Following several unanticipated delays, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) is pleased to announce the release of the draft introductory chapter of the Chiropractic Compass best practice document. Originally expected in February*, the initial chapter, "Low Back and Related Lower Extremity Conditions," has been posted online at www.CCGPP.org for comment as of May 11; the comment period will close July 10. Stakeholders, including chiropractic providers, patients, third-party payers, chiropractic students, and others are encouraged to provide feedback on the draft document by offering their opinions in a survey.
Stakeholder organizations, including state associations, national associations, chiropractic colleges, and other interested organizations, are encouraged to submit specific comments, preferably by organizing a committee of interested members to review and comment on the document. Comments should be directed to the organization's CCGPP representative:
Other national organizations should submit their organization's comments to the CCGPP office (ccgpp@sc.rr.com).
"Low Back and Related Lower Extremity Conditions" is the first of seven chapter drafts to be released over the next year. The CCGPP and others have worked for the past several years to develop the Chiropractic Compass, a best practices document designed to direct the doctor of chiropractic toward a comprehensive health solution for the patient.
Development of The Chiropractic Compass takes into consideration many key factors, not the least among them is research. Health care research is exploding and the typical practicing chiropractor has difficulty staying abreast of the information. The Chiropractic Compass will consolidate that information into a readily accessible database for the doctor's use. More importantly, this information will be viewed from a chiropractic perspective. By centralizing all relevant research, organizing it chapter by chapter and rating its strength, the CCGPP hopes to create a paradigm shift in the practicing DC, providing a convenient and powerful practice tool.
The Chiropractic Compass best practice document will differ from a standard set of guidelines with respect to the way the recommendations are handled. While both review the available evidence, "guidelines" generally provide treatment recommendations and numbers of visits, whereas a best practice initiative is based on three important elements: research, clinical decision-making and patient values. Once finalized, the Chiropractic Compass will allow the physician to weigh the evidence, consider the clinical situation and then select the treatment or diagnostic procedure that is best for each particular patient.
In the past year, Dynamic Chiropractic has published a series of articles on the CCGPP's ongoing best practice initiative. For more information, visit www.chiroweb.com and type "best practice" in the search box on the top left of the page.
*The CCGPP indicated in late January that the "Low Back" chapter of the Chiropractic Compass had been posted online and was open to comment for a 60-day period. As readers of this and other chiropractic publications undoubtedly realized upon visiting the CCGPP site, the document was not yet available for review at that time.
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.
