Texas Chiropractic eSource
The Texas Chiropractic eSource is your connection to Texas Chiropractic news, updates and events.
Clinical Prediction Rules Screen Cervical Spine Injury in Low-risk Patients
Written by Editor   
Wednesday, November 22, 2017 09:23 AM

To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk adult patients with blunt trauma to the neck. The authors of this study searched four databases from 2005 to 2015. 

Improper Medicare payments drop by nearly $5 billion
Written by Editor   
Tuesday, November 21, 2017 04:26 PM

The CMS has reported that the rate of improper payments doled out by Medicare is the lowest it’s been since 2013, accounting for less than 10% of overall Medicare payments.

Regular Use of Medication for Musculoskeletal Pain and Risk of Long-term Absence
Written by Editor   
Sunday, November 19, 2017 10:15 PM

The aim of this study was to determine the prospective association between use of pain medication – due to musculoskeletal pain in the low back, neck/shoulder and hand/wrist – and long-term sickness absence.  The study concludes that regular use of pain medication due to musculoskeletal pain is prospectively associated with long-term sickness absence (LTSA) even when adjusted for pain intensity.

This study suggests that use of pain medication can be an important factor to be aware of in the prevention of sickness absence. Thus, regular use of pain medication – and not solely the intensity of pain – can be an early indicator that musculoskeletal pain can lead to serious consequences such as long-term sickness absence.

Pediatric Concussion 'Grossly' Underdiagnosed in Hospital Emergency Departments
Written by Editor   
Friday, November 17, 2017 07:34 AM

Concussions were "grossly" underdiagnosed among children presenting to a Level 1 trauma center's pediatric emergency department, according to a study.  “We aren’t very good at diagnosing concussions in an emergency department setting,” the study author said.

TCA Statement on TDI-DWC Designated Doctor Proposed Changes
Written by Andrea Howard   
Thursday, November 16, 2017 11:20 AM

The Texas Department of Insurance – Division of Workers’ Compensation (“the Division”) has recently proposed changes to the Designated Doctor (“DD”) program. Specifically, the Division has proposed amending the types of examinations Doctors of Chiropractic are “qualified” to handle and changing the way DD examinations are scheduled.

The Texas Chiropractic Association (“TCA”) appreciates the Division’s attempts to improve the DD program, and we were particularly pleased that the Division revised its proposal regarding the scheduling of DD examinations. We are currently reviewing those revisions with our members.

Perspectives on Opioids and Alternative Treatments for Chronic Pain
Written by Editor   
Thursday, November 16, 2017 08:01 AM

Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives.

The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. The results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making chiropractic and acupuncture (A/C) care more easily accessible, might lead to more satisfaction for patients and providers, and provide important input to policy makers.

"Know Your Herbal Supplier": Unlabeled Ingredients in Herbal Supplements Seen Causing Liver Injury
Written by Editor   
Wednesday, November 15, 2017 02:44 PM

Herbal products and supplements are frequently mislabeled and may contain unlisted ingredients that are harmful to the liver, researchers said.

Of 272 herbal dietary supplements analyzed, 51% had inaccurate labels in which some or all of the listed ingredients were not detected in the product. “Herbal supplements are a common cause of liver injury,” one research stated.  “There are lots of products that are difficult to identify what they are and what they’re used for.” In 20% of cases, the injury was caused by dietary supplement. Many of the products are sold as body-building supplements or weight-loss supplements.

“A lot of the literature tells us supplements can be mislabeled or adulterated" -- the latter occurring when something is secretly included to support the purpose for which it is being marketed, such as for sexual enhancement, he added.

Executive Director’s Message: November 2017
Written by Jeff Jenkins   
Wednesday, November 15, 2017 11:53 AM
Thanksgiving is one of my favorite times of year. Family, friends and lots of good food!
It’s also the perfect time to give thanks and that’s the main purpose of my ED Message. First of all, I want to thank you, our members, for supporting YOUR state association through your membership and active involvement. 
Over the past year, the Texas chiropractic community pulled together and the end result was the most mind-blowing legislative session in decades. Getting four pro-chiropractic bills signed into law just doesn’t happen without hard work behind the scenes. We share these victories with every one of you who showed up at TCA Legislative Day in Austin and met, called and/or emailed a state legislator during the past session. You spread the message of chiropractic throughout the State Capitol and won us many friends along the way. Let’s keep it going ... we know we must raise the bar even higher for the next legislative session in 2019!
CMS to Ease Physician Burden, Give More Patient Time
Written by Editor   
Wednesday, November 15, 2017 07:41 AM

The Trump administration wants to give doctors more time with patients by rolling back the regulatory requirements foisted on physicians over the years.

