Chiropractic Standardization

Chiropractic Integration Into A Medical Setting

CF 151: Chiropractic Integration Into A Medical Setting Today we’re going to talk about chiropractic integration into a medical setting But first, here’s that sweet sweet bumper music  

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research.

We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

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

  • Like our Facebook page, 
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Do it do it do it. 

You have found yourself smack dab in the middle of Episode #151 Now if you missed last week’s episode , we talked about the fate of a big pharma company and we talked about the outdated use of MRI diagnosis of cervical dysfunction. That’s not necessarily the way to do it anymore in 2020. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

Well….how’s your week? Mine? It’s just eh… If you listened to a couple of weeks ago, I had a big week with some good numbers that looked like we were getting back to pre-COVID numbers. I was sniffing that level once again. Then, a three-day snow and ice storm decided that things were going a little bit too smoothly around here and shut us down for basically Monday, Tuesday, and Wednesday of last week. 

As a result, we went from 172 visits the week prior down to last week only seeing 71. So….roughly 100 visits just pissed off last week. Which left me pissed off. It’s been a mess this year and I’m no different than most. For that reason, I’m not going to sit here and gripe about it. We’re back in the ’70s this week so here’s to trying to reclaim those lost appointments and keeping our patients on track to getting better. 

Where we started the great week with 50+ patients on a Monday, this Monday we’re starting out the week with 26. Blah. But 4 new patients so, let’s hang our hats on the good stuff, shall we? And yes, we shall. 

This has absolutely been the year of making lemonade out of lemons. If you’re not strong mentally, this year is a bruiser, man. And let’s be honest, I’ve had ups and downs. I’m still having them. 

Hell, this week, as in many places, now that it’s time to rebuild after three lost days to weather, now the second COVID spike is in full swing. Yep, a bad day around here used to be 70 new cases. It was that way for 6 months or more. Now, in the last 2 weeks, we’re looking at averaging 240 or more cases per day. The hospitals are full and they’re bringing help in from out of town. I could let that work my head over but I won’t. Or…..at least I’ll try not to let it work me over. 

Have you ever watched The Secret? I sort of recommend it if you can absorb things in the right context. OR, I can just summarize it for you. Basically, it’s all about having a vision so strong that you basically will something to happen. If you believe it enough, the world will bend itself to make it happen for you. For example, from the movie, if you believe that there will always be a close parking spot available for you when you go shopping at different places, then you will indeed find close and wide-open parking spots. 

Or, if you really want a Ferrari, and you dream about it, feel yourself sitting in the seat, and feel the rev of the engine while you grip the steering wheel, etc….well, then surely, eventually you will indeed have yourself a Ferrari. Lol. 

Well, if you listen to this podcast enough, then you know damned well that I don’t buy into that kind of garbage. But there is a message in it that I do like and support. That message is that our lives are built on and based on our ability to be positive or negative basically.

I have an example from today for you. On the way to work this morning, not 2 blocks from my house, I almost got into 3 car wrecks within a time span of about 2 minutes. Seriously. At one point I had to stand on my brakes and throw everything into the floorboards. This while I was simultaneously yelling and hollering at this fool stopped in front of me. 

I could go into particulars on how it happened but that wouldn’t matter. What matters is that at that point in my day, I made a conscious decision. Was I going to let that ruin my day or was I going to see it for what it was and move on from it?

In The Secret, they say that our mentality from day to day affects our relationships with others. From our business interactions to our personal and family interactions. And it’s true. If you extrapolate that further, our mentality will either draw people TO us or push them AWAY from us. 

So, if I let that close encounter affect my mood from there on throughout the day, potentially, whether I was conscious of it or not, it could have affected my interactions with patients, staff, and then later at home. 

Alternatively, if I kick it out of my head and try to have a positive take on it….I didn’t get in a wreck after all!!! It could have been worse, right? 

That was my decision and I decided that it was over and I’m going to forget about it, not dwell on it, not be mad about it, and just move forward. 

On a larger scale, while I talk and share a lot about my business’s progress post-COVID here, for the most part, I’ve tried to adopt the ‘can do’ attitude. My generation Gen X is known for it. It is what it is. Let’s put on a smile, strap up our belts, and put one foot in front of the other. 

