Join Our Mailing List
Email:

 
header
August 1, 2009
Volume 9
Number 3 
In This Issue
Senate Says No Vote on Health Care Reform Before Summer Break
 
Shortly after President Obama made his appeal to the nation in an evening news conference on July 22nd, the Senate flexed its muscles and announced that there would be no definitive action on their part before the August legislative break. The House, under the leadership of San Francisco's own Nancy Pelosi, may press on and bring something to a vote before the recess, but absent their brethren in the other chamber, it will be a largely symbolic move.

That being said, there remains a great deal of activity behind the scenes, by staffers and by various interest groups, us included, to shape what emerges from the sausage maker known as the legislative process. There have been a number of developments of great importance to the profession, including the following:
Do not take one iota of comfort from all of this discussion. Now is the moment to act. If you don't know what to do, how to do it or how to say it, visit www.lifewest.edu/myfuture.html for some help. Encourage everyone in your sphere of influence to become involved. This is the most potential-filled moment for us as citizens and as providers to affect our individual and collective futures. Act today!
Who Says You Can't Go Home?
 
My wife, two daughters and I were in Buffalo, New York (my hometown) for the wedding of the youngest daughter of one of my dearest cousins. Cathy and I were able to merge this with a trip to Seneca Falls, New York for a meeting of the Association of Chiropractic Colleges on the campus of New York Chiropractic College. It was a Chamber of Commerce week in Buffalo. Beautiful weather graced the week and we had a wonderful visit with our family and friends. We even worked in a visit to Mrs. Audrey Cassan, wife of my late mentor Dr. Cameron Cassan of Port Colborne, Ontario.
 
We did all the required Buffalo events...a visit to The Anchor Bar (Main and North Streets), the official, undisputed home of "Buffalo Chicken Wings"; a visit to a neighborhood tavern for a "beef on weck", a roast beef sandwich on a caraway seed and pretzel salt encrusted hard roll known as a Kimmelweck roll; hot dogs at Ted's Charcoal Grilled Hot Dogs (serving since 1927); and a swing back to the old family homestead in Kenmore and cottage in Canada. Along the way, we saw some old things with a fresh eye, for example, Amigone Funeral Home. Never before did I see Am I Gone in Amigone! Did you know the Erie Canal, from Buffalo to Rochester, is emptied every winter--drained to wading depth. Great memories at every turn.
Barry Bonds, BALCO, the FDA and Your Patients
 
On July 28, 2009, the Food and Drug Administration issued a warning about "BALCO-era" steroid-containing supplements. In particular, supplements sold as Tren Extreme and Mass Extreme are feared to cause liver injury, stroke, or kidney failure (kinda like acetaminophen...). These products, according to the San Francisco Chronicle, are "chemical clones of two banned steroids; trenbolene...and DMT also called Madol...". Both of these compounds played a role in the circumstances of Barry Bonds and BALCO. 

If you have body-builder types in your practice, you might suggest to them that these might not be the way to go....
The Road to Damascus for Former Insurance Exec
 
The San Francisco Chronicle reported on July 29, 2009 on a presentation made by Mr. Wendell Potter, former chief spokesperson for Cigna Corporation who has become a major whistle-blower denouncing the practices he was formerly employed to defend. On July 28, Mr. Potter received an award from the San Francisco-based Civil Justice Foundation, and, in his acceptance remarks, he characterized the insurance industry as "beholden to the bottom line as opposed to patient care." He also related his epiphany arising from "seeing hundreds of desperate people waiting in long lines for free care when he visited a mobile clinic on the fairgrounds in Wise County, Virginia". After this experience, he quit his job of 20 years, escaped the dark side and moved into the light. Last month, he carried his "conversion" even further by testifying before the Senate Commerce Committee on the less-than-desirable behavior of his former employer community. Potter now works with the watchdog group the Center for Media and Democracy
Elevated PSA and Older Men
 
A recent study from the Journal of Urology (J Urol 2009,181;1606-1614) casts serious doubt on the value-human and economic terms-of addressing a PSA level of less than 3.0 ng/ml in men 75 and older.
 
Study co-author Edward Schaeffer commented, "Therefore, these men may represent an ideal target group for discontinuation of PSA testing, which could dramatically reduce the cost associated with screening, as well as the potential morbidity of additional evaluations and/or treatment in a population unlikely to experience benefit." Read that again-could dramatically reduce...the potential morbidity.
 
The bottom line for men in this age group:  this is a condition you are infinitely more likely to die with than from. The treatment at that point has the potential of being worse than the disease. In related commentaries:  from the University of Connecticut Health Center in Farmington, it was suggested that a few deaths could be prevented at an enormous cost in testing and treatment, where the Fred Hutchison Cancer Center in Seattle cautioned against "going directly from data to policy using observational data."
Travel Tips You Can't Get Just Anyplace
 
Tip #1...When you are about to open a liquid sealed item, such as salad dressing or coffee creamer, remember it too has been pressurized on the plane and point it away from you (and the person next to you) as you open it. If you don't, the likelihood of the item staining a garment correlates directly with the oil content (stain-making ability) and the expense of the necktie you are wearing-the greater either is, the farther the item will spit.
 
