The Georgia Chiropractor provides Georgia’s chiropractic profession with updates on legislative issues, new techniques, business tips, GCA news and more. For the full edition, click here.
Doctors of chiropractic are drawn to researched-based, scientifically sound, but wholly natural solutions to health issues. Sharing health information with patients is part of our role. Because most of our patients are also seeing medical doctors, and many of those are taking prescription medications, we must be conversant on those drugs, their side effects and their impact on overall health.
Many of our patients with cholesterol problems are taking a cholesterol buster (a "statin" drug). They sometimes work well, but there are unwanted side effects that are well known.
The very mechanism of the statin drugs that make them successful creates another dangerous problem that is not stressed sufficiently to consumers: they deplete Co-enzyme Q10 — in some patients, up to 40 percent. Co-Q10 is a co-enzyme, a vitamin-like substance that facilitates and mediates 95 percent of energy production in the body by helping to create adenosine triphosphate (ATP) in the mitochondria. It has been extensively studied for over 30 years.
A low Co-Q10 leads to dysfunction of skeletal as well as cardiac muscle, especially weakening the left ventricle of the heart. The heart alone needs millions of ATP molecules per second just to function normally. Nine very good studies report that supplementation of this co-enzyme supports cardiac function by increasing available energy for cardiac contraction.
Co-Q10 is made naturally in the body, peaking in production in the third decade of life and falling lower with increasing maturity. The diet to which most of us are accustomed provides only about 5 mg of this co-enzyme daily, but human bodies need six to 10 times that amount for general health maintenance alone. We need much more to stay healthy. Cardiovascular support requires even more — up to 250 mg/day.
Co-Q10 is also being studied in the management of Huntington's chorea, Parkinson's disease and Alzheimer's syndrome.
Co-Q10 may also:
Help prevent free radical damage
Help protect against oxidative stress
Maintain healthy, normal blood pressure
Help manage the entire circulatory system
Promote a healthy immune system
Maintain healthy neurological function
When discussing CoQ-10 with patients, bear in mind that there are two forms of this co-enzyme. The one more familiar to patients is the oxidized form, which is ubiquinone. The body converts ubiquinone to ubiquinol, the reduced form. 1t takes about eight times as much ubiquinone as ubiquinol to boost blood levels because ubiquinol is more water-soluble, thus better absorbed in the gastrointestinal tract. Thus, if you can find a CoQ-10 that is in the ubiquinol form, supplementation is far more efficient. This is the form I personally use.
If your patient is over 40 years of age, consider discussing supplementing the diet with a high-grade Co-Q10. If your patient is on a statin drug — Lipitor, Crestor, Simvistatin, Mevacor, Zocor, Lescol and others — get them on high-grade Co-Q10 (ubiquinol) as soon as possible. Don't let them take statin drugs without it.
Examples of doing the right thing the wrong way happen very day in chiropractic clinics across the nation.
It happens when you attempt to do the right thing for patients with no insurance or limited benefits by "tweaking" your documentation and coding to result in an overall lesser charge for the patient.
For example: A patient comes to see you and requires more than a routine workup. Since this patient has no insurance coverage, you decide to use a lower level exam code, perhaps a 99201 for the initial examination instead of a 99202 or higher.
How about a patient you treated in four spinal regions, but only documented one or two levels and charged for a 98940? What about a Medicare patient that required a detailed workup including X-rays and you charged a lower level exam code and a two-view X-ray series when you actually performed four, all because Medicare doesn't cover exams or X-rays? No big deal, right? Wrong!
With the potential of mandatory electronic medical records on the horizon, some doctors of chiropractic are considering switching from traditional X-ray imaging to digital. Two Georgia Chiropractic Association members have made the switch
Photo courtesy of Mid Georgia X-Ray
and are impressed with the results.
"We have two CR (computed radiography) rooms and one DR (digital radiography) room," explained Dr. Davis Kinney of MSA Chiropractic Sport & Spine in Albany. The chiropractic facility is equipped with a CR machine, while his partner group, MSA Orthopedics, has both CR and DR X-ray rooms.
Kinney is pleased with the performance of his Fuji FCR XC-2 machine. "We converted our current X-ray machine to CR for about $45,000 ", he said.
And he's realizing significant cost savings with the transition. "We've seen three primary areas of savings — no more film or chemicals to buy, no processor maintenance fees and no expensive office square footage dedicated to film storage," he said.
