We Get Letters & E-Mail
Uniting the Profession to Educate the Public
After reading the comments made by Richard Butykos, DC, in "Where's the 'Breakthrough' Coverage of Chiropractic in the Media?" [April 09, 2012 letter to the editor], the Foundation for Chiropractic Progress (F4CP) understands his frustration and agrees that there needs to be a major push in the media for chiropractic.Hence, the F4CP has worked tirelessly for nearly 10 years to accomplish this push with its national positive press campaign, and thus far has had a limited impact.
In 2011, the F4CP delivered to the public more than 3.5 billion positive impressions; in 2012, that number is expected to reach over 5 billion.
In years past, the chiropractic profession did not have a vehicle to communicate its value to the public. In fact, until 2006, when the foundation began advertising, the longest national public-relations campaign for chiropractic had lasted only three months. Today, the F4CP provides constant communication through its educational materials, including press releases, advertorials, public-service announcements and advertisements. Most recently, the following press releases highlighting the value of chiropractic care were distributed to more than 10,000 publications:
In addition to the extensive editorial coverage achieved, the foundation has continued its aggressive advertising campaign. Each month, a pro-chiropractic ad is placed in both The Wall Street Journal and USA Today. Some of the latest ads have highlighted the cost-effectiveness of chiropractic, as well as the patient value expressed by celebrities, including Reggie Bush, running back for the Miami Dolphins; Anthony Field, creator of the Wiggles; Allison Jones, world-champion paralympian; and retired Brig. Gen. Becky Halstead.
As mentioned by Dr. Butykos, there are still unfortunate instances of the media hesitating to "trumpet" chiropractic care for its positive results. However, as the F4CP approaches its 10th anniversary, it presents the profession with an opportunity to unite in an effort to adjust public perception and make the difference for patients with its positive press campaign. The campaign has already made its mark in society, but there is much more to be accomplished.
Dr. Butykos, the F4CP would like to personally invite you to pioneer this unification by becoming a monthly contributor to the foundation. In addition, we would like to encourage the entire profession to stand up and support the one and only campaign that will truly make the difference for chiropractic.
Today, only 3.5 percent of the chiropractic profession supports the Foundation for Chiropractic Progress. By increasing this percentage, the campaign can achieve monumental success and indisputably reach its goal of 1 billion positive messages each month. As a result, the paradigm will shift and more patients will seek the unique, highly valuable care provided by doctors of chiropractic. Do your part for this profession; pledge today at www.f4cp.com/pledge.
Is Maintenance / Preventive Care a Covered Benefit or Not?
As posted on the White House Web site: "On March 23, 2010, President Obama signed the Affordable Care Act into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices. The law allows all Americans to make health insurance choices that work for them while guaranteeing access to care for our most vulnerable, and provides new ways to bring down costs and improve quality of care."
During a recent speech regarding details of President Obama's health plan, he stated that "all insurance plans are required to cover preventative care at no cost … [which] includes coverage of contraceptive services such as birth control." An obvious double standard is illustrated, as one needs to look carefully at the details and guidelines of other government-run health care programs such as Medicare.
A February 2010 billing guide published by the Centers for Medicare & Medicaid Services defines maintenance therapy as: "A treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition." Medicare does not cover maintenance therapy, of course.
What I purposely omitted is that this was copied from a chiropractic services billing guide. Therefore, one can conclude that there is bias or discrimination against the chiropractic profession. Whether you call it maintenance therapy or preventative care, you can see what type of behavior this administration is encouraging by its policies.
Gene Kemper, DC, DABCO
Foot and Ankle Conditions
I read with interest parts 1 and 2 of Dr. Kevin Wong's extremity series ["Thinking Outside the Box and the Spine"] and wanted to comment. In the first article ("Part 1: The Feet," Feb. 12, 2012), Dr. Wong states that 80-90 percent of his patients have pronated feet. Perhaps Dr. Wong has a unique patient population, but that is not the case in my practice, or the practice of several other DCs I've asked.
