Chiropractic Integration

w/ Tim Bertelsman – Chiropractic Standards, Chiropractic Specialists, Importance of State Associations

CF 073: w/ Tim Bertelsman – Chiropractic Standards, Chiropractic Specialists, Importance of State Associations

Today we’re going to be talking with Dr. Tim Bertlesman about all kinds of things. Kind of like a discussion amongst friends where anything is really on the table but we’ll hone in a little on chiropractic standardization, chiropractic specialities, and our experiences working on the state levels for our respective state associations. 

It’s going to be another great one that you’ll want to share with your colleagues but first, here’s that syrupy bumper music!

Chiropractic evidence-based products
Integrating Chiropractors
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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. 

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. 

F4CP

We will be launching an athletes and opioids eBook toward the end of this month. It’s called A case for chiropractic disrupting the cycle of pain, prescriptions, and addiciton. I’m linking it in the show notes so go get and check it out. 

https://www.f4cp.org/package/home/viewfile/whiathletes-and-opioids-ebook

DACO

Let’s talk a bit about the DACO program. Well, our guest today is intimately involved with the DACO here in America and, in fact, is the one that unknowingly got me into this whole thing. 

I finished it. It’s all done. I’m just going ot start studying for the exams now. The first one will be on July 20th. If I come back from that one with my dobber in the dirt, then it didn’t go so well but we don’t plan on that happening. 

Since our guest is a big part of it all, we’re going to leave the DACO talk there and meet him. 

Our guest graduated from Logan College of Chiropractic in 1991. He then went on to get his CCSP there at Logan as well finishing those up in 1994. 

In addition to the CCSP, he is a DACO, a Diplomate of the Academy of Chiropractic Orthopedists and is an instructor for their live hours. So he gets to travel around getting unsusepcting and impressionable docs involved in the DACO. 

He is not only a member of the ACA and the Illinois Chiropractic Society, but is also a former President of the Illinois Chiropractic Society. 

He is also, and maybe most-importantly, the co-founder of ChiroUp which has to be seen to be believed quite honestly. You can do that by going to ChiroUp.com. I’m a member and you probably will want to be as well. 

Let’s get it started here. Welcome to the show Dr. Tim Bertlesman. Thank you for joining me today. 

  1. 300 hours later – I want to thank you for getting me into this mess called the DACO. I’m blaming it all on you and Bill Lawson. 
  2. Tell me about your journey into chiropractic
  3. From your CV, I see that you did the CCSP right out of school. What all have you done through that specific certification?
  4. Can you tell us the most striking difference between the two other than one is more geared toward sports?
  5. Tell me about your practice, what does it look like, who do you see mostly?
  6. Tell me about your journey into the DACO and what benefits you have personally realized from it.
  7. You and your business partner, Dr. Brandon Steele, do a great job at staying on top of the most current research. How do you do that? What are your sources?
  8. I want to hear a little about this friendly rivalry between you and Dr. Steele. 
  9. Did you realize that when I put your name into a Google search to learn a little more about you that Bertlesman Chiropractic pulled up with Dr. Steele’s picture on it? I think his evil plan is beginning to come to fruition. 
  10. When I had Dr. Steele on the show, we talked a bit about Standardization…as in making expectations more uniform for patients visiting chiropractic offices….. and we talked about Specialization such as through the DACO or the CCSP or CSCS. Can you share your thoughts on those two topics for us? 
  11. Tell me about your involvement with your state association and what it has meant to you both personally and professionally
  12. What have you been able to accomplish or have you tried to accomplish legislatively? What struggles are the Illinois and Missouri chiropractors in the middle of these days?
  13. Tell me about chocolate cookies and sushi
  14. I noticed a couple of things from your ‘About Me’ page on your website that I’d love to hear more about. 
    1. The Clinical Internship – Community Health Center
    2. Hospital externship at Deaconess Medical Center
  15. If people want to get more of Tim Bertelsman, what should they do? Where do they need to go to get their ‘fix’? I know you’ll be at ChiroTexpo in downtown Dallas again this year June 7-9. What else?
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

Kids Need A Rest, Chiropractic In Europe, & Exercise For Chronic Pain

CF 072: Kids Need A Rest, Chiropractic In Europe, & Exercise For Chronic Pain.

Today we’re going to talk about a surgeon that says let kids slow down, the shape of chiropractic in Europe, how exercise affects chronic pain.       

But first, here’s that 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 collapsed into Episode #72

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. 

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. 

F4CP

We will be launching an athletes and opioids eBook toward the end of this month. It’s called A case for chiropractic disrupting the cycle of pain, prescriptions, and addiciton. I’m linking it in the show notes so go get and check it out. 

https://www.f4cp.org/package/home/viewfile/whiathletes-and-opioids-ebook

DACO

Let’s talk a bit about the DACO program

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. 

Item #1

“Noted surgeon Dr. James Andrews wants your young athlete to stay healthy by playing less” by Dennis Manoloff of the The Plain Dealer(Manoloff D 2013). It was posted back in February of 2013 so a little old but has been making the rounds here lately in the private groups and with several colleagues. And it’s right up our alley when you consider we are also trying to keep kids out of surgery. 

Some highlights are when Dr. Andrews says they have worried for too long about patching people up rather than preventing the injury in the first place. Amen brothers and sisters. 

When asked why kids are getting hurt more and more these days, he says there are really two factors. One being that kids specialize too much now and what he calls professionalism. 

Specialization means kids are just playing one sport these days instead of being well-rounded athletes with a wide array of different activities and skills. When they’re only doing one thing and they’re doing it over and over and over…..well, that’s a recipe for surgery due to overuse.

He says ‘professionalism’ is taking these young kids that are 12 or 13 and working them like they are professional athletes with year-round training and activity. 

Advice he would give parents that can help us guide our conversations with patients and parents was 

  1. Use proper mechanics in any sport.
  2. Don’t play year round. Their kiddo needs at least two months off each year to recover from a specific sport. Ideally, 3-4 months. 

Basically, sometimes we have to look at mom and dad and say, cut it out or a surgeon will be cutting something out. 

I just made that up but you can use it if you like it. You don’t even have to give me credit for it unless you make money from it. Lol. 

Alright, Item #2, comin’ through.

Before the DACO course, chronic pain (while it should have been) was not on my radar at ALL as far as something I was interested in and something I wanted to learn to solve. It sure it now though and this next paper fits right in. 

It’s called “Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain” by Anne Polaski, Amy Phelps, Matthew Kosted, and more(Polaski A 2019). It was published in January 2019 and I’ve cited it in the show notes. 

Why They Did It

As more and more studies are showing the effects of exercise as a first-line treatment for “nearly all forms of chronic pain,” things like dosing for different treatment modalities has not been explored just yet. 

What They Found

As you can deduce from the title, this was a meta-analysis. 

They say in the abstract, “increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients.”

In the end, as is always a part of the conclusion, more research is needed but there is a modest effect. 

Item #3

This one was in BMC Chiropractic & Manual Therapies in April of 2019. Hot stuff….comin up! It’s called “The shape of chiropractic in Europe: a corss-setional survey of chiropractor’s beliefs and practice(Gislason H 2019).” It was written by Halldor Gislason, Jari Salminen, Linn Sandhaugen, and other names I refuse to attempt at this time. 

Why They Did It

Considering the ongoing split in the profession, the authors were looking to report an adherence to unorthodox descriptiions of chiropractic and the types of chiropractic practice in Europe. 

How They Did It

They sent out an online survey amongst European chiropractors in 2017. They sent it out through social media and through the different membership associations. 

What They Found

  • They got back 1,322 responses back representing about 17.2% fo the profession. 
  • The responses were boiled down to fit into 2 different groups of practices. 
  • The two groups were categorized as orthodox and unorthodox. 
  • The orthodox group made up 80% of practitioners
  • The unorthodox group made up 20% 

Some Key Differences

  • 23% of the unorthodox chiropractors x-rayed over 50% of their new patients while the orthodox chiropractors x-rayed only 5% of theirs. 
  • The amount of unorthodox chiropractors seeing over 150 visits per week was more than double the amount seen by the orthodox chiropractor. 
  • Then, of course, there’s info demonstrating how unorthodox hates vaccines while orthodox chiros are fine with them. 

Wrap Up

They concluded by saying, “in parallel with other research, this survey suggests that key practice characteristics in contravention of national radiation guidelines or opposition to evidence based public health policy are significantly more associated with non-orthodox chiropractic paradigms.”

Now, what does that mean exactly? Well, for those of us on the evidence-informed end of the spectrum, it means that we are in concert with 80% of the profession in Canada and in Europe. From what I recall, about 80% of the profession in America is either evidence-informed or somewhere in the middle. Basically, agnostic. 