"I'd like to think of regulatory reform in terms of painting a house," said Seema Verma, administrator for the Centers for Medicare and Medicaid Services.

"Typically, repainting needs to occur every few years, and before you do it, you need to strip the layers of paint underneath," she continued during a meeting with hospital, physician and other healthcare stakeholders held at the agency's Washington office. "Unfortunately, during past administrations CMS has been simply applying new layers of paint without taking this essential step."

Verma announced the launch of a "Patients over Paperwork" initiative, geared towards scrapping or reducing regulations while lowering healthcare costs and enhancing patient care.

Wanted, a Few Good Providers
Written by Editor   
Tuesday, November 14, 2017 01:38 PM

Sufficient research evidence and recommendations are documented in published guidelines, frameworks and models of care to inform clinical practice and the care of chronic spinal pain worldwide. 

The gap in care services is not the availability of prescription medication or allied health services, but rather the coordinated, multidisciplinary provision of care services by health care practitioners with an interest and skill in pain management. 

The challenge of our time is ensuring early access of patients with chronic spinal pain to care, coordinated practitioner teamwork and the application of the correct level of care individualized to the patient. 

Ex-Pharma Exec to Head HHS
Written by Editor   
Tuesday, November 14, 2017 07:27 AM

Former pharmaceutical company executive Alex Azar II is being nominated by President Trump to head the Department of Health and Human Services (HHS) and to preside over either the elimination or implementation of the Affordable Care Act (ACA).

Azar served as the HHS department’s general counsel from 2001 to 2005 in the George W. Bush administration and then as its deputy secretary, the number-two position, from 2005 to 2007.

It's his last high-profile job as president of Lilly USA, the largest affiliate of drugmaker Eli Lilly, however, that has raised the most eyebrows. If confirmed by the Senate, Azar will be Trump's lead person in dealing with Big Pharma. Azar worked at Eli Lilly for a decade after his stint at HHS.

Use of Integrative Medicine in the US Military Health System
Written by Editor   
Monday, November 13, 2017 07:45 AM

Integrative medicine (IM) is a model of care which uses both conventional and nonconventional therapies in a “whole person” approach to achieve optimum mental, physical, emotional, spiritual, and environmental health, and is increasingly popular among patients and providers seeking to relieve chronic or multifactorial conditions. 

The US Department of Defense (DoD) shows particular interest in and usage of IM for managing chronic conditions including the signature “polytrauma triad” of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) among its beneficiaries in the Military Health System (MHS).

These modalities range from conventional nondrug, nonsurgical options such as cognitive-behavioral therapy to nonconventional options such as acupuncture, chiropractic, and mind-body techniques. These are of particular interest for their potential to relieve symptoms without relying on opiates, which impair performance and show high potential for abuse while often failing to provide full relief.

On-Site Chiropractic Care as an Employee Benefit: A Single-Location Case Study
Written by Editor   
Thursday, November 09, 2017 08:48 AM

The purpose of this report is to describe the role of on-site chiropractic care in one corporate environment.  Absenteeism for the employee–patients was lower than equivalent national figures in this sample of workers. Though these results may or may not be related to the chiropractic care, these findings prompt further investigation into this relationship.

CMS Cancels Planned Home Health Pay Model,
Written by Editor   
Wednesday, November 08, 2017 08:04 AM

The CMS is canceling plans for a pay model it hoped would overhaul Medicare home health payment.  Under the home health groupings model, it was hoped that Medicare payment would have been based on patient characteristics rather than the number of visits for various forms of therapy. The new system would boost payment for skilled-nursing and home health aide visits for medically complex patients.  The CMS estimated that the model would result in a home health spending cut of $950 million, or 4.3%, in 2019, when it would take effect.

