Study Finds the Availability of Chiropractic Care Improves the Value of Health Benefits Plans

Foundation for Chiropractic Progress commissions landmark report delivers incremental impact on population health and total health care spending

Carmichael, CA - October 20, 2009 - A report, prepared by a global leader for trusted human resources and related financial advice, products and services, finds that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in US employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded at:

http://images.vortala.com/chiropractor/USA/California/Carmichael/Foundation%20for%20Chiropractic%20Progress/SiteGraphics/ChiropracticServicesReport.pdf

Accordingly, this report was commissioned by the Foundation for Chiropractic Progress (www.f4cp.com) to summarize the existing economic studies of chiropractic care published in peer-reviewed scientific literature, and to use the most robust of these studies to estimate the cost-effectiveness of providing chiropractic insurance coverage in the US.

According to Gerard Clum, DC, spokesperson for the Foundation for Chiropractic Progress and President of Life Chiropractic College West, ?While some studies reflect cost efficiencies and others clinical efficiencies, these findings strongly support both for chiropractic care of neck pain and low back pain.?

Executive Summary:

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, are used by almost half of US patients with persistent back-pain seeking out this modality of treatment.

The peer-reviewed scientific literature evaluating the effectiveness of US chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments. However, US cost-effectiveness studies have methodological limitations.

High quality randomized cost-effectiveness studies have to date only been performed in the European Union (EU). To model the EU study findings for US populations, researchers applied US insurer-payable unit price data from a large database of employer-sponsored health plans. The findings rest on the assumption that the relative difference in the cost-effectiveness of low back and neck pain treatment with and without chiropractic services are similar in the US and the EU.

The results of the researchers' analysis are as follows:

-Effectiveness: Chiropractic care is more effective than other modalities for treating low back and neck pain.

Total cost of care per year:

-For low back pain, chiropractic physician care increases total annual per patient spending by $75 compared to medical physician care.

-For neck pain, chiropractic physician care reduces total annual per patient spending by $302 compared to medical physician care.

Cost-effectiveness: When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.

These findings, in combination with existing US studies published in peer-reviewed scientific journals, suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorable to most therapies that are routinely covered in US health benefits plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

Anatomy of the Cervical spine

http://www.youtube.com/watch?v=aDvbAvBLQuM

Depressing News about Treatment of Depression

Note from Brian O'Hea

This article is from Dr. Andrew Weil M.D., who was one of the first MD's to popularize the field of "integrative medicine." This looks at the whole person and addresses lifestyle, nutrition, exercise etc. to help people be healthier. "Integrative Medicine" is much like the version of chiropractic care that Dr. Susan and I preach. The big difference is that we don't prescribe medications. We believe that most of the time your body heals itself. In fact, it's doing so right now.

On another note, I just read the book Generation RX by Greg Crister. It is how the pharmaceutical companies turn the everyday emotions and conditions that we all experience into maladies that can be fixed with the magic pill. The book details how drug companies create new markets and profit handsomely by doing so. There is a glimmer of hope at the end of the book on how we can create our own state of health and well-being. Well worth reading.

And now the Article......


Depression can be devastating. Its worst form, major depressive disorder, is marked by all-encompassing low mood, thoughts of worthlessness, isolation, and loss of interest or pleasure in most or all activities. But this clinical description misses the deep, experiential horror of the condition; the suffocating sense of despair that can make life seem too arduous to bear.
Here's something else we can say confidently about depression: it is complex. The cause is often a mix of factors including genetic brain abnormalities, sunlight deprivation, poor nutrition, lack of exercise, and social issues including homelessness and poverty. Also, cause and effect can be hard to tease apart -- is social isolation a cause or an effect of depression?
Unfortunately, we can make one more unassailable observation about depression: the disorder -- or, more precisely, the diagnosis -- has gone stratospheric. An astonishing 10 percent of the U.S. population was prescribed an antidepressant in 2005; up from 6 percent in 1996.
Why has the diagnosis become so popular? There are likely several reasons. It's possible that more people today are truly depressed than they were a decade ago. Urbanized, sedentary lifestyles; nutrient-poor processed food; synthetic but unsatisfying entertainments and other negative trends, all of which are accelerating, may be driving up the rate of true depression. But I doubt the impact of these trends has nearly doubled in just ten years.
So here's another possibility. The pharmaceutical industry is cashing in.
In 1996, the industry spent $32 million on direct-to-consumer (DTC) antidepressant advertising. By 2005, that nearly quadrupled, to $122 million. It seems to have worked. More than 164 million antidepressant prescriptions were written in 2008, totaling $9.6 billion in U.S. sales. Today, the television commercial is ubiquitous:
A morose person stares out of a darkened room through a rain-streaked window.
Quick cut to a cheery logo of an SSRI (selective serotonin reuptake inhibitor, the most common type of antidepressant pharmaceutical).
Cross-fade to the same person, medicated and smiling, emerging into sunlight to pick flowers, ride a bicycle or serve birthday cake to laughing children.
A voiceover gently suggests, "Ask your doctor if [name of drug] is right for you."