It’s not my place to argue if subluxation is a real thing or is not a real thing because I believe people define it differently. My opinion, not research because there is none to my knowledge….but my opinion is that if one defines a subluxation as something that can be removed thus fixing cancer, infections, and things like that…..well, my opinion is that that definition puts you in the unorthodox category and puts you in the 20%. 

That’s my opinion anyway and that’s worth diddly squat in the unorthodox community so, take as you may. 

We can also discuss the x-rays. I honestly have no problems with initial x-rays. I realize that flies in the face of a lot of newer guidelines but I believe that we get gut feelings that don’t fit into the definition of a ‘red flag’ per se. You damn well better get x-rays on those deals. 

I’d also say, if you have a history of x-raying every single patient that comes through the doors, that’s also putting you in the 20% that is defined as unorthodox and it’s also meaning that you’re considered an outlier. 

Outliers MUST keep an eye out if you have contracts with insurance companies. If you’re going to be an outlier, you’d best be a cash practice. Whether it be right or wrong in your opinion, insurance companies do NOT like outliers and unorthodox practitioners. And, honestly, who can blame them?

If I’m writing a bunch of checks and I have 80% of the profession over here mostly following guidelines, seeing people a reasonable amount of visits, I’m going to be cool with that 80%. If I have 20% of guys and girls over here seeing people 100 times per year when they have absolutely zero pain and taking repeated x-rays through the year, well…..if I’m writing those checks, I’m going to have a problem with that 20% at least 100% of the time. 

Do whatever you’re going to do but you should give at least SOME consideration to what I’m saying. 

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

Gislason H, S. J., Sandhaugen L, (2019). “The shape of chiropractic in Europe: a cross sectional survey of chiropractor’s beliefs and practice.” BMC Chiro Man Ther 27(16).

Manoloff D (2013). “Noted surgeon Dr. James Andrews wants your young athlete to stay healthy by playing less.” The Plain Dealer.

Polaski A, P. A., Kostek M, (2019). “Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain.” PLoS One.

Chiropractic Wins Again, Push Ups Say A Lot, Low Iron & The Disc

CF 064: Chiropractic Wins Again, Push Ups Say A Lot, Low Iron & The Disc

Today we’re going to talk about how chiropractic and spinal manipulative therapy win again, we’ll talk about how push ups may tell us more than what you see on the surface, we’ll discuss some new information on low back discs and how they’re affected by low iron, and then we’ll gloss over a paper on physical therapy to toss you some thought nuggets. 

Chiropractic evidence-based products

But first, jsut for my friend and collegue, Dr. Michael Henry down in Austin, here’s that ‘you know you love it’ bumper music. He’s a big fan. 

Integrating Chiropractors

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 shimmied all 60’s like into Episode #64

Introduction

We’re here to advocate for chiropractic and to give you some awesome information to make your life easier from day-to-day. We’re going to keep you from wasting time in your week and give you confidence in your recommendations and treatments. And I feel confident in guaranteeing that to you if you listen and stick to it here at the Chiropractic Forward Podcast.  

Store

Part of saving you time and effort 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. I noticed an error on the shipping charge. That has been corrected now. 

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 somehting is out of sorts or isn’t working correctly. 

DACO

Let’s talk a bit about the Diplomate of the Academy of Chiropractic Orthopedists probgram also known as the DACO. I finished up all 50 of the required live hours this weekend down in Austin, TX during the Texas Chiropractic Association’s legislative seminar. 

Not only did I get all of the hours wrapped up but I also got to see a lot of colleagues I have been doing battle along side with for the last 8 years or so. You may or may not know that the Texas Medical Association is particularly aggressive and attacks at will for anything and everything. Which means we have to constantly raise funds to defend the attacks. 

It’s this cute thing we do with each other from year to year. It’s really a special relationship chiropractors have with the TMA. I keep thinking one day they’ll start listening to their own profession and leave us the hell alone but nope. Not so far. Not until they have full and complete control of chiropractic care in Texas. Which is not going to happen. Just so you know.. 

They sued us because 2 docs in texas who were Neuro Diplomates were doing VONT testing. I’d never even heard of VONT until this last time we got sued by TMA. IF you can give me a good reason why a neuro diplomate cannot do VONT testing, I’ll send you a candy bar or some chicklets or something like that. 

It’s enough to make a guy crazy. I got to meet a lot of bright new people ready to help the TCA fight and overcome. Andrea Ohmann recently moved to Texas from Minnesota. She is in a hospital setting if I understood correctly. She’s a bright star to keep an eye on. I also need to thank Dr. Jamie Marshall for listening to us down in Conroe, TX. I really appreciate it!

I got to see Staff Sergeant Shilo Harris speak. I mentioned him a couple of episodes ago but I have to tell you, this man is a hell of a speaker and he’s in our corner specifically. He gives chiropractic care all of the credit for helping him get through all of his injuries and surgeries. He was blown up by an IED in Iraq and has been through absolute hell to get to where he is now and chiropractic was key to getting him there. 

Very emotional and very impactful. I can’t imagine a legislator being confronted by him and his story and not being forced to see it our way. It’s powerful. Thanks to Shilo for eveything he’s doing for this profession. I hope you’ll go to http://shiloharris.com and see what he’s about. 

Beyond that our DACO hours were taught by Jeffrey Miller who is a chiropractor on staff at the University of Missouri medical school. He’s not as sharp as a tack. He’s actually sharper than a tack and told me he’d love to join us on the podcast so I’m going to do us all a favor and get that set up. We also have Dr. Christine Goertz’s episode coming up quickly so keep your eyes peeled for that one too. 

This get on with this deal here. 

Item #1

Our first item here is called “Manipulative Therapies: What Works” and is authored by Dr. Michael Smith, an MD, and his herd of collegues. It was published in American Family Physician on Febraury 15, 2019(Smith M 2019). I got this one from Dr. William Lawson in Austin, TX who is a DABCO and a swell dude on top of that. 

In case you missed it, this herd of authors are medical doctors. They start by saying that manipulative therapies include things like osteopathic manipulative treatment which is the same as chiropractic manipulative treatment. 

They say that, when you compare manipulative therapy to oral analgesics, cervcial manipulation and/or mobilization appears to provide better short-term pain relief and improved funciton in patietns with neck pain. 

They go on to say that manipulative therapy may be as effective as amitriptyline for treating migraine headaches and can reduce the frequency and intesity of pain. 

While there is some evidence showing that manipulative therapy can reduce length of hospital stays for preterm infants, there is ZERO research for some of the other reasons we see chiropractors treating infants. Things like otitis media, colic, allergies, and respiratory conditions. 

That was all in the abstract. That’s the medical world starting to take note. Can you hear it? When do the insurance companies start to take note as well?

THAT’S REALLY when our lives start changing. Oh happy day….I have a dream. A dream where we are no longer pursecuted for being right all the damn time. A dream that chiropractors don’t go around saying crazy crap and making the rest of us look bad. I have a dream people. I’m not going to pretend to be as good of an orator as Martin Luther King Jr. but you get the point. 

You know that the more of these articles that come out, the more they have to start gathering steam. Turn on a light bulb at night in South Texas and see what happens. The bugs start swarming. Turn on this kind of light and you’ll see these articles begin catching more and more attention until we finally have a consensus in the medical field. A consensus that says, “Hell, looks like they’ve been onto something this whole time. We better take another look at it.”

This is an excellent paper. And we need to keep seeing this more and more. Even if they’re talking specifically about osteopathic manipulative therapy, we know that chiropractors do it too and, in fact, chiropractors do almost all of it these days. DO’s have moved almost completely to medicine. We are the ones moving joints. Make no mistake about it. 

Item #2

Pushups…what can they tell us? Well, it appears they can tell us quite a lot from an article in StudyFinds called “Men Who Can Do More Than 40 Push-ups Far Less Likely To Develop Heart Disease.(Finds 2019)”

This article covers a new study that showed that men posessing the ability to perform 40 push-ups in one attempt are much less likely to suffer from heart disease wihtin the next 10 years. 

They showed where middle-aged men who can put in more than 40 in a single try have a 96% less chance of having heart disease when compared to those who could complete no more than 10 push-ups. 

So, it appears, to me…..that it’s time to start doing some push-ups muy pronto. 

Item #3

This one comes to us from the American Journal of Translational Research and is called “Iron defficiency accelerates intervertebral disc degeneration through affectring the stability of DNA polymerase epsilon complex(Zhang C 2015).” 

It was published in November of 2015 and appears to be mostly Chinese researchers. Could be Japanese, Korean, or Vietnamese but the name of the lead author is Chungiang Zhang and whole host of names that appear to be just as difficult to pronounce. 

We will not get deep into the details here because I’m not too proud to admit that the information here goes far above my head in many ways. I’ve said it before, I’m no guru. I’m like Alex Trebec on Jeopardy. He delivers the info but I promise he’s no expert on every question coming across his lips. Lol. 