Patient Expectations of Benefit from Common Interventions for Low Back Pain and Effects on Outcome
Written by Editor   
Tuesday, November 07, 2017 08:12 AM

The findings of this secondary analysis indicate that patients seeking intervention for LBP expect active interventions and manual therapy to significantly help improve their pain more than interventions like traction, rest, surgery, or medication. Additionally, in patients who meet the clinical prediction rule for good prognosis when managed with thrust techniques, treating with thrust techniques is more important than matching treatment to patient expectation.

Making EHRs Doc-Friendly Only Part of the Job in the Feds' Health IT Office
Written by Editor   
Monday, November 06, 2017 08:26 AM

John Fleming, MD, is the deputy assistant secretary for health technology reform at the Office of the National Coordinator (ONC) for Health Information Technology, notes that “there has been layer on layer on layer of burden on physicians since the early 1980s, and computers increased it — one of the biggest burdens is documentation guidelines,” said Fleming. 

If the Back FEELS Stiff, is it Really?
Written by Editor   
Friday, November 03, 2017 04:51 PM

Does feeling back stiffness actually reflect having a stiff back? 

Research interrogates the long-held question of what informs our subjective experiences of bodily state. The paper reported here proposes a new hypothesis: feelings of back stiffness are a protective perceptual construct, rather than reflecting biomechanical properties of the back. 

This has far-reaching implications for treatment of pain/stiffness but also for our understanding of bodily feelings. Over three experiments, researchers challenge the prevailing view by showing that feeling stiff does not relate to objective spinal measures of stiffness and objective back stiffness does not differ between those who report feeling stiff and those who do not. Rather, those who report feeling stiff exhibit self-protective responses: they significantly overestimate force applied to their spine, yet are better at detecting changes in this force than those who do not report feeling stiff. 

'Choosing Wisely' Praised and Sometimes Feared
Written by editor   
Friday, November 03, 2017 07:37 AM

The “Choosing Wisely” initiative has done a lot to change the culture around performing unnecessary procedures. In 2012, the American Board of Internal Medicine (ABIM) debuted “Choosing Wisely," asking specialty groups to produce a list of five tests or procedures that may be overutilized. 

There were four rules that the groups had to follow:

  • It needed to be in their discipline
  • It needed to have an impact -- that is, it had to be a test or procedure that was very expensive or performed a lot
  • It needed to have evidence that it was being done too much
  • There needed to be a transparent process for choosing each item

Five years later 80 medical societies have lent their intellectual capital to thinking about this.

TBCE: Massage Therapy Risks in the Chiropractic Practice
Written by TBCE   
Wednesday, November 01, 2017 11:47 AM

Integrating massage therapy into a chiropractic practice can benefit patients as well as provide additional income to a clinic owner. However, performing massage techniques on patients in a massage therapy setting (i.e. patient disrobed, covered with sheet, dim lighting, etc.) can become a risky endeavor. In fact, it is the most common scenario leading to sexual misconduct complaints against licensees. 

Whether you administer the massage yourself or have someone in your office perform the procedure, your license and your professional liability are at risk. NCMIC notes that even when you have a licensed massage therapist in your office, providing an environment where the sexual misconduct occurs could make you legally liable. 

We asked our colleagues at the massage therapy board how their therapists protect themselves and their clients from misunderstandings. Accordingly, we put together a best practices list that may assist chiropractors when utilizing massage therapy in practice.

President Declares Opioid Crisis a Public Health Emergency
Written by Editor   
Wednesday, November 01, 2017 07:18 AM

President Trump has declared the nation’s opioid addiction epidemic to be a “public health emergency," freeing up government agencies to put more resources toward fighting the epidemic.

“This epidemic is a national health emergency, unlike what we've seen in our lifetimes," Trump said. “As Americans, we cannot allow this to continue. It's time to liberate our communities from the scourge of drug addiction. We can be the generation that ends the opioid epidemic."

“That is why, effective today, my administration is officially declaring the opioid crisis a national public health emergency under federal law, and why I am directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis," he said.

Because Trump declared the crisis to be a public health emergency rather than a national emergency, no additional funds can be allocated -- only existing funds can be used. However, "the administration is working closely with the Congress right now on an end-of-year budget deal. We expect that [funding for] this will be part of that conversation," a senior administration official said.

Texas Chiropractic College Board of Regents Announce Contract Extension for President Stephen Foster
Written by Editor   
Tuesday, October 31, 2017 03:01 PM

The Texas Chiropractic College Board of Regents has announced this past week that it has agreed with Dr. Stephen Foster to extend the term of his employment through 2020.   

