIC was proud to make this award
on behalf of the ICC.
Then in 2010 he won the RMIT
University College of Science,
Engineering and Health Certificate
of Achievement (Awarded for an
outstanding teaching score)
Brett was one of RMIT Chiropractic’s
most outstanding graduates and has
moved quickly into post-graduate
studies, research, publications and,
most recently, the production of an
evidence-based rehabilitation iPad
App that will greatly assist practicing
chiropractors and our profession.
The award recognizes not only
achievements to date but the potential
the recipient has shown for future
significant contributions to the
profession.
Brett is one of the youngest recipients
of the FICC and we are proud to count
him among our number.
THE YELLOW-HEAD METHOD
SIMPLE, SAFE CERVICAL TRACTION
SOOTHES MUSCLE TENSION
EASES HEADACHES
y e l l o w - h e a d
c o m . a u
Phone: 03 53344318
Email: [email protected]
15
The Many
Faces of
Women In
Chiropractic
Saturday 26th
October 2pm - 5pm
· Career Stages & Options
· Leadership
· Professional Networking
· Family Commitments
· Mentors and Sponsors
· Work/Life Balance
An incredible panel of
chiropractors explore options
and opport unities within the
chiropractic profession.
What stage are you at?
What choices do you see ahead?
How can you make a difference?
Our Panel of Speakers
include Drs...
Helen Alevaki
Vicki Anthonisz
Simone Aybar
Kim Furness
Navine Haworth
Kath Lawson
Katie Moss
Gillian Nixon
Michelle Ronan
CAA Members
$50 Full
$40 Non‐Practicing/ Limited/
Standard Year 1 (Concession)
$25 Student
Non‐Members
$60 Chiropractors / $40 Student
CAs $45
Venue: Ibis Hotel
297 Springvale Rd, Glen Waverley
To Register:
www.caavic.asn.au/wic
clinical review
MRI of the Knee –
The New Gold Standard
Chiropractors in Victoria now have
direct access to an MRI facility owned
and operated by Chiropractors.
MRI is increasingly acknowledged as
being preferable to arthroscopy for
evaluating knee pathology – noninvasive and safe. The ability to
perform weight-bearing MRI could be
regarded as the new gold standard for
knee evaluation.
Knee MRI comparison example
between recumbent and upright,
to help practitioners gain a better
understanding of pathology – such
as instability and cartilage thickness
changes.
While chiropractors have not
traditionally been considered by the
public to have a strong role in diagnosis
and management of extremity
conditions compared with the spine,
they have the opportunity to position
themselves as genuine experts for
managing a range of musculoskeletal
conditions by strategic use of
diagnostic imaging.
The advantage of MRI and low-field
comparison with higher field scanners
was highlighted in a recent article in
the Journal of Clinical Imaging Science:
“MRI is the examination of choice
in the evaluation of internal joint
structures of the knee like menisci,
cruciate ligaments, and articular
cartilage. The diagnostic accuracy of
MRI, although variable for different
individual structures, compares well
with arthroscopy, which is considered
the Gold Standard, especially when
assessing knee injury, in appropriately
identifying patients who require
arthroscopic therapy. MRI of the
knee joint has effectively replaced
arthrography and as the imaging
modality of choice in the evaluation
of both acute and chronic disorders
causing pain in the knee. Low-field
MRI is adequate for imaging the
knee. Studies have shown that it is as
effective as high-field MRI machines
in evaluating meniscal tears and
ligaments especially Anterior Cruciate
Ligament (ACL). Low-field MRI has been
readily accepted by both patients and
referring clinicians. MR 0.25 T magnet
is a safe and valuable adjunct to the
clinical examination of the knee in
preoperative planning and in avoiding
diagnostic arthroscopy.” (1)
suprapatellar pouch.
Following is a radiologist’s report
example of a recent patient (identifiers
removed) to give practitioners an idea
of style and potential content based
on the capability of the MR scanner we
use:
The patellofemoral joint is
developmentally narrow. Mild cartilage
changes are identified.
Name: Mr Klem Kadadlehopper
DOB: 27/03/1968
Exam Date: 12/09/2013
Date of Report: 12/09/2013
MRI Right Knee
Clinical Details: Right medial knee pain
that catches when weight-bearing,
then knee becomes hot and swells.
Patient points to medial femoral
condyle and describes occasional
shooting pain up medial thigh.
Technique: Protocol multi-planar data
sets have been performed at low field
including erect coronal imaging.
Findings: There is a small to moderate
degree of joint effusion in the
A complex tear of the posterior horn of
the medial meniscus exists involving
the free margin. Mild cartilage
irregularity at the medial compartment
is also seen.
The lateral meniscus is diffusely
thinned (meniscolysis). There are
mild cartilage changes at the lateral
compartment.