And that’s what’s making it happen here. We’re like Rocky in Rocky III. Clubber COVID Lang keeps slapping me around and punching me in the nose and when it’s not Clubber, it’s Thunder Lips throwing me out of the ring. Lol. Sometimes it’s like you just can’t win. And if you dwell on that crap, well, you know what happens. It affects everything you do and all of your connections. 

So, if Clubber Lang and Thunder Lips keep kicking your ass every week, put a smile on, stay doggedly determined, and come out swinging. All of this crap has a time limit. It will end eventually. Make sure you’re on top of the heap when it does.  Everyone loves an underdog. 

Item #1 First one of the day is called “Implementation of musculoskeletal specialists in the emergency department at a level A1 VA hospital during the SARS-Cov-2 pandemic” by Schielke et. al(Schielke A 2020). and published in The American Journal of Emergency Medicine on October 8, 2020,

Schiza….piping hot pile of poblanos!!

https://www.ajemjournal.com/article/S0735-6757(20)30894-9/fulltext?fbclid=IwAR1MFEaKmyTj990CjD3URlQP7Tnu45OSqsySUyQ7WZKmgcwxDP3RAnBSBQw

It’s not a research paper as much as an article so let’s get going with the highspots. 

  • They mention how the Rona depleted ER resources about the same time that pain management was deemed to be non-essential
  • They say that low back pain presenting in the ER has become more and more common and less traditional providers may be better suited to manage musculoskeletal pain. 
  • Bolstering the idea of alternative providers being involved, are the more current guidelines recommending nonpharmacologic treatment for low back pain. At least initially. 
  • Early conservative management for ED LBP has been associated with reduced pain and disability even when compared to patients with conservative outpatient physical therapy referrals
  • Multiple studies point out integrated ED MSK-specialist (MSK-S) reduced length of stay, imaging utilization, and opioid administration rates, and improved overall ED metrics when compared to patients seen by typical ED providers
  • Additionally, a 2018 systematic review and meta-analysis supports nonpharmacologic interventions for reduction of overall ED utilization and length of stay, and are effective in reducing pain in the ED with the potential to improve patient satisfaction, outcomes, and quality of life
  • VA Palo Alto Health Care System (VAPAHCS) 2019 proprietary data revealed approximately 60% of cases presenting to the ED were urgent/emergent MSK complaints, primarily LBP
  • As the health department postponed non-essential healthcare due to COVID, the plan to integrate non-traditional providers was amped up and happened on March 30, 2020, lasting through June 8th. 
  • Designated MSK-S care was provided during peak hours by chiropractic and physical therapy departments.
  • A “hub-and-spoke” arrangement was developed and per protocol, initial ED triage assessed for any serious spinal pathology, and a medical symptom evaluation was performed (“hub”). If diagnosed as MSK LBP, MSK-S referral was made with direct same-day hand-off (“spoke”).
  • Incorporation of MSK-S was shown, anecdotally, to be effective in treating acute MSK complaints as providers and patients were both able to benefit from the conservative options available in the ED
  • From the ED administration viewpoint, a liaison between ED and other sub-specialties utilizing a hub-and-spoke paradigm shift allows for the delivery of more efficient healthcare. With the positive feedback from the administration, ED providers, staff, and patients, integrated MSK-S clinics continue to develop within that VA system.
  • A 2018 review article by Kim et al. called for the use of an MSK-S in the ED and also provided clinical implementation guidance for any healthcare systems looking to adopt a similar practice.

Wow!! That’s pretty cool. Do you know what I did with this? I sent it to my friends in the medical field. Why not? The worst saying in the history of man is “We’ve just always done it that way.” What if there’s a better way? Of course, we know there is. The trick is in getting them to know there is. 

Item #2 Our last one today is called “Integration of Doctors of Chiropractic Into Private Sector Health Care Facilities in the United States: A Descriptive Survey” by Salsbury, et. al`. and published in the Journal of Manipulative Physiological Therapeutics in February of 2018. Not new but pairs well with our first item. 

Why They Did It The purpose of this study was to describe the demographic, facility, and practice characteristics of doctors of chiropractic (DCs) working in private sector health care settings in the United States.