Prior to his extension, Dr. Stephen Foster was officially installed as the fifteenth president of Texas Chiropractic College on November 5, 2016. 

Chairman of the Board, Dr. Monte Blue said, "The board unanimously approved the extension of Dr. Foster's contract at our fall board meeting...we are very pleased with the direction TCC is going and credit this progress to Dr. Foster's leadership." 

Presidents Message TCA Is All About Community
Written by Andrea Howard   
Friday, October 13, 2017 12:56 PM
By Dr. Max Vige, TCA President
The Texas Chiropractic Association’s main purpose is to protect the chiropractic profession through advocacy and legal means. It’s a 52-week, 365-day job, although it commands the most attention during years in which the Texas Legislature meets, such as 2017, when a record four pro-chiropractic bills were signed into law.
But TCA is much more than that: it’s also about community. And that was on full display last weekend, both in Dallas and Houston.
TCA Tour of Texas Returns
Written by Andrea Howard   
Friday, October 13, 2017 09:30 AM
Back by popular demand, the Texas Chiropractic Association is reviving the TCA Tour of Texas, our grass-roots effort to reach every licensed doctor of chiropractic in Texas. The TCA Tour of Texas will stop at cities throughout Lone Star State over the next year. There’s no cost to attend a TCA Tour of Texas event, although a contribution to the Chiropractic Development Initiative (CDI), which funds TCA’s advocacy, legal and public relations efforts, or to the TCA Political Action Committee (TCA PAC) which is dedicated to getting pro-chiropractic candidates elected to public office in Texas.
The kick-off TCA Tour of Texas stop will be held in conjunction with the District 11 meeting at 7:30 p.m. Thursday, November 16, at Sable Gate Winery in Midtown Houston (2600 Travis St., Ste. 104, Houston, TX 77006). To RSVP, email Dr. Alayna Pagnani.
Here are some of the reasons why you need to be there when the TCA Tour of Texas comes to your town:
Thank You to TCA Premium and Elite Members
Written by Andrea Howard   
Thursday, October 12, 2017 03:59 PM
A Big Thank You to TCA Elite and Premium Members 

The Texas Chiropractic Association wants to thank our Elite and Premium Members for their extra support of TCA and your efforts to advance the chiropractic profession in Texas.
The Elite Membership is an upgraded membership that includes unlimited access to all TCA events such as the Mid-Winter Conference, Texas Sports Chiropractic Conference and Chiro Texpo, TCA’s annual convention. Cost is $1,100/year or, if you prefer, you can pay $275/quarter.
The Premium Membership is a high-level membership that features 16 CE hours in the price of membership. Cost is $800/year or $200/quarter.
A significant discount off conference registration fees isn’t the only benefit of the Elite and Premium memberships. A portion of Elite and Premium membership dues support TCA’s Chiropractic Development Initiative (CDI), which funds TCA’s advocacy, legal and public relations efforts.
To join as a TCA Elite or Premium Member or upgrade your membership, contact the TCA office at (512) 477-9292 or email info@chirotexas.org. You also can join online or complete and return the Elite application and Premium application.
Call for Nominations for P. A. Willmon Memorial Award
Written by Editor   
Tuesday, October 10, 2017 05:34 PM

The P. A. Willmon Memorial Award is an award presented by the Texas Chiropractic Association to recognize a recipient from, or serving the people of a rural area. 

If you are aware of a TCA member who is from a rural area of fewer than 100,000 or who has served the TCA and/or chiropractic patients within a rural area, please forward a nomination and your reasons for consideration to the TCA office at 1122 Colorado, suite 307, Austin, TX 78701.

Deadlines for nomination are January 19th, 2018.

Call for Nominations for Executive Offices of TCA
Monday, October 09, 2017 12:16 PM

TCA is putting out a call for nominations for the offices of secretary/treasurer and vice president. Nominations are due in the TCA office by Jan. 31, 2018.

TCA’s membership elects all executive officers every year. The next annual elections will take place early in 2018. Each executive officer serves a one-year term. The vice president succeeds to the to office of president of the association.  

Candidates must also meet the following qualifications:

Call for Keeler Award Nominations
Monday, October 09, 2017 12:00 AM

Keeler Plaque Call for Nominations

TCA is accepting nominations for the Keeler Plaque, the Texas Chiropractic Association’s most prestigious award.  The Keeler Plaque designates the chiropractor of the year in Texas.

