Business Talk: Expenses are expensive

Business Talk: Expenses are expensive

Stay healthy and take on only what you can

Safe keeping: Protecting your patient files

Safe keeping: Protecting your patient files

Is your patient’s health data secure?

Tough love

Tough love

What’s slowing down your business, in a nutshell

Neuroreality for pain management

Neuroreality for pain management

The concept of neuroreality in the treatment of pain

In my previous article (April 2018) I presented and discussed the concept of “neuroreality” as the most accurate science-based conceptual foundation available to approach the understanding of “pain with movement” disorders.
Three centuries ago, in 1710, the Irish philosopher George Berkeley proposed this famous thought experiment: “If a tree falls in a forest and no one is around to hear it, does it make a sound?” He used this question to discuss his philosophy of “immaterialism,” which argued that perception creates reality and that nothing exists outside our minds.
i recently had the opportunity to travel to Mumbai for the Sant Nirankari Mission, a five-day spiritual event attended by millions of devotees from different parts of India.
Despite claims that helmets do not protect the cervical spine during a motorcycle crash and may even increase the risk of injury, researchers from the University of Wisconsin Hospitals and Clinics in Madison found that, during an accident, helmet use lowers the likelihood of cervical spine injury (CSI), particularly fractures of the cervical vertebrae. These findings appear in a new article published in the Journal of Neurosurgery: Spine, "Motorcycle helmets and cervical spine injuries: a 5-year experience at a Level 1 trauma center," written by Dr. Paul S. Page, Dr. Zhikui Wei, and Dr. Nathaniel P. Brooks.
Nearly every minute, a woman dies from heart disease in the United States – it is the number one killer of women, causing one in three deaths each year, according to the American Heart Association (AHA).
Opioid cessation in non-cancer pain may be more successful when depression is treated to remission, a study from Saint Louis University in Missouri shows.
HAMILTON, Ont. – The type of needle used during a lumbar puncture makes a significant difference in the subsequent occurrence of headache, nerve irritation and hearing disturbance in patients, according to a study by Hamilton medical researchers.
A new study has revealed that chiropractic care is improving low-back pain among female veterans, according to the American Chiropractic Association (ACA). Female veterans are one of the fastest growing populations receiving treatment through the Veterans Administration (VA) health care system in the U.S.
McMaster University neuroscientists studying sports-related head injuries have found that it takes less than a full concussion to cause memory loss, possibly because even mild trauma can interrupt the production of new neurons in a region of the brain responsible for memory.
A new U.S. study published in the Journal of the American Medical Association found no significant difference between opioids and non-opioid analgesics for treating arm of leg pain.
LOUISVILLE, Ky. – A research participant at the University of Louisville with a complete spinal cord injury, who had lost motor function below the level of the injury, has regained the ability to move his legs voluntarily and stand six years after his injury.
Patients significantly overestimate the anticipated amount of pain they'll experience following surgery, which researchers say can cause unnecessary anxiety in patients, according to a study being presented at the Anesthesiology 2017 annual meeting. Patients who receive regional anesthesia, such as peripheral nerve blocks, epidurals or spinal anesthesia, were most likely to overestimate their postoperative pain.
Low back pain is the leading cause of disability worldwide and is becoming more common as our population ages. Most people who have an episode of low back pain recover within six weeks, but two-thirds still have pain after three months. By 12 months, pain may linger but is usually less intense.
Researchers at Dartmouth College have found a way to make back surgery safer, faster and more cost effective.
AURORA, CO—A new study of treatment options for military veterans with chronic pain has determined that care practices at Veterans Health Administration (VHA) facilities vary widely and could contribute to a veteran's likelihood of using opioids.
A new study confirms that rocker bottom shoes helps strengthen back muscles, improving the spine's curvature and thus reducing low back pain.
BUFFALO, N.Y. – The more educated a member of the baby boomer generation, the more likely they are to misuse prescription opioids, according to new research from the University at Buffalo.