But, when we stick with the basics, we see that iron serves as an important cofactor of iron-containging proteins that play critical roles in the maintenance of DNA stability and cell cycle progression. They say that disturbed iron homeostasis gives rise to things like cancer and anemia. 

In addition, they say that they found clear correlation between iron deficiency and intervertebral disc degeneration. 

They wrapped up their paper by saying, “In summary, our study suggests that iron deficiency is an important factor in the aggravation of IDD. Proper iron supplementation may be an effective strategy to alleviate the symptoms of patients with intervertebral disc degeneration.”

Item #4

Our last on the list, it has to do with PTs and is called “Minimal physical therapy utilization compared with higher physical therapy utilization for patients with low back pain: a systematic review,” authored by Heidi Ojha and a gaggle of others and published in Physiotherapy Theory and Practice in February 2019(Ojha H 2019).

This was a systematic review to compare the effects of minimal physical therapy utilization (two visits or less) vs. typical physical therapy utilization consisting of 3 or more visits on patient-important outcomes for patients with low back pain. 

They say this research is needed because there is such variation in physical therapy use for those with low back pain. 

Interestingly, they found that, when compared with minimal utilization, higher utilization demonstrated no significant differences on pain, disability, or quality of life at the 1-year follow-up.

Even more interesting was that the conclusion of the paper said the following, “While higher utilization may not result in significant improvements in patient-important outcomes, it may be more cost-effective for patients with chronic or complex LBP conditions when compared to minimal utilization.”

So, what the hell is that? It’s not going to make you any difference to see us a lot but the price point is agreeable so, by all means, we’d like to see you a crap load. Which isn’t as much as a crap ton. By the way. But I think you see what I mean. 

I have noticed so many papers that basically cast a lot of doubt on PT in general while all we seem to find in regards to manipulative therapy are positive reaffirmation of the chiropractic profession. 

It just makes me wonder where the tipping point is to be honest. When does the medical industry start to look at chiropractic as being more effective for these conditions that PT and making those referrals accordingly? I had some insight on a PT private group on Facebook a couple of weeks ago. 

The PTs were piling on a chiropractor’s advertisement techniques. Let’s be fair, the DC was a knucklehead and wasn’t being honest and identifying himself as a chiropractor in his marketing but, for discussion purposes here, that’s beside the point. 

They were bashing not only on that chiropractor but our profession as a whole. I bash on aspects of my profession as well but, where the rubber hits the road, we average better patient outcomes, we are safe, we are effective, and we average higher patient satisfaction. Even if some in our profession would win a county craziness competition. 

Don’t believe me? Go listen to Episode #49 of this podcast where we go over the Parker-Gallup poll. Very interesting episode and there are some valuable marketing nuggets in that one for you as well. Definitely worth the listen. 

Also Episode #26 talks about PTs and DCs. The age old grudge match. Go check them out and see what you think. 

Some in our profession are simply imbeciles. That sounds harsh but for a time after graduating, I held no interest in furthering my education. I wanted to coast. I’d done the hard work, right? I was so smart already after all those years of college. Well, you don’t know what you don’t know. And, I can admit that for a few years there, I was an imbecile. 

They learned enough to pass but that doesn’t make them smart or ethical and that’s sad. But again, when said and done, our profession consistently proves itself and is proven by insurance companies, governments, polls, surveys, and universities. 

From what I’ve seen recently, I can’t say the same for them and I just can’t see where they feel they have some moral high ground or platform to stand on and spout a bunch of denigrating thoughts at us. 

I thought it’d be a good idea once to refer to a PT. I had a car wreck patient and thought they could use PT and at that time, I wasn’t equipped to do much rehab. So onto the PT they went. In two damn weeks, the PT ran up a bill that would have literally taken me 4 months to run up. I was astounded. And, in that two week period, there was little to no improvement for the patient. 

On a separate occasion, I had a disc patient finally settled down and doing great. She was very active and very much into working out. I had her disc settled down to a point that she thought she’d go get PT on top of what I was doing. She did not talk to me about it. She just did it. Her thought process was that it would just be that much better to combine the two. Chiropractic and PT. Honestly, that’s not bad thinking in theory. 

She came back after one visit almost unable to walk or function. We tried and tried to get it to settle back down but she ended up taking herself to a surgeon to get our of pain. Sorry PTs. Quit talking smack and work with us instead of against us.

Ideally, PTs and chiropractors work hand in hand and complement each other. Many offices can and should operate in this manner. In reality though, I see PTs as great for post-operative rehab and rehab after certain types of injury. When it comes to joints and spines in general though, they can’t touch us. They talk bad about us, they steal services from us, they think they have the moral ground on us, but they can’t touch us.

Those of us practicing in an evidence-informed manner anyway. Those not practicing evidence-informed actually continue to provide them with whatever moral ground they believe they have. 

I for one would like to move on from the beginnings and progress our profession much like the MDs have done over the last 150 years. They went from blood-letting, leeches, and labotomies to what they can do now. Yet, there’s still a part of our profession wanting to hold on dearly to our originations of 100+ years ago. 

Chiropractors, let go. Progress. Practice current, in the current day and age. Practice evidence-informed. It’ll help you and it’ll help the profession in general. 

That’s my opinion anyway. Take it or leave it. 

This week, I want you to go forward with

  1. Chiropractic wins and wins and wins again. We made the right decision. We just need to only use our powers for the good. 
  2. Push-ups….let’s get to doing them!
  3. Iron deficiency for disc degeneration is something worth looking at. 
  4. When we are practicing evidence-informed chiropractic care, PTs only wish they could get the results we can get.

Subscribe Button

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

About the Author & Host

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

Bibliography

Finds, S. (2019) “Men Who Can Do More Than 40 Push-Ups Far Less Likely To Develop Heart Disease.” StudyFinds.

Ojha H, M. M., Johnston M, (2019). “Minimal physical therapy utilization compared with higher physical therapy utilization for patients with low back pain: a systematic review.” Physio Theory Practice.

Smith M (2019). “Manipulative Therapies: What Works.” AMerican Family Physician 99(4): 248-252.

Zhang C (2015). “Iron deficiency accelerates intervertebral disc degeneration through affecting the stability of DNA polymerase epsilon complex.” Am J Transl Res 10(11): 3430-3442.

CF 062: Chiropractic Prevalence, JAMA’s Awful Info on Opioids, & New Info on Screen Time

CF 062: Chiropractic Prevalence, JAMA’s Awful Info on Opioids, & New Info on Screen Time

Today we’re going to talk about chiropractic prevalence, a new article in JAMA with some pretty terrible projections for opioid use and deaths, and new information on kiddos and the time they spend on screens. 

But first, here’s that bumper music

Chiropractic evidence-based productsIntegrating Chiropractors

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 collapsed into Episode #62

Introduction

We’re here to advocate for chiropractic and to give you some awesome information to make your life easier from day-to-day. We’re going to keep you from wasting time through your week by giving you confidence in your recommendations and in your treatments. This is something I feel confident in guaranteeing you if you listen and stick to it here at the Chiropractic Forward Podcast.  

Evidence-Based Chiropractic Store

Part of saving you time and effort 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. 

DACO

Let’s talk a bit about the DACO program. Man, this is how it goes with the DACO: just yesterday morning, I had a patient come in, mid-’60s and literally everything hurt. Restless leg syndrome was her main complaint but her GP just yesterday already started her on Vitamin D and iron supplements so she’s going in the right direction there. I have heard of acupuncture being good for it as well but have not seen any research on that so can’t make that claim. 

Anyhooo…literally everything hurt, couldn’t sit down and basically, a general overall look of being unwell for a lack of a better word. She just didn’t look healthy. I started asking her about bone scans and she’d never had one. Well, this guy just gets feelings and when I get a feeling, they get sent out. I sent her out for a bone scan. 

No kidding, that afternoon I sit down for a class. The next one up? Yep, diagnosing osteoporosis. Lol. Wouldn’t you know it? Anyway, had I had this class before the encounter with the new patient, I might not have sent her. I’m not sure.

But, it’s just funny how in tune with clinical practice the classes really are. Also, as a consequence of the class, I have a quick sheet made up that changes the way I deal with potential osteoporosis patients from here on out. Forever and ever amen. 

Personal Happenings

So far, not a lot of blowback on my recent episode covering my thoughts on faith-based practices. Sometimes I’m mouthy, right? I get it. Who the hell cares what I have to say? I don’t know who cares honestly. Lol. But, we’re growing and growing so at least some of you identify with my way of thinking.

I’m religious and I think that’s what makes me feel that I can be credible in critiquing certain things in regard to religion. I just have a hard time with management companies coaching their impressionable doctors how to use the bible to manipulate scared patients looking for answers. When I think about it, it makes my pee hot. 

Anyway, it turns out that you guys agree with me and that makes me like you even more. Before you know it, we’re all going to be besties and share milkshakes with two straws and all of that mumbo jumbo. 

I’m glad you’re here with me today as we dive into the information I have for you this week. Here we go. 

