Chiropractic Economics Blog

I just came back from a weekend in Chicago where I visited my two small grandchildren, ages 3 and 5. Since I live in Jacksonville, Fla., I only get to see the grandkids about twice a year. Those semi-annual long weekends are never enough; I miss out on so many of the things they are learning to do.

The one advantage of visiting infrequently, though, is that I have a different perspective of the kids than their parents have. I can see how much they have grown since the last visit, and how well they have mastered “little” things, such as dressing themselves, expressing their thoughts, and understanding and respecting boundaries. It’s not that their parents don’t see these accomplishments; it’s just that I see them with a fresh eye. And my perspective allows me to take great joy in them and to “ooh” and “aaah” over what they do.

Several years ago Kent Greenawalt, CEO of Foot Levelers, launched the Campaign for Chiropractic. He mobilized the profession’s leaders and educators and asked them to stand united behind a single public relations campaign, both in spirit and with money to support it. The vehicle that drives the campaign is the Foundation for Chiropractic Progress (F4CP).

F4CP started small. But it is growing and getting better all the time. Its aim is to position chiropractic so that the public will consider it as a healthcare option.

I think the advertisement F4CP placed in USA Today last week (April 25) was significant: It was an endorsement of chiropractic by three medical doctors.

Some people might look at the ad and think, “That’s nice.” But you need to put the ad in its proper perspective. During the 1960s medical doctors were ordered by the AMA not to associate in any way with chiropractors! Wilk vs. the AMA caused the AMA’s directives to be stricken down.

Yes, chiropractic has a long way to go. Only about 12 percent of the U.S. population goes to a chiropractor each year, so clearly F4CP needs to continuing its education and public relations program.

But I urge you to look at F4CP’s accomplishments in the same way I look at the development of my small grandchildren. Take pride in what it has done and support it in any way you can so the Campaign can continue to develop and grow. Make it your “baby” and take pride in what it does.

Until next time,

I am not a big fan of health-insurance companies. To me, they are like death and taxes: necessary but not nice.

Because I am not a big fan, I was pleasantly surprised by an April 3 newspaper article I read in the Indianapolis Star about WellPoint, the nation’s largest commercial health insurer in terms of membership. The article said that WellPoint would this year begin halting reimbursement payments to hospitals and doctors for 11 medical errors considered preventable.

Some of these errors include surgery on the wrong body part, a wrong surgery performed on a patient, surgery on the wrong patient, bed sores, sponges left in the body after surgery, urinary tract infections associated with catheter use, injuries due to falls, and blood incompatibility.

In 2007 the Centers for Medicare and Medicaid Services (CMS) authorized the nonpayment for six medical mistakes. (On April 14, the agency announced it would be seeking to withhold payment for nine additional preventable mistakes.) WellPoint, which provides healthcare benefits to about 35 million Americans, is following the lead of CMS. The newspaper said other insurers may also stop paying for certain medical errors.

Skeptic that I am (having been “burnt” many times by insurance companies), I immediately assumed that if WellPoint withheld payment for services (even though those services resulted in pain and suffering), the patient would be stuck with the bill.

Not so! Again following CMS’s lead, WellPoint said it would make sure its members are not billed for any of the errors it refuses to pay. Not only that, but according to the newspaper, officials at WellPoint, said any savings WellPoint gets from stopping payments for mistakes would result in reduced premiums for patients.

Bravo!

I am not a fan of insurance companies, but I am a fan of accountability. Doctors and nurses are not infallible; they make mistakes. But there is no excuse for mistakes that can be prevented. And there is no reason to reward healthcare providers for mistakes that could have been avoided.

Now if we could only get WellPoint and all other insurers to pay just claims on time, insurance companies might gain my respect.

Until next time,

Today is April Fool’s Day, and perhaps you were the butt of a harmless prank, such as these:

About two years ago, a colleague in our office found a telephone message left on his desk while he was out to lunch. It asked him to call Jay Raffe at a local telephone number. He didn’t know the man, but he picked up the phone and called the number. When the phone rang, the person on the other end answered, “Jacksonville Zoo.”

Jay Raffe. Giraffe. He still laughs at himself for falling for the oldest joke in the book.

Did you put Peeps into your kids’ Easter baskets? Peeps are those marshmallow confections that look like little chickens. They used to come in only one color — yellow — but now their sugar is dyed blue, green, and purple, in addition to yellow. All of the colors taste the same.

When my husband confessed his liking for Peeps (which are only manufactured at Easter time), I stocked up on them.

One recent night when I doled out our Peep dessert, I sampled both a blue and a purple Peep, while he munched on a blue one. I innocently said, “They taste different!” He looked at me skeptically, said, “No, they don’t,” then took the blue Peep out of my hand and bit its head off. “See,” he said. “The blue one tastes the same as all the others!”

When I smiled broadly, he realized the joke was on him. We both laughed.

These are innocent pranks. No one was inconvenienced and the person on the receiving end of the joke didn’t lose anything except a small bit of dignity.

This week I began the very time-consuming task of analyzing the data you provided for our 11th Annual Salary & Expense Survey. This is an enormous task, even though we use powerful survey software to gather and crunch data.

Over the years that I’ve analyzed this data, I’ve learned that the first thing to do is to review the raw data. Mistakes can easily happen. For example: One question asks the respondent to input an annual salary in whole numbers. A few people forget to put zeros on the number, and instead of entering (for example) $35000, they may input $35. Obviously, the lack of zeros would skew the data.

I reviewed all the data and thought I had caught all of the errors, so I began to do my analysis. I compiled information on several sets of statistics, and was typing in the range of ages of respondents on my data sheet. The software told me the age range was from 26 through 100.

A 100-year-old chiropractor? Unlikely. So, I looked at the information the 100-year-old respondent entered. I followed the data to the end, and came to an e-mail address: nobody@nobodyherecares.com.

I’m sure the person who went to the trouble to input phony data throught he (or she) was being funny. I didn’t laugh.

Why would someone go to the trouble to enter fake data? Why would someone want to jeopardize the integrity of the only survey on the income and expenses of chiropractors — a survey whose results are reported by the U.S. Department of Labor in its Occupational Outlook Handbook?

This was a sophomoric gesture that caused much inconvenience. Fortunately, I caught the sabotage in time. I hope it never happens again. I would prefer for the jokester to just opt out of receiving our e-mail.

But in case the person doesn’t, the next time I conduct a survey, I will scan the raw data with an eagle eye before I begin to analyze the results.

Until next time,