Researchers at the University of Pennsylvania are working to uncover ways to encourage the cells in and around the meniscus to repair themselves, hopefully leading to less invasive procedures. Scientists within the McKay Orthopaedic Research Laboratory are taking a tissue-engineering approach to improve many types of healing related to the skeletal system, says Lou Soslowsky, the vice-chair for research in the department of orthopaedic surgery. "We blend biology with engineering to understand normal and pathologic processes to ultimately replace or regenerate musculoskeletal tissues."
STUDY TITLE: Chiropractic Treatments for Idiopathic Scoliosis: A Narrative Review Based on the SOSORT Outcome CriteriaAUTHORS: Morningstar MW, Stitzel CJ, Siddiqui A et al.PUBLICATION INFORMATION: Journal of Chiropractic Medicine 2017; 16(1): 64-71
Idiopathic scoliosis (IS) is widely treated by chiropractors. The common goals of treatment include correction or stabilization of the Cobb angle (i.e. curve severity) and/or to provide pain relief. It is uncertain whether the body of chiropractic literature fits the criteria for reporting of results as outlined by the 2015 Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) and the Scoliosis Research Society (SRS) consensus paper and Weiss et al.
COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center examines what may cause chronic back pain in runners and the exercises to help prevent it.
Muscle paralysis rapidly causes inflammation in nearby bone marrow, which may promote the formation of large cells that break down bone, a new study finds. The article is published in the American Journal of Physiology – Cell Physiology.
It is the number one reason that people go to see the doctor, and it is now a national crisis. The problem: chronic pain and prescription opioids. The dilemma: how to provide the most effective pain treatment for 80 per cent of pain patients who are at least risk for addiction while causing the least harm to the remaining 20 per cent who are at most risk. The solution: it's very complicated, but it may be possible to address both problems without adversely affecting either.
Moderate to high intensity exercise does not slow cognitive (mental) impairment in older people with dementia, finds a trial led by a University of Warwick researcher.
Poor sleep quality was linked with less physical activity in an Arthritis Care & Research analysis of individuals with or at risk for knee osteoarthritis.
QUINCY, MA—The last thing Lizabeth Loud, a month from giving birth, wanted was to be forced into treatment for her heroin and prescription painkiller addiction.But her mother saw no other choice, and sought a judge's order to have her committed against her will. Three years later, Loud said her month in state prison, where Massachusetts sent civilly committed women until recent reforms, was the wake-up call she needed.''I was really miserable when I was there,'' the 32-year-old Boston-area resident said. ''That was one bottom I wasn't willing to revisit again.''An Associated Press check of data in some key states has found that the use of involuntary commitment for drug addiction is rising. And in many places, lawmakers are trying to create or strengthen laws allowing authorities to force people into treatment.But critics, including many doctors, law enforcement officials and civil rights advocates, caution that success stories like Loud's are an exception. Research suggests involuntary commitment largely doesn't work and could raise the danger of overdose for those who relapse after treatment.And expanding civil commitment laws, critics argue, could also violate due process rights, overwhelm emergency rooms and confine people in prisonlike environments, where treatment sometimes amounts to little more than forced detox without medications to help mitigate withdrawal symptoms.At least 35 states currently have provisions that allow families or medical professionals to petition a judge, who can then order an individual into treatment if they deem the person a threat to themselves or others. But the laws haven't always been frequently used.Wisconsin Gov. Scott Walker signed a law last year allowing police officers to civilly commit a person into treatment for up to three days. In Washington state, legislation that took effect April 1 grants mental health professionals similar short-term emergency powers. In both states, a judge's order would still be required to extend the treatment.Related bills have also been proposed this year in states including Pennsylvania, New Jersey and Massachusetts, where involuntary commitment has emerged as one of the more controversial parts of Republican Gov. Charlie Baker's wide-ranging bill dealing with the opioid crisis.Massachusetts already allows for judges to order people to undergo up to three months of involuntary treatment, but lawmakers are considering giving some medical professionals emergency authority to commit people for