Chiropractic Integration

Chiropractic Business Opportunity & How Chiropractic Solves The Opioid Issue

CF 119: Chiropractic Business Opportunity & How Chiropractic Solves The Opioid Issue

Today we’re going to talk about some recent numbers that came out in JAMA on healthcare spending. Then we’ll talk about how chiropractic has the answer to the healthcare spending issue. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #119

Now if you missed last week’s episode, we had one of our biggest episodes in the history of Chiropractic Forward and than’s because we were joined by the one and only clinical ninja and world-renowned expert himself, Dr. Stu McGill. 

I was a bit of a fanboy so I’m still not sure how strong my part of it came out but I can tell you that Stu is ALWAYS strong and this information is a ‘Do Not Miss’ type of thing. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

I’m doing the same thing as you’re probably doing. I’m freaking out a little or a lot. OK, some of you aren’t but I have no idea how you’re able to chill out. I’m not a hype type of guy. Hopefully, by now you know I’m a very reasonable kind of guy. 

Here’s what I got; I record these podcasts two weeks prior to airing. This pandemic is changing every day so for me to offer opinions, comfort, hope, and things of that nature just seems pointless right now. Because nobody knows what the hell the landscape will be when this goes live. Nobody knows what business is going to look like. 

Just know this, if you are a listener, I love you. Even if we’ve never met. I love you. Please be safe. Please listen to the CDC and not chiropractors that think they can end this through adjustments. Please stay in touch with the elderly you are connected to. Encourage them, help them if they need it. They’re scared too. Probably more so than the rest of us. 

It’s time to be humans. Not partisans. Not North, South, East, or West. Not even American, Korean, Italian, or Chinese. It’s time to be humans and do our parts to keep this thing from doing any more damage than it has to do. 

And, as a Christian myself, if you are a Christian or religious whatsoever, pray. Whether you think it’ll do any good or not. I can promise it won’t hurt. 

If you are living day to day financially, I wish I had something amazing to say but, I WILL offer this. The more my business struggles and the more your businesses struggle. The more this goes on, the more you’ll see the system buckle and bend to accommodate you. That may look like no payroll tax, tax relief, tax incentives, extended lease payment options on your office spaces, school loan interest was already waived and it won’t surprise me if there’s a suspension on school loan defaults as well, the government paid leave for employees, and on and on. 

What I’m saying is that some things are out of our control. This is out of our control. Hell, by the time this airs, we may all be on mandatory shut down for business and you may be listening from home. 

Here’s what you have to know; The country cannot have thousands and thousands and thousands of businesses going under. Landlords cannot have non-leased, empty buildings

The system will figure out how to keep everyone afloat. 

Stay strong and stay hopeful. Stay clean and stay separate for a bit and maybe we can get a handle on it. 

Alright, enough of that. I’m sure we’re all sick of hearing it by now.

Item #1

Let’s start with this one called “US Health Care Spending by Payer and Health Condition, 1996-2016” by Dieleman et. al(Dieleman J 2020). published in JA<A on March 3, 2020. Yep, it’s hottern’ hell!!

Here’s the deal, this was March 3rd so….just before this mass hysteria started. Healthcare spending may look different now but, this was from 1996-2016 before anyone ever heard of this pandemic. 

Why They Did It

They wanted to answer the question, “How does spending on different health conditions vary by payer and how has this spending changed over time?

How They Did It

  • Information was collected from the following: government budgets, insurance claims, facility records, household surveys, and official US records from 96-2016.
  • They used the info to estimate spending for 154 health conditions
  • Spending growth rates were calculated for each type of payer as well as each type of condition. 

What They Found

  • From ’96 to 2016, healthcare spending when up from $1.4 trillion to $3.1 trillion. 
  • For the mathematically challenged, that is up to $1.7 trillion. I was always under the impression that our system and our treatments should get MORE efficient through the year rather than more and more expensive. 
  • In 2016, private insurance paid for 48% of it
  • Public insurance paid for 42.6% of it
  • Out-of-pocket was 9.4%

For the stuff that matters to us chiropractors specifically, 

  • In 2016, among the 154 conditions, low back and neck pain had the highest amount of health care spending with an estimated $134.5 billion
  • 57.2% of that was paid by private insurance
  • 33.7% of it was paid by public insurance
  • 9.2% was paid out-of-pocket

Other musculoskeletal conditions cost the system a further $129.8 billion. So if we’re keeping count here peeps, that means the total cost of musculoskeletal system issues cost the system in 2016 and grand total of 264.3 billion dollars. 

I’ll have you know that the second most expensive condition was diabetes coming in at a grand total of $111.2 billion. That’s a full $153.1 billion dollars less than m/s issues. 

So that we’re not drowning in numbers here….remember this; M/S conditions cost 264.3 billion. The next most expensive was diabetes at $111.2 billion. 

Do you smell some business opportunities there? I sure as hell do. You realize they used to be putting a good number of those people on muscle relaxers and opioids but they aren’t anymore. Right? Now, a large number of those people need an alternative and we are uniquely poised and positioned to be that help. To be that alternative. 

Mmmmm….when this mess calms, I’ve got some business ideas. You should be cooking up what brew you want to have ready as well. 

Item #2

Our second and last item here is called “Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain” by Whedon, et. al(Whedon JM 2020). and published in Pain Medicine on March 6 2020. Smokin plate of whatcha havin!!

Why They Did It

They say that the utilization of nonpharma pain management may prevent unnecessary use of opioids. The objective here was to evaluate the impact of chiropractic utilization on the use of prescription opioids among patients with spinal pain. 

How They Did It

  • This was a retrospective cohort design for analysis of health claims data from three states for the years 2012-2017
  • They included 101,221 adults from 18-84 yr old that had office visits to a primary or a chiropractor for spinal pain. 
  • They identified two types; 
  • Recipients of both primary and chiropractic care
  • Non-recipients that got primary care but not chiropractic.
  • They compared the two groups as far as the risk for filling an opioid prescription. 

What They Found

“Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription. Among those who saw a chiropractor within 30 days of diagnosis, the reduction in risk was greater as compared with those with their first visit after the acute phase.”

So, your next social media graphic is this; “patients who saw a chiropractor had half the risk of filling an opioid script.”

Then the next one will be; “Patients that saw a chiropractor in less than 30 days of diagnosis had been more than half as likely to fill an opioid prescription.”

Then the next one will be “US spends $236 billion on musculoskeletal pain but those treating with a chiropractor are less than half as likely to fill an opioid script.” See how I tied that all together for you? Did you see what I did there?

Don’t just listen to this stuff. Turn it into something. I’m trying to help you! Or, you can just join our private Facebook group and I’ll try to start making these more often so you can just share them without going through the effort. 

I’m totally cool with that. 

Alright, the message is the same every week.

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Dieleman J, C. J., Chapin A, (2020). “US Health Care Spending by Payer and Health Condition, 1996-2016.” JAMA 323(9): 863-884.
  • Whedon JM, T. A., Kazal L, (2020). “Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain.” Pain Med.

American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

CF 111: American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

Today we’re going to talk about how the American Family Physicians may be warming up to chiropractic for chronic pain and what supplements actually have some evidence behind them.

But first, here’s that sweet sweet bumper music


Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #111

Now if you missed last week’s episode , we talked about Dry Needling vs. Massage and even more importantly, we talked about the topic of “What is your exit number?”. What are you looking to get out of it all in the end? I feel like there were points made in there that could really get you to contemplating and thinking going forward. So, make sure you don’t miss that info. Keep up with the class. 

That reminds me, did you know that you can use our website as quite a resource? I do it all of the time. If you think I can keep every one of these papers in my noggin and pull them out of my brain files on demand, that’s a big nope. But I can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever I want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

Rinse and repeat man, rinse and repeat. If you’re friends with me on Facebook, then you know life has been crazy and there’s no slow down in site. 

Some really positive stuff happening though too. For example, I was interviewed for two different articles in Chiropractic Economics recently. They published an article called “Chiropractic for prevention: the latest research on maintenance care” by Michele Wojciechowski. Michele used my comments exclusively in this article and that’s just a big honor. 

I remember when I was new in practice. I remember reading articles in Dynamic Chiropractic and Chiropractic Economics and thinking that would be cool to be in that one of these days. Now…..now…I’ve been fortunate enough to be in Reader’s Digest, on the ACA Blog a couple of times, and now Chiropractic Economics. It’s pretty damn exciting and it’s an honor. 

Thank you Michele for finding value in my comments and sharing them with everyone else. I’ll leave a link to that article at this point in the show notes if you’re interested in giving it a read through. 

Other than that, my family and I took a quick ski-cation to Red River, New Mexico. If you haven’t been, look it up. Here’s why we like Red River, First thing, it’s close. For a Texan to be able to just drive about 4 hours and be in the mountains, that’s pretty exciting. 

Next thing, it’s just gorgeous. And, the ski slope comes right down into the town so you don’t have to drive out to a mountain which is nice. 

Let’s talk about why I retired from skiing myself though shall we? This may make you think a bit about some of the stuff you do in your offtime. Maybe it won’t but it’s important to think about things which is the whole point of me bringing it up.

I used to ski a lot back in high school and junior high. I was pretty decent at it too. Then I went off to play football and be a college kid. Well, Louisiana for a bit and Dallas for a bit…..those areas aren’t very conducive to learning to snow ski. It’s too damn far. Especially when you’re still a kid and broke as hell. Skiing just doesn’t happen at that point in life unless you have parents taking you. I didn’t.