Item #1

I want to start with one that had some conclusions I found surprising and somewhat encouraging……sort of. This new paper from The Journal of Alternative and Complementary Medicine published January 18, 2019, and authored by Stephanie Taylor, Patricia Herman, Nell Marshall, and colleagues called “Use of Complementary and Integrated Health: A Retrospective Analysis of US Veterans with Chronic Musculoskeletal Pain Nationally[1].”

Due to time constraints on me, I didn’t go beyond the abstract here so….freaking sue me. I’ll have it cited in the show notes at chiropracticforward.com so you can go get it and dive in you over-over-achiever you with all that time sitting around. Must be nice pal. 

Why They Did It

The authors say that little is known regarding the use of complementary and integrative health therapies for chronic pain in the VA system which is the nation’s largest integrated healthcare system. We will get into chiropractic prevalence briefly.

In my experience, I can echo this paper’s sentiment that the VA is at the forefront of the movement away from opioids and toward alternative healthcare. 

They researched this paper over 2 years for the use of 9 types of alternative therapies that included meditation, yoga, acupuncture, chiropractic, guided imagery, biofeedback, tai chi, massage, and hypnosis. 

What they found

27% of younger veterans with chronic musculoskeletal pain use alternative healthcare

The most used for was meditation at 15%. I found that surprising. Meditation means slowing down, sitting still, relaxing, and all that good stuff. In this day and age, I just have a hard time seeing that as the most prevalent form of alternative healthcare. 

We all think we’re so busy and, for us chiropractors, a lot of us really ARE too busy to stop and meditate. I may just be taking my own personal experience here and assuming everyone else on the planet is like me and, of course, that’s not true. Still, meditation was the most prevalent in this study. 

Yoga was next at 7%. Again, I guess I haven’t realized how popular yoga is getting these days but, I know the VA is pushing it so that may be playing a part in it. 

Coming in in 3rd place we have acupuncture. Once again, it’s surprising to me but, the VA is directing the recommendations and, in the real world, outside of the VA, acupuncture does not out-pace chiropractic. I do believe the VA is seeing it’s use for PTSD and chronic pain though and is responding appropriately. 

Finally, here comes Chiropractic care coasting in in 4th place for chiropractic prevalence.

Ugh. We know outside the enclosed ecosystem of the VA, chiropractic care is not less prevalent than yoga, meditation, and acupuncture. But, being within the VA, we know that medical doctors, PA’s, and nurse practitioners are making these recommendations and referrals so we still clearly have a lot of work to do. We are still a world away from where we need to be in regard to chiropractic prevalence,

You know what else that means though right? There are incredible potential and opportunity. If the VA is an example of the rest of the allopathic world, we could say that even fewer than 5% of chronics get referred to us from the GPs and orthopedic surgeons. I think that’s fair because most of them are unaware of Dr. Christine Goertz’s work that was published in JAMA not long ago.

If you’re unfamiliar with that, go listen to Episode 25 of this podcast. In short, she showed how veterans with chiropractic care mixed in with their traditional care had better outcomes. That’s when we started seeing the referrals from the VA

Also, you’ll notice that all of the nine therapies tracked here were on the list of first-line therapies that came from the updated recommendations by the American College of Physicians in February of 2016[2]. 

I guess my point on the paper here is that the medical world, or at least the VA part of it, is paying attention to research regardless of whether it goes against their previously held biases. They are absolutely trying to reverse the opioid epidemic. And we have a lot of work to do to gain that trust and get those referrals. When they’re recommending meditation before chiropractic care for chronic pain, then there is a ton of room for us to shine. So go shine it up all you shiny happy people out there. 

Item #2

On to item numero dos, number 2 for our non-Spanish speaking population out there. This one is discouraging and…..well….awful if I’m being honest.

This one is from JAMA called “Prevention of Prescription Opioids Misuse and Projected Overdose Deaths in the United States” published on February 1, 2019, and authored by Quiushi Chen, Marc Larochelle, David Weaver, and colleagues[3].

Why They Did It

In JAMA, they always start with the question being answered here. The authors wanted to answer this one: “what is the projected effect of lowering incident non-medical prescription opioid use on the future trajectory of the opioid overdose crisis in the USA?

I’m just going to cut to the chase on it and leave a bunch of details out. Here’s why. I don’t want us getting bogged down in the details and methods and all that stuff.

I want you to be able to retain just a few numbers and not be distracted by the rest of the minutiae. You like that word? I know you do. Minutiae, You say that to the right fellow nerd and you may just get you a date, people.

It’s a powerful word so take it, use it, enjoy it. I swear I’m undiagnosed ADHD. I swear it. 

Anyway, here’s the deal, although we as a nation, as a world, now see the issues with opioids and are now trying to address the issue, It’s not getting better and it won’t get any better according to this paper. 

Check it out, according to this paper, the annual number of opioid overdose deaths is projected to increase from 33,100 in 2015…..then we know that 72,000 died in 2017….all the way up to 81,700 deaths projected 2025. 

They are projecting from 2016-2025 to lose a total of approximately 700,400 people to opioid deaths. They say about 80% of that will be due to illicit opioids. I don’t know how the hell they can tell that but that may be a little bit of, “yeah it’s happening but it’s not our fault,” BS going on there but who knows? In this paper, they’re assuming that the illegal use of opioids will increase from 61% in 2015 to 80% by 2025. I don’t know. Sounds like fuzzy math to me but I’m not a researcher. 

I think their numbers are fuzzy because we know 2015 saw about 36,000 die, but then 2016 saw around 63,000 die if I remember correctly. Then, 2017 saw 72,000 die. Are you seeing the graph there in your mind? It’s not only up and to the right on this deal, but its up and to the right like it’s climbing Mt. Everest. The numbers have harnesses fastened tightly and ropes and expert climbing guides and they’re going straight up the face like pros! 

These guys are guessing that by 2025, in 9 years, the deaths will only have increased a total of 9,000 per year, so….they’ll only increase an average of 1,000 deaths per year. Do you see why I think they’re crazy? The deaths increased by 9,000 just last year. Do you see what I’m saying? I’m not saying they’re wrong but….they’re wrong. Lol. 

They then say that across all interventions tested, further lowering the incidence of prescription opioid misuse from 2015 levels is projected to decrease overdose deaths by only 3%-5.3%. 

Their quoted conclusion is, “This study’s findings suggest that interventions targeting prescription opioid misuse such as prescription monitoring programs may have a modest effect, at best, on the number of opioid overdose deaths in the near future. Additional policy interventions are urgently needed to change the course of the epidemic.”

So what do we take from this exactly? Here’s my deal. On the surface at least it smells like a steaming pot of shoo shoo caca doody, 

Instead of recognizing the fact that unnecessary surgeries were many times the reason people got addicted in the first place, and that there are amazing opportunities outside the allopathic world to prevent those unnecessary and financially motivated surgeries, they say, “Hey look, a lot of this is done illegally and that’s just going to get worse and our part of this is really very small.

In fact, we can lower the prescriptions of opioids but it’s really not going to do a lot of good and, in fact, we think we should still be able to prescribe them as much as we are right now….blah blah blah poop coming out of the mouth and falling onto the floor with a splat. 

They are making guesses 9 years in the future what addict behaviors will be. I think that’s presumptuous and ultimately impossible. I just thought it was entertaining and that you all might enjoy this group trying to minimize responsibility or what role they can really play on decreasing opioid use.

I could totally be mischaracterizing this and they may have the best intentions in mind. While I trust my GP and I trust the friends of mine that are surgeons personally….I just don’t trust stuff like this. 

Obviously, I don’t agree with them but I’m a bumpkin chiro on the Texas Plains. I wouldn’t listen to me if I were them either. Lol. 

Item #3

OK, last item for this week and it’s something I’m admittedly fascinated with and I think that’s because I have a high schooler and a 5th grader and this stuff hits home any time I see it or read about it. 

This one was in JAMA too and called, “Association Between Screen Time and Children’s Performance on a Developmental Screening Test” written by Sheri Madigan, Dillon Browne, Nicole Racine and colleagues[4] published January 28, 2019. 

Why They Did It

The main question they were trying to answer was this, “Is increased screen time associated with poor performance on children’s developmental screening tests?” Basically, does screen time have a direct effect on child development?

They had 2,441 kiddos in it. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months and 60 months. 

What They Found

Their conclusion was, “The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use.”

Yes, it’s easy to just hand them a device and hope they’re quiet long enough to get a nap in. Guilty as charged. Guilty as charged. 

But, turns out as we may have guessed if we really thought about it 8-9 years ago when all of this really started….this isn’t in their best interest in the long run. 

Chiropractic evidence-based productsIntegrating Chiropractors

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

https://twitter.com/Chiro_Forward

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

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Stitcher:

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

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

1. Taylor S, H.P., Marshal N,, Use of Complementary and Integrated Health: A Retrospective Analysis of U.S. Veterans with Chronic Musculoskeletal Pain Nationally. J Altern Complement Med, 2019. 25(1).