How They Did It

  • They conducted an online, cross-sectional survey using a purposive sample of DCs working in integrated health care facilities. 
  • The 36-item survey collected demographic, facility, chiropractic, and interdisciplinary practice characteristics, which were analyzed with descriptive statistics.

What They Found

  • The response rate was 76%
  • Doctors of chiropractic reported working in hospitals (40%)
  • multispecialty offices (21%),
  • ambulatory clinics (16%)
  • or other (21%) health care settings
  • Most (68%) were employees and received a salary
  • More than 60% reported co-management of patients with medical professionals.
  • Integrated DCs most often received and made referrals to primary care, physical medicine, pain medicine, orthopedics, and physical or occupational therapy
  • Although in many facilities the DCs were exclusive providers of spinal manipulation (43%), in most, manipulative therapies also were delivered by physical therapists and osteopathic or medical physicians.

Wrap It Up

Doctors of chiropractic are working in diverse medical settings within the private sector, in close proximity and collaboration with many provider types, suggesting a diverse role for chiropractors within conventional health care facilities. Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourself and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. 

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website http://www.chiropracticforward.com

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography

  • Schielke A, B. A., Walsh R, Rajagopal P, (2020). “Implementation of musculoskeletal specialists in the emergency department at a level A1 VA Hospital during the SARS-CoV-2 pandemic.” American J Emerg Med.

Sports Performance / Chiropractic Care Standardization / Proprioception

CF 086: Sports Performance / Chiropractic Care Standardization / Proprioception 

Today we’re going to talk about Sports Performance / Chiropractic Care Standardization / Proprioception 

But first, here’s that arm like a big fuzzy coat 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 tripped into Episode #86 and when I say tripped, I don’t mean so much the LSD kind of trip but more like the I’m an idiot and fell face first in a room full of people sort of tripped. So, welcome you fools!! Lol. I kid, I joke. I’m honored to have you here today. We have some good stuff to cover. 

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

It works by using a tailor-fit video playlist that only promotes the products and services available in your practice. Not only that but the videos are replaced automatically on a weekly basis. There’s nothing complicated. You truly can just set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription and you can’t hardly beat that deal. 

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial. Take your practice to the next level with GoChiroTV.

Introduction

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

Personal Happenings

I always feel that, if I share personal experiences with you guys, first you’ll know me as a person better and I don’t see anything wrong with that. Second, you may identify and sympathize. Third, if you can’t necessarily identify with what I go through, you may be able to learn from it if you get to that point. 

With that I’ll say that 2019 has been quite the year for us around my office. New faces, lots of new patients, and less and less time to do things outside of seeing patients. My work/life balance is out of balance at the moment and I’m afraid my health is starting to show some dents in the armor. 

I think I have an undiagnosed anxiety thing and, typically, I’m very good at managing anxiety and stress and having 4 or 5 balls up in the air at the same time. I’m a juggler people. And I have been for quite a long time. 

But, in January, something clicked. Something changed. I don’t say this to brag. I say this to explain. My practice numbers just started to climb during a time that we are traditionally slow. Really slow. The holidays are usually a time when you just know you’re going to have extra time to catch up on all of those things that have been piling up in front of you. Back to school time as well right? It’s always been a down time for me for one reason or another. 

Yeah, well, not this year. The holidays only got busier. Much busier. The kids go back to school in two weeks and there’s been no slow down this Summer. Which is awesome. But my problem is, I don’t know what I did to cause the influx. If I knew, you better believe I’d be repeating it!! Over and over and over. 

The end story is, growing is great but growing can be stressful. That’s why they call it growing pains right? Think about it: how many staff member do I need to handle the patient load? Am I over staffed or understaffed? Do I need an associate? Which one is the right one? Will they take care of things like it’s their own and they care? Where do I get good contract for one? I have a bathroom that needs tiled and I have an Air conditioner that need’s replaced. My dog pissed on the carpet this morning. Blah blah blah. 

You all know how it goes. Every aspect of practice has stressors. When you’re new in practice and don’t have a heavy load, you’re sitting looking at your watch, playing on the computer, hopegully you’re out marketing, and you’re stressed about how you’re going to provide for your family. 

I’m aware that being too busy is a nice problem to have. I don’t want to come off as a spoiled brat here. I’m just saying that I have been stressed and it’s starting to affect me a bit. We have been blessed and we are going to take blessings and we are going to turn them into more blessings for us and for our patients and staff. 