So then you start life and you’re building a business and there’s never time to go then either. 

Well by the time I got back around to going skiing again, I hadn’t done it in about 20 years give or take. So, i got a private coach for a morning just to get me back on that bicycle and rocking and rolling again. I have to tell you, it was hard as hell!! It was NOT like riding a bike. Nothing at all like it as a matter of fact!!

But, I took it slow, I didn’t fall at all, and was fairly happy with my progress over the weekend. HOWEVER, I got to thinking when I got home. I went back to work and had about 45 patients that next day. What if I had twisted a knee, broken and elbow, or dislocated a shoulder while I was skiing? What would I have done?

You know this sounds stupid when you say it but, “They call them accidents because you don’t plan them.” But you can avoid them sometimes. I got to thinking long and hard enough about the risk vs. rewards for continuing to ski and……honestly, on paper, it wasn’t worth the risk. 

So, I retired. Maybe if I had an associate. Maybe I could make more sense of it but, the truth is, I don’t have an associate. It’s just me although I’m thinking of hiring one just as soon as it makes sense. Anyway. I took the kids skiing while the wifey and myself enjoyed the mountains, some brewskis, and some playoff football games. 

What are you involved in as far as physical activity outside of your practice that puts you at risk and puts your ability to earn a living at risk? Do you have disability insurance? Life insurance? Long term care insurance? I have all of that. Do you need it?

Start thinking about these things. Certainly, the more successful you get and the busier your practice gets. Risking an injury just might not be worth it at some point. 

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that. 

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, activities of daily living, & for their exercises. 

This saves you so much time – no more explaining & re-explaining your patient’s care because they have access to it right there at their fingertips. 

You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Item #1

Let’s start with this one from American Family Physician. I got this one from one of my amazing colleagues, Dr. Craig Benton down in Lampasas, TX. It’s called “Nonpharmacologic therapies can improve chronic pain outcomes” authored by Michael Devitt and was published in American Academy of Family Physicians on January 15, 2020(Devitt M 2020). Damn it’s hot…..

Not a research paper but more of an article in their publication but has plenty to do with chiropractic. 

They set the stage here by pointing out that chronic pain is something that can cause people to go to extreme measures just to get the pain to go away. Or at least lighten up. They say this includes potentially harmful behaviors like drug and alcohol misuse and/or abuse. 

Then this article in the American Family Physicians journal starts to highlight and promote the nonpharmacologic treatment modalities that are available to family physicians. Honestly, did you think you’d ever see the day? Ever? The battle isn’t over by any stretch of the imagination but research is gradually, inch by inch, turning the tide. 

They say these modalities include simple methods like massage and heat as well as more complex therapy like acupuncture and chiropractic manipulation. They called us ‘complex’ and I’m taking that as a compliment. Lol. What we do can damn sure be complex. 

They say that these nonpharma strategies aren’t only effective for decreasing pain and improving function, but can also be effective for reducing longer-term adverse effects such as substance use disorders and suicide attempts. THAT’S A BIG DAMN DEAL. 

In fact, I got one word, two syllables….day-um. 

One researcher, the lead author from an active-duty US Army service study said “Chronic pain is associated with adverse outcomes such as substance use and suicidal thoughts and behavior,” said Esther Meerwijk, Ph.D., M.S.N., a statistician at the VA Palo Alto Health Care System in California. She added, “It made sense that if nondrug treatments are good at managing pain, their effect would go beyond only pain relief. However, I was surprised that the results of our analyses held, despite our attempts to prove them wrong.”

Despite our attempts to prove them wrong! Haven’t they been trying to prove us wrong for generations now? Lol. I always say that with all of the powers against us, if we were wrong, if we were ineffective, we would have been wiped out years ago. 

In one of her projects, they reviewed the records of more than 275,000 active-duty service members reporting chronic pain.

They combed through their files to determine whether they had received any of 13 nonpharmacologic therapies after their deployment. Those therapies were acupuncture or dry needling, biofeedback, chiropractic care, cold laser therapy, exercise therapy, lumbar supports, massage, osteopathic spinal manipulation, other physical therapy, superficial heat, traction, transcutaneous electrical nerve stimulation, and ultrasonography. 

After crunching all of the numbers and outcomes here’s what they came up with:

Specifically, service members who received nonpharmacologic therapies were

  • 8% less likely to experience new-onset alcohol and/or drug use disorders;
  • 12% less likely to experience suicidal ideation;
  • 17% less likely to experience a self-inflicted injury, including attempted suicide;
  • 18% less likely to intentionally poison themselves with opioids, related narcotics, barbiturates or sedatives; and
  • 35% less likely to accidentally poison themselves with the same types of drugs.

The researchers acknowledged several limitations in their research. For example, although most nonpharmacologic therapies were provided after service members were diagnosed with chronic pain, the authors could not determine whether those nonpharmacologic therapies were used specifically to treat that pain.

In the news release, Meerwijk also explained that her team did not study the effects of individual nonpharmacologic therapies.

“We treated them as one,” she said. “Most likely, only some of the therapies that we included are responsible for the effect that we reported, whereas others may have had no effect at all, assuming there’s no other variable that explains our findings.”

Despite these limits, the authors expressed confidence in their research methods and findings.

“Our results suggest that (nonpharmacologic therapies) provided to active-duty service members with chronic pain may reduce their odds of long-term adverse outcomes,” they concluded in the study. “Given known associations of these adverse outcomes with morbidity and mortality, providing (nonpharmacologic therapies) to service members with chronic pain could potentially save lives.”

I’ve been hearing this crashing tidal wave coming. It’s not here yet. But the roar is approaching and it sounds like sweet sweet music to me ears. 

Item #2

I’m going to do everything I can to boil this sucker down and strip it to the bare bones without it getting too long or boring. This one is called “Evidence-based supplements for the enhancement of the athletic performance” by Peeling, et. al(Peeling P 2017). and published in the International Journal of Sport Nutrition and Exercise Metabolism in 2017. 

The authors wanted to put together a review focusing on the available evidence based for performance supplements commonly used in sports and summarizing the when’s and the how’s around their uses.

The ysay there is robust evidence that the following supplements can enhance sports performance when used according to established protocols. 

So let’s motor through this like poop through a goose, shall we?

  1. Caffeine -There exists a lengthy research history on caffeine supplementation across a range of performance protocols, including endurance-based situations, resistance training exercise, short-term supramaximal efforts, and/or repeat-sprint tasks. Reported benefits of caffeine include benefits include adenosine receptor antagonism, increased endorphin release, enhanced neuromuscular function, improved vigilance and alertness, and a reduced perception of exertion during exercise. Low to moderate doses of caffeine (∼3–6 mg/kg BM), consumed 60 min pre exercise, appear to have the most consistent positive outcomes on sports performance in research situations, although a variety of other protocols (as mentioned above) also appear beneficial, and are practiced in real-life. Of note, athletes who intend to use caffeine as a performance aid should trial their strategies during training or minor competitions, in order to fine-tune a protocol that achieves benefits with minimal side effects.
  2. Creatine – widely-researched supplement, with creatine monohydrate (CM) being the most common form used. Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (e.g., team sports), as well as the chronic outcomes of training programs based on these characteristics (e.g., resistance or interval training), leading to greater gains in lean mass and muscular strength and power. When accepted creatine monohydrate supplementation protocols are followed, the expected increase in intramuscular creatine stores is likely to enhance lean mass, maximal power/strength, and the performance of single and repeated bouts of short-term, high-intensity exercise.
  3. Nitrate –  The authors say Nitrate is a popular supplement initially found to improve oxygen uptake kinetics during prolonged submaximal exercise. Great sources are Leafy green and root vegetables (i.e., spinach, rocket, celery, beetroot, etc.
  4. Beta-Alanine – The paper says this is one of the immediate defenses against the accumulation of protons in the contracting musculature during exercise. I can also tell you that this is just something I never nerded out on. Lol. Not my cup of tea but I like to offer something for everyone here at the Chiropractic Forward Podcast. They say it can improve tolerance for maximal exercise bouts lasting 30 s to 10 min and provide small yet significant benefits in both continuous and intermittent exercise tests. Basically, it’s used in order to augment high-intensity exercise performance ranging from 30 s to 10 min in duration.
  5. Sodium Bicarbonate – benefits are generally seen in short-term, high-intensity sprints lasting ∼60 s in duration, with a diminishing return as the effort duration exceeds ∼10 min. However, greater benefits may be realized (>8% improvement) with a greater number of repeated sprint bouts

Go to our show notes at chiropracticforward.com if you’d like to get dosing information and all the little technical tidbits. It’s really interesting. Even to an orthopedic guy like me although, its technical enough to make my eyes glaze over as well. 

There are several others listed in the paper as well but the authors point out that the evidence for their effectiveness is much less clear. They are Sodium citrate, Phosphates, and Carnitine.

Even though that stuff is not my cup of tea, it’s good to know, it’s good to have as a reference, and it’s good to pass on to you because many of you actually do nerd out on that stuff and thank God for that. That means I can call people like you and ask what the hell. On the other hand, if it’s something I nerd out on like orthopedics, you can call me and say what the hell?

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Devitt M (2020). “Nonpharmacologic Therapies Can Improve Chronic Pain Outcomes Reductions in Drug Misuse, Suicide Attempts Reported.” AAFP.

Peeling P, B. M., Paul S, (2017). “Evidence-based supplements for the enhancement of athletic performance.” IntJ sport Nutrition Exercise Metabolism 28(2): 178-187.

