ideal diet

Reduced Access To Chiropractic & The Ideal Diet

CF 203: Reduced Access To Chiropractic & The Ideal Diet Today we’re going to talk about reduced access to chiropractic and we’ll talk about the ideal diet.  But first, here’s that sweet sweet bumper music  

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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. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
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You have found yourself smack dab in the middle of Episode #203 Now if you missed last week’s episode, we talked about Pain And Clumsiness & Treatment Escalation. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

The resurgence continues in my clinic’s numbers. I believe we had 26 new patients this last week and about 183 or so patients. Our Nurse Prac is still building slowly. Honestly, a little slower than I expected. He is averaging around 15-20 appointments per week. Some are as simple as trigger points. Some are as extensive as hormone pellets and PRP injections. I’m telling you I’ve railed against cortisone injections for years and I still do. But lidocaine trigger points …..now that’s a different deal. I’ve been floored at how much they can make a difference for some of my patients that have been on the more pesky side with regard to some nagging pain.

Good stuff and it’s a $50 cash service so it’s not out of reach for most patients and it seems, so far, to be very effective for most. 

As with everything in life, nothing can stay good for too long, can it?

It seems the answer is no. It can’t. I left work on Friday after a great, busy, fairly stress-free week. As I was walking out the back door, my front desk employee for the last year and a half or so gives me her 2-week notice. Yep, we just got everything up and running and kicking some butt, and boom.

There are lots of reasons behind the scenes as to why she made the decision but the end story is that there was a bit of internal conflict, we’ve had some difficulties in the past with how this person handled some patients or situations, and….though we’ll miss this person’s incredible attention to detail, it’s probably a good move for all involved. We wish her the very best.

She’s a great person and a hard and dependable worker. Just a bad fit I suppose 

Now, you all know how valuable a front desk employee is. They are simply hard to replace but, it is what it is. Fortunately, and you all might listen up here, my wife took classes and became a front desk billing guru. So, she can train new front deskers, She can get them up to speed quicker than anyone I know because she’s smarter than anyone I know.  I mention this because my wife being trained so well takes a lot of burden off of us when it comes to replacing the front desk staff. It’s going to happen sooner or later and why be held hostage by employees because the owners don’t know what’s going on?

Now let’s be honest, I don’t know the front desk. That’s why at one time in my career, I absolutely WAS held hostage by the front desk. That’s why, several years ago, I found out that I lost an incredible amount of money over a 3-year time span. And when I say ‘incredible’, I’m talking around $750,000 over three years. I don’t like saying it but I’m always honest with you all. That’s the best way to be a coach or mentor or adviser.

It’s with honesty.

It wasn’t stolen or embezzled. It just wasn’t collected on and then the time passed to where it could no longer be billed and collected on. So…all of that work was just gone.  It’s not every day you find out you’ve lost around $750,000. Time and Bud Light helped me through and I’m doing OK today. You have to move beyond the things that will bring you down and keep you down if you allow them to.

But yeah, that’s why you can’t be held hostage by employees.  That’s also exactly WHY my wife got trained. So that we’d never be in that position again. And….we aren’t this time either.  We have the luxury of being able to pick and choose by personality type rather than strictly experience because we can train the skills ourselves.

So, to Indeed we go. Wading through hundreds of resumes that won’t show up when we schedule interviews. It’s insane. But, it’s a necessary evil and, I’m a Christian, so we pray for the perfect person to be led our way.  What do you need in a front desker? Personality! They are the first impression a person gets when they call on the phone. They are the first person a patient encounters when they get there and the last person they encounter on the way out. That’s as important and vital as anything.

Pain is weird and responds differently in everyone. so I don’t care if someone leaves feeling better immediately. Obviously that’s the goal but not the most important thing. What I really care about is how they feel about their experience being in our clinic and how they felt about the people they came into contact with while they were there. THAT’s what matters the most. Especially in the first visit or two. 

They can be practice builders and they can be practice killers.