The collateral ligaments and associated
tendons are unremarkable. The cruciate
ligaments are unremarkable also.
Conclusion: Multi-directional medial
meniscal tear as described. Joint
effusion.
Yours sincerely,
Dr Reporting Radiologist
MBBS FRANZCR
For more information, visit www.
baysidestandingmri.com.au or phone
David Proctor and Peter Dun on 0417
160 912.
Reference:
(1) Lokannavar H, et al. Arthroscopic and low-field
MRI (0.25T) evaluation of meniscus and ligaments
of painful knee. J Clin Imaging Sci 2012:2(24)
17
clinical jottings
Dr Russell Mottram
Straight Teeth, at what Price?
One could say that there is almost
an obsession these days (amongst
middle class Australians at least) with
straight teeth and a “Hollywood smile”.
To the extent that if you do not, as
a parent, embark upon the path of
straightening your child’s teeth you
can be made to feel as though you are
negligent. Or at least in some way you
are handicapping your child’s future
prospects in the same way as say,
neglecting their education. Particularly,
may I say, if they are female.
We sometimes make the assumption
that orthodontic treatment is tried and
true, protocols are well established,
backed up by hard research, and that if
you go to six orthodontists, they would
all agree on the type and approach
best suited for a particular patient.
Generally, as an outsider looking in,
you would get the impression that
the whole process was totally noncontroversial.
Yet my practice, (over the last 20
years treating a lot of “TMJ” patients),
is populated to a significant degree
with “post ortho” cases. Patients that
have presented, or been referred by
other chiros or dentists, with jaw pain,
headache, and neck pain and with a
history of orthodontic treatment. Some
of these patients report no craniofacial
symptoms prior to orthodontics, but
development of jaw, head and neck
pain during or after orthodontic
management. In some cases, a different
type of occlusal therapy to “reverse”
18
the effects of the original ortho has
resulted in relief of their symptoms.
The whole question of the relationship
between orthodontic treatment and
TMD (Temporomandibular Disorder,
the preferred dental terminology),
whether beneficial, detrimental, or
both, has concerned some dental
researchers over the last few decades.
The number of studies in this area
is not large and they vary in their
conclusions, some suggesting that
there is no relationship, good or bad,
some that ortho helps TMD without
causing any problems and others that
suggest that ortho is a risk factor for
TMD. (For a comprehensive look at this
research, I suggest you go to PUBMED,
type in “TMD orthodontics relationship”
into the search engine and peruse the
86 or so articles that come up).
My own opinion on this matter is that,
like any other afferentation into the
central nervous system, orthodontics
can and does have more widespread
effects on the brain and body apart
from the targeted tooth movement.
The broader structural influences of
occlusal change, plus the significant
neural input via the trigeminal complex
into the mesencephalon, can be
profound and must be considered
before, monitored during, and assessed
after, the active treatment phase of
orthodontic management.
This is especially important considering
the long term nature of both the
treatment and effects of orthodontics.
One of the hardest tasks in my practice
is to inform patients that they may
need to undergo a second course
of orthodontic treatment to “fix” the
effects of the first.
So here are a few questions worth
considering if you, your children, or
your patients are about to embark
upon orthodontic treatment.
1. It is actually necessary?
I’m more inclined to recommend ortho
for functional reasons other than
purely aesthetic. If you are considering
treatment for only cosmetic reasons, is
the current scenario that bad that the
benefits outweigh the risks? Sometimes
an imperfect dental occlusion is the
body’s “best fit” for a distorted cranial or
body alignment.
Trying to fit a perfect bite onto an
imperfect skull and body may deharmonise the whole balance of the
cervico-craniomandibular system
leading to stresses further afield.
2. What might be needed before
braces?
My advice is that if there are signs of
obvious cranial distortion, scoliosis
or gross mandibular malposition (eg
crossbite), then ortho should proceed
with caution and signs of cranial or
bodily distress be heeded. This type
of patient is likely to benefit from
general chiropractic, cranial release
and possibly dental orthopaedic
treatment that is holistically orientated
to optimising bony jaw alignment and
TMJ function, before the application
of wires, brackets and fixed appliances
characteristic of orthodox orthodontics.
3. Is the Orthodontist flexible?
The orthodontist may need to be
prepared to slow down or modify their
treatment protocol should significant
headache, neck, spinal and jaw pain
manifest during treatment. Many
orthodontists seem to plough on
regardless in the expectation (or hope)
that these symptoms are temporary.
My experience is that this is not always
the case.
Attempts by patients to question the
timing and type of procedure, is often
ignored by the busy practitioner.
Some ground rules about ongoing
monitoring of progress might be good
to establish before treatment.
Orthodontists would be advised
sometimes to consider removable
orthopaedic appliances first to see how
the body is going to react instead of
going straight into more permanent
fixed braces.
