Chiropractic Spinal Manipulative Therapy for Cervicogenic Headache
A ChiroSecure Research Update Abstract Cervicogenic headache is a disabling headache where pharmacological management have limited effect. Thus, non-pharmacological management is warranted. Our objective was therefore to investigate the efficacy of chiropractic spinal manipulative therapy versus placebo (sham manipulation) and control (continued usual but non-manual management) for cervicogenic headache in a prospective 3-armed single-blinded, placebo, randomized controlled trial of 17 months’ duration. Discussion Nineteen participants were equally randomized into the three groups, and 12 participants completed the randomized controlled trial. Headache frequency improved at all time points in the chiropractic spinal manipulative therapy and the placebo group. Headache index improved in the chiropractic spinal manipulative therapy group at all time points, while it improved at 6 and 12 months’ follow-up in the placebo group. The control group remained unchanged during the whole study period. Adverse events were few, mild and transient. Blinding was concealed throughout the RCT. Thus, our results suggest that manual-therapy might be a safe treatment option for participants with cervicogenic headache, but data need to be confirmed in a randomized controlled trial with sufficient sample size and statistical power. Reference Chaibi, A., Knackstedt, H., Tuchin, P.J. et al. Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BMC Res Notes 10, 310 (2017). https://doi.org/10.1186/s13104-017-2651-4
Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study
A ChiroSecure Research Update Abstract The purpose of this preliminary study was to determine if a course of chiropractic care would change blood pressure measurements in African American patients and to determine if a study was feasible in a chiropractic teaching clinic. Discussion Twenty-four African American patients received chiropractic care in a chiropractic teaching clinic over a study period that spanned 23 visits for each patient. Inclusion criteria consisted of patients having a diagnosis of prehypertension (120-139/80-89) or hypertension stage 1 (140-159/90-99). The mean values of 3 baseline blood pressure readings were compared with the mean values of blood pressure readings taken on visits 21, 22, and 23. This study showed that research of this nature may be feasible in chiropractic teaching clinics. The preliminary findings of this study showed that, for a subgroup of African American patients receiving chiropractic care, blood pressure decreased for (a) hypertension stage 1 patients and (b) the sample when those with excessive body mass index were excluded. Reference McMasters KL, Wang J, York J, Hart J, Neely C, Delain RJ. Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study. J Chiropr Med. 2013;12(2):55–59. doi:10.1016/j.jcm.2013.06.002. https://www.ncbi.nlm.nih.gov/pubmed/24294146
Outcomes of Pregnant Patients With Low Back Pain Undergoing Chiropractic Treatment
A ChiroSecure Research Update Outcomes of Pregnant Patients With Low Back Pain Undergoing Chiropractic Treatment Abstract The purpose of an outcome study of pregnant patients with low back or pelvic pain undergoing chiropractic was 1) to report outcomes in receiving chiropractic treatment; 2) to compare outcomes from subgroups; 3) to assess predictors of outcome. Baseline numerical rating scale (NRS) and Oswestry questionnaire data were collected. Duration of complaint, number of previous LBP episodes, LBP during a previous pregnancy, and category of pain location were recorded. Low back (LBP) and pelvic pain in pregnant women is such a common phenomenon, affecting 50-80%, that it is often considered a normal part of the pregnancy. Discussion Out of the 115 recruited pregnant patients, 52% ‘improved’ at 1 week, 70% at 1 month, 85% at 3 months, 90% at 6 months and 88% at 1 year. There is clinical evidence that proves most pregnant patients undergoing chiropractic treatment reported relevant improvement at all time points up to 1 year. No serious adverse events were reported in this study and over 85% of the patients were happy or very happy with their chiropractic treatment. Adverse events from spinal manipulation to pregnant women or those in the early post-partum period are very rare with only 7 cases found in the literature. The impact that LBP or pelvic pain may have on quality of life, as well as the fact that back pain during pregnancy is commonly linked to low back pain persisting after pregnancy, mandates that it be taken seriously by health care practitioners. Reference Peterson, C.K., Mühlemann, D. & Humphreys, B.K. Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropr Man Therap 22, 15 (2014). https://doi.org/10.1186/2045-709X-22-15
Board Issues – ChiroSecure
Hi everybody Dr. Stuart Hoffman here to talk to you Today about something that has been a big issue in chiropractic world. So many of you have issues with you license in court and I wanna share to you some of the things that happened so that we can hopefully try and reduce your risk. And when I tell you that the license in board issues are big. It has sky rocketed over the last year. And I think some of the reason for that is kind of simple. In that when I graduated 1981 from life college. If someone wanted to make a board complaint against me at that time they had to find the board. You don’t find them in the yellow pages for those of you that even remember what the yellow pages is and you had to actually find it in the separate section of the white pages under government agencies. And you found them, and made a long distance phone call which cost you money to get someone at the board once they actually picked up. They would then send you by mail an actual complaint letter. You fill it out and send it back in to the board. By the time all of that hassle happened most people that it was just on the edge just went away. Because lot of that motion that was build up had already passed. But on this teen age people need to get their feelings hurt and if you didn’t listen to them they’re gonna have it heard somewhere whether it just to be heard out or to hurt you. And simple fact is that they can go on Google and in nano second find the license in court and on the homepage click here if you want to make the complaint. It takes nothing and your license in board has the legal obligation to follow up on any on every complaint that comes in to that. So its our job to defend you if in you when get one of these complaint. And if you are with chirosecure and I hope you all are then I would expect that you would know we need you to let as know as soon as you get a letter or call from the board that they are just checking in something. They are investigating or there are something that they need to follow up on. Any and all of that means that there is an investigation. So always contact whether be us or who ever your courier is. Because they should be put on notice and you should have an attorney help or respond to any complaint to the license in court no matter what it is. And I have so many times that people will say to me “You know I hear you, but this is a stupid little thing I’m gonna send in a respond and be done with it.” Well that’s fine except that you have three of those people wind up coming back because now the board want to interview them in person and they now need the attorney when we could have resolved it perhaps with a good respond in the first place.