10 Back Facts & How Does Chiropractic Perform When Integrated?

Jordan Hospital Spine Care demonstrated the quality and value of care rendered to a population of patients. This was accomplished with a relatively low cost and with high patient satisfaction.

... continue reading.

w/ Dr. James Lehman (Pt. 2) – National Scope, Chronic vs. High Impact Chronic Pain, Coordinated Care/Medicaid, DACO to DIANM

CF 097: w/ Dr. James Lehman (Pt. 2) – National Scope, Chronic Pain vs. High Impact Chronic Pain , Coordinated Care/Medicaid, DACO to DIANM

Today we’re going to be talking with Dr. James Lehman. This is Part Two of the interview. If you are just now joining us and did not get to hear Part One, make sure you do so. When Dr. Lehman speaks, you don’t want to miss a word. We’re going to cover topics like implementing a national scope of practice, chronic pain vs. high impact chronic pain, and topics like should a chiropractor own rural healthcare clinics and chiropractors working in coordinated care and medicaid integrated settings. 

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research. It’s like we’re talking about research over beers. Which is NOT like talking about research in a classroom or an institution of some sort. Accessible research if you will. I could be more professional but I’m not. 

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  If you haven’t yet I have a few things you should do, like our facebook page, join our private facebook group and interact, and then go review our podcast on iTunes. We have a youtube channel and twitter too but those are the main things. 

You have collapsed into Episode #97

I always do a little update on my personal practice and life in the trenches. In the real world if you will. Instead of that, I want to say that last week, I was scrolling through my Facebook page and Dr. Lehman and I are friends on Facebook. 

I noticed a picture he posted laying in a hospital bed watching his beloved St. Louis Cardinals play on TV. 

It turns out that just last week, Dr. Lehman suffered a myocardial infarction. I normally wouldn’t mention this but, I figure if it’s posted on Facebook by the man himself, he’s OK with it. 

Anyway, the main reason I mention it is to ask you all to say a prayer for Dr. Lehman if you are the praying kind, which I most certainly am. If you are not, then please send some positive vibes, energy, or thoughts his way through the ether. Whatever it is, let’s give it to him because Dr. Lehman certainly has given us chiropractors a lot. 

Dr. Lehman, from what I can tell through Facebook and text, Dr. Lehman is doing well and on the mend. From me to Dr. Lehman, you have my prayers and thoughts and please get well my friend. 

Now, before we dive into this interview that we did a couple of weeks ago with Dr. Lehman, we have to pay the bills. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Introduction of Dr. James Lehman

Now, let’s go ahead and get on with the reason we’re all here. Before we speak with Dr. James Lehman, I want to go through a little background information on him for you so you are well aware of who he is and where he is coming from. 

Dr. James Lehman is an Associate Professor of Clinical Sciences at the University of Bridgeport/College of Chiropractic and Director of Health Sciences Postgraduate Education (HSPED). 

Dr. James Lehman completed his MBA at the University of New Mexico and a doctorate in chiropractic medicine at the Logan College of Chiropractic in St. Louis, Missouri.

Dr. James Lehman is a board-certified, chiropractic orthopedist. He teaches orthopedic and neurological examination and differential diagnosis of neuromusculoskeletal conditions. In addition, he provides clinical rotations for fourth-year chiropractic students and chiropractic residents in the community health center and a sports medicine rotation in the training facility of the local professional baseball team. 

As Director, Dr. James Lehman developed the three-year, full-time resident training program in chiropractic orthopedics and neuromusculoskeletal medicine. The program offers training within primary care facilities of a Federally Qualified Health Center and Patient-Centered Medical Home. While practicing in New Mexico, he mentored fourth-year, UNM medical students. We could go on and on. 

In your article, you include a section titled “Modernization of Medicare and Medicaid Coverage” which will lead us nicely into one of the main topics of our episode today. In this section you mention how Article 2706 of the Affordable Care Act is supposed to prevent discrimination against chiropractors but, for whatever reason, it hasn’t. I’ve been hollering about this through my position with the Texas Chiropractic Association for years. You talk about this a little in the article but…..why do you think nobody is forcing 2706 down people’s throats and what would it take to take a stand against insurance companies with 2706 as the basis?

OK, coordinated care and Medicaid: a topic you are very knowledgeable. In fact, we have discussed the integration of chiropractors into the FQHC’s around the nation. FQHC, for those that don’t know means Federally Qualified Health Centers. One of our former podcast guests is Dr. Kris Anderson from North Dakota who just happens to be the first in his state to work in an FQHC. 

Can you tell us more about coordinated care and Medicaid and the initiative to get chiropractic care integrated more into that setting?

Alright, last on our list of things we must talk about is the topic you have done a ton of work on. I remember one of the DACO classes I had with you as the instructor. In the class, I recall you mentioning that we as a profession do not diagnose chronic pain syndrome nearly enough. It’s a big problem, and one I’ve become more and more engaged in through the DACO program, so let’s dive into the topic of Chronic Pain Syndrome vs. High Impact Chronic Pain. 

I’m just going to turn it over to you on this. The way I want to start is for you to just tell us what you think we as a profession need to know and we can take it from there.  Chronic pain is a huge topic that really can be it’s own year long topic of chiropractic forward podcasts. Chronic pain affects a huge number of patients.

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

w/ Dr. James Lehman (Pt. 1) – National Scope, Chronic vs. High Impact Chronic, Coordinated Care/Medicaid, DACO to DIANM

Today we’re going to be talking with Dr. James Lehman. Yes, THE Dr. James Lehman and we are fortunate to have him with us. The experience and the common sense Dr. Lehman brings to the table is immense and I can’t wait to dive into it today. We’re going to talk about national scope

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #96

Now if you missed last week’s episode on chiropractic and opioids, on anti-inflammatory diets, and on screen time for kiddos…. make sure you don’t miss that info. Go back and listen. I think there were some good information there within so make sure you’re up to date and not falling behind the rest. 

Advertisement

We can’t get started without mentioning the sponsor of the show, 

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Introduction of Dr. James Lehman

Now, let’s go ahead and get on with the reason we’re all here. Before we speak with Dr. James Lehman, I want to go through a little background information on him for you so you are well aware of who he is and where he is coming from. 

Dr. James Lehman is an Associate Professor of Clinical Sciences at the University of Bridgeport/College of Chiropractic and Director of Health Sciences Postgraduate Education (HSPED). 

Dr. James Lehman completed his MBA at the University of New Mexico and a doctorate in chiropractic medicine at the Logan College of Chiropractic in St. Louis, Missouri.

Dr. James Lehman is a board-certified, chiropractic orthopedist. He teaches orthopedic and neurological examination and differential diagnosis of neuromusculoskeletal conditions. In addition, he provides clinical rotations for fourth-year chiropractic students and chiropractic residents in the community health center and a sports medicine rotation in the training facility of the local professional baseball team. 

As Director, Dr. James Lehman developed the three-year, full-time resident training program in chiropractic orthopedics and neuromusculoskeletal medicine. The program offers training within primary care facilities of a Federally Qualified Health Center and Patient-Centered Medical Home. While practicing in New Mexico, he mentored fourth-year, UNM medical students. We could go on and on. 

Welcome to the show Dr. James Lehman, it’s an honor to have you on the Chiropractic Forward Podcast this week. 

Let’s start with the topic that immediately impacts me. I have been telling our listeners for a year or more that I’m going through the DACO program. DACO stands for the Diplomate of the Academy of Chiropractic Orthopedists. Very recently, as in just a few weeks ago, I received notice that the designation has changed to DIANM which stands for the Diplomate of the International Academy of Neuromusculoskeletal Medicine. 

What was the impetus for the change and what all went in to making the decision, deciding on the name, and then moving forward with the decision?

You wrote an article recently that Dynamic Chiropractic published in their September 2019 issue. The title of it was “What Is Chiropractic? We Need A National Practice Act.” We are in a profession that seems to me to bristle at the idea of standardization. How has this article been recieved or is it still a bit too early to tell?

In the article, you say, “Limited Medicare and Medicaid scopes of reimbursement and individual state scope-of-practice restrictions reduce access to chiropractic wervices for patients in pain.” Can you explain how you think limited scopes reduce access and how a broader scope can help us? And how broad of a scope do you advocate for?

I would assume a national scope would be something the ACA would be in the driver’s seat for, which is something you mention in the article as well. Is this something the ACA is looking at? Other than resistance within our own profession, what hurdles would you see in the way of a national scope?

You say it’s not impossible to accomplish and offer 6 essential charactieristics which include:

  1. Chiropractic Physician designation. 
  2. The scope being determined by Doctoral and Post-Doctoral education, trainng and experience 
  3. Full management, referral and prescription authority commensurate with contemporary chiropractic education for patient examination, differential diagnosis, working diagnosis, and health assessment
  4. Full evaulation and management, referral and prescription authority commensurate with contemporary chiropractic education for the care and treatment of neuromusculskeletal and other health conditions or issues. 
  5. Full authority for the delivery of information, advice, recommendations and counseling regarding general health matters, wellness, and health optimization. 
  6. Full authority and adaptable requirements fo the management and training of health care teams and the participation in collaborative or integrative health care groups. 

When I read through that list, does anything jump out at you as being particularly radical or provocative to some chiropractors?