4. Is the Orthodontist open to nonextraction techniques?
In my experience, one of the
commonest orthodontic procedures
that may lead to later complications is
that of upper bicuspid extraction.
A lot of the time, an underdeveloped
maxillary dental arch (extremely
common) leads to insufficient room
for the emerging permanent dentition,
so the teeth have to find bony room
by twisting, crossing over, tilting etc.
Hence the mouth becomes crowded
and the teeth crooked.
One common procedure used by
orthodontists to allow more room is to
extract the upper 1st bicuspids then fit
braces to pull the front teeth back into
the created space, thus uncrowding
them. This has the unfortunate byproduct of forcing the mandible to
posture posteriorly during closure,
as the bottom front teeth seek to fit
behind the top teeth that have just
been retruded.
This posterior posturing is a recognised
cause of TMJ distress as it pushes the
condyles of the mandible up and back
in the fossa. (Simmons 2005, Cooper 2009)
If possible the orthodontist should
seek to expand the upper arch to make
more room rather than extract to make
more room.
This is not always easy to achieve
particularly in adults, but not
impossible, if removable orthopaedic
rather than fixed orthodontics are used
first.
The use of these removable appliances
often distinguishes a more holistically
oriented dentist from a more
traditionally trained orthodontist.
Typical removable expansion appliance.
Having said all of the above, the innate
adaptive capacity of young bodies
(the age when most orthodontics is
attempted), means that the majority
of orthodontic procedures are
accommodated into the changing
body, however I think that if the above
precautions are considered, those
that do have complications might
be significantly lessened. The trend
towards more adult orthodontics,
I think, makes these points more
pertinent.
References
Narrow dental arch with crowded teeth.
Simmons HC, Gibbs SJ. Anterior repositioning
appliance therapy for TMD disorders. J
Craniomandibular Pract 2005; 23:89-99
Simmons HC. White Paper: Guidelines for anterior
repositioning therapy for the management of
craniofacial pain and TMD. J Craniomand Pract
2005;23:300-306
Cooper BC, Kleinberg I. Relationship of
temporomandibular disorders to muscle tensiontype headaches relieved and relationship to disc
status on MRI. J Craniomand Pract 2009: 27:101-107
Occupational Chiropractor cont from 11
Abstract
OBJECTIVE: To determine whether
work performed with the arms in a
highly elevated position is associated
with alterations in the rotator cuff
tendons as assessed by magnetic
resonance imaging (MRI).
METHODS: A cross-sectional study was
performed in a historical cohort of male
machinists, car mechanics, and house
painters. The participants were righthanded, ages 40-50 years, and had
been employed in their trades for not
less than 10 years. Seventy-one percent
of invited subjects participated (136
of 192). Lifetime upper arm elevation
was assessed by direct measurements
combined with individual work
histories obtained by questionnaire
and from registry data. Supraspinatus
tendinopathy was evidenced by
MRI signal intensity changes and
morphologic alterations. Infraspinatus
and subscapularis tendinopathy
were also assessed. Additional
outcomes were acromioclavicular
joint degeneration and humeral head
cysts. The MRI findings were evaluated
by radiologists who were blinded to
exposure status and symptoms.
RESULTS: An exposure-response
relationship was found between
lifetime upper arm elevation and
supraspinatus tendinopathy, with an
age-adjusted odds ratio of 1.27 (95%
confidence interval 1.02-1.60) for a
5-month increase in the total number
of full-time working months spent
with the arm elevated >90 degrees .
CONCLUSION: Work with the arms in a
highly elevated position is associated
with MRI-diagnosed alterations
in the supraspinatus tendon. By
demonstrating the first part of a
possible biologic pathway, the study
corroborates the work-relatedness of
rotator cuff disorders.
19
health, wellness &
lifestyle
Dr Orly Zuker
Nature makes no mistakes…
•
•
Much to the shock of public
perception, red capsicum & kiwi
fruit contain more vitamin C then
the humble orange and other
citrus fruit. Be sure to eat kiwi fruit
when they are still a little hard and
tart, and go raw with red capsicum
too.
Interestingly, carrots are a source
of calcium and sesame seeds
(tahini) are high in bioavailable or
easily digested calcium. To reap the
benefits of such minerals, be sure
to eat your carrots raw!
•
Coconut naturally contains a
medium chain fatty acid or fat/
oil that is in fact healthy for the
cardiovascular system and may
decrease ‘bad’ cholesterol &
enhance immune system function.
•
The sweet & juicy tomato contains
an enzyme known as lycopene
which may decrease the risk of
prostate cancer in men. Always
avoid hydroponic and nonseasonal varieties as the nutritional
benefits are greatly lost when not
grown in nutrient rich soil.
•
•
•
20
Grapes naturally contain
bioflavonoids (antioxidants) such
as resveratrol that ultimately
work towards destroying free
radicals, enhancing cell function
and encouraging overall health &
wellbeing (specifically the heart
organ).