The message -- all sadness is depression, depression is a chemical imbalance in the brain, this pill will make you happy, your doctor will get it for you -- could not be clearer. The fact that the ad appears on television, the ultimate mass medium, also implies that depression is extremely common.
Yet a study published in the April, 2007, issue of the Archives of General Psychiatry, based on a survey of more than 8,000 Americans, concluded that estimates of the number who suffer from depression at least once during their lifetimes are about 25 percent too high. The authors noted that the questions clinicians use to determine if a person is depressed don't account for the possibility that the person may be reacting normally to emotional upheavals such as a lost job or divorce (only bereavement due to death is accounted for in the clinical assessment). And a 15-year study by an Australian psychiatrist found that of 242 teachers, more than three-quarters met the criteria for depression. He wrote that depression has become a "catch-all diagnosis."
What's going on?
It's clear that depression, a real disorder, is being exploited by consumer marketing and is over-diagnosed in our profit-driven medical system. Unlike hypertension or high cholesterol -- which have specific, numerical diagnostic criteria -- a diagnosis of depression is ultimately subjective. Almost any average citizen (particularly one who watches a lot of television) can persuade him or herself that transient, normal sadness is true depression. And far too many doctors are willing to go along.
The solution to this situation is, unsurprisingly, complex, cutting across social, medical, political and cultural bounds. But here are three major changes that are needed immediately:
Medically, thousands of studies confirm that depression, particularly mild to moderate forms, can be alleviated by lifestyle changes. These include exercise, lowered caffeine intake, diets high in fruits and vegetables, and certain supplements, particularly omega-3 fatty acids. Physicians need to be trained in these methods, as they are at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson. See Natural Depression Treatment for more about these low-tech methods, or the "Depression" chapter in the excellent professional text, Integrative Medicine by David Rakel, M.D. (Saunders, 2007).
Politically, if Congress -- which seems hopelessly addicted to watering down all aspects of health care reform -- can't manage to ban all DTC ads in one stroke, it should start by immediately ending those for antidepressants.
Personally, be skeptical of all DTC ads for antidepressants. The drugs may turn out to be no more effective than placebos. Many of them have devastating side effects, and withdrawal, even if done gradually, can be excruciating. While they can be lifesavers for some people, in most cases they should be employed only after less risky and expensive lifestyle changes have been tried.

Finally, recognize that no one feels good all the time. An emotionally healthy person can, and probably should, stare sadly out of a window now and then. Many cultures find the American insistence on constant cheerfulness and pasted-on smiles disturbing and unnatural. Occasional, situational sadness is not pathology -- it is part and parcel of the human condition, and may offer an impetus to explore a new, more fulfilling path. Beware of those who attempt to make money by convincing you otherwise.
Andrew Weil, M.D


Read more at: http://www.huffingtonpost.com/andrew-weil-md/are-you-depressed-or-just_b_307734.html

Run, Run, Run, Run Away...

The above is a reference to a line from a Jefferson Starship (or if you are an old hippie, the Jefferson Airplane) song and a lead in to a few of my thoughts on running. I often get asked if running is ok on the body, especially if you have a neck or back injury. And the answer is a resounding maybe! It depends on a bunch of factors-such as the severity of your problem, health of your joints (like your knees and hips), patterns of muscle imbalances, and your feet. Everyone is a little different and there isn't one simple answer.
Let me explain some of the ways you can get from where you are ( maybe sitting on the couch) to a place you would like to be (active, jogging, maybe competing in a race). First off, I start by looking at your feet. If your arches are flat or you notice your shoes wearing more on the outside of the heel, you probably need to start with orthotics. Orthotics are inserts that you put into your shoes to correct biomechanical problems in your gait. I use (both personally in my own shoes and in my practice) FootMaxx orthotics. They have a great method at determining the type of foot problem you have an have a semirigid orthotic that is comfortable to wear. Most of the patients at the office really feel they are helpful. Orthotics not only help your feet, but they can relieve pressure on your knees and back.
Next, I will see if any of the muscles in your legs are tight and imbalanced. It's very common to have a tight hamstring or ITB and it is important to deal with this. Otherwise, running will continue to strengthen the imbalance. People often have tight hamstrings; what I have learned ( and some recent research has shown) is that you can stretch and stretch and stretch your hamstrings, but they won't get any more flexible until you fix your back.
So what if your joints are already worn out? If you have a lot of wear and tear on your joints ( arthritis) walk, don't run. Sorry. You can make your walks more interesting by varying your pace. You can also get a nice heart work-out by carrying two water bottles in your hands and occasionally pumping them above your head. This was the idea behind the "heavy hand" wrist weights that were popular in the early 80's. Even though I don't recommend running, you need to walk, especially if you have arthritis. The right amount of movement and pressure stimulates cartilage growth. Supplements for joint health are a great ides and will be covered in a future post.
What about shoes? I can't keep up with all the brands so I recommend you get fit at a local store, Running in Motion, in Edmonds. The owner, Frank, knows his stuff. He put me in a size larger than I normally use and they feel good. The concept is that feet swell when you run so a tight fitting shoes gets too tight when you are exercising.
IF you "don't have a runners body" just remember that you do. It's in there, it just needs some help to come out.