Tip #2...When you are traveling in the mid-afternoon, be on the lookout for a gate agent with a falling blood sugar level. Delivering a cup of frozen yogurt with a pure heart has been known to yield a thoughtful upgrade in return. If you do it for the upgrade, it won't work, but if you do it to be kind, it sometimes does and you always feel good about the effort.
 
Tip #3...Useful websites: www.seatguru.com has the configuration of every commercial flight. Visit it to find out the best seats on a flight, the dog seats, the closest to the bathroom seats, etc. Very useful if a little edge in seating is enough to make your day. Track any flight, private or commercial, in real time by visiting www.flightaware.com. It is free and kind of interesting. You can sign up for free flight change notifications at many sites.
Complain About the Weather - You Can't Do Anything About It. Complain About the CCE - That Is Another Matter
 
The Council on Chiropractic Education (CCE) is several years into a five-year plan to completely revamp and rewrite the educational standards for chiropractic colleges. On Saturday, July 25, 2009, the Council approved a first draft of the effort and set in motion the steps to send the work-product out to the world for comment. The proposed revisions are expected to be available in late August or early September. The draft proposal will be posted to the CCE website at www.cce-usa.org. In addition, a copy of the first draft will also be posted at www.lifewest.edu/CCErevisions.html around Labor Day weekend. Please visit either site, download a copy of the proposed Standards and read them carefully. Then, most importantly, if you have any concerns or suggestions after reading the proposed Standards, write to the CCE and let your thoughts be known. I have every confidence that each and every bit of feedback will be reviewed and considered-that doesn't mean adopted, but considered and it will help inform the process in a broader sense. Don't leave this for someone else to attend to; if you have ever bitched about the CCE now is your chance to provide input about its future.
FTC and the DC - August 1, 2009 Red Flag Implementation Date Revised by FTC to November 1, 2009
 
What started out as a regulation to apply to banks and other lending institutions to protect against identity theft has morphed in a requirement for virtually all health care providers except those that are 100% cash 100% of the time. So that means just about everyone oughta be paying attention to this one.
 
As of July 29, 2009, the August 1, 2009 implementation date has been postponed (again) to November 1, 2009. If you are a covered entity (forget the contortionist moves to get out of it, you're covered), you are expected to have in place policies and procedures related to your compliance with the Red Flags rules. This is something you can do yourself, something you can cobble together from stuff other folks are doing or something you can do right, get it over with and be done with it.
 
If you have any degree of insomnia or are otherwise suffering from a severe case of OCD, you might want to visit the following websites for more information and regulatory jargon than most people's brains can tolerate. FTC Business Alert, or FTC Release 04/30/09, or the granddaddy of the line-up: Guidelines to FTC Red Flag Rule 
 
The College falls under the umbrella of the Red Flag rules and, as such, we have been working for some time to bring our policies and procedures up to date and ready for the August 1, 2009 ready, set, go, date (now November 1, 2009). In the process, we encountered folks who would help us "become compliant" for remarkable sums of money! Unless you have the conditions noted above, or a staff that even knows what NACUBO is (National Association of College and University Business Officers), you will want to farm this out ASAP.
 
The most straight-forward and simplest approach I have seen comes from a group out of Michigan and they can be reached at www.ICCOM.org. They have a customized handbook with the required policies and procedures to bring you into compliance that will cost the grand sum of $59. Move quickly on this to save yourself some time, hassle, headache and cash. Visit: www.iccom.org (that is a ".org", NOT a ".com"). Disclaimer: Neither I, nor the College are associated in any way, shape form or fashion with ICCOM. This recommendation is not to be construed to be legal advice or counsel, for that ya gotta pay money; it is intended to convey that, as I understand the requirements of the law and the related regulations, this appears to bring you into compliance.
Legislative Update
 
The Association of Chiropractic Colleges is ably represented in Washington by its Executive Director, Mr. David O'Bryon and its consultant from The Advocacy Group, Mr. Bobby Mills. The following are excerpts from a report they presented to the ACC on July 22:     
    • Once again, we have attempted to obtain language directing that the Surgeon General assert his or her current statutory authorities and begin to commission Doctors of Chiropractic into the U.S. Public Health Service Commissioned Corps.   You will recall that in fiscal year 2006 language was included in the report accompanying the Labor-HHS, Education Appropriations bill directing that the Surgeon General report to the Committee on their plans to start the commissioning process, but never responded to the Committee directive.