Mushrooms are a vegetarian’s
protein super food & also contain
high levels of VIT B12. There a
many different varieties which
make cooking with mushrooms
easy and versatile.
Great news for cocoa and
chocolate lovers… Cocoa is the
highest food source of magnesium
on the planet.
•
Spirulina, a naturally occurring
algae is higher in absorbable
protein, iron and vital nutients than
red meat.
•
The apricot pip contains a kernel
which is rich in vitamin B17, a
powerful substance that has been
found to destroy cancer cells at a
cellular level..
•
Oats are rich in VIT B which
acts biochemically to reduce
cholesterol.
•
Pineapple is rich in the enzyme
bromelain which has been found
to reduce inflammation & aid in
digestion by neutralising stomach
acids.
•
Garlic contains a compound known
as allicin that has been found to
reduce cholesterol and which has
anti-bacterial, anti-viral, anti-fungal
and anti-parasitic properties.
•
The Noni fruit (juiced) is packed
with over 150 naturally occurring
antioxidants, minerals, vitamins,
proteins, enzymes, trace elements
for health.
•
According to manufacturers, chia
seeds have been found to contain
15 x more magnesium than
broccoli, 8 x more omega-3 than
salmon, 5 x more calcium than
milk, 3 x more iron than spinach,
3 x more antioxidants than
blueberries and is a great source of
vitamins and minerals.
•
Quinoa is a great source of protein,
has a delightful nutty flavour and is
a terrific alternative to grains such
as rice and wheat that we all eat
too much of.
Interesting fact:
Have you ever wondered why certain
fruits and vegetables look somewhat
like different body parts? According
to “Ancient Roman Scripture”
specific foods have benefits which
corresponded to the health of specific
organs.
For example ...
• A bunch of grapes is shaped like a
heart. They contain bioflavonoids
that are helpful in enhancing heart
health.
• Walnuts are shaped like a brain.
They contain important fats and
nutrients which enhance brain
function.
• Cashews & kidney beans shaped
like the kidneys. They contain
minerals and vitamins which
enhance kidney health.
• Carrot/ beetroot (cut horizontally)
appear similar to the eye/ iris. They
contain high levels of vitamin A
and betacarotene which are known
to augment eye health.
• Avocados are shaped like the
uterus. They contain vital fats for
female reproductive health.
Please visit
docorlyzukerchior.blogspot.com.au
world congress of
chiropractic students
RMIT Chapter
2013 AGM report
At 5:35am on Tuesday 16th April, six
mentally and physically exhausted, yet
inspired RMIT chiropractic students
finally arrived back in home from Durban,
South Africa; the home of 2013 World
Congress of Chiropractic Students
(WCCS) 34th Annual General Meeting
(AGM). This year’s RMIT delegation
consisted of Kate Slattery (4th year, Head
Delegate), Jeremy Balbin, Grace Wangui
(both 4th year), Ashley Burian, Chelsea
Dickins (both 2nd year) and Cassie
Atkinson-Quinton (graduated, mentor).
The Hosting team, lead by Justin
Adams of Durban University of
Technology, delivered an incredible
6-day event, which was followed by
access to the 3-day World Federation of
Chiropractic (WFC) Congress. This year,
as an organisation, WCCS focused on
continuing to build and professionalise
the foundations of our corporation in
order to establish a strong and united
base. These discussions took place
formally, using Robert’s Rules of Order,
and less formally in smaller breakout brainstorming groups. Invariably,
each discussion came back to how we
could use our variety of opinions and
philosophies to ultimately achieve the
purpose of WCCS: ‘To advance and
unite the global chiropractic profession,
through inspiration, integrity and
leadership’
discussed with the entire chapter prior
to congress on the microphone, as well
as stepping up to be part of and head
various committees. This culminated in
our delegation receiving numerous votes
for delegation of the year (ultimately
won by the New Zealand College of
Chiropractic). A big success for the
chapter was winning the rights to host
the 2013 and 2014 Western Pacific
Regional events, ‘Enhancing Connections’.
Through these events we aim to share
the passion, excitement and personal
development experienced each year by
AGM attendee’s with a larger contingent
of local and other Western Pacific
students and recent graduates.
Out of business hours consisted of a
number of cultural experiences including
a braai (South African BBQ), a tour of
DUT facilities, a billet night and a trip to
Phezulu Safari Park to watch local dances
and rituals.
Attending the WFC was an honour to our
entire chapter, having the opportunity
to listen to the people who wrote
the textbooks we study from, and
attend workshops on the most recent
techniques. This additional inclusion
enriched the experience.
Due to the success of the AGM, and the
inspiration gained by our delegation,
our chapter has already grown, with the
addition of 7 new members.
Attending a WCCS AGM changes people.