In your article, you include a section titled “Modernization of Medicare and Medicaid Coverage” which will lead us nicely into one of the main topics of our episode today. In this section you mention how Article 2706 of the Affordable Care Act is supposed to prevent discrimination against chiropractors but, for whatever reason, it hasn’t. I’ve been hollering about this through my position with the Texas Chiropractic Association for years. You talk about this a little in the article but…..why do you think nobody is forcing 2706 down people’s throats and what would it take to take a stand against insurance companies with 2706 as the basis?

OK, coordinated care and Medicaid: a topic you are very knowledgeable. In fact, we have discussed the integration of chiropractors into the FQHC’s around the nation. FQHC, for those that don’t know means Federally Qualified Health Centers. One of our former podcast guests is Dr. Kris Anderson from North Dakota who just happens to be the first in his state to work in an FQHC. 

Can you tell us more about coordinated care and Medicaid and the initiative to get chiropractic care integrated more into that setting?

Alright, last on our list of things we must talk about is the topic you have done a ton of work on. I remember one of the DACO classes I had with you as the instructor. In the class, I recall you mentioning that we as a profession do not diagnose chronic pain syndrome nearly enough. It’s a big problem, and one I’ve become more and more engaged in through the DACO program, so let’s dive into the topic of Chronic Pain Syndrome vs. High Impact Chronic Pain. 

I’m just going to turn it over to you on this. The way I want to start is for you to just tell us what you think we as a profession need to know and we can take it from there. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

An Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies

CF 095: An Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies

Today we’re going to talk about the relationship between chiropractic and opioids, we’ll talk about anti-inflammatory diet ideas, and a little ditty about screen time and dumb butts. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have slinkied into Episode #95

Now i you missed last week’s episode on my trip to St. Louis for the Forward ’19 seminar, decompression research, and young baseball pitchers, make sure you don’t miss that info. I’d like to think that all of our episodes are such that you walk away better than before you hit the play button. That’s my goal anyway. 

I usually am not at a lack of words when it comes to the personal side of what’s been going on lately. I have to say though, not much is going on around the office these days. It’s slower this week but not much slower. I’m just trying to get everything done. 

For a chiropractor, what exactly does that mean? Well, I’ve created two or three new graphics for social media posts and loaded them into the hopper for realease later this week. 

I proofread two blog articles my writer sent to me for two websites. I’ve gotten those posted after making corrections. 

I’ll be proofreading and scheduling my patient weekly email as soon as my staff member finishes it. 

I met with our marketing staff member to go over what marketing we are doing and want to do before she headed out onto the town this morning. 

It’s 1 pm and I’ve already seen two new patients and my fair share of established patients. 

I’ve dealt with a roof leak, a staff member that ended up with a migraine that required us to take her to be treated. Taht’sAn Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies a whole different crazy story. 

I get off early on Tuesdays to go home and study for the DACO part II test so I’ve got that going for me today. 

So…..my point is, even when we are a bit slower, we don’t slow down. Hell, that’s when we are actually able to ramp it up. 

If you are not doing external AND internal marketing consistently, you are behind your colleagues. Wake up. Dan Kennedy has a saying I follow. It’s YCDBSOYA. That stands for you can’t do business sitting on your ass. 

I hate a liar but I love a hustler. I mean that in the ethical manner. Not hustling someone as in lying and cheating for financial gain. I mean hustling as in constantly busy getting the word out about how amazing your office is. The more you hustle in that manner, the more business you see. It’s magical like that. 

You want a slow practice, sit on your butt in your office playing games on the computer. That’s exactly how you can accomplish that. 

You would have a hard time coming up with any form of marketing that I either have not tried or am not currently doing. I’m probably doing some marketing you’ve never even thought of. 

So, here’s your pro tip. When things get a little slower in the fall when the kids get back to school, that’s when you have the time it takes to really market effectively. So do it. 

I may end up doing a marketing epsiode. I should totally do that. If I forget in the next several weeks, y’all send me an email or two and I’ll do it. 

The first paper we’ll breeze across is a brand new one about the association between chiropractic use and opioid use. 

First, It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

OK, back to the research. As I mentioned, this first paper is called “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis” Now remember, systematic reviews and meta-analyses are at the top of the research pyramid. It was authored by Corcoran, et. al(K 2019). and published in Pain Medicine on September 27, 2019…whoa….that’s like last week. Scorching hot off the presses, watch out, don’t burn your finger prints off….

Why They Did It

They wanted to investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt. 

How They Did It

  • The study was as systematic review and meta-analysis
  • The databases mined for information were Medline, pubmed, embase, amed, cinahl, and web of science.
  • The search was through April 18 of 2018
  • They identified 874 articels 
  • Those were whittled down to 6 articles
  • 5 studies focused on back pain while one focused on neck pain

What They Found

In a random-effects analysis, chiropractic users had a 64% lower odds of receiving an opioid prescription than nonusers. 

Bam pop snap!

Come on MDs, DOs, and all of your flock. It’s time to start turning the back and neck pain folks over to the profession that continually proves, through research I might add, that we can get them better safely, effectively, non-invasively, non-pharmaceutically, with better outcomes assessments, and better patient satisfaction than any other healthcare practitioner in the world. 

If it’s really all about the patient, and you all REALLY mean that, then start referring these patients to evidence-informed chiropractors. Like yesterday. 

If you want to try PT first, OK. Do that. Then, when PT isn’t as effective as the patient was hoping it to be, send them to an evidence-informed chiropractor. 

That’s if it really is all about the patient. 

Item #2

Item 2 is from Harvard Health Publishing from Harvard Medical School and is called “Foods that fight inflammation.” (2014)They published it in June of 2014. It’s an older study. Old Man River, that old man river….

They start by asking what does an anti-inflammatory diet do? Your body creates inflammation in response to anything it recognizes as foreign. Things like microbes, plant pollens, and chemicals. That’s great obviously but sometimes inflammation persists right? The article goes on to state that many major diseases like cancer, heart disease, diabetes, arthritis, depression, and even Alzheimer’s have been linked to long-standing, chronic inflammation. 

Dr. Frank Hu, professor of nutrition and epidemiology in the Dept. of Nutrition at Harvard School of Public Health says, “Many experiemental studies have shown that components of foods or beverages may have anti-inflammatory effects.”

Wouldn’t it be nice if we can reduce our risk of these deadly serious diseases just by eating more of the right stuff?

First they list foods they have identified as CAUSING inflammation so that you can stay away from them. Take a deep breath, this is going to hurt a little bit. OK, it’s going to hurt a lot. 

  • Refined carbohydrates – yes, white breads, pastries, noodles, yep I know
  • French Fries – no real loss there. 
  • Soda and other sugar-sweetened drinks. Honestly, if you’re still drinking soda as an adult, you’re behind the curve. 
  • Red Meat – like burgers, steaks, and processed meat like hot dogs and sausage. Although I saw a report this morning that red meat isn’t as bad as they thought. 
  • Margarine – shortening, and lard

The anti-inflammatory foods they highlight are:

  • Tomatoes
  • Olive oil
  • Green leafy vegetables – spinach, kale, and collards
  • Nuts – almonds and walnuts
  • Fatty Fish – like salmon, mackerel, tune, and sardines
  • Fruits – strawberries, blueberries, cherries, and oranges. 

That would be a brief overview of the article but I’d encourage you all to go read the whole thing. Very interesting stuff. I just wanted to give you the short version of it. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Item #3

On to our last item here. It doesn’t have anything to do with musculoskeletal issues but might be a little something you could print up and put in your lobby for your patients to look over and think – Dayum. 

It’s called “Association Between Screen Media Use and Academic Performance Among Children and Adolescents A Systematic Review and Meta-analysis” by Adelantado-Renau, et al and published in JAMA Pediatrics on September 23, 2019(Adelantado-Renau M 2019). 

Why They Did It

They were trying to find out if there was any association between screen-based activites and academic performance areas among children and adolescents. 

How They did It

  • They took 58 cross-sectional studies, television viewing and video game playing were inversely associated with academic performance. 
  • In addition, it was more profound in adolescents than it was for the smaller children. 

Wrap It Up

  • Television and video games were the worst of the screen time culprits. 
  • This study suggests that education and public health professionals should consider screen media use supervision and reduction as strategies to improve the academic success of children and adolescents.
Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • (2014). “Foods that fight inflammation.” Harvard Health Publishing https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.
  • Adelantado-Renau M, M.-U. D., Cavero-Redondo, (2019). “Association Between Screen Media Use and Academic Performance Among Children and Adolescents A Systematic Review and Meta-analysis.” JAMA Pediatr.
  • K, C. (2019). “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis.” Pain Med.

10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust

CF 091: 10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust

Today we’re going to talk about the 10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #91

Now if you missed last week’s episode on Healthcare, the Days Of Old,  make sure you don’t miss that info. It was a bit of a brain dump. The week before that was on Decoding Fibromyalgia and we had a great episode before that one called Closing Patients…..we’ve had a lot of beneficial discussion on Facebook come out of that episode and it’s definitely worth checking out. 

We can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

In personal practice, I have to say I’m testing. What I mean is that you never have everything as cookie cutter as you’d like do you? I used to have patient time and paper time and life was good. i got plenty done but never seemed to break through as far as patient load. 

I had a new front desk scheduler come on board and she basically ignored my paper time patient time dynamic and, after some time, my practice blew up and went crazy as hell. 

Now, the key is, did the roof blow off because she put the patient preference in regard to the schedule…..did she put their wants first? So they loved it because it was so convenient? Or, was it a natural progression of practice and it happened to simply coincide?