2. Qaseem A, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med, 2017. 4(166): p. 514-530.

3. Chen Q, L.M., Weaver D,, Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States. JAMA Network Open, 2019. 2(2): p. e187621-e187621.

4. Madigan S, Association Between Screen Time and Children’s Performance on a Developmental Screening TestAssociation Between Screen Time and Child DevelopmentAssociation Between Screen Time and Child Development. JAMA Pediatrics, 2019.

CF 025: Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone

CF 027: WANTED – Safe, Nonpharmacological Means Of Treating Spinal Pain

CF 052: Chiropractic Forward Podcast Year One Review

 

 

 

CF 060: Medical Marketing & Integration Care Expectations

CF 060: Medical Marketing & Integration Care Expectations

Today we’re going to talk about medical marketing scoundrels and about what the multidisciplinary world expects of us chiropractors. 

But first, here’s that ‘goes down so smooth’ bumper music

Integrating Chiropractors

And we’re back. .Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  We are honored you’re spending some time with us and we hope we give some entertainment and some value in return. 

Introduction

You have disco’ed your way into Episode #60 just like John Travolta in Saturday Night Live. Kids, go Google that. It was cool back then. You could walk down the street in a Staying Alive strut man. Travolta was the bee’s knees back then wasn’t he? From Mr. Kotter, to Grease, to Staying Alive. Then turned kookoo wacko on everyone. He got so open-minded that his brain fell out and went splat. 

Let’s talk a bit about the diplomate of the Academy of chiropractic orthopedists quickly. That’s also known as the DACO program that I’m currently going through. I’ve officially hit the halfway point for the online hours and only have one class left for the live hours which I’ll get in less than a month down in Austin. Basically, out of 300 hours, I have about 125 left and have just been serious about this thing since October. Recent classes have been A Neurological Approach to Scoliosis, and the Neck and a Sense of Well-Being. 

I feel like it’s scooting fairly quickly at this point. It’s funny to watch my staff when I’m performing an exam these days. They’re familiar with the way I do exams and have done them for years. Just about every week, including this week, I’m adding or taking away from what I normally do. They don’t really know how to handle it. Lol. These classes really do change what you do almost immediately. 

If I can help you get started and rocking and rolling on your DACO, shoot me an email at dr.williams@chiropracticforward.com and I’ll be glad to point you in the right direction. 

New Year

How’s your new year starting? By the time this episode goes live, we’ll have been in it for a little over a month. I have to say that I’m confused this year. This is typically our slowest time of year. But, it’s going a little crazy this year for whatever reason. I have literally had 35 new patients in the last two weeks. It’s all I can do to get this podcast written each week, to be honest, but I’m committed. 

I actually had to come in on a Saturday to record the last episode because I just didn’t have the time available during the week to get it done. I’m not trying to brag. I think if you have a good staff, which I do, and you have them spaced appropriately, which I do, you can make your way through them while giving them the best care possible. Especially when you’re using post-graduate educations like the DACO to guide your exam and diagnosis. 

Crazy Busy

And, 35 new patients for my practice looks different than it may in a lot of clinics. I don’t see how many times we can run them through the doors. I don’t convince them their lives are at stake if they don’t see me 50 times this year. 

I used ChiroUp for all of my patients which I highly recommend. An additional $150/month seems like a lot. I know. But this programs is worth even more than that and they’re not paying me anything at all to say that. One of the things it does is track your patients through follow up emails. 

That’s how I know my case average, which is the number of times I typically see a person, stands at around 8 times while their national average stands at about 7 times. 

I know that my average improvement rating is 79.43% for ALL cases and that included everything from cervical radiculopathy and lumbar stenosis to cervicogenic headache and greater trochanteric bursitis. Their national average for improvement is 71.8% so I’m doing good there. If I’m getting 80% of my patients well, I’m happy. 

They have also tracked me at having a 98.6% likely to refer from my patients. Meaning, our patients are 98% happy to refer us to their family and friends and that makes me feel warm and fuzzy inside. I’d still like to know what I can do to make that other 1.4% happy but I think some people cannot be made happy at all. 

Even if you get them well and gave them free ice cream. They’d still gripe because the ice cream didn’t have chocolate syrup on it. You know those people. You know who I’m talking about, don’t you?

Anyway, the point was….I hope your 2019 has started off like my 2019. If it sustains, I’m going to have to get me some help in here! Including a nurse practitioner. Ahhhhh, the day I finally make that leap I may have a few hundred beers. Lol. 

Paper #1

The first item of research I want to get to is on medical marketing. Why do we care what the medical field is doing for marketing? Well, because they’re the main stakeholders in healthcare and it’s important to know what they’re doing. Either we can copy it or we can go 180 degrees from it depending on what we’re talking about. 

This paper we’ll talk about was in the Journal of the American Medical Association also known as JAMA on January 1, 2019, so it’s hot off of the press. It is called “Medical Marketing in the United States, 1997-2016” and was written by Lisa Schwartz, MD and Steven Woloshin, MD[1].  Please remember, if you’d like to see the paper, the methods, and that good hulabaloo….I always cite the papers at the end of the show notes over at chiropracticforward.com. This show is episode 60 just so’s you’s knows. 

Why They Did It

They wanted to answer the question, “How has the marketing of prescription drugs, disease awareness, health services, and laboratory tests in the United States changed from 1997 through 2016?” I think that’s a great question. 

Let’s find out, shall we? I say hell yes we shall!

As far as medical marketing goes, they say, “From 1997 through 2016, medical marketing expanded substantially, and spending increased from $17.7 to $29.9 billion, with direct-to-consumer advertising for prescription drugs and health services accounting for the most rapid growth, and pharmaceutical marketing to health professionals accounting for most promotional spending.”

Let’s dial down into that just a bit. 

As you are probably already guessing because you see this trash on TV every time you turn it on but the most rapid, crazy increase in medical marketing advertising was in the direct-to-consumer advertising. It went from $2.1 billion in 1997, which was 11.9% of the total marketing….it went from $2.1 billion all the way up to $9.6 billion and now, marketing meds directly to the consumer now make up 32% of the total spending. I say NOW….that was 2016’s numbers. Probably worse now.

They broke it down even further and highlighted the prescriptions that are marketed directly. The drugs you need a prescription for ….ads for them went from $1.3 billion in ’97 which was 79,000 ads, all the way up to $6 billion dollars and 663,000 ads in 2016. 

All I have to say here is, “Dayum.”

Then, I’m not done yet….hold my beer and watch this….Lol. That’s what I feel like here. Then, they say that medical marketing straight to healthcare providers like the MDs, DOs, etc….that marketing went up from $15.6 billion to 20.3 billion in 2016 but here’s what’s crazy when you think about it, folks, $13.5 billion of that was for free samples….OK, whatever. Then $979 million went to payments to physicians for speaking fees, meals, and things like that that were related to specific products. So they paid almost a billion damn dollars to MDs to go around medical marketing & touting their drugs.  

It’s insane. You cannot tell me no way no how that with that much money in the hopper, that we don’t have some nefarious skunky smelly dirty crap snaking around and messing with people for the worse. You can’t convince me of it and I’m not a conspiracy guy either. 

Like, when they say we didn’t land on the moon, it was shot in a studio in Hollywood? Yeah, they need a kick in the nuggets. Really? The Earth is flat? Are you sure? I’ve seen a lot of pics from outers space and round is what I’m getting people!! 

You see what I mean here but I also know people and I know what greed does to people. It’s insane, honestly. 

Pharmaceutical Commercials

Let’s talk about those medical marketing commercials for a minute. Let’s make up a name that sounds a little like a prescription. How about Killyametrix? Yeah, sounds good. OK, here’s how it usually goes, “Have you been having a hard time getting into your life? Are you just tired? No energy, no drive, no ambition anymore? Wouldn’t you like to have more energy? You’re too young for this. Killyametrix has been shown to increase energy and get patients back to enjoying their lives quicker and faster than any medication in the history of man that was ever made. There are some side effects. You’ll want to talk to your doctor if you experience any of the following symptoms: gout, liver failure, tumors coming out of your eyeballs, if your foot falls right off in mid-stride, high blood pressure, going cross-eyed, bleeding from the ears and fingernails, if your hair curls, if all of your hair falls out, or if your knee cap pops right off as you sit down and shoots straight across the room knocking someone out. Other than those issues, it’s a great drug. Try Killyametrix. Ask your doctor about Killyametrix and if it might be right for you.”

Here’s the deal, when I was growing up, did you realize whiskey, bourbon, scotch, …..the hard stuff…..it was never advertised on TV because they knew it was damaging to the population so why promote it nationally. I believe it was actually illegal to advertise the hard stuff but I’m not 100% on that. 