Students, who are motivated and lucky
enough to be a part of the remarkable
experience that is WCCS, come back
with a newfound, amplified devotion
to the chiropractic profession. They will
grow to be leaders in our profession and
through their enthusiasm they will rouse
the sleeping passion in as many of their
colleges and classmates as possible. This
is because they can see the potential
that the future may bring. They’ve just
spent the greatest week of their life in
one room, filled with students of differing
backgrounds, differing philosophies and
some with polar opinions on certain
aspects of chiropractic. However, these
students alleviate themselves from the
minute perceptions that separated them
and formed bonds that will last their
entire lives. These students came to
realise that the small details that divide
us are insignificant to the ones that bring
us together. For what brings us together
is a vision, of the chiropractic profession,
unified through our diversity and moving
forwards in the world.
Some of the interesting discussion topics
included each school’s stand on drugs
in chiropractic, recent changes to the
New Zealand Chiropractic Board’s code
of ethics, international mobility and
exchanges between colleges, board
exams for chiropractic accreditation,
social responsibility and accountability
for chiropractors, and the possibility of
introducing more relevant sciences into
the global curriculum.
The RMIT delegation was very well
represented, with all delegates having
a turn sharing opinions that were
21
creating your own
marketing plan - part 24
Winston Marsh
Sell the sizzle:
Recruiting team members,
associates or successors
We were relaxing in the country with our
dogs on a short break. Then I noticed that
Millie, my pink and purple tinged Groodle
was favouring one leg. A visit to the Vet was
called for. Naturally, as the Vet assessed
Millie we chatted more so about him, his
practice and his challenges than would be
usual probably because I’d just spoken at a
Vet’s conference.
Assessing his age as about when he might
be thinking of winding down, I took a stab
at his biggest challenge and asked, “How is
the succession plan going?”
“It’s not going anywhere,” he answered, “It’s
impossible to get young vets interested in
working in the country.”
That’s when I had to prescribe a course of
treatment for him known as “Selling the
sizzle not the steak.” Let me explain.
“So how do you go about getting the right
person to join your practice and hopefully
become your successor?” I asked him.
“Well, I run an advert in Vet publications
describing the position and the potential,”
he replied.
“And would it start something along the
lines of ‘Practice for Sale... busy mixed
animal practice in provincial town for
sale due to retirement of current owner.
Beautiful modern clinic with all the latest
bits and pieces?” I said.
Editorial
cont. from pg. 4
personal wellness of the highest order.
There are plenty of research papers out
there that suggest that lives that are
shared are enhanced and enriched.
Personally, I have so much fun being
part of a group of Venturers enjoying
themselves in some interesting location
that I’d pay to do it.
22
“Yes,” he agreed.
“And how would that look compared to all
the other practice for sale adverts?” I asked.
“The same,” he admitted ruefully.
An advert that doesn’t stand out, demand
attention or attract an interested party. The
result... no results!
That’s when he had to sell the sizzle not the
steak! To do that, he must...
Decide who his target market is. And that’s
just not any Vet. In fact it is somebody just
like he was when he arrived in the town
on a locum assignment 35 years ago and
stayed forever... a young married man with
a family for whom a lifestyle for him, his
partner and young family was important.
And this was where he could achieve that.
So why wouldn’t there be someone like that
today?
Explain why the person targeted should
choose to investigate his opportunity rather
than one of the alternatives. We’ll, that’s
simple... they’re all vets so they’ll have a
pretty good idea of what the clinic look will
look like and what it’s got. So sell the sizzle...
the lifestyle, particularly for the partner and
kids.
Get their attention by making sure they
see it using both the traditional option of
the Vet’s magazines (still well read) and the
cyberspace alternatives like the Association
e-newsletter. Use a headline that seizes
their attention and write copy that compels
them to read on.
Come to think of it, I do. Bicheno
Tasmania in January 2012 teaching
scuba, Sorrento in April each year
with scuba camp, Queenstown, NZ in
January 2013 at an Extreme Adventure
camp are all recent wonderful
memories.
So, what wonderful memories do you
have, are you creating, have you helped
The advert could start something like I’ve
written in the box.
What’s the secret? Walking in the moccasins
of your ideal prospect and thinking about it
through their eyes and ears. Find out what’s
important to them, what their real needs
are and demonstrate that you have the
answer.
Does an approach like this work? It sure
does... the last advert I helped a prospective
employer write generated 220 outstanding
applicants!
Lifestyle opportunity for a Vet
with a young family!
If you have primary school age children and
are looking for a great opportunity for them,
your partner and you then this is ideal for
you.
Located in a prosperous country town with a
fantastic primary school (high achievement
at all levels) and a secondary school (with
great Year 12 pass rate) this position
offers all of the conveniences with none of
the drawbacks of the city (although a few
people have been fined for returning library
books late)... ...