Who the hell knows? I think we do a lot of things right so I don’t know. Here’s what I’m certain of though. If we continued putting patients wherever they wanted to be on the schedule rather than forcing them into a formatted schedule that still takes advantage of peak and most requested times…..if we continue to allow patients to run our practice rather than us running the practice….I’m quitting!! Lol

Here’s the thing, I don’t want to brag about numbers and things of that sort. I’m just telling you that it’s been at a point where, when the patients run the schedule, I have zero time to produce a great podcast, zero time to collect thoughts on anything at all, hell I don’t have time to go to the bathroom. 

So, a couple of weeks ago, I decided it was time to put a foot down. A foot down outfitted with a  steel-toed boot! We will have paper time and we will have new patient time. Period. 

Here we are with week #2 of the schedule playing out and you know what? We are a little slower today than normal. I’ve been in practice long enough to know that is not a big deal. Sometimes, it’s just that way. But there still is that part of me that wonders what in the hell? Is it the new schedule? Is it this is it that? 

Blah…. So, even 21 years later, it can be a rollercoaster. It can be a day to day, week to week, month to month thing and that drives me crazy. Mostly because I believe I have an anxiety disorder. 

Again, I share these more personal problems or issues with you all because I know some are going through the exact same thing and some younger docs WILL. 

I’ve been making plans on being at the Forward Thinking Chiropractic Alliance’s conference called Forward ’19 in St. Louis, MO….actually Chesterfield, MO but had I said that first, you’d have no damn clue where I was talking about and you’d have to get out your Google machine and waste time looking for the damn place and I don’t want to do that to you. OK?

It’s the little things I do for you all right? Anyway St. Louis on the weekend of September 20-22….it’s that weekend. They have Gray Cook as the headlineer. They also have , Greg Kawchuck, Annie O’Connor, Christine Goertz, a guy I got to know a bit through the DACO program and a great speaker and doctor, Dr. Brandon Steele, and several more. It’s a time to not miss. Plus, hell, I’ll be there. 

I’ll be staying at the Drury Inn there in Chesterfield and it’s right next door to a Cheesecake Factory so, honestly, what’s not to love about this weekend that’s coming up on us rather quickly?

They aren’t paying me to tell you about it. In fact, nobody associated with the FTCA has even asked me to mention it. But, I think it’s important and I think attendees will walk away as better doctors. That’s why I’m going. 10% better every day, week, month, and year. 10% better. 

go to https://www.forwardthinkingchiro.com/convention if you’re interested.

Item #1

We have a short one to kick this off with. It’s called ‘For Mortality, Busting The Myth of 10,000 Steps Per Day” by Jennifer Abbasi and published in the Journal of the American Medical Association in July of 2019 (Abbasi J 2019), hot cakes, hot stuff. 

Jennifer says the goal of reaching 10,000 steps every day has been a thing for a while now but, in truth, that may not actually be necessary. She said that older women who walked more than their peers and lower death rates in a recent study in JAMA Internal Medicine but….here’s the gotcha part….but the mortality benefit was seen with as few as 4400 steps. 

She says the recommendation of 10,000 steps may be disinclusive – is that a word?I think you know what I mean. She says 10,000 steps can be daunting to many. Especially older people and can actually keep them from walking any more. Whereas 4,400 is much more realistic and the that’s where the benefit is actually seen. 

Interesting stuff right there and definitely worth mention. I’m taking that to my practice. You should too. 10,000 steps may not be the gold standard.

Item #2

This is one called “Spinal manipulation therapy: is it all about the brain? A current review of the neurophysiological effects of manipulation” by Giles Gyer, Jimmy Michael (don’t trust someone with two first names), and James Inklebarger, et. al(Gyer G 2019). It was published in the Journal of Integrative Medicine in September of 2019. Hell, it’s September of 2019 right here right now. Hot potato, hot potato…..

They start out by saying that the the mechanisms underlying the pain modulatory effects of spinal manipulative therapy remain elusive. And although biomechanics and neurophysiological phenomena have been thought to play a role in the effects we see, more and more studies are showing improved outcomes suggesting peripheral, spinal, AND supra spinal mechanisms are playing a part. 

If you listen to our episode with the esteemed Dr. Christine Goertz, she was very clear in saying that we are currently a long way away from being able to say exactly how adjustments get the amazing results they get. That’s frustrating in a way isn’t it? It is for me. I want to know exactly how. 

In describing the article, she says, “The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability, increase in cortical drive and many more.”

I have cited this article in case you want to go and find it. It’s in the show notes at chiropracticforward.com so go check it out. But I couldn’t find the whole article. At least not yet. Not until one of you awesome listeners sends it to me at dr.williams@chiropracticforward.com I would be grateful. 

But it is good for discussion. I actually did an episode dedicated to this topic. It was Episode #56 and I’m linking right here at this spot in the show notes so you can hear it. I actually had several people emailing me with some thanks on that one. 

The first reason this one was a big episode is because there were some knucklehead wannabe chiropractic gurus out in California claiming to have reversed spinal arthritis after two weeks of draining a patient’s bank account….errr. cough…I mean….of treating the patient 4x/day for 3 weeks. Which quickly adds up to a whole pile of steaming fresh hot brown….BS.

That episode came with pictures and illustrations in the show notes even. I was really fired up there. Lol. 

Anyway, the main reason I’m talking about that episode right now is that I provided a pretty solid description of the latest research and ideas on what an adjustment just may actually be doing for our patients. 

Basically, 

A recent paper by Anderstt et al. (2018) confirmed that cervical manipulation results in facet gaping.  This force also improves regional motion across multiple spinal levels during and post-manipulation.

“This study is the first to measure facet gapping during cervical manipulation on live humans. The results demonstrate that target and adjacent motion segments undergo facet joint gapping during manipulation and that intervertebral range of motion is increased in all three planes of motion after manipulation. The results suggest that clinical and functional improvement after manipulation may occur as a result of small increases in intervertebral ROM across multiple motion segments.” 

And according to the DACO learning

It appears that manipulation relies upon signaling properties of the muscle spindles that lie embedded in the paraspinal tissues. As the spindle registers rapid lengthening of the muscle it transduces this into a large proprioceptive barrage. 

The unique nature of a manipulation seems to alter the responsiveness of second-order neurons in the dorsal horn and make them less sensitive to incoming nociceptive signals from injured tissues.”

Adjustments are gapping the facets, improving proprioception and sensorimotor function, helping the body and brain know better where everything is and know better how it’s supposed to move thus, improving that movement and function. 

So, until new research comes out that makes us throw all of our best information out the window, that’s what I’m going with and, for evidence-informed practitioners, would suggest you adopt as well. 

Short break here….

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Now, Item #3

This one is an obvious one and is called “Association Between Soft Drink Consumption and Mortality in 10 European Countries(Mullee A 2019)” by Amy Mullee, PhD, Dora Romaguera PhD, and Jonathan Pearson-Stuttard, BMBCh whatever the hell that is. 

Brand new info here. They took 451,743 individuals from 10 countries in Europe consuming more sugar-sweetened and artificially sweetened soft drinks. 

What they found was that those drinking more of either of those had a higher risk of all-cause mortality. Consumption of artificially sweetened soft drinks was positively associated with deaths from a circulatory disease while those consuming sugar-sweetened soft drinks suffered more deaths from digestive disease. 

So, why not cut them all out? I think water rules the day and NOT tap water by the way. I drink a lot of coffee and tea but I’m doing my best to drink more water. I know I’m supposed to. I get it but dammit it has no umph to it so water just sort of pisses me off and leaves me wanting. Lacking. And basically bitchy. 

Anyway, Item #4

This one is called “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada” by Rivka Green, Bruce Lanphear, and Richard Hornung, et al and published in JAMA Pediatrics in August of 2019(Green R 2019). Look out hot stuff everywhere, steamin’ plate…

The question they wanted to answer was, is maternal fluoride exposure during pregnancy associated with childhood IQ in a Canadian cohort receiving optimally fluoridated water?

Their conclusion was as follows “In this study, maternal exposure to higher levels of fluoride during pregnancy was associated with lower IQ scores in children aged 3 to 4 years. These findings indicate the possible need to reduce fluoride intake during pregnancy.”

Interesting stuff. Especially for those of you that make pediatrics and prenatal care such a big part of your practice. Knowledge nuggets all over the place today. You can’t listen today and avoid getting hit in the head with at least one of them. It may slap some sense into the recipient. At least that’s the goal. 

OK, last thing I have on tap today is Item #5

It’s called “Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students” by Guillaume Goncalves, Marine Demorier, and others. I say and others because I’m not even about to try to pronounce the next name. There would be a verbal murder of probably a perfectly good name and I don’t want to play any part in that. 

It was published in BMC Chiropractic and Manual Therapies in 2019. Once again, too hot to handle, step back one….no two steps…

In the background section of the abstract, they start by saying “While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative ‘subluxation’ model. The main goal of this study is to determine if chiropractic students with such conservative opinions are likely to have a different approach to determine contra-indications, non-indications and indications to chiropractic treatment versus those without such opinions.”

What They Found

  • They had 359 student respond out of 536.
  • They generally recognized a number of contra-indication as well as indications for treatment
  • What the problem was was in identifying non-indications for treatment. 
  • The subluxation students were much more willing to treat someone even when there was nothing relevant wrong
  • For example, they were much more willing to treat a 5-yr-old kid with no history of back pain or disease to prevent future back pain and to also prevent non-musculoskeletal disease. 