This one, very key person. So…..let’s make it count shall we?? Let’s dive into the research this week. 

Item #1

This first one is called Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review” by English et. al. (English LK 2021) and published in JAMA Open Network on August 31, 2021, and that’s hotter than that the Texican sun in the Summer. 

Why They Did It

They wanted to answer the question, “What is the association between dietary patterns consumed and all-cause mortality?”

How They Did It

  • It was a systematic Review but of only one randomized clinical trial but 152 observational studies 
  • Participants were from 17-84 and from 28 different countries
  • They were all on the topic of dietary patterns and all=cause mortality

What They Found

  • They found a lot of what you’d probably expect they’d find. 
  • Evidence demonstrated that dietary patterns characterized by increased consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) among adults and older adults were associated with decreased risk of all-cause mortality. 
  • These healthy patterns consisted of relatively LOW intake of red and processed meat, high-fat dairy, and refined carbohydrates or sweets.

Wrap It Up

Despite the different approaches, study designs, dietary assessment methods, geographical regions, and dietary pattern labels, the evidence demonstrated that dietary patterns associated with lower all-cause mortality risk were consistently characterized by higher intake of vegetables; legumes; fruits; nuts; either whole grains, cereals, or non-refined grains; fish; and unsaturated vegetable oils.  These patterns were also characterized by lower or no consumption of animal products (red and processed meat, meat and meat products, and high-fat dairy products), refined grains, and sweets (ie, higher in added sugars).  Labels that were assigned to the dietary patterns varied widely (eg, Mediterranean, prudent, Healthy Eating Index, DASH, and plant-based), highlighting that high-quality diets with nutrient-dense foods are associated with better health, regardless of diet type or dietary pattern name.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783625?guestAccessKey=cea01652-195e-4ee2-ac19-d204e60b224f&utm_content=weekly_highlights&utm_term=091221&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email

Item #2

This second one is called “The Effect of Reduced Access to Chiropractic Care on Medical Service Use for Spine Conditions Among Older Adults” by Davis et. al. (Davis M 2021) and published in the Journal of Manipulative and Physiological Therapeutics in June of 2021 and toastier than a hot toddy!

Why They Did It

The purpose of this study was to examine the extent to which access to chiropractic care affects medical service use among older adults with spine conditions.

How They Did It

  • They used Medicare claims data to identify a cohort of 39,278 older adult chiropractic care users who relocated during 2010-2014 and thus experienced a change in geographic access to chiropractic care. 
  • National Plan and Provider Enumeration System data were used to determine chiropractor per population ratios across the United States. 
  • A reduction in access to chiropractic care was defined as decreasing 1 quintile or more in chiropractor per population ratio after relocation.
  • Using a difference-in-difference analysis (before versus after relocation), they compared the use of medical services among those who experienced a reduction in access to chiropractic care versus those who did not.

What They Found

  • Among those who experienced a reduction in access to chiropractic care (versus those who did not), they observed an increase in the rate of visits to primary care physicians for spine conditions 
  • An annual increase of 32.3 visits per 1,000 
  • And the rate of spine surgeries (an annual increase of 5.5 surgeries per 1,000). 
  • Considering the mean cost of a visit to a primary care physician and spine surgery, a reduction in access to chiropractic care was associated with an additional cost of $114,967 per 1,000 patients
  • That’s to the tune of $391 million nationally

Two syllables – one word…..Day-um. 

That’s a metric crap-ton of green cheese. A gob of Benjamins. A Gaggle of American greenbacks. 

https://pubmed.ncbi.nlm.nih.gov/34376317/

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

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

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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.

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

 

Bibliography

  • Davis M, Y. O., Liu H, Anderson B, Bynum J, (2021). “The Effect of Reduced Access to Chiropractic Care on Medical Service Use for Spine Conditions Among Older Adults.” J Manipulative Physiol Ther 44(5): 353-362.
  • English LK, A. J., Bailey RL, (2021). “Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review.” JAMA Netw Open 4(8).