Marketing Guru Winston Marsh works with
chiropractors to take the grunt work out of
profitable practice building. Call 03 9803
7555, e-mail [email protected] or
visit his website winstonmarsh.com.au
create? What great projects have you
been part of? How have you enhanced
the wellness of your community by
more than your professional presence?
Shortly, we’ll be asking you to update
us on what you are doing. I’d love us to
be able to prove that Australia is vastly
richer because of your input.
a big thank you to the
Back to Sleep Team
Norm Brockley
Down through the years there have
been some amazing chiropractors who
out of the goodness of their hearts
have mentored chiropractic students.
Some have opened their practices,
others like Max Joseph opened their
homes and welcomed students to
come along and learn a bit more about
what it is to be a chiropractor.
It is truly wonderful to see that this
practice has never stopped.
Recently I was invited to participate in
a Student Social Support Forum which
is being put on by the team at back to
sleep®.
New in the Library
Autism: The Scientific Truth About
Preventing, Diagnosing, and
Treating Autism Spectrum Disorders-and What Parents Can Do Now
Dr. Robert Melillo
From the bestselling author of
Disconnected Kids, a clear and
compassionate explanation of the
causes of the autism epidemic—and
a scientifically based approach for
prevention and treatment.
As he travels the country helping
parents and children cope with
neurological disorders, Dr. Robert
Melillo is always asked one question:
Why? Why are autism rates exploding?
But an equally important question
always follows: What can we do about
it as a society—and what can I do to
help my child?
In this candid, research-based, practical
book, Dr. Melillo presents the latest
scientific explanation for how we got
here and proven, drug-free strategies
that parents can employ to help
prevent, detect, and address the autism
any if not all of you will be aware
that back to sleep® is a mattress and
pillow specialist company owned and
managed by Dr George Skandalellis, a
chiropractor himself.
George and his team, offer regular
forums as an extension of their support
as Founding Sponsor of the Australian
Spinal Research Foundation ‘Jumpstart’
programme, where guest speakers are
brought in to talk to a small group of
chiropractic students. The students are
provided with light refreshments (all
free) and then listen to and question
people from all parts of the chiropractic
profession. This forum really is a great
opportunity for them!
epidemic for themselves and their
families.
With honesty and compassion, Dr.
Melillo explains what the latest
scientific research tells us about the
role of genetic, environmental, and
lifestyle factors, dispelling myths
and replacing them with the facts. In
addition, he presents early warning
signs, a prevention plan for parentsto-be, and an intervention program for
babies and young children.
Functional Neurology for
Practitioners of Manual Medicine, 2e
Randy W. Beck BSc(Hons) DC PhD
DACNB FAAFN FACFN
This book takes the reader from the
embryonic beginnings of the nervous
system, through the biochemistry
of receptor activation and on to the
functional systems of the nervous
system. Concepts, relationships and
scientific mechanisms of the nervous
system function are covered, and this
aids the practitioner in developing their
clinical approach to a wide variety of
patient presentations. The text is fully
referenced, which allows the reader
to immediately apply the concepts to
practice situations. New for this edition
I have now participated in two of these
forums which have always been well
attended by students who are clearly
engaged and in part through this
process, I am sure will be well prepared
to enter their chosen profession.
So I would like to offer my
congratulations to George and his
team, Jennifer Luu, Paula Atkins and his
brother Phillip for their generosity in
giving of their time to help support the
students.
are new chapters on pain (including
headache) and theoretical evidence,
plus extensive electronic resources
supporting the text.
•
•
•
•
•
•
•
Utilizes our understanding of how
the nervous system works in the
treatment of a variety of clinical
conditions
Demystifies the clinical results
seen in the practice of Functional
Neurology and scientifically validates
its clinical success
Addresses function rather than
pathology, allowing the reader to
gain a firm understanding of the
neurological processes seen in
health and disease
Contains clinical cases which are
designed to be read and answered
before starting the chapter to allow
the reader to gauge their current
state of knowledge
‘Quick Facts’ introduce new concepts
or allow rapid review of information
already presented in the text in a
brief and succinct manner
Contains a detailed overview
of the concepts relating to our
understanding of the development
of emotion to demonstrate the link
between physical health and the
mind
Contains abundant references to
support controversial concepts
23
locum list
When seeking a locum you are advised to confirm with them that they are registered
and that they supply you with a certificate of currency for their Professional Indemnity
Insurance.
Dedicated Locums
Joanna Revilla
0487 303 177
[email protected]
Techniques: diversified, basic SOT, activator, cranials, drop piece, dry
needling, soft tissue therapy. Available Victoria-wide.
Tony Courtin
0409 259 392
Wayne Jennings
0457 931 377
[email protected]
Available Australia wide. Techniques: SOT (diplomate), diversified,
activator, drop piece.