up to three days without a judge's order.The proposal is a critical stopgap for weekends and nights, when courts are closed, said Patrick Cronin, a director at the Northeast Addictions Treatment Center in Quincy, who credits his sobriety to his parents' decision to have him involuntarily committed for heroin use almost 15 years ago.But giving doctors the ability to hold people in need of treatment against their will, as Massachusetts lawmakers propose, will burden emergency rooms, which already detain people with psychiatric problems until they can be taken to a mental health centre, said Dr. Melisa Lai-Becker, president of the Massachusetts College of Emergency Physicians, an advocacy group.''We've got a crowded plane, and you're asking the pilots to fly for days waiting for an open landing strip while also making sure they're taking care of the passengers and forcibly restraining the rowdy ones,'' Lai-Becker said.Baker's administration stressed the proposal wouldn't take effect until 2020, providing time to work out concerns.Even without the state legislative efforts, use of involuntary commitment for drug addiction is rising, according to information the AP obtained from states that have historically used it the most.Florida reported more than 10,000 requests for commitment in both 2016 and 2015, up from more than 4,000 in 2000, according to court records.Massachusetts reported more than 6,000 forced commitments for drug addiction in both fiscal years 2016 and 2017, up from fewer than 3,000 in fiscal year 2006.In Kentucky, judges issued more than 200 orders of involuntary commitment for alcohol or drug abuse in the last calendar year, up from just five in 2004, according to court records. The state has so far reported nearly 100 such commitments this year.But researchers caution there hasn't been enough study on whether forced treatment is actually working. And many states don't track whether people are being civilly committed multiple times, let alone whether they get sober for good, the AP found.In Massachusetts, where fatal overdoses dropped for the first time in seven years in 2017, state public health officials don't credit increased use of civil commitment, but rather better training for medical professionals, tighter regulations on painkillers, more treatment beds, wider distribution of the overdose reversal drug naloxone, and other initiatives.A review published in the International Journal of Drug Policy in 2016 found ''little evidence'' forced treatment was effective in promoting sobriety or reducing criminal recidivism.Another 2016 study by Massachusetts' Department of Public Health found the involuntarily committed were more than twice as likely to die of an opioid-related overdose than those who went voluntarily, but those findings shouldn't be viewed as an indictment of the process, argues Health and Human Services office spokeswoman Elissa Snook.''Patients who are committed for treatment are among the sickest, most complex and at the greatest risk for an overdose,'' she said.''Involuntary commitment is an emergency intervention, to help individuals stay alive until they are capable of entering treatment voluntarily.''Most states send the civilly committed to treatment facilities run or contracted by public health agencies. The costs generally fall on patients, their families or insurance providers.Massachusetts stands out because, until recently, it sent those civilly committed for drug addiction to prisons. That decadeslong practice ended for women in 2016, but many men are still sent to the Massachusetts Alcohol and Substance Abuse Center, which is housed in a minimum-security prison in Plymouth, near Cape Cod.Patients wear corrections-issued uniforms and submit to prison regulations like room searches and solitary confinement. They also aren't given methadone or buprenorphine to help wean off heroin or other opioids, as they might in other treatment centres.Michelle Wiley, whose 29-year-old son David McKinley killed himself there in September after he asked her to have him civilly committed for the third time, said she isn't opposed to expanded use of the practice as long as those with addiction aren't sent to places like Plymouth.In the days before he hanged himself in his room, Wiley said, her son had complained to her about dirty conditions, poor food and not enough substance abuse counsellors while he went through withdrawal.''You think it's going to be helpful until you hear what it's like,'' she said. ''If I had to do it over, I wouldn't send him to that place.''The corrections department has since taken steps to improve conditions, including more frequent patrols by prison guards and extended hours for mental health professionals, department spokesman Jason Dobson said.As for Loud, the Massachusetts woman civilly committed while pregnant, she said she has found peace.After briefly relapsing following her son's birth, she has been sober for about a year and a half. She focuses her energies on raising her son, attending regular support meetings and pursuing a passion sidelined by her addiction: competitive Muay Thai fighting. Her fourth bout is in July.Loud has also reconciled with her mother. The two now live together, along with her son.''It took me a long time to understand what she was going through,'' Loud said. ''She was just trying to save her daughter.''