It’s just getting through some of the mud and muck along the way. I just need to keep my anxiety under the surface a little longer. Lol. So that nobody thinks I’m insane. 

I’ve fooled them this long haven’t I?

On another note, Charlie Manson. Y’all, I was fascinated by their shenanigans when I was in high school but got over it. Every now and then I’ll see something about it and I’ll perk up and listen but I went to see the new movie Once Upon A Time In Hollywood. 

I’ve been seeing where some hate it and some love it and I’ve seen a bunch of ehhh comments but I gotta tell you. I’m firmly in the hell yeah category. Brad Pitt and Leo DiCaprio knocked that sucker straight out of the parking out onto the parking lot. It was funny, it was vintage, it was nostalgic, and no…..of course it didn’t happen that way but it was excellent. 

If you went, shoot me an email at dr.williams@chiropracticforward.com and tell me what you thought. I can share you thoughts next week on the podcast. Or you can get on our Facebook page or our private Facebook group and we can discuss. 

Item #1

Let’s get to our first item here. It’s titled “The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence” and written by Meliss Corso, Silvan Mior, Satrah Batley, et. al. It was published in BMC Chiropractic and Manual Therapies in June 2019. Brand new…..hot stuff people. (Corso M 2019)

Why They Did It

The authors wanted to perform a systematic review regarding the effect spinal manipulative therapy has on athletic performance in asymptomatic adults. 

What They Found

They concluded “The preponderance of evidence suggests that SMT in comparison to sham or other interventions does not enhance performance-based outcomes in asymptomatic adult population. All studies are exploratory with immediate effects. In the few studies suggesting a positive immediate effect, the importance of such change is uncertain. Further high-quality performance specific studies are required to confirm these preliminary findings.”

That doesn’t mean we can’t help with pain and discomfort which aids in better performance. But it does suggest that, if a person feels great, getting spinal manipulative therapy isn’t very likely to make any difference in how fast they are or how far they can throw. 

Item #2

This one is called “The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain” by JA Quan, et. al and was published in the Journal of Manipulative and Physiological Therapeutics in June 2015 so 4 years old. (Quon JA 2015)

Why They Did It

The aim of this study was to determine if effectiveness differs between community-based doctors of chiropractic administering standardized evidence-based care that includes high-velocity low-amplitude spinal manipulative therapy (SMT) for acute low back pain (LBP).

How They Did It

  • A secondary analysis of randomized controlled trial and observational pilot study data was performed with nonrandom allocation to 4 DCs. 
  • Patients included those with Quebec Task Force categories less than or equal to 2 and acute LBP of 2 to 4 weeks’ duration. 
  • The intervention included high-velocity low-amplitude SMT. 
  • Outcomes assessed using Roland Disability Questionnaire (RDQ) at 24 weeks. 

What They Found

The findings of this study show that regardless of the treating DC, most patients with acute LBP without radiculopathy appear to experience consistent levels of improvement in terms of BP and general PF after receiving guidelines-based treatment that include s a component of standardized HVLA SMT.

If we dive into the paper, they mention that until now, inconcsistency hasn’t been regarded as a significant barrier to chiropractors getting referrals from the medical realm. Butthere are guarded attitudeds about chiropractors when we’re talking about quality of care and that’s been confirmed in other papers. 

In fact, in a survey of 487 Canadian and American orhtopedic surgeons, they found that about 71% of them held either a neutral or a negative view of chiropractors. That means only 29% of them looked at us in a positive way. 29%. Dammit

Also, when you break down that 71% of neutral or negative….you get 26% were neutral but 45% were in the negative category. Dammit. 

73% of orthopedic surgeons thought chiropractors provided unnecessary treatment. Yeah, they’d probably just do better if you intubated them, knocked them completely out, and drove screws through the bones of their spine to fixate the segments on top of each other and then sewed them back up, and then sent them home with a bunch of pills. That’d probably be much more necessary. Sure thing chief. 

Hell, 52% of them thought chiropractors make their patients dependent on short-term relief. I will say that it feels good to feel good and why wouldn’t a patient want to feel good as often as they can? But putting the shoe on the other foot here, let’s assume they’re right, isn’t being addicted to safe, conservative, non-invasive treatment better than being addicted to opioids or some sort of medication? Our nation’s opioid crisis suggests it is better. 