Roxanne JenningsPayne
0417 625 303
[email protected]
Available Australia wide. Techniques: Diversified, drop piece, SOT,
activator.
David McNair
0434 948 718
[email protected]
Qld member, available Australia wide. Techniques: Diversified,
gonstead, drop piece, activator, SOT.
Nicole Moore
0438 545 504
[email protected]
Available to work anywhere in Melbourne. Techniques: Diversified,
drop piece, activator and basic SOT
Renata Perilli
0423 655 457
[email protected]
Available Australia wide. Techniques: SOT, diversified, drop piece,
cranial, activator, soft tissue
Joseph Salameh
0404 899 661
[email protected]
NSW Member. Techniques: Diversified, activator, drop piece and SOT.
Anna Schwager
0422 735 738
[email protected]
Short or long-term, available Victoria-wide (would consider Australiawide positions). Diversified, TBM, AK, Drop-Piece, Activator, SOT, Soft
tissue
Sarah Stella
0497 110 801
[email protected]
Available Victoria-wide. Techniques: Activator, drop piece, diversified,
soft tissue.
James Washington
0408 260 868
[email protected]
Available nationally. Techniques: Diversified, SOT, thompson, activator,
gonstead, blocks, drop piece, STT, Rad.
Tania Leski
0417 300 402
[email protected]
Full or part time, Melbourne or nationally. Manual Adjustment,
Activator application, drop piece, Joint Mobilisation, spinal distraction,
extremity adjusting.
Nathan Petridis
0404 303 073
drnathanpetridisdc@hotmail.
com
Melbourne area and surrounding outer suburbs. Techniques:
Diversified, Thompson, Blocks, Activator, Drop Piece, Soft Tissue, Rehab.
Anna Beaton
0414 234 828
[email protected]
Part time (Monday & Thursday). Techniques: SOT, Gonstead,
Diversified, Thompson, Drop-piece, cranials and Paediatric care.
Simone Aybar
0409 490 990
[email protected]
Emergency. Techniques: Activator, cranial, drop piece, manual,
gonstead.
Celia Burrows
0406 914 180
[email protected]
Techniques: Gonstead, diversified, thompson, drop piece, activator, dry
needling
Clare Coleman
0433 292 150
[email protected]
Melbourne Area. Techniques: manual adjusting, activator, SOT blocks,
applied kinesiology, NET
Bridget Kelly
0432 645 146
[email protected]
Melbourne Area. Techniques: diversified, thompson, activator
Renata Perilli
0423 655 457
[email protected]
Available Australia wide. Techniques: SOT, diversified, drop piece,
cranial, activator, soft tissue
Kristian Rodoni
0438 581 500
[email protected]
Available Victoria-wide. Techniques: Diversified, Thompson, AK,
Damiano Tomassoni
0400 417 586
[email protected]
Available Victoria-wide. Various techniques practiced, including
Diversified.
Jackie Swiatlowski
0402 317 268
[email protected]
Melbourne. Techniques: diversified, activator, soft tissue/deep tissue
therapy, dry needling
[email protected]
US trained with 10 years Australian experience. Techniques:
Diversified, Gonstead, Drop-piece, SOT, Activator, basic AK + more.
Available short or long-term, Melbourne and surrounding suburbs
Techniques: Diversified, Gonstead, Thompson, Activator, muscle energy
technique.
Part Time Locums
Non-Member Locum
Greg Bowers
24
0425 841 487
continuing professional
development
calendar of events
OCTOBER 2013
Friday 11 - Sunday 13
Neuron Theory and Receptor
Activation (Module 901)
Punthill Conference
Centre, South Yarra
Carrick Institute for
Graduate Studies
www.carrickinstitute.org
Friday 18 - Sunday 20
National Development Forum
Sofitel Wentworth,
Sydney
CAA National
Saturday 26
The Many Faces of Women in
Chiropractic
Ibis Hotel, Glen
Waverley
CAAVIC
www.caavic.asn.au/wic
03 9328 4699
Sydney
SOTO
www.soto.net.au
[email protected]
NOVEMBER 2013
Sunday 10 - Monday 11 SOTO Annual Convention & AGM
www.
nationaldevelopmentforum.
com.au
Wednesday 13
WEBINAR - Reading an MRI :
Lumbar Spine
Your computer
CAAVIC
www.caavic.asn.au
03 9328 4699
Saturday 16
SEMINAR - Road to Recovery:
Managing better outcomes for
patients with road and workplace
injuries
LIVE BROADCAST - Clinical
Assessment of Mild Traumatic
Brain Injury (mTBI) in Chiropractic
Practice
Rydges, Melbourne
CAAVIC
www.caavic.asn.au
03 9328 4699
CAAVIC Hub, and outer
metropolitan and
regional Pods
CAAVIC
www.caavic.asn.au
03 9328 4699
Neuromuscular Applications
(Module 902)
Punthill Conference
Centre, South Yarra
Carrick Institute for
Graduate Studies
www.carrickinstitute.org
Wednesday 20
DECEMBER 2013
Friday 6 - Sunday 8
Publication of seminar details in no way implies endorsement of C AAVIC Limited or the Edi tor
of Your Voice. Whilst all care is taken in the preparation of this list, no responsibilit y can be
accep ted by C AAVIC for the accurac y of this information. Please note that not all courses may be
CPD accredited - please contac t the organiser to confirm.