ChiroSecure Stroke Risk Management
In todays lesson we are going to discuss strokes. The stroke myth in chiropractic is one of those things that we absolutely cannot ignore and we have to deal with it. And in order to deal with it, is it essential that we take into consideration all of the relevant information that is out in the public. And that’s both PRO and CON. But you cannot dispute actual research and I’m gonna share a little bit of that with you today. So I wan’t to start by saying “Hey if you have somebody in your office and you adjust them and all of they sudden they start getting dizzy and they start vomiting, don’t run to the telephone to call me. Call 911! That is the number one thing you can do to not only save that person, but save yourself at the same time”. I get those calls. People don’t believe it when I tell them that people are actually calling me “Hey I’ve got someone vomiting all over the place what do I do?” Well what am I gonna do to help you at that point. But with the strokes situations. The faster you get emergency medical attention the better the outcome will be for that patient. If you prolong it, it could be a disaster for both the patient and for you. So don’t be afraid, if an ambulance shows up to your door, they can show up because someone passed out or anything else. It doesn’t always have to do with you. You do the right thing by the patient and it will also help protect you at the same time. So let’s talk about strokes in the United States. 750,000 stokes occur in the US annually. But strokes arising from dissection, which is what we are associated with, are rate of 1 per 133,000 people. If there are 315 million people in the US we can expect 2,368 of these strokes to occur each year. That means that we are not even associated in anyone’s mind with 750,000 of them. So strokes annually in the US, ours that we have any association are so insignificant. But to us they are everything. And if you think about it, if an average of 10% of the US population seeks chiropractic care annually then we could anticipate about 237 dissections leading to strokes to cross the path of chiropractor this year. And if we have 65,000 practicing doctors that means that 1 in 275 chiropractors will have a patient that winds up with the dissection leading to stroke each in every year. So as much as that sounds that nothing, it’s everything if it’s you. Realize that its estimated that one vertebral artery related stroke is associated, and I’m using specific words with you here so I hope you are hearing me not say cause, but have an association, with 1 to 2 millions cervical adjustments.
Informed Consent With ChiroSecure
“Your expectations shape your reality. They can change your life, emotionally and physically. You need to be extra careful about (and aware of) the expectations you harbor as the wrong ones make life unnecessarily difficult.” – Travis Bradberry So what are the three questions patients want answers to once in the door? Do you know what is wrong with me? Do you think you can help me? Have you ever helped anyone else with the same problem? As far as expectations, they only have one. YOU WILL FIX THEM! What about your expectations? When a patient comes to your office what do you expect? They will sign up for your care program. They will understand the value of regular ongoing chiropractic care. They will make all their appointments. They will pay you for your services. They will get better if they follow your recommendations. They will refer their friends and family members. Do you see the problem here? They enter your office with one expectation, and that expectation is not even on your list. Good relationships require both parties have the same expectations, and the ones that don’t do not last very long and usually end painfully (forgive the pun here). If you are going to have a successful risk free relationship with your patients, the first thing you need to do is change their expectations so that theirs and yours are the same? First, let’s look at the things you are most likely already doing that unfortunately do not change the patient’s expectations. Patient Case History Patient Consultation Patient Examination Report of Findings Care Recommendations Care Plan Financial Discussions All those things, even if the patient completely understands your report of findings and care plan recommendations, do not change their expectations. If they did, every patient would become a life-long patient and follow-through with care. How many of your patients follow through with care? With the wrong expectations, if the patient gets better they leave; if they don’t get better right away or may even get a little worse they leave. As a result, most doctors are on a constant quest for new patients. There is only one thing that changes the patient’s expectations. Sitting down and talking about their expectations. Asking them what their expectations are and explaining to them what they should be and why. In our world of Risk Management, we call that Informed Consent. In your world of patient expectations, you should call it Informed Consent. Is the Informed Consent that you are using designed to create the right expectations? It should! Are you even using an Informed Consent? You should! Our good friends at ChiroSecure have provided a quick video on Informed Consent and exactly how you should use it. Check it out. Want to know more about ChiroSecure visit: https://www.chirosecure.com/more-chiropractors-choose-chirosecure/
ChiroSecure Malpractice Insurance Basics
Hi I’m Dr. Stuart Hoffman, president of Chiro Secure I wanted to make sure that the lessons I created for you where more than what you would ever expected. Which would probably be the typical and somewhere dry and scary topic of malpractice insurance. You know, this is how much coverage you need and this is why you need it etc. I wanted it to have real impact. And I wanted you to experience what really goes on in the world of chiropractic malpractice. The issues that cause my phone to ring every single day. The issues that you yourself may one day may experience. So I created seven special lessons for you from my experience as a risk management expert for over 27 years. Your gonna hear about situations you need to watch our for. How to handle certain situations and the expected outcome. Most importantly your going to hear stories real stories. From doctors just like you who where in the front lines every single day. Some of the stories will actually surprise you. And some will make you wonder what docs are thinking when they did some of these things. What I hope all of them do is to help you realize that we are all human and with 3 things come great responsibilities. And I believe that the 7 lessons will help you better deal with this responsibilities by lowering your risk while still maintaining your practice growth. So I look forward for your feed back and to any questions that you may have. Hi I’m Dr. Stuart Hoffman, president of Chiro Secure. And I’m here to help you with your understanding of malpractice insurance. So many people find it a little confusing as to what they need to purchase what they even have that they’ve already purchased. And how to make sure that they safe guard them selves and their practice base on their own insurance coverage. So I’m hoping to demystify some of this information for you Today. And what I want you to understand is why even have a malpractice insurance? Malpractice insurance is something that I think is essential in Today environment. Some people think its a choice, I think its a responsibility. And if you understand that a patient can sue in his teen age for anything. There are attorney that will take the most privilege things and send you legal papers. And that’s all because the patient think that they where wrong or receive some sort of negative outcome to their treatment. Insurance just simply help manage that risk while protecting you and your practice and your family from huge legal expenses from this potential pay out. But even more than the pay out, a Doctor will say will if I didn’t do anything wrong once I defend my self it will all go away. Well maybe, maybe not but either way it so important to understand that the number one concern we have in chiropractic medical legal realm is a straw claim.
Benefits of Cloud-based Software
In the past years, a lot of chiropractors believed that only large businesses should use software to automate their various tasks. However, small businesses are gradually waking up to the importance of automation. All thanks to the availability of better cloud-based software. If you are still thinking about whether you should use software to help automate your practice, consider the following benefits of small business automation: Improve customer experience Generally, the success of any practice depends mostly on patient satisfaction and experience. Nevertheless, due to time constraints and limited staff, many small practices have issues with communicating and managing the needs of their patients effectively. Of course, you don’t have to worry about this issue because you can now take advantage of the customer management system (CMS). By using customer management software, your team can communicate seamlessly and electronically with your patients irrespective of the time they are trying to use your services or products. This communication plays a pivotal role in enhancing the experience of your customers. Enhancement of the speed and efficiency of your small business By executing your business processes manually, you are going to be performing the same tasks over and over again. Resultantly, you are exposing your practice to human errors and time waste, which, in turn, leads to inefficiency. Automation software can carry out any time quickly without any errors. This will not only improve your business speed, but it will serve as a boost for your practice efficiency. Reduction of your running cost Without a doubt, some software can be expensive to acquire for the automation of your small business. However, once you have bought the software, there will be a significant reduction in your running cost. This reduction is because you may not need many employees to execute specific tasks. The software may be enough to perform the tasks of 2 or more employees. What Parts of Your Practice Process Can You Automate? You can automate most parts of your small business. Here are a few examples of business processes that you can automate with software: Email marketing Email marketing is one of the most common business processes that software can automate. Email marketing software can add the contact of each new client to the right segment, send them a welcome message, and acquire information about the clients. Sales Sales pipeline can be highly demanding; hence, managing it manually can be a daunting task. With the automation of the sales process, small business owners can improve their business in all ramifications. Some of the tasks that the sales software can do include tracking the changes in your sales funnel and identifying the best prospects. All these benefits can help you make an informed decision about your small business. Customer support Chatbots and other systems have been designed for providing quick responses to the request of your customer. In lots of cases, they may be able to solve the problems of your customers without any human input. However, you need to be careful and not rely too much on software for customer support. Other business processes that software can automate for small businesses include workflow, social media, finance, data backup, and onboarding.