In Canada, approximately one in five adults will experience a mental illness in their lifetime, with similar numbers reported in the United States.
In the largest, most up to date study of its kind, researchers from the University of Surrey examined the link between diet and the effective self-management of osteoarthritis. Analyzing 68 previous studies in the field, researchers found that a low-dose supplement of fish oil (one and a half standard capsules) could result in pain reduction for patients with osteoarthritis and help improve their cardiovascular health. Essential fatty acids in fish oil reduce inflammation in joints, helping to alleviate pain.
RESTON, VA—A novel PET tracer developed by Korean researchers can visualize joint inflammation and could provide early diagnosis of rheumatoid arthritis, a common autoimmune disease that causes chronic inflammation of joints and can lead to deformity and dysfunction. The study is reported in the featured basic science article in The Journal of Nuclear Medicine's May issue.
VANCOUVER—A woman whose son fatally overdosed after becoming addicted to the painkiller OxyContin is backing a New Democrat member of Parliament's calls for the federal government to launch a criminal investigation of opioid manufacturers.
Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure – if it's enough exercise, and if it's begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources.
ANN ARBOR, Mich. – Until now, academic research examining the connection between body weight and related pain has been limited.
A new Mayo Clinic book – Mayo Clinic: The Integrative Guide to Good Health – highlights the importance of mental and spiritual wellness when maintaining an individual's overall health.
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study led by the University of Southampton.
BIRMINGHAM, Ala. – Bananas and avocados — foods that are rich in potassium — may help protect against pathogenic vascular calcification, also known as hardening of the arteries.
As a chiropractor, you’ve worked tirelessly to improve your patients’ quality of life and build your practice – and then you get a two-star rating on Google. No one likes a bad review and you don’t want it affecting your business.
Toys “R” Us (USA), Sears Canada, and Target Canada. All of these companies had expenses that grossly overshadowed their revenue. As the losses mounted, they did nothing to stop the financial bleeding. When these businesses finally tried to do something, they were in too deep.
In 2017, headlines from across the world showcased hackers targeting multinational corporations, government agencies and charities, among other organizations. As executive leaders recognize the impact of cyberattacks, more organizations are prioritizing security.
Halifax, N.S. — There's a new website aimed at helping Canadians find their ideal chiropractor. Chiropractors.ca has completed its first month of operations, demonstrating encouraging growth. Within its first 30 days, 90 Canadian chiropractors registered their practice profiles with Chiropractors.ca.
In my 36-years in practice I have experienced and gained perspectives from all the different sides of running a practice.
Chiropractic patient communication has been a serious problem over the years and it has caused a lot of issues in not only driving more people to chiropractic offices, but also getting the population as a whole to accept and understand our profession.
Changes to the Ontario employment law have been passed and for small business owners, this is bad news. The Canadian Centre for Economic Analysis was commissioned by the Keep Ontario Working coalition to measure the potential impacts of six key areas of change in Bill 148, including changes to minimum wages, equal pay provisions, vacation, scheduling, personal emergency leave, and unionization.
Health spending in Canada is expected to reach $6,604 per capita this year – or about $200 more per person compared to last year – according to a report released Tuesday by the Canadian Institute for Health Information.
For the people of the City of Nanaimo, the spirit of Christmas is a really big deal.
Rising chiropractic association fees, dramatic hikes in minimum wage, and the elevation in inflation are only some of the factors that negatively affect our small business practice.
