Miller\'s Moments

Is the product/procedure backed by research? 

In today’s world of evidence based medicine research is a key component.  If a product or procedure has research standing behind it and there is evidence for its use the likelihood of the procedure being a part of a scope of practice and the chance of third party reimbursement are good. 

If there is minimal research then the product/procedure may still have merit.  Sometimes vality for use is provided by wide spread use.  If many are using it with results even if antidotal  then there may be justification for use. 

Of course we have to realize that insurance carrier reimbursement is sometime scarce even with research is available.  This is often a matter of choice for them as apposed to common sense or good health care. 

Ask salesmen for copies and references of research related to there product/service.  You are always better off with it than without it.

Our first question falls under patient need.

“Is the product or procedure safe?”

This may seem a little obvious to some.  However, there are dozens of new products and service offered to the chiropractic profession each year.  Some of these are FDA approved or qualified under state law but some are not. 

No one wants to hurt a patient and it is a good idea to ask about FDA and other approvals prior to buying new equipment.  You should also double check your state law/scope of practice prior to purchase.  Just because a vendor tells you the product is ok, it does not mean it is.  Check it out.  Vendors of some products don’t always limit displaying and selling to states their products are approved in. 

A final thought for this question concerns the qualifications of the doctor and/or staff running the equipment or performing the procedure.  The products and services are often only as safe as those running them.

Talk to y0u later.

Jeff

Everyone,

I was excited when I was first asked to have a blog on the Chiro Eco website.  Honored in fact.  However, despite being a writer I am a all or nothing writer.  I will write several articles or a book and then not be in the mood to write or have an idea to write about for several weeks even months.  Posting one a week did not sound like much but then I experience a gap and I go weeks without ideas.  I always thought I would have a hard time having a week column in a newspaper because of my writing frequency.  I was right but, here is to making myself a columnist.

I have stressed over this now for months and I have now hit upon a subject I feel will be beneficial to Chiro Eco readers.  It originated with an article I wrote for Chiro Eco I believe in 2003 about avoiding a cluttered office.  This topic resurfaced in late 2008 and became the basis for a four hour lecture titled Revenue Centers; Purpose Purchace and Profit.  I brought out the article to prepare for a lecture at a chiropractic college, reworked the title and got together with Dr. Brian Jensen who works with me at Foot Levelers for his input.  We both use the lecture now and it has gotten a good response when we have used it.  Primarily when talking to chiropractic students.

The lecture covers five categories of questions a doctor should think through before purchasing equipment and services.  The questions are based on logical thinking  and avoid impulse buying.  The questions are timeless and could be used in any era of chiropractic practice.

I will begin by listing the question categories for you and then over the next several weeks I will go through each question individually discussing the pros and cons of the questions for adding equipment or services.

The categories are; Patient Need, Personnel (Doctor and Staff), Expenses, Facilities and Income. 

Talk to you soon

Jeff

The Pot Calling the Kettle Black

Many patients entering a chiropractic office report a history of allergies and have been receiving allergy shots for years.  One example of this is a patient who had received an allergy shot once a week for 15 years.  That is 780 office visits just for shots, not to mention office visits that might have occurred for other health problems.

We see several referrals each week from medical doctors.  Yet, a few medical doctors and other critics are still quick to knock chiropractic saying, “Once you start you have to keep going and going”.  Doctors of chiropractic often do recommend monthly maintenance visit for patients with certain spinal problems.  However, one adjustment per month for 15 years would only be 180 office visits.  This is 600 less than the above patient encountered for allergy shots.

If you have been considering chiropractic care and were warned against it because of multiple visits, don’t be the victim of a double standard.  Not every chiropractic patient has to return each month and certainly not 780 times.

Recently the Foundation for Chiropractic Progress drafted Hall of Fame wide receiver Jerry Rice as the spokes person for their cause. 

The foundation stated my Kent Greenawalt owner of Foot Levelers began the foundation 2 years ago in an effort to avance the publics knowledge of and enhance the publics view of the chiropractic profession.  The initial investment of Mr. Greenawalt and contributions of other has alowed advertizements for chiropractic to appear in highly circulated publications such as Sports Illistraed and USA Today.

If you would like to help carry the ball for chiropractic then contact the foundation at www.foundation4cp.com or Gary Cuneo at gcuneo@aol.com or 703-868-2420

I recently received a call from a CA who was fighting with an insurance carrier over denial of a product that had been precertified.  The product was included in the managed care policy the doctor signed with the company and the company had been paying for the procedure up to that point.  I offered several options for one of which was Promissory Estoppel.  This action isn’t common and it can be a long shot.  WHat is it?

Many doctors and their staff members have never heard of Promissory Estoppel.  Have you?

How about these terms: 

Any willing provider, upcoding, down coding, unbundling, maximizing, Locum Tenens

Give it a shot at defining these and next post I’ll provide the answers.

Jeff