The paper itself is really a preliminary study and meant to further knowledge and information for other papers down the line but I found it more interesting because of the orthopedic survey discussion. Pretty interesting. And….disappointing I’d add but that was 4 years ago. Maybe those numbers are changed a bit from then to now? Not sure. 

This is a great spot to take a short break to talk about ChiroUp. If you’re a regular listener of our podcast, you I use it and I’ve told everyone how amazing it is since about June of 2018. Well now they’re a sponsor of our show and we are really excited to have ChiroUp on board the train. 

Have you heard about the #1 online resource for chiropractors? Well, let me tell you about it. 

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

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

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

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

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

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

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

I’m trying to save you people some money here alright?Trust me, you’re not going wrong with ChiroUp. In fact, in studying for the Diplomate of the Academy of Chiropractic Orthopedists part two exam, I’m studying the orthopedic tests and videos from the ChiroUp website. It’s phenomenal. 

Anyway, on to Item #3

It’s called “Neck proprioception compensates for age-related deterioration of vestibular self-motion perception” by G Schweigart, RD Chien, and T. Mergner. It was published in Experimental Brain Research all the way back in 2002. Bringing the old man out of the archives here. (Schweigart G 2002)

Why They Did It

Vestibular functions are known to show some deterioration with age. Vestibular deterioration is often thought to be compensated for by an increase in neck proprioceptive gain. That’s what the authors were studying here….. this presumed compensatory mechanism.

What They Found

Generally, we hold that the transformation of the vestibular signal from the head down to the trunk proceeds further to include the hip and the legs as well as the haptically perceived body support surface; by this, subjects yield a notion of support kinematics in space. 

As a consequence, spatial orientation is impaired by chronic vestibular deterioration only to the extent that the body support is moving in space, while it is unimpaired (determined by proprioception alone) during body motion with respect to a stationary support.

Just to add a little sidebar here: did you know that muscle spindles are our motion detectors? Think about this. There are 16 muscle spindles per gram of muscle in our fingers. Our hands and fingers are highly sensitive with regard to proprioception arent they? Think of a musician playing with their eyes closed. 

You know exactly where your fingers are without looking at them or really even thinking about them. How about typing? You don’t look right?

Now, we only have about 2 muscle spindles per gram of muscle in the traps. Which makes sense. Why do we proprioceptively need to know where our traps are? They’re attached to our axial skeleton. They’re not going anywhere. They’re not out flapping in the wind like our hands right?

Here’s the weird deal though: in our deeper cervical muscles, we have 242 muscle spindles per gram of muscle. That IS our axial skeleton basically so why so many spindles? There’s no flapping out in the wind with the upper cervical muscles either. But, it is the connection between our head and the rest of our body. 

It is to the point that anatomists look at the upper cervical muscles as more of a proprioceptive organ rather than as simply muscles. 

Our three proprioceptive inputs are the eys, the vestibular organ, and the muscles of the upper cervical area. When you do a Romberg’s test and you remove proprioceptive input from the eyes, and the vestibular organ….., part of what you are measuring is the input from the upper cervical region. 

It’s fascinating. Absolutely fascinating when you dive off into it a bit and I encourage to do so.  

Store

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

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

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

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

Connect

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

Website

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 & VloggerBibliography

Corso M, M. S., Batley S, (2019). “The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence.” BMC Chiro Man Ther 27(25).

Quon JA (2015). “The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain.” J Man Physiol Ther 38(5): 311-323.

Schweigart G, C. R., Mergner T, (2002). “Neck proprioception compensates for age-related deterioration of vestibular self-motion perception.” Exp Brain Res 147(1): 89-97.

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

Home

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

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 040: w/ Dr. Brandon Steele: Chiropractic Standardization & The Future of Chiropractic

w/ Dr. Brandon Steele: Chiropractic Standardization & The Future of Chiropractic

Today we’re going to talk with Dr. Brandon Steele about a lot of stuff but specifically, we’ll talk about Chiropractic standardization, educational advancement, and the future of chiropractic. Stick around for an awesome discussion with an extremely sharp doctor on the forefront of our profession.