But, now, or at least in 2016, it’s OK to advertise prescription drugs straight to the consumer to the tune of 663,000 ads at a cost of $6 billion dollars. It’s lunacy. 

How about you go to your doctor with no preconceived idea of what’s wrong with you and he or she plays doctor, figures out what’s going on with you, and the DOCTOR, the actual doctor, decides what medication you need if any at all. 

Why don’t we try that crap out in America for a change? 

If I were an MD or DO, I’d be livid every time I saw one of those stupid commercials on TV. Hell, I’m a DC and I’m livid when I see them. 

Make me a crazy person. Makes me want to go live in a rubber room for a couple of weeks to decompress.

Paper #2

Let’s get to the last thing here. This one is called “Stakeholder expectations from the integration of chiropractic care into a rehabilitation setting: a qualitative study” by Zacariah Shannon, et. al[2]. published in BMC Complementary and Alternative Medicine in December 2018. 

Why They Did It

They say that few studies exist on what the expectations of chiropractic care really are within a multidisciplinary setting so they wanted to add to the literature on this topic. 

What They Found

They found that expectations for the chiropractic program in this study were mostly positive. Good news. The idea of the patients making progress was the overriding theme for the group. They expected the addition of chiropractic to help patients progress by improving pain management and physical functioning. 

In addition, they also expected indirect effects of chiropractic on healthcare integration. Things like increasing the patient participation in other providers’ treatments which would lead to improved care for the patient across the board. 

I wonder if those other providers were or will be helping increase the chiropractor’s load as well? That’s a good question to ask. 

Wrap It Up

They summed it up by saying, “Stakeholders expected the addition of chiropractic care to a rehabilitation specialty hospital to benefit patients through pain management and functional improvements leading to whole person healing. They also expected chiropractic to benefit the healthcare team by facilitating other therapies in pursuit of the hospital mission, that is, moving patients towards discharge.”

Not bad, not bad. It’s a helluva lot better than we had going on for us before the opioid crisis. I’ll give them that. I think the only part of this I really don’t like is their expectation of the chiropractor helping feed the rest of them while, in my biased opinion, they should be feeding the chiropractor first in an effort to keep people off of meds. 

Their stated goals are pain management and physical function. Well…that’s sort of right in our wheelhouse so why wouldn’t we be getting those first? I think the stakeholders have been fed quite enough. They’re fat as hell and slobbering. 

Bring the evidence-informed chiropractors in and watch your patients shine with happiness, leave amazing reviews, and go out and tell your city about all of the good things your clinic is doing. 

If they get the right evidence-based chiropractor in there, that’s the way I see it playing out because the research we covered several weeks ago shows us that chiropractors have the highest patient outcome satisfaction when compared to MD and DO’s, in fact, we wipe the floor with those people in regard to musculoskeletal issues. Not only that but we beat out the PTs as well on outcome measures. 

But we should feed them, right? They should be thankful to have us. 

Integrating Chiropractors 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

1. Schwartz L, W.S., Medical Marketing in the United States, 1997-2016. JAMA, 2019. 321(1): p. 80-96.

2. Shannon Z, S.S., , Gosselin D, Vining R,, Stakeholder expectations from the integration of chiropractic care into a rehabilitation setting: a qualitative study. BMC Comp Altern Med, 2018. 18(316).

 

https://www.chiropracticforward.com/cf-025-vets-with-low-back-pain-usual-care-chiropractic-vs-usual-care-alone/

https://www.chiropracticforward.com/cf-032-how-evidence-based-chiropractic-can-help-save-the-day/

 

CF 027: WANTED – Safe, Nonpharmacological Means Of Treating Spinal Pain

 

 

CF 055: w/ Dr. James Lehman – The Future Of Chiropractic, Chiropractic Specialization, & Chiropractic Integration

CF 055: w/ Dr. James Lehman – The Future Of Chiropractic, Chiropractic Specialization, & Chiropractic Integration  

Today we’re going to talk to one of the giants in our profession, Dr. James Lehman. We will be talking to Dr. James Lehman all about all sorts of things but mostly about the future of chiropractic. What is it looking like for those of us in the profession over the course of the next 15-30 years?

Dr. James Lehman, FACO - University of Bridgeport Connecticut

But first, here’s that delicious bumper music

Integrating Chiropractors

 

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  We will get to Dr. James Lehman soon. 

Introduction

You have fluttered into Episode #55 kind of like the feather on Forrest Gump. Come on, you know the feather from literally one of the best movies of all time. Yes, that feather. 

Diplomate of the Academy of Chiropractic Orthopedists

This is normally the point in the program where I mention the DACO program and how I am progressing through it but, for reasons that will become obvious fairly quickly, we are going to save that talk for just a little later in our program. 

However, I will tell you I have 80 online hours at this point and some of my more recent classes have been Why does my shoulder keep hurting and how to diagnose a tension-type headache. If you recall from a week or so ago, two classes on migraines were among the classes so, after this last week, I’m getting a handle on the headache mystery. 

I have just about completed all of the Diagnostic Drills. There are 40 of them and I’ve finished 39 of them. The last one is on ankle sprain and what we really need to know about them. Then, we move on to Communication Drills that reinforce these Diagnostic Drills and help you write to your colleagues in an effective and professional way to describe your findings. I’m looking forward to those!

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. 

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

Questions for Dr. Lehman

How did the job at UofB become a reality for you? How did you make that happen or even make it a possibility?

Can you tell me about your position at UofB? 

What are your responsibilities? 

What does a regular day for you look like? 

Dr. Lehman and I became acquainted with each other through the DACO program. In case you have been hiding under a rock, zoning off during our podcasts, or maybe this is the very first podcast you’ve listened to of ours, DACO stands for Diplomate of American Chiropractic Orthopedists. 

What got you so interested in the Orthopedic side of our profession? 

What was it that made you want to specialize originally?

Can you tell us a little about your experience with chiropractic integration over the years? 

Have you had some battles to fight internally against medical practitioners?

What are some of the pitfalls and what are some of the rewards beyond seeing the patients recover?

Can you tell us about FQHCs? I had no idea they existed, especially in my city, until you showed me. Integrating into an FQHC was something that was never on my radar until we talked in Dallas.

At this point in our discussion, I need to tell you, the audience, that Dr. Lehman has played a vital role in furthering the DACO program. Through his position at the University of Bridgeport Connecticut, and through a partnership of sorts with online education through Chiropractic Development International out of Australia, obtaining the DACO has become very do-able and very attainable for all that may be so inclined. 

Dr. Lehman, can you tell us a little about how you and the University of Bridgeport got involved in the DACO and how it’s going so far? How did you identify the need and then go about filling that need?

Can you tell us why you feel like specialization like the DACO is so important to doctors of chiropractic these days? 

Why has this become your mission?

Through email, you suggested to me that, for the chiropractic profession to gain the respect of the healthcare system, a reasonable definition of chiropractic would be a good starting point. You offered a definition that doesn’t restrict providers nor does it highlight ‘subluxation.’ That definition is as follows:

“The evidence-based practice of differential diagnosis, patient-centered treatment, and prevention of pain and human disease as taught by CCE-approved chiropractic colleges, institutions, or schools.”

Tell me how you came up with this definition. 

Just to tell a quick personal experience, I have been introduced before by one neurosurgeon to another neurosurgeon using a disclaimer. He said, “He’s not one of THOSE chiropractors. He’s one of the good guys.” Which, I have to say that I appreciated the vote of confidence but at the same time it made me think, “With such a prevailing sentiment toward our profession, how will we ever integrate successfully or is it even possible?”

Do you think that even those of us that are specializing are going to be forever introduced with a disclaimer? I personally don’t see how a profession as split as ours progresses and integrates successfully. Is there a solution to this or are we just stuck with the split and the internal fighting?

With the knowledge that PTs are now utilizing spinal manipulative therapy, what do you feel is going to happen with our profession in the next 15-30 years?

In the two classes I’ve sat through with you as a speaker, you were adamant about Informed Consent. I read your paper on that topic after I got back from Dallas and thought it was pretty interesting. Informed Consent doesn’t sound like a particularly interesting or sexy topic to the general population so, would you mind telling us about that and what interested you enough in a topic like Informed Consent to actually publish a paper on it?

We covered the vast divide in our profession, what are some other big obstacles you see on the horizon for our profession right now?

In our private Chiropractic Forward Group, when we discussed you episode coming on the show, Dr. Brandon Steele said I need to ask you this question, “What can students do right now to prepare for current trends in Healthcare? Are there residencies, certifications, internships or other equivalents they should be considering going through to prepare for their future after graduation?”

Also in the private group, Dr. William Lawson, who has been a guest with us before, told me to ask you about rural healthcare centers and how a chiropractor can work in or own a rural healthcare center. 

 being with us and taking time out of your day. I really appreciate you and what you are doing for our profession. I don’t know where we would be without folks like you and others just like you. 