This past June I wrote an eye-opening article that revealed the truth about how chiropractors and team medical doctors get paid in professional football. My research verified that while many non-health-care professions who work with pro teams get paid – chiropractors are merely volunteers. For this follow-up piece, I look to answer the question: How are chiropractic practitioners treated in other sports, namely the Olympics and Major League Baseball.
Chiropractors either dread missed appointments or bury their heads in the sand and ignore them. I believe missed appointments provide us with a great deal of information.
ARLINGTON, VA.—The American Chiropractic Association (ACA) has elected N. Ray Tuck, Jr., DC, of Blacksburg, Va., as its new president.
UQTR's undergraduate Doctor of Chiropractic degree (DCP) is celebrating its 25th anniversary this year, and the university will host a special continuing education event, which will take place from September 27th to 29th, 2018.
The new CCGI clinical practice guideline on spinal manipulative therapy and other conservative treatments for the treatment of low back pain is now in press in the Journal of Manipulative and Physiological Therapeutics (Bussières et al, in press).
Arlington, VA. — The American Chiropractic Association (ACA) has announced that Congress (with the passage of the Consolidated Appropriations Act of 2018) has approved a plan to expand access to chiropractic's nondrug approach to pain relief to veterans, many of whom suffer from back pain and other musculoskeletal conditions resulting from their service. The vote follows House passage, and the bill now heads to the president's desk for his signature.
Dr. Ken W. Dick established Britannia Chiropractor Clinic in Ottawa more than three decades ago. He since went on to build a successful practice and professional career. His recently published book, Healing Satori, is a culmination of the most important principles he has learned about patient care and helping them achieve optimal health.
HALIFAX – Nova Scotia's persistent family doctor shortage has the province increasingly looking to provide care through collaborative practices – local teams that partner physicians with nurse practitioners, social workers and other health care professionals.
It all started when the two of us sat down over a cup of coffee. As a family physician and endocrinologist, we stand on opposite sides of a large chasm called patient wait times, and we both started seeing more and more of our patients getting swallowed up by this abyss.
Arlington, Va. – Members of the U.S. House of Representatives has introduced a bill that would expand access to chiropractic services to military retirees, dependents and survivors through the Department of Defense TRICARE health program.
Sylvia Hoyt believed she’d never ride her beloved Quarter Horses again – until she met chiropractor, Dr. Erik Klein, who was determined to get her back up in the saddle again and competing against the world’s top equestrians.
Changes to the Ontario employment law have been passed and for small business owners, this is bad news. The Canadian Centre for Economic Analysis was commissioned by the Keep Ontario Working coalition to measure the potential impacts of six key areas of change in Bill 148, including changes to minimum wages, equal pay provisions, vacation, scheduling, personal emergency leave, and unionization.
The continuously evolving dynamics of health care means practitioners must constantly keep abreast of issues that can affect delivery of care, clinic management and day-to-day operations. As 2017 draws to a close, Canadian Chiropractor explores emerging trends, issues and opportunities in the health care sector.
When Ed Cunningham resigned his lucrative post as a college football analyst for ESPN last August, he made clear the reason for his departure: he no longer wished to be at the forefront of a sport that endangers its players.
New York, NY—Spine deformities, such as idiopathic scoliosis and kyphosis (also known as "hunchback"), are characterized by an abnormal curvature in the spine. The children with these spinal deformities are typically advised to wear a brace that fits around the torso and hips to correct the abnormal curve. Bracing has been shown to prevent progression of the abnormal curve and avoid surgery. The underlying technology for bracing has not fundamentally changed in the last 50 years.
Back Mechanic guides you through a self-assessment of your pain triggers, then shows you how to avoid these roadblocks to recovery.
Data from a recent University of Toronto study has found that MuscleCare all-natural topical product is as effective as those containing non-steroidal anti-inflammatory drug (NSAIDs). A recent double-blind study also revealed that all- natural Professional Therapy MuscleCare is marginally more effective than Voltaren, which contains Diclofenac NSAID.