Wrap Up

Their conclusion was “It is concerning that students who adhere to the subluxation model are prepared to ‘operationalize’ their conservative opinions in their future scope of practice; apparently willing to treat asymptomatic people with chiropractic adjustments. The determinants of this phenomenon need to be understood.”

I can help them understand it. It’s BS passed on by wannabe gurus and colleges like Sherman and Life and was once shoveled in large amounts by Palmer and my alma mater, Parker. Although, to my understanding, those discussions are fewer and further between at Palmer and Parker these days. 

Look, I’ve made no secret, I’m not a Subby, a TOR, or a TIC. I’m an evidence-informed chiropractor. Just like Subbys and other evidence-informed chiropractors…..I too get great results for my patients. 

Unlike SOME of my Subby counterparts….not all of them….but certainly SOME of them…….I communicate with the medical field in effective ways that make sense to them, I do not take advantage of my patients, I do not use techniques and recommendations not back in part by evidence and research, I run a patient-centered practice, and don’t treat when I shouldn’t and treat when I should, and I do not try to see how many times I can run a patient through my doors based on the idea that I’m going to prevent some sort of mythical loss of curve issue 30 years in the future. Folks, we’re highly educated. It doesn’t happen that way and in 2019, we damn well know it doesn’t happen that way.

Your bank account might not like it but your patients will and they’ll know you care and they’ll know you’re different than the rest when you’re worried about them and NOT their wallet or their purse. 

The golden rule isn’t just for kiddos. IT’s for everyone regardless of age. Treat others the way you want to be treated. If you want to be treated a million times through your life because you may lose some degree of curvature in your neck, then 10/4, rock on with your bad self. 

I for one have no interest in that for myself so I’d never recommend it to anyone. Why would I? Other than financial motivation of course.

I wouldn’t.  

Before we sign off here, I made some awesome evidence-informed brochures and posters for your offices. Go check them out at the store link at chiropracticfoward.com 

While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Abbasi J (2019). “For Mortality, Busting the Myth of 10 000 Steps per Day.” JAMA Open 322(6): 492-493.
  • Green R, L. B., Hornung R, (2019). “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada.” JAMA Pediatr.
  • Gyer G, M. J., Indlebarger J, Tedla JS, (2019). “Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation.” J Integrative Med.
  • Mullee A, R. D., Pearson-Stuttard J, (2019). “Association Between Soft Drink Consumption and Mortality in 10 European Countries.” JAMA Open.

Healthcare Of Old – Days Gone By

CF 090: Healthcare Of Old – Days Gone By

Today we’re going to talk about how healthcare has changed – gone are the days of this and gone are the days of that. And there will be plenty of room for me to spread some personality in there too. If you’re a regular listener, you know I’m never lacking an opinion. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #90

We can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

We have some great stuff this week. It’s a short week due to Labor Day so this episode may run a little short and that’s OK. I try to not get too long winded. I think I went on about 45 minutes when we talked about Closing Patients two episodes ago.

But, a little gripe session never hurt anyone. If you’ve ever wondered whether Closing patients is right or wrong, get my take by going and listening to episode #88. I lay it out pretty clearly there. 

And don’t forget, last week’s podcast about Fibromyalgia. New info on fibro and treatment. Good stuff there in episode #89

Item #1

I want to start with an article that kind of struck me as…..huh….interesting. It’s called ‘The Old Days of Medicine Are Gone” by Michael Weiss(Weiss M 2019) and it was published in MedPage Today on January 17, 2019. Hot potato, heads up now. 

Weiss is a cardiologist and I have cited this article in the show notes over at chiropracticforward.com. This article refers to medical doctors specifically but there are a lot of parallels that we doctors of chiropractic can relate to. 

The article starts by saying that in the last 5-6 years, physicians have become less and less powerful. So have their patients. This disempowerment is due to a lot of things according to this article. Chief among them are:

  • Health management organizations
  • Managed care and 
  • The insurance exchange

Mr. Weiss says that all of these factors have taken power from the doctors and put the power into the hands of the large insurance companies and in the hands of the government. Well, that’s been going on for at least a generation. 

I remember a pencil pusher with an insurance company several years ago, a person who doesn’t have any kind of degree other than following prompts on a computer…..I remember them telling me how to treat a patient. What they needed. How many times….I was stunned. I will just say that I had a strongly worded conversation that I’m certain went in one ear, bounced around in that dude’s empty noggin, and fell out the other without making any impact. 

But I remember thinking, we are allowing insurance companies, the guys with a financial stake and a financial bias, we are allowing these people to tell us how and when to treat patients when they’ve never seen them in their lives. These patients are just numbers on a page to these companies and they’re going to tell us how to treat them. 

Same goes for the government. Whether it’s a popular opinion or not, makes not one damn to me. I’m going to tell you that when you put all of your healthcare decisions in the hands of one big fat, red-taped fat bureuacratic entity that has already screwed up Medicare and Social Security for no reason at all, due to both sides of a messed up aisle, well, you are once again numbers on a page and sometimes you get what you deserve. Of course that doesn’t mean everything’s peachy and we don’t need some changes to the healthcare system. We most certainly do. Universal healthcare medicare for all though…..I don’t see how that is the solution. Again, one fat, slow, dumb entity that has a history of screwing up big programs isn’t what I personally want making all of the healthcare decisions for me and my family but to each their own. 

Getting back to the article, Mr. Weiss says this physician disempowerment was basically a money grab on the parts of these powers and on the part of the pharmaceutical industry. Well…..of course. I think all that goes without saying doesn’t it? But I’m glad someone is indeed actually saying it. We should be shouting it out loud but, will it change anything? Politicians won’t do anything about it when big pharma is in their pockets and they’re scared of the insurance companies. 

Anyway, he says that doctors’ incomes have been progressively on the decline for years. Can i get an ‘amen’ on that my people. Testify!!  He says this cash-strapped generation of physicians have been forced out of private practice into working for hospitals and huge conglomerates and that gone are the days of Wednesday off for golf, gone are the days of being called a doctor rather than a provider, gone are the days of being respected, gone are the days when patient’s would say “But what does the doctor say?” rather than “Will the insurance pay?”, gone are the days when a physician could direct care they deemed necessary. Even the prescription pad is becoming useless since insurance doesn’t cover a lot of the scripts written these days. 

He says gone are the days when a physician could sit down and perform a detailed and thorough examination. Instead, we have be busted down to being typists, chaotic clerks, mindlessly clucking away at meaningless electronic health records benefiting only large entities. Hallelujah!! 

In order to make money these days, it has to be quantity and, unfortunately, quality many times suffers. For better or worse. When your income goes down, you see more to maintain the income you have built your life around. Quality of care suffers. Not intentionally. Nobody is morally corrupt typically. It’s just a natural consequence. You have bills to pay and you’ll figure out a way. 

Take a radiologist. They used to get about $35 for reading a neck series. Now, after Obamacare, they make $7-$10. I happen to know a radiologist very well so you can trust what I’m telling you. At least here in Texas. Could be different in your area. What happens when you income gets reduced by roughly 2/3 but you still have a big house and some extra toys you have purchased? 

Maybe you have a big garage sale and get rid of the extra fat? Ah hell no, that’s not what happens. Instead of 5 films read in 30 minutes you read 10. Think you might have an elevated risk of missing something? Of course you do. 

Back to the article….I keep getting side-tracked, he says gone are the days when a physician had the luxury of utilizing their skills of observation. He says now there are cookbook guides that have become the puppet masters of the physicians. I’d like to go on record right now, as part of a profession that has no standardization whatsoever…..I’m all for researched and evidence-backed guides. I love it. Give us some guides. Hell, don’t just give them to us, FORCE us to abide by them. Please? Lol. Just make sure they weren’t generated by a damn insurance company. That’s all. 

He says gone are the days of decent hospital stays and the days of when a patient could be cured of infections from a decent stay at the hospital. Now, he claims that patients are kicked out of the hospital early and take the buggies back to their community and spread them which leads to resistant buggies. I’d argue that commonly prescribing antibiotics when it’s a virus was problematic and the cause of a lot of resistance back in the day as well? He left that out oddly enough. 

He hit on a HUGE one when he says gone are the days of reasonable costs for a doctor visit or a drug co-pay. Now, since Obamacare, we see double and triple premiums, up to $100 co-pays, and double or triple deductibles. 

This sucker continues but, before I get to the rest of it, I need to talk about one of our amazing sponsors here at the show. It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Back to the article, Mr. Weiss says gone are the days of visiting an ER and getting immediate care as if illness is the priority. Instead, we gotta get that co-pay covered first. 

He claims the days of physicians not having to worry about a patients insurance are gone. But…haven’t those days been gone since the 80’s or so? Honestly? That’s not something new. He says though that the insurance companies have encouraged minute clinics where the nurse pracs, and he says soon the pharmacists, will be giving the medical advice. 

He doesn’t seem to like this idea much but he’s OK with people waiting for hours to see a ‘physician’ because there aren’t enough of them. I’m pretty OK with nurse practitioners for the more mundane stuff. Plus, in my experience, NPs are more likely to refer to chiropractors for whatever reason. 

While Mr. Weiss is right to some extent, a lot of this is just whining in my opinion. The traditional physician doctor had their run with all of the power, the glory, and the golden ticket they cash when they get their medical degree. And, to an extent, they damn well still have a certain amount of power, glory, and golden ticket status. Although to a lesser extent currently. Admittedly. 