This year Senator Sam Brownback (R-Kansas), a Member of the Senate Appropriations Committee and strong supporter of chiropractic, has agreed to pursue new, directive language in the same appropriations measure to force the Surgeon General to proceed with the development and implementation of a plan to commission Doctors of Chiropractic into the Commissioned Corps.   With a new Administration, new Surgeon General, and a new Secretary of HHS, it is our hope that, finally, the Department will comply with the Committee directives and begin the process of commissioning Doctors of Chiropractic.

    • I am pleased to report that the House of Representatives has approved Section 702 of the National Defense Authorization Bill to direct the Department of Defense to make permanent the chiropractic health care benefit for active duty military and to carry out a demonstration of providing such care in Iraq and Afghanistan.  
    • We are pleased to report that Rep. Filner, Chairman of the House Veterans' Affairs Committee, and Senator Patty Murray of Washington, have introduced companion bills in the House and Senate respectively (H.R. 1017; S. 1204), to expand DVA facilities providing chiropractic health care services to veterans.  We continue to work with both the House and Senate Committees on Veterans' Affairs to ensure that both bills are reported out of Committee, passed and signed into law this year.

The three key issues that we have collectively tried to crystallize with key Members of the House and Senate Committees of jurisdiction in the health care reform debate are:

    • A provision to instruct a new Advisory Council to help ensure that recommendations proposed by policymakers under the health care plans reflect all benefits, state authorized health care services and insurance guarantees available in at least 26 states. 

This proposal provides consumer protections and treatment options that are widely available in a majority of the states by virtue of state insurance equality, and related state laws.  It would provide that a greater range of existing treatment and provider choices that are widely available under state authority be given priority.

    • A provision addressing the issue of 'point of service' requirements.

This proposal would instruct a new Advisory Council to develop recommendations for insuring that all health plans established under the Act adopt "point of service" provisions, allowing beneficiaries to select the health care provider of their choice for the treatment of any covered health condition without regard to whether the provider is a member of the plan network.

    • A provision stating that a health insurance issuer to which this Act (or amendment) applies shall not discriminate with respect to participation, reimbursement, covered services or indemnification under a health plan or other health insurance coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law.

For a copy of the report, please visit www.lifewest.edu/ACCupdate.html.
The Answer Man - Opening at a Theater Near You
 
Not since Danny Aiello's role as a chiropractor in Jacobs' Ladder has a chiropractor been a major character in a major movie. On July 26, The Answer Man opened across the country and we have the next cinematic chiropractor...the female lead (the chiropractor) is played by Lauren Graham (Gilmore Girls, Bad Santa) and she is the focus of leading male Jeff Bridges' (the Answer Man's) romantic interest.
 
The trailer shows Bridges as Arlen Faber having a low back pain episode and crawling down the street and into the office of Elizabeth the chiropractor. I haven't seen the movie. I am not recommending it for its cinematic value; just the interest each of us might have to see how we are portrayed by Hollywood these days.
CNBC Blurb About Work-Site Chiropractic Services
 
Visit: http://www.cnbc.com/id/15840232?video=1192796478&play=1 
 
Very positive from the perspective of a major corporate player.
For California License Holders Only!
 
At a recent committee meeting of the Board of Chiropractic Examiners, there was discussion about the requirement of a chiropractor who uses the term "Doctor" or the abbreviation "Dr." in written form to also use either D.C. or "chiropractor" immediately thereafter. That is nothing new and it has been in the California Code of Regulations (CCR) for years.
 
What is new is the question that, if John Smith has a website with the URL of www.DrJohnSmith.com , is that a violation of the reg because it is not www.DrJohnSmithDC.com or www.DrJohnSmithchiropractor.com? There was discussion that, yes, this would be a problem...the argument I would offer is that www.DrJohnSmith.com is part of the website the URL points to and if this disclaimer/disclosure of D.C. or chiropractor is on the website that would fill the bill. I can see the argument coming back that www.DrJohnSmith.com will be used in print by itself and, therefore, in print, is inadequate. A heads up and an encouragement to be cautious, you might want to reserve additional URLs accordingly.
Recommended Song of the Fortnight
 
"Mental Floss" by Jimmy Buffet..."in one ear and out the other, don't get cris-crossed, don't forget to mental floss...wisdom of the islands." I am not a certified parrot head. I have, however, taken to listening to this Mr. Buffet song on the treadmill in the morning and I am thinking about getting fitted for head feathers.
Life Chiropractic College West
25001 Industrial Blvd.
Hayward, California 94545
 
Please feel free to send any correspondence to TLS@lifewest.edu. To view previous issues of the TLS, visit www.lifewest.edu/TLS.html. You can also send your friends to this page to subscribe to our mailing list.
 
The Latest Stuff from Gerry is a FREE newsletter from Dr. Gerry Clum, President of Life Chiropractic College West (http://www.lifewest.edu). The Latest Stuff from Gerry keeps you in the know by giving you a brief summary of the news and events of importance to your practice, your patients, and your family.