One of the most interesting aspects of the current United States presidential campaign is the attention devoted to the issue of health care. Each candidate is being forced to address this complex and costly problem. In an effort to position themselves favorably, some candidates have made this a primary issue.
Recent attention given to the rising costs of health care in the campaign is a sign of the times. At long last, the country is beginning to awaken to the fact that we do not have a healthy health care system. It is too costly, too inefficient, and has done little to provide the average American with better health. The vast majority of our resources are spent on end-stage disease and illness, with only a fraction spent on prevention and education.
One of the problems associated with the health care issue is the increasing number of individuals without any type of health insurance. Many in the United States receive what insurance they do have through their employer. Unfortunately, for many this too is changing. With rising costs of production, the competition to produce a quality product at a competitive price is forcing many companies to view health insurance as a luxury they can no longer afford.
At the beginning of the 1990s, American industry faces many critical problems. Of these, one of the most significant is the spiraling cost of health care. Some estimates place the cost of health care as second only to payroll. Faced with these skyrocketing costs, industry is forced to direct its attention to cost containment. The primary objective of any cost containment program must be a reduction of expenditures.
One of the most expensive health problems in many industries is back pain. Studies show that musculoskeletal problems in general account for nearly one-half of the costs of workers' compensation. Back pain alone accounts for slightly more than one-third of total costs. As the cost of back injuries continues to escalate, industry must find new ways to address this problem. Injury prevention and management, once considered a low-priority issue, is rapidly becoming a necessity. Recent legislative changes have forced every industry to develop an effective injury and illness prevention program.
Recently, the chiropractic profession has taken an active role in the industrial arena. The impact of the chiropractic industrial consultant is growing. The chiropractor is uniquely positioned to provide the industrial client with a comprehensive approach to managing back problems. Combined with their understanding of the spine, the development of back problems, and the holistic approach to health care, the chiropractor becomes a natural resource for the prevention-minded industrial client. The chiropractor is equipped to assist industry in the following ways:
One of the newest areas of back pain prevention programs is education of the management staff. This involves addressing methods of prevention and worker training and, perhaps more importantly, appropriate management skills for supporting the injured employee. The emphasis of most industrial back safety programs is on preventing injuries from occurring. Here, the emphasis is on minimizing the impact of the injury on the injured worker and on preventing drawn-out litigated cases that often end in disability.
Several studies have shown that the manner in which a supervisor, company doctor, or employer responds to the injured worker may have a significant impact on the seriousness of the injury. Chronic back pain and disability are not solely a result of physical injury. It is, rather, associated with a complex interaction of factors, including psychosocial issues. Efforts must be made by management and by the clinician to understand the impact of the injury on the individual.
Industry can facilitate worker recovery by providing early return-to-work policies, by maintaining contact with the injured worker, and by accepting the injury as real. Efforts should be made to reduce the likelihood of litigation. One study by the California Workers' Compensation Institute showed that the most critical element in reducing litigation was information. Most injured workers went to an attorney because they felt they did not properly understand the workers' compensation system. Other studies have clearly demonstrated that the presence of an attorney delays the "healing" time.
It is our belief that appropriate management of on-the-job injuries must include a cooperative effort between the injured worker, the company, the clinician, and the insurer. This may only be achieved through proper education. The individual who provides this information is placed in a unique position in the industrial arena.
Paul D. Hooper, D.C.
Diamond Bar, California
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