Spenco has introduced its new Professional Collection, attractive footwear ideal for people whose professions require long hours of standing or walking.
The new Biofreeze Professional is based on the original Biofreeze formula and has optimized key ingredients based on scientific research to provide a longer-lasting experience, according to the brand's proponent, Performance Health. It also has a smoother application with fast absorption for relief from backaches, arthritis, sore muscles and joints, sprains, strains and bruises.
EmoBridge has introduced what it claims is the world's first smart wristband for accurately tracking and analyzing daily stress levels and sleep patterns to help people live a more well-balanced, peaceful life. The new Sensmi is built with patented, hospital-grade GSR-PRO bio-sensing technology that tracks brainwave activity through galvanic skin response (GSR) and a proprietary algorithm that disperses data that is easily understandable. Sensmi provides users with straightforward results and easy-to-follow instructions on how to confront lifestyle stressors.
A new line of instantly customizable insoles offers quick relief for athletes and others whose feet need orthotic support, according to its producer Spenco Medical Corporation. Spenco has just stocked its complete line of Spenco Medics Adjustable Replacement Insoles.
Vitality Depot has launched Pain Gone, a clinically tested pen-like device that patients can use for pain management.
LifeLabs Medical Laboratory Services has launched JOINTstat, a diagnostic blood test for rheumatoid arthritis. The JOINTstat blood test is the first test of its kind available in Canada that aids in the early detection and diagnosis of rheumatoid arthritis. When caught and treated early, rheumatoid arthritis outcomes can be greatly improved. Through an agreement with Augurex Life Sciences Corp., developer of the JOINTstat test, JOINTstat is now offered exclusively by LifeLabs to patients and physicians across Canada.
Dr. Chris Oswald had been practicing chiropractic in the Toronto area for 16 years when he reached a point of frustration and decided to change the game.
California based health and wellness company Metagenics launches FirstLine Therapy Healthy Transformation Weight Loss program, its latest product to assist in weight loss and healthy living.
This Jan. 1, Ontario residents who are 24 and younger rang in the new year with a pretty big upgrade to their health care: something called "OHIP+", which gave young people a government insurance plan for prescription drugs.
The longer I practice, the harder it is to give business practice advice because what works for one person doesn’t work for another. Additionally, very few people will discard their old failing ways in exchange for what you recommend for improvement.
I recently had the opportunity to travel to Mumbai, India, for the Sant Nirankari Mission, a five-day spiritual event attended by millions of devotees from different parts of India.
Toronto (Troy Media) – Canadians suffer when important mental health services are unavailable or wait times are too long.
Each year, there are at least one million unnecessary tests, treatments and procedures done in Canadian health-care settings. This means that hundreds of thousands of Canadians are exposed to potential harm by unnecessary care.
I was horrified to see that 47 per cent of our profession is in favour of the move to expand the chiropractic scope of practice to include limited prescription rights. This is according to results from the recent Canadian Chiropractor Practice Trends Survey.
Rising business costs, government mandated minimum wage increases, hikes in chiropractic licence fees, spikes in our association premiums, cut-backs by insurance companies and changes in the auto injury guidelines – these are only some of the barriers chiropractors have to deal with when running their practice. These obstacles are enough to drive the most successful practices out of business.
I write this final column with mixed emotions. I am a little sombre that it is time for me to move on; at the same time feel excited to leave you with my biggest pearls that you can use to create success in your practice.
According to the federal government’s timeline, by the summer of 2018 Canada would have legalized the use of recreational marijuana. This impending legalization is causing anxiety among certain sectors, including the health-care profession – and for good reason.
Many Canadians can hardly wait for the day that the recreational use of marijuana becomes legal. As a medical doctor, I'm far less enthusiastic. I worry about two things: the experimental nature of marijuana in medical practice and the public health consequences of legalized marijuana.
The brain was the big subject at this year’s Wave conference, held in San Francisco in August and hosted by Life Chiropractic College West.  

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