25
classifieds
Practice For Sale
Practice for Sale: Watsonia.
Very well presented, paperless practice
ideal for the motivated chiropractor.
Two fully equipped treatment
rooms, EMG and Thermal scanning
technology. Great maintenance base,
established 35 years.
Contact Pete 0408 05 3415
or [email protected] for a
prospectus
Chiropractic Clinic for sale - Inner
Western Melbourne suburb .
This would suit first time purchase for a
motivated Chiropractor or as a second
practice for an existing business.
• Located within a small group of
shops
• Leased for a further 1 year with
potential for longer lease
• 1 Private Consulting room
• Small Reception & waiting room
and kitchenette.
• Hicaps, EFTPOS & PBSA Diary
Management system
• Large existing client base primarily
due to Word of mouth
• Genuine future growth potential.
• Owner selling due to business
restructure of other clinics
Additional information available on
request. All genuine offers considered.
For more information, phone Lisa
on 0405 3131 98.
Employment
Paediatric Chiropractor Wanted
Chiropractic clinic in Rosanna, with
many years of providing paediatric
chiropractic services, is looking for a
chiropractor to take over existing paeds
patients as current chiro is leaving.
Current chiropractor is working 2 to 3
shifts per week, which can be increased
if desired. We are a low stress, fun,
family oriented chiropractic clinic in
search of an energetic, self-motivated
person to join our team. You must
have either completed or be currently
enrolled in a paediatric chiropractic
program.
Please email your CV to yourchiro@
hotmail.com or call Dr. Mike on 0421
392 708.
Part Time Maternity Cover Groovy Brunswick
Needed for 9-12 months beginning
mid October 2013. We are looking for
an experienced chiropractor to fill our
existing associate position while she
goes and has a baby. We are looking
for someone with excellent manual
adjusting skills, SOT and activator.
Paediatric experience would be an
asset. Shifts include Tuesday am/pm,
Thursday am/pm and Saturday am.
Please email CV to Paul - gochiro@
gmail.com or call on 9388 1233 or
0417 589 462
Equipment For Sale
Chiropractic Hi-Lo Table
Great table with adjustable tension,
pelvic drop, adjustable lumbar
segment (ideal for pregnancy
treatment). Well maintained and
in perfect working order. Photos
available by email amelia@
melbournespineclinic.com.au. $4000
Portable Tables
Height adjustable, 2 drops, tilt head
piece, face paper holder,
Carr y bag, light weight at 18kg Black
only $699.00 incl GST
Call 0418 575 052 or
[email protected]
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Perfect support and comfort
The back to sleep® range of pillows has been tested by health care professionals ensuring each pillow provides
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email [email protected]
Memorable Range
Dust mite
resistant
5 year
guarantee
passed SGS for
passed TGI for
Latex content
quality & ecological
accuracy & purity
safety
Natural Range
Breathable
Environmentally
friendly
1300 854 557 I backtosleep.com.au
ADV003
passed strict
Oeko-Tex
standards
Exclusive to health professionals.
Comfort & support for everybody.
Australian owned Therapeutic Pillow & Thera-med supplies
postural comfort products for your patients so they can leave
your clinic with a pillow that complements your treatment.
Premium grade products, at the right price.
Not available through bedding & department stores, only you!
Premium products for
your deserving patients
 Sensible margins
 No minimum orders
 Return as you wish
 Free display stand
CompleteSleeprrr - Memory foam adjustable pillow
TM
Reworkable inserts allow the shape, height, and angle to be changed to suit
all physiques. In luxurious Australian made memory foam or premium foam.
Wholesale Deluxe Foam $43.82 +gst, Memoryfoam $51.88 +gst
Naturelle - Luxurious latex pillow in three sizes
TM
Pure latex.. naturally! Sumptuously soft, wonderfully supportive.
Superb quality & we believe it is the world’s best contoured latex pillow.
In three sizes (High, Medium and Low) Wholesale $51 - $57 +gst
For a catalogue & wholesale prices of all products please contact your State distributor
Pressure care comfort products that aid circulation
and encourage better posture for everybody.
Qld: 07 3279 4400
NSW: 02 9316 9012
VIC, TAS & NT: 03 8585 6685
SA: 08 8365 4066
WA: 08 9381 2333
View full range at www.pillows.com.au