It’s one of the last quotes of the article that gets my goat a bit. He says, “Physicians’ voices have been drowned out, their plights buried, leaving their patients helpless,,,,”

Well freaking whaaaa Weiss. Yes, chiropractic has the status it has in healthcare right now because a certain portion of its practitioners refuse to progress. In fact, they work to inhibit any progress and cripple any efforts to expand the profession. Yep, it’s there and it’s undeniable but, when we talk about having voices drowned out, plights buried, and helpless patients, let’s go a little deeper. 

I’ve said it a million times but the medical field is going to look back on spinal fusions in 20 years and wonder what the hell they were thinking. I think I heard where lumbar fusion surgery has gone up 500+% in the last decade or so with little to zero hard stats that show any improvement in outcomes. 

Oh looky there, I see a herniation. Let’s cut that out and you should be good as new. We know so much more now. We know you can’t cut out pain. We know you don’t treat an image. You treat the patient in front of you because most of the time, there is little to no correlation between what you see on an x-ray and what the person’s pain generator is. 

We know now that chronic pain is mostly in the central nervous system. Not out in some peripheral part of the body. You cannot typically get rid of chronic pain by cutting something out. We know more and more now that it just doesn’t work that way. 

Yet, I feel confident promising you that right now, several fusions across the country are taking place. As I type this out. We also know that less than half of those fusion surgeries will be successful, right?

We know this stuff. Yet, they continue. Unabated. So, while I agree that insurance, the government, and the whole managed care concept have screwed up our healthcare system, I would say that physicians have played very key parts in their own downfall. Hello….opioid crisis anyone? Unnecessary surgery? Surgeries for the wrong candidates? Super bugs from overprescribing? Any of this ringing any bells? 

Have you heard the podcast called Dr. Death? Basically, a so called spinal surgeon down in Plano, TX maimed several patients and even killed several and the hospitals protected him and enabled him to keep hurting people over and over and over again. 

It’s not just insurance companies and big pharma that has cause any fall from grace. And let’s be clear, I don’t think there’s been a fall from grace. Go to a hospital and see the interactions. Everyone still defers very clearly to the physician and I don’t see that changing. It’s just now they have to work more, follow rules, and get paid less. I think that’s the big gripe. 

And to that I’d say, welcome to my world friend. Welcome to my world. 

But again, it’s not just the system. Medical doctors have done their part. And, as a chiropractor, I’d argue that part of that is they have largely ignored the American College of Physicians’ recommendations to try spinal manipulative therapy, exercise, massage, acupuncture, yoga, thai chi, and heat first for back pain. 

Those are the first-line recommendations and they are in concert with The Lancet papers on low back pain, the CDC, the FDA, the Joint Commission, The White House, and just about anyone else with any sense at all when it comes to non-complicated musculoskeletal pain. Yet, as I said, fusions are going on all over the country right now. As I speak. That’s when only 5% of back pain sufferers truly need surgery. 

When does someone truly need spinal surgery? When they hurt? Nope. Not usually anyway. Remember, you can’t cut pain out. Outside of an obvious case of a spinal fracture, tumor…..the bad bad stuff….I think it’s commonly accepted that surgery is necessary in a loss of bowel or bladder function, saddle anesthesia – cauda equina- type stuff, or a progressive neural deficits. 

So, if only 5% of back pain sufferers truly need surgery, why are so many still happening every day? After all of the research and after all of the updated recommendations?

Well, I’d say it’s financial. Get this, according to the American Medical Group Association’s Physician Compensation Survey says their research spine surgeons make $688,500 a damn year on average. 

Me personally, I’m doing pretty well in practice. But, it took me 16 years before I really started putting the pedal to the metal. Now part of that was my fault because I was traveling around playing music. Part of it was chiropractic’s fault because we have a system that eats its own. 

Either way, check this out, it took me 16 or so years to really build but, for an orthopedic surgeon, during the first two years of employment, bring in $400k and by their third year, $670k. Allied Physicians reported the maximum orthopedic spine surgeon salary was $1,352,000. 

Crazy. We have some chiropractors that make that kind of money but it’s not many and it’s not very likely. 

Anyway, I agree with some aspects of the article. Other aspects make me chuckle because, although it’s to a much lesser extent, physicians of our day are dealing with some of the things we’ve been dealing with for years and years. 

If we could just communicate with them the fact that we evidence-based chiropractors can play such a big part in helping them treat their patients and getting them back to work and back to life, I probably would have more sympathy. 

Hell, people come to us because we’re experts in what we do, because we are safe, and because we’re effective but, a large part of the medical field looks at us like stumbling idiots playing doctor and hurting our patients. While that may be true for some in our profession as well as for some in THEIR profession (hello Dr. Death), for the most part, we are all highly educated, highly capable doctors getting patients well. 

Maybe when they begin seeing us in that light, we start to see some sort of deeper, more meaningful integration. It’s started here and there in some pockets of awesomeness but not in general. It’s still a goal worth chasing. 

That’s assuming we chiropractors can get our of our own way. Otherwise, if I were a medical doctor, I wouldn’t want any part of something I could only explain as pseudoscience. I WOULD however be interested in a healthcare discipline that had the randomized controlled trials backing the meat of their modality. Count me in on that. 

And that’s the way I see it today. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

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TuneIn

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Weiss M (2019). “The old days of medicine are gone.” Medpage Today – KevinMD.com.

w/ Dr. John Van Tassel – (Part Two) Florida State Athletics, Mentoring, & Life/Work Balance

CF 083: w/ Dr. John Van Tassel – Florida State Athletics, Mentoring, & Life/Work Balance

Today we’re going to continue talking with our guest, Dr. John Van Tassell. This is part two of our interview so, if you’ve yet to listen to part one, stop now and go back one week and start there. You don’t want to miss the sage-like wisdom of this amazing chiropractic ambassador.  You are absolutely going to love listening to Dr. Van Tassel talk about Division I college sports, mentoring, and a good healthy life/work balance.

Before we get going with part two, here’s that Miami Vice-like bumper music

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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have twisted and shouted your way right into Episode #83. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast. 

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription. 

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk. 

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? 

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points. 

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks. 

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts. 

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal. 

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX. 

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it. 

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere. 

All of that is personal experience and fine and dandy but how about we give him an official introduction?

  • Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida. 
  • He has been an adjunct professor at Tallahassee Community College and Florida State University. 
  • He has been the FCA Sports Council Doctor of the Year
  • The ProSport Chiropractic Doctor of the Year for the Southeast Region
  • And has been a contributing author in various publications

What really gets one’s attention about Dr. Van Tassel is that he is the team chiropractor for the Florida State Seminoles. A perennial powerhouse of anything athletic in the SEC. 

We’re going to talk about all of it and you’re going to be fascinated so here we go. 

Let’s welcome to the show, the pride of Tallahassee, Dr. John Van Tassel. Thank you so much for taking the time out of your schedule to be with us today. 

Let’s start with a little humor. The first thing I want to know is…..what in the heck is up with Florida? There was even a Facebook game going around for a while where you just Google your birthday and the words “Florida man…” Lol. Are Floridians just inherently crazy?

Tell me….we all have a story that got us where we are. I always like to ask this question because chiropractic is a bit of a niche choice when choosing a career. What was your story toward being a chiropractor?

Now I noticed you’re originally from North Carolina. Why the move to Tallahassee. 

We became acquainted either through the evidence based chiropractic group or the forward thinking chiropractic alliance group. I can’t remember which but one of them for sure. They’re great groups. You’ll find people that are bull-headed that it’s their way or they scoff at you but that’s with any group really. Mostly….overall….they’re very friendly, very helpful, and very giving people. Giving of their experience and information as well as giving with their assistance should you need something. 

I always encourage anyone that considers themselves on the evidence-informed spectrum of the profession to join both groups. I learn SOMETHING from each of them just about every week. 

With that being said, I think you’ll agree that you are one of the more active members of the FTCA. Tell me about how you got involved with the Forward Thinking Chiropractic Alliance and what keeps you coming back daily.

One of the things that obviously sets you apart from the run-of-the-mill chiropractor is your involvement with Florida State. Let’s start at the beginning and just talk about that for a bit. How did you get started with a D-I program? Was it a specific certification that moved you in that direction? What’s it like day to day, month to month, and year to year? And has it morphed through the years? 

In our preparation for this episode, you mentioned that you enjoy mentoring younger practitioners. With that in mind, what advice do you feel is vital for someone just starting out trying to open or build their own practice?

Continuing with the mentoring theme, what do you find to be the important aspects of maintaining a healthy work/life balance?

You seem to have a unique ability to recall things. For example, I can’t remember what I had for lunch yesterday but you can recall happenings and conversations from 20 years ago. 

I really think, and I believe most of the FTCA members would agree, that you have the best stories and should probably be working on your first book by now. 

With that in mind, can you re-tell the one you shared yesterday about the carpal tunnel patient that went to the GP who basically told her you didn’t know what you were talking about?

Now, the reason I asked for that one specifically, is because you’re in an arena where you commonly interact with other practitioners from the medical field. Are you experiencing this sort of bias against chiropractic in that world as well? Why do you think MD’s still don’t understand what it is that we do?

One of my favorite stories of your was about your Wall of Fame down your hallway. I’m sure there are plenty of recognizable names on that but your favorite is Mrs. Jones. Someone nobody outside of your practice and her personal circle would know. Is that a story you would mind sharing with us?