TCA members are encouraged to nominate a colleague who is a fellow TCA member. The list of nominations is presented to the Keeler Plaque Committee, which will select the honoree. Nominations are not held over from year to year.

Nominations for the 2018 Keeler Plaque are due by May 17.

Chiropractic Cares: Harvey Help
Written by Editor   
Thursday, September 07, 2017 05:35 PM

How to Help Those Affected by Hurricane Harvey

The Texas Chiropractic Association, Texas Chiropractic College and Parker University have teamed up to create a fund for Texan chiropractors who have been affected by the storm. Monetary and chiropractic equipment donations are being requested. Learn more about C.H.I.R.O.

ACA leadership requests that if you know of any member who has been seriously affected by the storm and subsequent flooding, please pass that information on to ACA Vice President Dr. Karen Konarski-Hart at communications@acatoday.org. Dr. Konarski-Hart, a trained disaster relief responder, offers this additional information for those who wish to help in some way:

TCA Response to TDI-DWC Proposed Changes
Written by Andrea Howard   
Friday, August 25, 2017 12:55 PM



TCA Members and Texas Chiropractors,

As many of you are aware, the Texas Department of Insurance, Division of Workers’ Compensation (the “Division”) published informal working draft rules regarding Designated Doctor Procedures and Requirements. The draft rules can be found here: http://www.tdi.texas.gov/wc/rules/drafts.html.

Doctors of Chiropractic from across Texas have contacted TCA to express their grave concerns about the impact several of these rules would have on injured workers and chiropractors. TCA shares these concerns. While TCA will be submitting comment on the proposals to the Division on behalf of its membership, the Association strongly encourages Doctors of Chiropractic to review the draft rules and submit their individual comments to the Division. It is critical that the Division hear how these draft rules would impact the chiropractic community.

Provisions in the Division’s draft rules prioritize Medical Doctors, Doctors of Osteopathy, and board-certified specialists over Doctors of Chiropractic in case assignments within the Designated Doctor Program (see draft rule § 127.5(f)(1) and (2)). Other provisions reduce chiropractic scope of practice within the Designated Doctor Program by prohibiting Doctors of Chiropractic from examining injured workers with torso-related injuries, hernia injuries, cauda equina syndrome, fractures, dislocations, tendon and nerve lacerations, compartment syndrome, and brachial plexus and lumbosacral plexus injuries (see draft rule § 127.130(b)(3), (8) and (9)).

TCA Member Issues 100 x $100 Challenge to Benefit CDI
Thursday, June 29, 2017 02:02 PM

Congratulations, Texas chiropractors! Because of your generous contributions over the past year, the 85th Texas Legislative Session was TCA’s most productive in decades. Your donations to the Chiropractic Development Initiative (CDI) allowed TCA to allocate additional resources to our advocacy efforts in Austin, resulting in four chiropractic bills that were signed into law – most notably SB 304 (which affirmed your right to diagnose).

Unfortunately, the fight is far from over. In order to appeal the decision in the TMA vs. TBCE lawsuit (which threatens your right to treat nerves and the subluxation complex), it will take $100,000 in legal fees per year, every year. Dr. James Fowler, a member of the CDI Committee, is challenging all DCs to participate in the 100 x $100 Challenge! Donate $100 a month over the next three years or make a one-time donation of $2,500.

The goal is to sign up 100 more doctors in the program. Check out Dr. Fowler’s video message on the TCA YouTube Channel for more details. To make a donation or get on monthly autodraft, please visitwww.chirotexas.org/CDI or call the TCA office at (512) 477-9292.

TCA Texas Sports Chiropractic Conference
Tuesday, June 27, 2017 09:38 AM


 April 6-8, 2018 | Texas Chiropractic College | Pasadena, TX

Sports means big business in Texas and doctors of chiropractic have never been more involved in the training and care of athletes at all levels. If you see high school, collegiate, professional or amateur athletes, you don’t want to miss the 2018 Texas Sports Chiropractic Conference.

Join TCA, in conjunction with Southeast Sports Seminars, April 6-8, 2018 at Texas Chiropractic College in Pasadena for this unique opportunity to earn all 16 CE hours toward your Texas license and increase your knowledge of sports chiropractic.