| Healthy Living
September 15, 2009
Osteoporosis: Disease or selling opportunity?
If you’re a female patient over 50, then you’ve probably heard me express concern that a significant amount of the recommendations for prescribing biophosphate medications (Fosamax, Boniva, Actonel, etc.) for osteoporosis is just plain bad medicine. I have relied on the World Health Organization’s fracture risk calculator (FRAX) for basing my opinion about drug therapy and I’ve printed the numbers for quite a few patients to share with any doctor who may be recommending medication. Often the evidence shows that drug therapy is not appropriate. If you have concerns about your bone density test or your risk of hip fracture let me know and we’ll use the FRAX assessment tool to determine your risk status. If you have not had your vitamin D level checked, let’s get it done.
Here is a must read article in the American Journal of Nursing that discusses the business of Osteoporosis. How a risk factor has now become a disease. The Marketing of Osteoporosis
Regular Chiropractic Care
Could regular chiropractic adjustments keep you healthier?
I’ve always advocated that patients get regular chiropractic adjustments. But, if you know me, you know that my style is low pressure. I value my relationships with patients and never want to give the impression that I’m putting my interests before yours.
The downside is that there may be a missed opportunity to improve your overall health. Here are some reports that are worth your consideration:
“Individuals with musculoskeletal disorders who received
chiropractic care or physical therapy had lower health care costs and
were less likely to have surgery than employees who did not receive
those services, according to a recent report.”
The findings come from a one-year pilot program designed by Wellmark
Blue Cross and Blue Shield to measure patient quality of care.
Researchers concluded that significant clinical outcomes and health
care cost reductions were attributable to the use of chiropractic and
other physical medicine services.
Or a study in the Archives of Internal Medicine that concluded: Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care,
particularly for spine conditions; (3) more conservative, less invasive
treatment profiles; and (4) lower health service costs associated with
managed chiropractic care. Systematic access to managed
chiropractic care not only may prove to be clinically beneficial but
also may reduce overall health care costs.
Another study used Chiropractors as primary care physicians. The results were interesting.
The AMI Study
In this study, a chiropractic network in which DCs
performed all patient examinations, treatments, and procedures at
their own discretion was constructed. Recommended follow-up visits,
choice of appropriate treatment, and ancillary therapies utilized did
not require approval from an MD. The original study, which focused on
the years 1999-2002, found decreases of: 43 percent in- hospital
admissions per 1,000; 58.4 percent in hospital days per 1,000; 43.2
percent in outpatient surgeries and procedures per 1,000; and, 51.8
percent in pharmaceutical costs. It noted that: “The AMI experience
seems to indicate that a non-pharmaceutical/nonsurgical orientation can
reduce overall health care costs significantly and yet deliver high
This study was updated in 2007, covering the years
2003-2005. The results of the original study were confirmed, with
demonstrated decreases of 60.2 percent in in-hospital admissions, 59
percent in hospital days, 62 percent in outpatient surgeries and
procedures, and 85 percent in pharmaceutical costs.
So why aren’t you getting regular chiropractic care?
Chiropractic in Health Care Reform
Will chiropractic be included in a government option?
I’ll go on record stating that I believe a government insurance option is a good idea. Am I fearful of the government running something as big as healthcare insurance? You bet I am. But, I’ve seen the mess that private insurers made of things. I’ve been doing battle with insurers just to get paid for my professional services as well as doing battle with the insurance industry testifying in Hartford while I was president of the Connecticut Chiropractic Association. I’ve watched reimbursements drop while patients pay more copays and premiums every year. Check out this Bill Moyers interview with Wendall Potter. My impression of the health insurance industry is so bad that I truly believe the government needs to step in.
My biggest fear though, is that chiropractic will be left out of any government option. I’ve been writing my congressmen about maintaining provider equality and protecting individual state laws providing insurance equality. I’ll remind you to join ChiroVoice and lend your support. A heartfelt thank you, thank you to the many people who have joined and written letters. I really appreciate you!
Want to see and hear some incredible music? I’ve spent hours listening and watching the performances on this website: LiveFromDarylsHouse
Sometime today they should be uploading legend Todd Rundgren’s visit with Daryl and his great band. I came across the site when I was doing a YouTube search for guitar genius Monty Montgomery. Watch his episode to see what I’m talking about. Thanks to Karen and Ed Bassett for turning me on to Monty!