I want to close with this because this may be something that people can really use as the key takeaway from our time together today. 

I was reading one of your posts that went like this, “I was just thinking about something while A plumber unclogs my system at the house. I tell people, patients and students and athletes mostly, that desire and passion and determination are key. But it’s our habits that get us where we are going. We accomplish goals by developing habits.”

Now, I don’t know how a plumber brings to mind things like goals and habits but, I couldn’t agree more. What would you say are your core habits that have made the difference in your career?

You have slithered right into Episode #82. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast. 

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription. 

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk. 

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? 

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points. 

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks. 

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts. 

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal. 

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX. 

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it. 

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere. 

All of that is personal experience and fine and dandy but how about we give him an official introduction?

  • Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida. 
  • He has been an adjunct professor at Tallahassee Community College and Florida State University. 
  • He has been the FCA Sports Council Doctor of the Year
  • The ProSport Chiropractic Doctor of the Year for the Southeast Region
  • And has been a contributing author in various publications

What really gets one’s attention about Dr. Van Tassel is that he is the team chiropractor for the Florida State Seminoles. A perennial powerhouse of anything athletic in the SEC. 

We’re going to talk about all of it and you’re going to be fascinated so here we go. 

Let’s welcome to the show, the pride of Tallahassee, Dr. John Van Tassel. Thank you so much for taking the time out of your schedule to be with us today. 

Let’s start with a little humor. The first thing I want to know is…..what in the heck is up with Florida? There was even a Facebook game going around for a while where you just Google your birthday and the words “Florida man…” Lol. Are Floridians just inherently crazy?

Tell me….we all have a story that got us where we are. I always like to ask this question because chiropractic is a bit of a niche choice when choosing a career. What was your story toward being a chiropractor?

Now I noticed you’re originally from North Carolina. Why the move to Tallahassee. 

We became acquainted either through the evidence based chiropractic group or the forward thinking chiropractic alliance group. I can’t remember which but one of them for sure. They’re great groups. You’ll find people that are bull-headed that it’s their way or they scoff at you but that’s with any group really. Mostly….overall….they’re very friendly, very helpful, and very giving people. Giving of their experience and information as well as giving with their assistance should you need something. 

I always encourage anyone that considers themselves on the evidence-informed spectrum of the profession to join both groups. I learn SOMETHING from each of them just about every week. 

With that being said, I think you’ll agree that you are one of the more active members of the FTCA. Tell me about how you got involved with the Forward Thinking Chiropractic Alliance and what keeps you coming back daily.

One of the things that obviously sets you apart from the run-of-the-mill chiropractor is your involvement with Florida State. Let’s start at the beginning and just talk about that for a bit. How did you get started with a D-I program? Was it a specific certification that moved you in that direction? What’s it like day to day, month to month, and year to year? And has it morphed through the years? 

In our preparation for this episode, you mentioned that you enjoy mentoring younger practitioners. With that in mind, what advice do you feel is vital for someone just starting out trying to open or build their own practice?

Continuing with the mentoring theme, what do you find to be the important aspects of maintaining a healthy work/life balance?

You seem to have a unique ability to recall things. For example, I can’t remember what I had for lunch yesterday but you can recall happenings and conversations from 20 years ago. 

I really think, and I believe most of the FTCA members would agree, that you have the best stories and should probably be working on your first book by now. 

With that in mind, can you re-tell the one you shared yesterday about the carpal tunnel patient that went to the GP who basically told her you didn’t know what you were talking about?

Now, the reason I asked for that one specifically, is because you’re in an arena where you commonly interact with other practitioners from the medical field. Are you experiencing this sort of bias against chiropractic in that world as well? Why do you think MD’s still don’t understand what it is that we do?

One of my favorite stories of your was about your Wall of Fame down your hallway. I’m sure there are plenty of recognizable names on that but your favorite is Mrs. Jones. Someone nobody outside of your practice and her personal circle would know. Is that a story you would mind sharing with us?

I want to close with this because this may be something that people can really use as the key takeaway from our time together today. 

I was reading one of your posts that went like this, “I was just thinking about something while A plumber unclogs my system at the house. I tell people, patients and students and athletes mostly, that desire and passion and determination are key. But it’s our habits that get us where we are going. We accomplish goals by developing habits.”

Now, I don’t know how a plumber brings to mind things like goals and habits but, I couldn’t agree more. What would you say are your core habits that have made the difference in your career?

Chiropractic evidence-based products

Integrating Chiropractors
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The Message

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

w/ Dr. Anthony Nicholson – (Part One) Decoding Chronic Pain

CF 080: w/ Anthony Nicholson – Decoding Chronic Pain

Today we’re going to be fortunate enough to be joined by Dr. Anthony Nicholson from Australia. It was so nice we had to do it twice. This time around though, we are focusing mostly on chronic pain. Pain in the frame, if you will. If you are new to the concept of chronic pain as part of a centralized experience, buckle up because the school bus is about to arrive

But first, here’s that delightful bumper music

Chiropractic evidence-based products

Integrating Chiropractors
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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have skidded your way into Episode #80 and we are glad to have you. 

We here at the Chiropractic Forward Podcast have gotten fancy. 

I’m happy to introduce a new sponsor for the Chiropractic Forward Podcast called GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription. 

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Store

Go check out chiropracticforward.com and go to the store link. That’s where you’ll find brochures a plenty to get you started with some good, solid patient education. They look sharp and they read smart if you’re picking up what I’m throwing down. 

Do it do it, chiropracticforward.com and sign up for our newsletter while you’re at it, won’t you?

I want to thank Dr. Nickell in Kansas City for your recent feedback and for all of your encouraging words. Made my day and I appreciate it. 

DACO

Let’s talk a bit about the DACO program. Not a lot to talk about right now. Just studying my little hiney off. I li e. Not about the studying. About being little. I’m a big guy. The studying part is good. I enjoy going back through the courses. 

It’s funny to see the sort of student I am at this time in my life compared to me in school. Lol. I guess I thought I HAD to do it the first time through so I wasn’t as interested as I probably should have been. NOW, I want to be learning so I’m all in and my notes and study habits certainly reflect the fact. 

Personal Happenings

If you hear something here that you really like and would like it in written form rather than spoken, just hop onto  chiropracticforward.com, find the episode, and just scroll down to copy and paste it. If you’re using it for content or on your website for some reason, just be cool and give us some credit please. I’d sure appreciate it and I’m sure the researchers we discuss would too. 

Now, let’s get to our incredible guest today. Dr. Tim Bertelsman, one of the most talented speakers out there on the circuit today, says that our guest is just one of those people that really make you proud to be a chiropractor and I agree 187%. 

That’s a glowing endorsement but that not my official intro. Here’s the official intro:

Dr Anthony Nicholson is the CEO of Chiropractic Development International (CDI), a global continuing education organization for chiropractors that he co-founded in 2002.  

CDI’s innovative online learning technology has led to formal accreditation in over 35 states in North America, along with a growing learner base in the UK, Europe and South East Asia.  

CDI provides 250 hours of advanced online clinical training for the Neuromusculoskeletal Medicine Program offered by the University of Bridgeport in Connecticut and had developed an online board examination for the Academy of Chiropractic Orthopedics.

As a partner of Spine Partners Wahroonga in Sydney Australia, Dr Nicholson is also a full-time chiropractic physician in private practice, is a board certified chiropractic neurologist (DACNB) and is board certified in Chiropractic Orthopedics (FACO).  That means he has a Diplomate in Neurology AND Orthopedics. 

In addition, he is an adjunct senior lecturer in Neuromusculoskeletal Diagnosis and Evidence-based Practice at Macquarie University ion Sydney’s north shore.  

Welcome to the show Dr. Nicholson thank you for joining us for the second time.

We already had you on the show for a two-part discussion so we have already covered a lot of topics from medical marketing, to CDI, to the DACO. For this episode, I’d like to concentrate mostly on the topic of pain. Particulary centralized pain. 

When I started the DACO program I had no idea what you were talking about. I was slow to the show but find myself fascinated by it all. 

I don’t know if this is the best starting point or not but….What is pain? What basic responses are needed in response to a noxious stimulus? 

OK, now we know what pain is…can you tell us….what is chronic pain? How is it defined?

I believe this questions will lead us into the big concept. Can you tell us a bit about neuroplasticity? What is it? What does the term mean and what do we know about it now vs. traditional thinking on neuroplasticity?

OK….here’s the big question and the reason I wanted to do this interview with you. This question may just take up the majority of the episode and that’s OK. That’s what we’re here for and this questions gets to the foundation of it. 

For our audience’s benefit, what’s the difference between peripheral pain sources and central pain sources and what exactly is an upregulated or a sensitized central nervous system?

Let’s say someone has a bad shoulder for a while…..does anyone that has had literally anything hurting for 3 months or more now have an upregulated CNS?

Other than hurting chronically, are there other signs and symptoms that can give us a clue someone is suffering from chronic pain or are in chronic pain syndrome?

To me, having chronic pain at one site seems different than chronic pain SYNDROME. Let’s continue with the person with the bad shoulder for six months. Is that considered being in chronic pain syndrome vs. just having chronic shoulder pain?

What are we learning about centralized chronic pain and how to treat it effectively? What do you do in your office to treat it?

Let’s say someone doesn’t have the time or maybe the money to go through the DACO. Where would you tell them to start searching to learn more on the condition?

Chiropractic evidence-based products

Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

http://www.chiropracticforward.com

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger