Why Can’t We Just Forget About Medicine and Just Do Our Own Thing? Competency
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Tuesday, August 30, 2016 12:00 AM

For those who promote “Let’s forget organized medicine and just do our own thing,” what will you do about those who espouse the following policies?

Comment:  Competence of non-physician reviewers and the availability of same-specialty peer review must be delineated and assured in utilization review, but physicians, apparently, are not required to be competent.

Decision in Acupuncture V. Chiropractic
Written by Editor   
Monday, August 29, 2016 12:00 AM

In Brief:

  • The appeals court affirms the denial of the Acupuncturist's motion for summary judgment except for one part.
  • The appeals court affirms the upholding of Chiropractic's motion for summary judgment.
  • The court says dismissal of the portion of the Acupuncturist's claim to the validity of TBCE Rule 78.14 was not correct because both parties "failed to establish entitlement to judgment as a matter of law."
  • The Parties may appeal the decision to the Texas Supreme Court or let the case return to the trial court so that the last question can be decided.
  • The court opined that the history of the legislative and legal tug-of-war between chiropractic and other medical providers “underscores that the scope of chiropractic vis-a-vis other healthcare fields is a puzzle best solved by the Legislature in a clear and precise manner, rather than leaving these policy-laden issues to the Judiciary for a determination of legislative intent from statutory language that is, to say the least, not the model of clarity. We respectfully request that the Legislature solve this problem.”
  • The Court stated "Because each statute serves the purpose of defining and regulating a separate health-care field ... We cannot conclude that the Legislature necessarily intended for the respective regulatory authorities ... to apply the same meaning to the term “incisive,” and accordingly, we will not construe the Chiropractic Act as if it includes the Acupuncture Act’s definition 'acupuncture.'”
  • On the acupuncturist's claim that the Chiropractic Act violates the Texas Constitution to the extent it permits chiropractors to practice acupuncture, the court stated, "because we cannot conclude, as a matter of law, that the Chiropractic Act authorizes chiropractors to practice acupuncture, we need not decide" this issue.

The Texas Association of Acupuncture and Oriental Medicine (the Acupuncture Association) sued the Texas Board of Chiropractic Examiners (the Chiropractic Board) asserting that certain chiropractic rule provisions are void because they authorize chiropractors to perform acupuncture, impermissibly expanding the scope of practice for chiropractors beyond that permitted by statute.  In 2015 the district court rendered its final order.  The TAAOM filed for a Summary Judgement, but was denied. The TBCE also filed a motion for summary judgement and the court granted the TBCE’s motion.  The Acupuncture Association filed the appeal considered by the appeals court.

Use of Spinal Manipulation to Treat Acute On-Field Athletic Injury
Written by Editor   
Friday, August 26, 2016 12:00 AM

Spinal manipulative therapy (SMT) is a treatment modality that has been utilized for centuries.  There are numerous theoretical mechanisms of action for SMT. These theories are based around three major concepts: the biomechanical effects, the muscular reflexogenic effects and the neurophysiological effects. In addition, SMT also appears to have systemic effects on the body.

SMT have been demonstrated to be effective for the treatment of numerous conditions; research has consistently demonstrated its effectiveness for neck and low back pain.  It has also been shown that SMT may have positive effects on pain and injury in the extremities. However, there is limited evidence of the use of SMT during a sporting event to treat an acute injury. The goal of this case study is to demonstrate the utilization of SMT during competition and to discuss the times when it may be appropriate.

This case describes the utilization of spinal manipulative therapy for an acute athletic injury during a Taekwondo competition. During the tournament, an athlete had a sudden, non-traumatic, ballistic movement of the cervical spine. This resulted in the patient having a locked cervical spine with limited active motion in all directions. The attending chiropractor assessed the athlete, and deemed manipulation was appropriate. After the manipulation, the athlete’s range of motion was returned and was able to finish the match. Spinal manipulation has multiple positive outcomes for an athlete with an acute injury including the increase of range of motion, decrease in pain and the relaxation of hypertonic muscles. However, there should be some caution when utilizing manipulation during an event.

Why Can’t We Just Forget About Medicine and Just Do Our Own Thing? Just Don't Interfere
Written by Editor   
Tuesday, August 23, 2016 12:00 AM

For those who promote “Let’s forget organized medicine and just do our own thing,” what will you do about those who espouse the following policies?

Comment:  Sure organized medicine supports payment models for non-physician practitioners, as long as it doesn't interfere with medical residents.

ExcerptAMA will only support payment models for non-physician practitioners that do not interfere with graduate medical training.  Procedural training is a critical portion of resident education and the augmentation of patient care by non-physician practitioners should not interfere with a resident’s ability to achieve competence in the performance of required procedures.

Chiropractic Identity:A Neurological, Professional, and Political Assessment
Written by Editor   
Wednesday, August 17, 2016 12:00 AM

From its origins in 1895 with DD Palmer’s original focus on magnetic healing, chiropractic identity has been beset with the challenging task of keeping up not only with clinical and scientific observation but with political trade winds involving public perception and the marketplace of health care.  At present, the chiropractic profession continues to be underrepresented in most discussions of health care delivery, a situation in which the greater clarification of chiropractic’s identity and more practitioner consensus may help to alleviate this problem.

Originally, DD Palmer viewed the body from a more mechanical viewpoint, but he paid particular attention to the nerves.  It was from this origin that the popular but often misinterpreted concept grew that doctors of chiropractic dealt with “bones out of place,” the locus of such derangements being the spine. Leading to the modern notion that doctors of chiropractic were managing primarily musculoskeletal problems with emphasis upon back pain.  Yet, numerous distinguishing characteristics, including providing a model of holistic, preventive medicine and embracing a concept of neurological imbalance, have prevailed.   

The purpose of the article reported is to propose a focused assessment of the identity of chiropractic and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of neurology, manual medicine, and alternative or mainstream medicine.

Distinguishing characteristics of doctors of chiropractic include the following:

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