In addition, Dr. Wong says he uses the navicular drop test to help him decide if the patient needs orthotics, but his explanation is different than what I learned. See Michaud's text, Human Locomotion, pages 285-286 for a detailed explanation of the navicular drop test. Dr. Wong recommends orthotics for many of his patients; I assume his orthotics are non-custom, as no one is permitted to see the manufacturing facility where he buys them.
In the second part of his series ("Part 2: The Ankle," April 22, 2012), Dr. Wong repeatedly describes misaligned bones and how he repositions them with an adjustment. This is 2012 and the modern DC knows we do not reposition the bones of the foot / ankle with our adjustments. Our adjustments have a neurologic effect to decrease pain, and we improve movement and neurologic coordination.
Chiropractic treatment of foot and ankle conditions is extremely effective. We should be as accurate as possible whenever we write or teach about this important topic.
Mark A. King, DC
How Did This Happen?
I know most chiropractors have never studied contract law, so I understand why we as a profession have such a problem with Medicare and health insurance in general. However, keep in mind that we are not alone in this area. The medical profession is just as ignorant as we are. We all have been forced to allow others to determine how we will do business in order to get paid.
Look at contract law and you will discover that in simple terms, a contract should be between two parties. Each party agrees to the contract; party A agrees to pay "X" amount and party B agrees to provide goods or services for that fee.
So, what does the payee (Medicare, Blue Cross, et al.) do? They find ways to avoid paying for the services we've already provided. In the past this would be called theft.
The answer to this dilemma is simple and difficult at the same time! We (DCs and MDs alike) must take control of our offices and stop providing services unless we are paid for those services at the time of service. The government will do everything in its power to prevent us from doing this, and as long as we do not all agree to act together, we will continue to essentially function as serfs and work for free based on some paperwork issue after the service has been provided.
Perhaps it is time to form an uncivil union with all health care professionals and kick the claims clerks out of the business. The biggest issue with Medicare, in my opinion, is that we cannot just say "no" and demand cash for services provided. This is what we all should demand. MDs can refuse to be Medicare providers and demand cash for services, but somehow we are banned from doing so by law. How did this happen?
J.C. Watson, DC
Guidelines, Yes; Harassment and Threats, No!
Drs. Rossi and Jusino [We Get Letters & E-Mail, April 22, 2012 DC] are correct on every issue regarding the present managed health care system. I also have to take exception to Dr. Friesen's remarks about ASH [Jan. 15, 2012; "An Insider's Look at Managed Care"]; I laughed so hard I nearly fell out of my chair. These managed care companies are slashing our reimbursements, limiting out patient visits and denying services they say we do not need to perform. In return, the patient's health suffers, out-of-pocket costs skyrocket, their deductible goes up and their premiums rise annually, if not quarterly.
In the meantime our services are greatly reduced and if we do not accept the terms presented to us by these managed care companies, they either reduce our tier ranking or call and verbally spank us on the phone, letting us know we are not following their procedures. Or we may be removed from their insurance carrier altogether.
I have yet to have anyone from these managed care companies come to my office and physically examine, adjust or even set up a care schedule for any of my patients. And yet they even dictate what X-ray views we can take and say that it is according to "their protocols."
This can't be legal. I use the Georgia procedure and protocol guidelines. It seems to me that the insurance companies are guilty of malpractice. Until chiropractors and our so-called associations get a handle on this, it is only going to continue.
I have practiced for 33 years in Georgia. I have never seen my profession subjected to these types of restrictions and treatment as I have witnessed lately. The sad truth is that the managed care doctors who impose these limits, and manage and dictate our care, are often chiropractors. Think about it.
Guidelines, yes; harassment, dictating and threats, no!
Eddy Nestle, DC
Dynamic Chiropractic encourages letters to the editor to discuss issues relevant to the profession and/or to respond to a previously published article. Submission is acknowledgement that your letter may be published in print and/or online. Please submit your letter to ; include your full name, degree(s), as well as the city and state in which you practice.