Integrating Chiropractors

 

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

About the Author & Host

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

CF 029: w/ Dr. Devin Pettiet – Is Chiropractic Integration Healthy For The Profession?

CF 039: Communicating Chiropractic

CF 046: Chiropractic Effectiveness – Chiropractic Integration – Chiropractic Future

CF 052: Chiropractic Forward Podcast Year One Review

CF 052: Chiropractic Forward Podcast Year One Review

One year. I started this podcast exactly one year ago. 52 weeks. 52 episodes. We’re going to talk about the highlights of the first year. We’re going to talk about chiropractic today vs. chiropractic when I started a year ago. Has anything changed? The short answer is yes. Quite a bit has changed in just a year. 

But first, here’s that sweet like honey bumper music

Integrating Chiropractors

Welcome

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 collapsed into Episode #52 and it feels good to say that. To be able to do anything consistently for a year straight, every single week, it’s an accomplishment for sure and it sure as hell feels good folks. 

DACO Program

Before we get into the highlights. let’s talk a bit about the DACO program. For those new to the Chiropractic Forward Podcast, I have been going through the Diplomate of American Chiropractic Orthopedists. I’m 92 hours into a 300-hour course. Ugh…that hurts just to say it. Lol. I don’t even feel close to being done. 

I figured it out that at the rate I’m going now, which is about 8 hours per week, I can be done around May I believe. While it seems way off, you know what? I’d be learning and educating myself anyway. Why not get something out of it, right? That’s the idea and May will be here before you know it. 

Hell, it seems like it was Summer just a couple of weeks ago. Lol. 

Products

I have been fast at work preparing some new options for you. I have noticed  a lack of what I would want in my office when it talks 

One-Year Anniversary

Let’s get on to talking about our one-year anniversary. I want to start by talking listen out our top 10 episodes so far and what we talked about that made everyone listen to each of them. I’m linking them all for quick reference in the show notes. So away we go!

Number 10

Episode #30 – Integrating Chiropractors – What’s It Going To Take? We discussed the medical field and what they are looking for in a chiropractor in regard to integrating that individual into the system. We went over The Lancet papers as well. Great episode to check out. 

CF 030: Integrating Chiropractors – What’s It Going To Take?

 

Number 9

Episode #25 – Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone. This episode revolved around a paper in JAMA from Dr. Christine Goertz where she and her co-authors showed additional support for including chiropractic as part of a multidisciplinary team for treating low back pain. Great paper by a great asset for chiropractic. 

CF 025: Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone

Number 8

Episode #28 – Will Chiropractic First Finally Take Its Place? In this installment, we went through a paper that showed non-pharma and non-opioid therapies are now the preference. Well, that’s chiropractic, right? We talked about some GREAT resources in this episode including the President’s Commission on Combating Drug Addiction and The Opioid Crisis report as well as a great paper by Jon Adams Ph called The Prevalence, Patterns, and Predictors of Chiropractic Use Among US Adults. That one had some marketing nuggets for the nugget pouch.

CF 028: Will Chiropractic First Finally Take Its Place?

 

Number 7

Episode #27 – Wanted – Safe, Nonpharmacological Means of Treating Spinal Pain. This episode went through treating spinal pain, thoracic manipulation, lumbar manipulation, guidelines from Canada, and the perceptions of our profession. We discussed a paper about how some in the medical profession think chiropractors go around herniating discs all the time. Pfft… 

CF 027: WANTED – Safe, Nonpharmacological Means Of Treating Spinal Pain

 

Number 6

Episode #9 – With Dr. Tom Hollingsworth of Corpus Christi, TX called The Case Against Chiropractic In Texas. We talked with Dr. Hollingsworth about the Texas Medical Association’s attacks on Texas Chiropractors and our rights. We talked about the latest in the current court case and the appeal process. 

Just a couple of weeks ago, in fact, this case had a decision that was reached and it wasn’t good for chiropractors. And I’m talking about chiropractors nationwide. We’ll have to do an updated episode with Dr. Hollingsworth because what may be on its way down the pike for all chiropractors…..well….let’s just say it’s no bueno. 

CF 009: With Dr. Tom Hollingsworth: The Case Against Chiropractic In Texas

 

Number 5

Episode #26 – Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues. The title is accurate. And researched fact. There are some that don’t like that language. Can’t we all get along? That type of deal and yes, we can all get along. Most certainly. My issue is with PTs being the first referral for non-complicated musculoskeletal issues when research shows they have decreased effectiveness when compared to chiropractic care. 

They have less patient satisfaction when compared to chiropractic care as well. In addition, research shows chiropractic care to be a lot less expensive. So why in the hell is a practitioner that is exponentially more expensive, much less effective on their outcomes, and patients don’t like as much…..why the hell are they the first referral? That still makes my pee hot when I really really think about it. It’s dumb. 

I don’t think we should be doing post-surgical rehab unless we take specific training in that. I think PTs and DCs can work very well together but there should be lanes and I don’t think PTs stay in their lane. Not when they’re out there taking a weekend course on adjusting. It’s BS and that doesn’t stand for Bad Students. 

CF 026: Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues

 

Number 4

Episode #29 – With Dr. Devin Pettiet of Tomball, TX, still the President of the Texas Chiropractic Association. This episode was titled Is Chiropractic Integration Healthy For the Profession? We talked with Dr. Pettiet all about chiropractic integration into a medical based case management or medical team. 

This one was one of my favorites too. For sure. Devin is a great resource and a great personality. He’s all energy and has an awesome amount of information and experience.

CF 029: w/ Dr. Devin Pettiet – Is Chiropractic Integration Healthy For The Profession?

 

Number 3

Episode #6 with Dr. Tyce Hergert from Southlake, TX. This episode is called Astounding expert Information on Immediate Headache Relief. This one was all about headaches and highlighted one service that was dressed up and parading around as another. Yes, those pesky PTs are moving in on us and this episode talked about little bit about that along with some great papers showing chiropractic’s effectiveness with treating headaches. Fun episode. 

CF 006: With Dr. Tyce Hergert: Astounding Expert Information On Immediate Headache Relief

 

Number 2

Episode #13 – DEBUNKED: The Odd Myth That Chiropractors Cause Strokes. My favorite episode and my favorite endeavor as far as really putting together information to stick a fork in an anti-chiropractic idea or myth. This is actually a three-part series consisting of #13, 14, and 15. All three episodes really paint a picture of foolishness on the part of the medical field and a coordinated attack that is easily put to rest through common sense, correct context, and research. 

It’s really so simple when you take the time to listen, learn, and just think about it for a minute. They are the three episodes I encourage you to share the very most out of all of them I have created. 

CF 013: DEBUNKED: The Odd Myth That Chiropractors Cause Strokes (Part 1 of 3)

 

Number 1

Episode #11 – called It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring.

The most listened-to episode for our first year was Episode #11 once again with my old friend and colleague Dr. Tyce Hergert down in Southlake, TX. He has TWO episodes in the top 10 from our first year. That’s because he’s smart, he’s the ex-President of the Texas Chiropractic Association, and he’s entertaining if he’s had his coffee. 

In this one, we talked about current healthcare guidelines, why they matter to chiropractic patients and even non-patients, and whether MDs are getting it or not. Guess what? They’re still ignoring these guides!

CF 011: With Dr. Tyce Hergert: It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring

 

Wrap Up

So….there you have it, folks. That’s our Top 10 in a nutshell with all of the links in the show notes. We have had a great first year. We hope you have enjoyed the content we have been bringing to you as much as we have enjoyed gathering it for you. 

There is so much going on in our profession. Both good and bad. It’s important to stay plugged in now more than ever. We’ll talk about it in a future episode but the Texas Chiropractors lost their appeal and the medical kingdom will bring their dog and pony show to your state before you know it. Believe me. 

But, for evidence-based chiropractors, there’s still no better time than today to be a doctor of chiropractic. I firmly believe that to be the truth.

Integrating Chiropractors

 

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!

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. 

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

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About the author:

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

CF 045: Harvard Health, Low Back Stenosis, Allergy Autism

CF 045: Harvard Health, Low Back Stenosis, Allergy Autism

As the title this week indicates, I’ve taken some files that have been gathering a little bit of dust in the dark corner and I’m bringing them out into the light.

Today we’ll talk about an article in Harvard Health, we’ll talk about low back stenosis research (something that doesn’t get a lot of attention), we’ll talk about a JAMA article on allergies and autism, and we’ll hit on a paper attempting to explain why some patients respond while others do not. 

Integrating Chiropractors

 

But first, you know what’s up, I wrote and recorded our jingle so you might as well just sit back and enjoy this candy for your ears. When you do create something, it’s going to be in EVERY show don’t ya know!! Here’s that bumper music

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 collapsed into Episode #45

OK, first thing, we should probably talk about the Texas vs. Oklahoma game that just happened this last weekend. By the time this posts, it’ll be two weeks ago but, still need to brag. What a game that was. I’m a Texas boy but either way would have been fine since most of OU’s players are from Texas anyway. I go for all of the Texas teams. 