The CR system captures the X-ray image on a digital cassette instead of film. The technician then puts the cassette into a digital film reader that converts the image into a format that can be seen on a radiological quality computer monitor. The image is then sent to software that doctors can view on their laptops with patients in examining rooms. "The biggest dividend is that the film quality is much better — we have far greater detail image, and we can manipulate the image. For instance — we can change the contrast so we very rarely have a `bad' X-ray, and we have virtually no retakes. That saves time and reduces X-ray exposure to the patient," he said.
"You can also draw lines on the image and measure angles like the Cobb angle for scoliosis analysis," Kinney said. "We can see the image much more clearly, and we can flip it, turn it around or enlarge it. We see much more bone and soft tissue detail."
ACA wins important victory in retaining physician status:
After months of intensive negotiations between the American Chiropractic Association (ACA) andBlue Cross Blue Shield Association (BCBSA), doctors of chiropractic are once again designated as "physicians" in the BCBSA Federal Employee Plan (FEP), the world's largest health plan and one that President Barack Obama has identified as a template for future health care reform. The 2010 FEP benefits brochure confirms the change.
"We believe this action will be view by future doctors of chiropractic as a landmark development in the history of this progession."
"We are pleased to report that doctors of chiropractic are in the physician category under the Blue
President Barack Obama
Cross Blue Shield Federal Employees Benefit Plan, limited only by state scope of practice authorization," said ACA President Rick McMichael, D.C.. "The agreement culminates months of negotiations between the ACA and BCBSA and assures that a doctor of chiropractic will be identified and defined as a `physician' in the FEP. This plan has been specifically and repeatedly identified by Congress and President Obama as the template for coverage and recognition in national health care reform. Physician status under this health plan is critical, and ACA action has assured that this status is once again recognized.
Two congressional letters urging non-discrimination of providers in national health care reform were sent to Speaker of the House Nancy Pelosi (D-CA) in September and October. The first letter, written by Rep. Bruce Braley (D-IA) and Rep. Martin Heinrich (D-NM), and co-signed by 45 additional members of the U.S. House of Representatives, focuses on the importance of patients being able to choose the type of health care provider who will treat them as well as the need to prevent discrimination against entire classes of health care providers by insurance plans.
The letter notes that if reform legislation allows for the creation of a public plan, a federal-level provider non-discrimination provision should be adopted and applied to all plans established or regulated by the final legislation.
The second letter, written by Rep. Mike Ross (D-AR), a leader within the "Blue Dog" coalition of centrist leaning and fiscally conservative House Democrats, urged that Pelosi include a provider non-discrimination amendment he offered in the House Energy & Commerce Committee in September in the House reform bill. Ross' letter garnered the support of 69 House members. The American Chiropractic Association and other members of the Patients' Access to Responsible Care Alliance (PARCA) Coalition non-M.D. provider groups lobbied Congress to sign onto the Ross letter.
About 400 chiropractors from Georgia and around the Southeast gathered at the Atlanta Marriott Century Center October 23 – 25 to learn from the profession’s premier lecturers, visit top suppliers and discover what the Georgia Chiropractic Association is doing on their behalf to protect their right to practice.
Dr. Gregory Gosline made the trip to Atlanta from Warner Robins. “The conference was very nice and informative,” he said. “I enjoyed the TV and media class. It was very good.”
This year’s conference included a special free marketing seminar that taught attendees how to use the media to get free publicity by Shawne Duperon, a five-time EMMY® award-winning reporter and producer, as well as classes to fulfill continuing education credits. Seminars included:
Jurisprudence by Aubrey T. Villines, Jr., J.D.
Risk Management by Anna Allen, M.S.N., R.N., C.L.N.C. of NCMIC
Marketing Wellness, StrongPostureTM and Anti-Aging by Steven Weiniger, D.C.
Nutritional Pearls by David Lee, D.C., Ph.D., C.Ad.
Common Patterns of Postural Abnormalities by Dar Griffeth, IV, B.A., B.S., D.C.
“I’ve been coming here for 20 years, and the Steven Weiniger seminar was the best by far,” said Dr. Alan Bragman of Atlanta. “It was so useful, and to include what I learned from him in my practice will help us expand.”
The conference also gave attendees the opportunity to network with other doctors and suppliers.
“I’ve been networking with other chiropractors and learned as much from them as the classes,” said attendee Dr. Sharon Riley of Gainesville.
doing on their behalf to protect their right to practice.