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Research Update Newsletter Index |
JVSR Research Update - May 31, 2002Show me Your Evidence Dr. Matthew McCoy I recently had the opportunity to provide testimony to the Colorado Board of Chiropractic during an open hearing where they sought public comment on a number of issues. They included the use of neurodiagnostic technology such as NCV’s, evoked potential testing, Surface Electrode Electromyography, Laser and Network Spinal Analysis. The significant issue to me revolved around the parameters of evidence they were interested in hearing about. They essentially boiled down to three items:
These questions should be familiar to any chiropractor who has dealt with third party payers as these are very similar to the requirements they mandate a procedure must meet in order for them to reimburse it. The following quote is from a recent denial letter from Aetna received by a chiropractor:
Prudential has these parameters that define necessity:
Prudential goes on to define educational, experimental and investigational. These parameters are similar to what Colorado and many of our states require regarding chiropractic procedures Whether or not we all like these parameters is not the subject of this Update. The facts of the matter are that they exist and we are either aware of them or we are not and if you or I don’t like their measuring sticks then it is up to each of us to show up on their doorsteps and lobby for change. Having said that, since it is the job of the regulatory boards to “protect the safety of the public” then no matter what we do to change the particular yardsticks being used, we will still end up with… yardsticks. And of course we should if the public is to be protected. So the task remains for the chiropractic profession to continue to have its procedures measure up to some yardsticks and to do so means we need evidence. And to get evidence we need to do research. And to do research, the profession needs to support a culture of research. Many within subluxation based chiropractic have a bitter taste in their mouths regarding research as it seems much of the research that’s been done does not necessarily support what they do. Worse still is that IME doctors, state boards and insurance companies tend to use the literature selectively in an effort to avoid paying a claim. This leads chiropractors to the mistaken belief that all research is negative. Unfortunately this is not the whole landscape but merely a particular region and subluxation based chiropractors are cutting their own throats with this attitude. It has to stop. Research that is subluxation based has and is being done. This is thanks to those chiropractors and organizations that actively support it. Are you one of those people and is your organization one of those groups? While it would be nice if chiropractors supported this type of research out of a sense of responsibility and duty to their profession, the bottom line is that most support it, or eventually look for it, out of fear. You too may need it some day. Thankfully, Dr. Bob Blanks Bio attended the hearing in Colorado and presented testimony on the issue of research evidence supporting Network Spinal Analysis. Those of you who practice Network owe a thank you to Dr. Epstein for having the foresight and sense of responsibility a number of years ago to know that he needed to conduct research. A thank you also needs to go to Dr. Blanks for knowing how to do the type of research needed to investigate what our profession was founded for in the first place. He also pointed out to the standing room only crowd that he can assure us that the medical profession is and has been doing this type of research. He should know since, in his spare time, he teaches anatomy to medical students. Those of us who use SEMG owe a thanks to Dr.’s Gentempo and Kent for their work during the past 15 years to validate its use and to show up at Board hearing after Board hearing over those years in order to make sure that the Boards know the current status. Yesterday it was Network, and SEMG. A few months ago it was CBP in Canada, a year ago it was Activator and before that it was full spine x-rays. Chiropractors contact me daily asking for help on these types of issues because of a board action, malpractice accusation or insurance problems. Who will be next? Will you be ready? Why not start today by subscribing to the only peer reviewed chiropractic research journal devoted to subluxation. Here is a partial sampling of just some of the excellent research articles JVSR will be publishing over the next several months:
As always I look forward to your feedback, comments and suggestions. Dr. Matthew McCoy editor@jvsr.com
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