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January 2007, Vol. 17, No. 1
Table of Contents
• Are You Busy Selling Chiropractic or Correcting Subluxations
• BJ's House Needs Repairs • Another Look At Cell Phones
• Chiropractic R.I.P. • Colloca and CBP Nonprofit Study Wins Best Paper Award • Help Us Locate Allen Botnick • Letters to the Editor
• Michigan Chiropractic Society Sees Evidence of Growing Need For Chiropractic • Meeting With Success • A New Look At Mirror Image Exercise • Mourning The Loss Of Tony Keller • Past Present and Future In Chiropractic • Posture Study By UQTR Researchers and CBP® Published by JCO • PostureRay™, PosturePrint™ Helping Doctors Help Patients
• The Importance of A Clinically Relevant Presentation of Findings
• It's Pauls Opinion • Research Corner • Scoliosis: SpineCor Brace
• Triano and CCGPP's Will Give You Six Visits
• Clinical Indications for Videoflouroscopy
• Western States Chiropractic College Receives NIH Grant •
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Triano and CCGPP's Will
Give You Six Visits
Part III
by Joseph W. Betz, BS, DC
After graduating from the University of Pittsburgh with a B.S. in Biological Sciences in 1995, Joe Betz attended Life University where he graduated Magna Cum Laude in 2001. He received the CBP® Outstanding Achievement Award in the year 2000 for his service as the CBP® club president while at Life University. He was also presented with the CBP® Researcher of the Year award in 2003. Most recently, he was named the CBP® Chiropractor of the Year in 2006. He is currently in private practice in Boise, Idaho. He serves as the ICA Representative for the state of Idaho and is active in his state association. He has co-authored several research papers with CBP® Nonprofit and is currently working on several chapters in a text on CBP® Structural Rehabilitation of the Thoracic Spine.
For the past two previous issues of this journal, I have been exposing the fact that CCGPP will give you six visits in two weeks total for chiropractic coverage. CCGPP has of course denied this, but I determined that CCGPP needs to have no frequency and duration in their document because they have a contract with Work Loss Data Institute (WLDI), and WLDI has six (6) visits in two (2) weeks for LBP subjects. That’s right, I said a contract! On their web site, CCGPP provides copies of their telephone conferences. By reading these, I found a segment where CCGPP tells that they have a contract with WLDI in which CCGPP receives 20 percent of sales of their “Best Practices”/ Guidelines. Wow, that has got to be a big financial conflict of interest!
Recently, in a press release CCGPP expounded on how they will “Certify” DCs on their CCGPP “Guidelines” by giving seminars to DCs. Wow, can you imagine 3rd party payers requiring you to be “Certified” in CCGPP so you can get six (6) visits!! I can’t wait to call and sign-up for the CCGPP Certification seminars!
This CCGPP (Council on Clinical Guidelines and Practice Parameters) press release, issued on December 9, 2006, was written by Mark Dehen, DC (Vice Chair of the CCGPP) to dispel some confusion regarding the Best Practices process. After reviewing reports of clinical practice guidelines for other professions, the CCGPP personnel rightly discovered that provider acceptance of the guideline recommendations was the most significant obstacle to “implementation”.
The question in the back of my mind, since the release of the CCGPP Low Back Draft, has been, “what is in it for these researchers and CCGPP Commission members?” I mean other than the elimination of subluxation-based chiropractors, because this would certainly not be enough. By the time this question is really answered it will likely be too late, because they only occasionally spoon-feed us their ultimate plan. By the time the average chiropractor discovers that this CCGPP thing is worse than everyone has been saying, it will be too late for them to stand, united, to fight the process.
In his December press release, Dehen stated, “The common denominator in virtually every study has been a lack of enthusiasm and confidence in the information by stakeholder populations, particularly providers.” So they discussed the most “promising approach” to change provider behavior...”a variety of interventions including audit [emphasis mine] and feedback, reminders, patient mediated intervention [emphasis mine] and educational outreach.” Audits are something chiropractors have become accustomed to dealing with...from insurance carriers. But now we read that these self-appointed CCGPP personnel themselves plan on auditing us as well??
In addition, exactly what is meant by “patient mediated” intervention? Does this imply that they plan on “educating” our patients when we see one of them more than 6-8 visits? Or when we use a Technique outside the CCGPP document, since the CCGPP Research Commission refuses to consider chiropractic Techniques. The CCGPP also described (spoon-feeding style) their plan to “offer” Evidence-Based seminars, of course with certification courses and testing. Whom this financial windfall will benefit remains to be seen, perhaps a group of “certified instructors”. Perhaps they will even recommend one of their own “certified” CCGPP compliant physicians. Perhaps they could spoon-feed us some answers next time, since they think we are too stupid to comprehend everything at once.
Of course the CCE (Council on Chiropractic Education) will enthusiastically endorse this document as well. The press release also states, “The best way to introduce evidence based care is through the training of future chiropractors. Currently, our chiropractic colleges are adopting best practices curricula in varying degrees. CCGPP hopes the ‘Chiropractic Clinical Compass’ will become the resource for that curriculum.” When I was attending chiropractic college just five years ago, almost every patient had radiographs of their spine taken. Now the CCE has strong-armed the schools into reducing the percentage of new patients receiving radiographs, as if there is evidence that reduction of radiographs results in better patient outcomes. We are slowly being molded into chiropractic as spine care, as Triano and his insurance company colleagues from ASHN described in their chiropractic manifesto. Do you want to know where chiropractic is headed if it’s left up to Triano, the CCGPP and other like-minded individuals? Download their manifesto for the future of chiropractic http://www.chiroandosteo.com/content/13/1/9 and try to have a nice day.
By the time the average chiropractor discovers that this CCGPP thing is worse than everyone has been saying, it will be too late for them to stand, united, to fight the process. NOW is the time to take a stand. The organizations of the Chiropractic Coalition (ICA, WCA, FSCO and 15 other chiropractic organizations) have been doing everything possible to stand up for chiropractors like you and me. We cannot expect every practicing chiropractor to critically analyze the actions and documents produced by the CCGPP and their spin doctors. But each and every one of you can join one or more of the organizations that make up the Chiropractic Coalition (www.chiropracticcoalition.org). Let your voice be heard through increased membership of the organizations willing to take a stand against these biased academicians and researchers.
So, as I have stated in the past two articles of this series, this is not about insurance reimbursement alone. Operating a “cash-based” practice will not protect you. This is about our right to practice chiropractic in the near future in a way we are currently entitled today. This is about being able to treat Bryan...an eight-year-old patient recently diagnosed with ADHD, or Sarah...a four-year-old diagnosed with chronic, recurrent otitis media, or John...a 55- year-old janitor suffering from symptoms associated with Multiple Sclerosis. We have all seen and helped the Bryans, the Sarahs and the Johns in our practices. Will the chiropractor of the future?
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