Integrating Chiropractors

But first, 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.  

Now that I have you here, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. It makes it easier to let you know when the newest episode goes live and if we come up with something pretty cool we need to be telling you about. We won’t use it any more than once per week and that’s about all you need to know. It’s not as big of a deal as most of you have in your mind. Just go do it right now while you’re thinking about it. 

We continue to grow our listenership here. I’m a stats nerd. Trust me, I check them more than what one may consider a healthy amount of times. It’s just who I am. Thank you to you all for tuning in. 

If you can continue to share us with your network, we sure would appreciate it. 

We are honored to have you listening. Now, here we go with some vital information that we think can build confidence and improve your practice which will improve your life overall.

You have passed out and woke up right here in Episode #40

Welcome Dr. Brandon Steele

We have a special guest with us this week. As I said from the top we have Dr. Brandon Steele with us today. He is a very respected speaker and has the awesome chance to travel all over doing just that. 

I first became aware of Dr. Steele when I began taking courses in the DACO program. Dr. Steele is one of the instructors and I got to sit in a classroom for two days listening to him cover everything we needed to know about the shoulder. 

I also much have some full disclosure here I think. Dr. Steele is a co-owner of ChiroUp with Dr. Tim Bertlesman and I’m a user/subscriber of ChiroUp. But, ChiroUp isn’t sponsoring this episode. I haven’t received a thing from them. Not even a free membership. Cough cough… 

Seriously though, I’m having Dr. Steele on today because we think a lot alike from what I can tell, I love what they are doing with the DACO program, and I love where I think ChiroUp can help take our industry down the road in regards to Chiropractic standardization & the future of chiropractic. So, without further adieu…….

Questions for Dr. Brandon Steele

Welcome to the show Dr. Steele. Let’s start off with the obligatory question of, “What made you decide to be a chiropractor?”

In our discussion in Dallas, you told me that you’ve moved around a bit. Where are you from and what led you to St. Louis?

I have seen the terms evidence-based and evidence-informed used for what we do and must admit my ignorance of the subtle differences here. I have assumed that, since I follow research, guidelines, and things like that, that I am indeed what is referred to as an evidence-based chiropractor. Can we assume the same about you? 

When exactly did you decide to start traveling more in the direction of evidence and research rather than the philosophical route in the profession? Was there an aha moment?

Tell me a little bit about your hilarious alter-ego, the wide-lapeled chiropractic huckster we see you play in videos from time to time on the ChiroUp Facebook page. 

Part of the idea of being more into the research and being based or informed with the evidence, I think, is Chiropractic standardization…. to standardize our profession to some extent as well as increasing the level of education of the run of the mill chiropractor. We know we don’t have a low level of education at all so….can you go into that a little bit for us? What do you mean when you speak about Chiropractic standardization & the future of chiropractic?

Tell me everything about the DACO program. What got you involved with the DACO program originally?

Our regular listeners should be well-aware of you, Dr. Tim Bertlesman, and ChiroUp at this point. I’ve been pumping your tires for a bit. How did you and Dr. Bertlesman become acquainted with each other and then decide to go into business together?

Questions About ChiroUp, Chiropractic Standardization, and the Future of Chiropractic

Now, tell us a bit about ChiroUp. It feels like to me that it is really starting to hit its stride. I think ChiroUp is huge for Chiropractic standardization & the future of chiropractic.

Obviously, you want it to be successful for your own financial reasons….we all want to see our businesses to well….. but don’t you see something more than that for the profession coming out of ChiroUp? How do you think ChiroUp can affect or change our profession for the better in the years to come, for the future of chiropractic?

What is in the future for ChiroUp as far as updates, functionality…..things like that?

Questions About Dr. Steele’s Speaking Events

What are some of your upcoming speaking events so people can come to see you do your thing?

How can listeners find you on social media or on the internet and contact you or learn more about you and what you do?

So there you have it folks, Dr. Brandon Steele. There’s no doubt you loved this podcast episode as much as I did. The future is bright for Chiropractic standardization & the future of chiropractic.

Integrating Chiropractors

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio. That’s because spinal pain is a mechanical pain and responds better to mechanical treatment instead of chemical treatments.

Chiropractic Description

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 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