I want to thank Kyle Swanson for the shout out on the Forward Thinking Chiropractic Alliance group a couple weeks ago. He’s a Texas A&M Aggie. Look, like I said, I root for A&M too so we would probably be buddies in the real world if I’m guessing out loud. 

Front Desk Staffing

Let’s get to the ongoing saga of hiring a new front desk staff. If you’ve been following along, you’ll remember that hiring a new front desk staff member has been nothing but a soup sandwich. 

Messy. Gloppy, Unreal and confusing. Those are just some words I’m laying on you. I have more words for what we’ve been through on this deal but then my podcast would have an explicit designation and I try to keep it clean around here. 

But, I believe progress has been made. We seem to have a new one that seems to be on top of her game. If she’s a “sticker,” then the search may very well be over. Of course, she’s not young which is probably why she’s a sticker so far. She’s closer to my age than any of the others have been. I’m not saying that young people have no work ethic…..I’m just saying that all of the young people that we interviewed for this job have no work ethic. 

That sounds like I’m against young people, millennials, blah blah blah. I’m not. I have had some VERY intelligent and capable young people come through here as employees over the years. There are very smart, very talented young folks out there. We just didn’t encounter any of them for this round of hiring. That’s all I’m saying. 

Moving on

October has really taken off in terms of listens for the podcast. I can only guess you’re sharing episodes here and there with your network. To that, I say thank you. If I ever see you somewhere and you tell me you have been sharing my stuff, and hold your hands out like, “bring it in big boy,” well then…you’re getting a hug my friend.

I’m a hugger. Which can probably be scary if you don’t know me. I’m 6’4” and like 280 so….big guy coming through! But, those that know me know that I’m a teddy bear. Unless you try to steal my food. Then it’s pretty much on at that point. 

On to the research

Let’s get on with trying to make your practice better. When your practice is better, your life is better. 

Let’s start with the Harvard Article. It was published in November 2017. I have it linked at chiropracticforward.com for you all in the show notes for episode 45. The name of the article is “Where to turn for low back pain relief[1]” and I couldn’t find the name of the author so there ya go. 

https://www.health.harvard.edu/pain/where-to-turn-for-low-back-pain-relief

The subtitle of this Harvard Medical journal….medical journal……is this: in most cases, a primary care doctor or chiropractor can help you resolve the problem. What the hell??? It seriously says that in a Harvard Medical article. I’m trying to catch my breath here. Sorry…..

It was published in November of 2017. The article says that there are many causes of low back pain and some of the most common is an injury to muscles or tendon which we know is called a strain and then injury to back ligaments which we call a sprain. And then there are herniated or bulging discs. 

Going through the DACO program tells me that the prevalence between disc, facet, and SI joint pain stands at 40% for the disc, 30% for the facet, and 22.5% for the SI joint pain. BUT….over the age of 50 years old, it flips a little and the Facet joint gains prevalence over disc or SI pain. Just some nuggets to tuck away in your nugget pouch. 

This article just blows me away when it gets to the “Where to Turn” subtitle. Beneath this subheader, it says, “Since you shouldn’t try to diagnose your own back pain, make your first call to a professional who can assess your problems, such as a primary care physician or a chiropractor.”

Both can serve as the entry point for back pain says Dr. Matthew Kowalski who serves as a chiropractor with the Other Clinical Center for Integrative Medicine at the Harvard-affiliated Brigham and Women’s Hospital. 

What the hell is happening here? Am I in the Twilight Zone where everything is flipped and the medical world finally gets it?

The article goes on to say “A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor.”

And here’s the difference between evidence-based/patient-centered chiropractors and those that are not. 

The more not evidence-based amongst us, the ones that drive a billion people through their doors for everything from allergies to whatever…..they will not typically be turning those patients over to the medical doctor or the PT. 

Moving to the next paper, it’s called “Comprehensive Nonsurgical Treatment Versus Self-directed Care to Improve Walking Ability in Lumbar Spinal Stenosis: A Randomized Trial” authored by Carlo Ammendolia, et. al. It’s all about low back stenosis. This paper is co-authored by DCs, AND MDs. It was published in the Archives of Physical Medicine and Rehabilitation on October 27, 2017[2]. 

Why They Did It

They wanted to the effectiveness of a comprehensive nonsurgical training program to a self-directed approach in improving walking ability in low back stenosis.

How They Did It

  • It was a randomized controlled trial
  • It was done in an Academic hospital outpatient clinic
  • Participants suffered neurogenic claudication
  • MRI confirmed lumbar spinal stenosis
  • Subjects were suffering low back stenosis and randomized

What They Found

The conclusion stated, “A comprehensive conservative program demonstrated superior, large, and sustained improvements in walking ability and can be a safe nonsurgical treatment option for patients with neurogenic claudication due to LSS”

Low back stenosis can be helped

Dr. Ammendola has an amazing lumbar spinal stenosis program and training course. I have not personally taken it just yet but, it’s on my list after I finish up the DACO program. It comes HIGHLY recommended and this paper shows us why. 

Trucking on, this one is called “Do participants with low back pain who respond to spinal manipulative therapy differ biomechanically from nonresponders, untreated controls or asymptomatic controls?” It was published in Spine Journal in September of 2015 and authored by Wong, et. al. [3]

Why They Did It

To determine whether patients with low back pain (LBP) who respond to spinal manipulative therapy (SMT) differ biomechanically from nonresponders, untreated. Some, but not all patients with low back pain report improvement after a visit to the chiropractor. Why does that happen?

What They Found

After the first SMT, SMT responders displayed statistically significant decreases in spinal stiffness and increases in multifidus thickness ratio sustained for more than 7 days; these findings were not observed in other groups.

Wrap It Up

Quote, “Those reporting post-SMT improvement in disability demonstrated simultaneous changes between self-reported and objective measures of spinal function. This coherence did not exist for asymptomatic controls or no-treatment controls. These data imply that SMT impacts biomechanical characteristics within SMT responders not present in all patients with LBP.”

And our last one this week comes to us from JAMA, also known as the Journal of the American Medical Association. This one is called, “Association of Food Allergy and Other Allergic Conditions With Autism Spectrum Disorder in Children.[4]” It was authored by Guifeng, et. al. and published in 2018. Again, these papers are cited in the show notes at chiropracticforward.com under episode 45 so check them out yourself please. 

The question they attempt to answer here is, “What are the associations of food allergy and other allergic conditions with autism spectrum disorder (ASD) in children?”

They say in the paper that Common allergic conditions, in particular, food allergy, are associated with autism among US children, but the underlying mechanism for this association needs further study.

The study was a population-based, cross-sectional study used data from the National Health Interview Survey collected between 1997 and 2016

The conclusion was quote, “In a nationally representative sample of US children, a significant and positive association of common allergic conditions, in particular, food allergy, with ASD was found.”

They now need to find out the cause and underlying mechanisms so they can attempt to reverse the upswing of autism here in America. 

So….it appears maybe it’s not all due to vaccines after all. 

Integrating Chiropractors

That wraps it up for us this week. I hope you enjoyed it. Research can be boring but, it can be fascinating too when you allow it to help guide your thought process when you are approaching your daily tasks and deciding on treatment options for your patients. 

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 a mechanical pain and responds better to mechanical treatment instead of chemical treatments.

The literature is clear: research and experience show that, in 80%-90% of headaches, neck, and back pain, patients get good to excellent results when compared to usual medical care and it’s safe, less expensive, and decreases chances of surgery and disability.

It’s done conservatively and non-surgically with little time requirement or hassle for the patient. If done preventatively going forward, we can likely keep it that way while raising overall health! At the end of the day, patients have the right to the best treatment that does the least harm and THAT’S Chiropractic, folks.

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.

Being the #1 Chiropractic podcast in the world would be pretty darn cool. 

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/groups/1938461399501889/

iTunes

Player FM Link

Stitcher:

TuneIn

About the author:

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

 

Bibliography

1. School, H.M., Where to turn for low back pain relief. Harvard Health Publishing, 2017.

2. Ammendolia C, Comprehensive Nonsurgical Treatment Versus Self-directed Care to Improve Walking Ability in Lumbar Spinal Stenosis: A Randomized Trial, in North American Spine Society Meeting. 2017, Archives of Physical Medicine and Rehabiliation: Orlando, FL.

3. Wong AY, Do participants with low back pain who respond to spinal manipulative therapy differ biomechanically from nonresponders, untreated controls or asymptomatic controls? Spine, 2015. 40(17): p. 1329-37.

4. Guifeng X, Association of Food Allergy and Other Allergic Conditions With Autism Spectrum Disorder in Children. JAMA, 2018. 1(2).

 

CF 016: Review of The Lancet Article on Low Back Pain (Pt. 1)