85% of managed care organizations provide chiropractic benefits. However, utilization is low. Corporate America really dictates the coverage for health care. MCO's create a level playing field in chiropractic. Instead of fighting it be ahead of it.

There are 615,421 medical doctors in the United States. That is 328,468 over capitation. Paradigm shift is needed for doctors of chiropractic, insurance companies and patients.

Information systems - the ability for us to acquire information, document, authenticate data. All health care needs guidelines for its' infrastructure. For example: The Mercy Guidelines. It stabilizes and authenticates what we do.

There is only one doctor of chiropractic in a policy position. He is in Washington state. His name is Dr. Bob Moose.

FACTORS - Outcomes, patient satisfaction, quality of life, cost effectiveness (these are the basis for chiropractic inclusion). The highest degree of patient satisfaction than any other profession is the chiropractic profession.

Medical doctors are studying ways to increase their patient satisfaction. For example, instead of saying they are displeased with a patient going to another doctor outside of the medical profession they will start being sympathetic to the other doctors ways but enforcing that their ways are still the best.

Cost effectiveness in chiropractic is being measured against what physical therapists and McKenzie specialists are doing. There are 9,000 physical therapists in the United States. One half of the United States population is 50 years old or older. There are 55,000 doctors of chiropractic in the United States. Approximately 1,000 subscribe to JMPT. As MCO's are established they attempt to trim cost with a trade off of losing some quality. They are now focusing on quality. They are going by Waddell's, McKenzie, Oswestry, Rehabilitation and Functional Capacity Evaluations. Capitation Coverage: is a set number of dollars for treatment and that's it. This is what this means.

Insurance companies and reviewers will be looking through this transition time with MCO's. We have to ask ourselves where will we be 10 years from now. All care will be capitated.

Communication is needed for patient's to meet their physical needs. Primary care physicians find no problems 1/3 of the time. In other words, patient's need you to lend your time and your tender care. Dave Eisenberg found that more visits went to alternative physical medicine that to physicians and internists in the last couple of years. When you think of it, that's incredible. Multiple unexplained symptoms = think treatable mental disorders, possible depression or anxiety. Today the patient/consumer is really in charge. We need to educate the consumer = educate the patient. Note the following abbreviations and what they stand for: NCQA = National Committee of Quality Insurance CAM = Complimentary Alternative Medicine.

We D.C.'s need to have a shared vision for our profession. We have thought of this for many years and we need to really focus on this for our profession to grow leaps and bounds in the very near future.

Meet with an MCO one on one or with a letter. Let them know what they need to know.. Also, let the patients know how you handle the MCO.

Two more abbreviations to remember AHCPR = Agency for Health Care Policy and Research CAHPS = Consumer Assessment of Health Plans Study

Make sure you write the medical doctor of your patient and let them know your course of treatment. This will help educate the doctor and make the patient feel secure that all primary care physicians are on the same page of understanding their particular condition(s).

94% of all manipulations are done by D.C.

Dr. Sportelli feels that most medical doctors cannot tell who is good. Managed Care will help the credibility factor because it will help unveil what he called the "voodoo mask." In SPINE MAGAZINE even after the AHCPR study over 50% of medical doctors' still felt that manipulation was not effective for acute or chronic back pain.

Our public needs to view chiropractic care as necessary service, not as a specialty.

D.O. (Osteopathic Doctors) are now offering continuing education credits for O.M.T. training and are offering courses in their schools.

Miscommunication is the number one concern in malpractice suits between the doctor and patient.

Acceptance of the patient. Take history and do an exam. This is when you accept the patient. It is not the treatment that initiates the acceptance of the patient. This is known as the process of acquiring information.

The 3 three things Dr. Sportelli suggested we rule out immediately on some questionable cases are cancer, heart disease and stroke.

Write a medical doctor a thank you for referring any patients and send an article to educate them in your course of treatment. Send them research articles, send anything that would pertain to your patient and help them understand your course of treatment.

Spinal manipulation releases beta endorphins and this is one of the reasons why the patient starts to feel better. These endorphins are released from the pituitary adrenal axis producing an analgesic effect.

Contact the pharmacist for a printout of the medication taken by the patient. If more than 1 medical doctor is involved there may be misuse of medication.

Send doctors a magazine with cover letter. Example: JMPT, send a basket of fruit for the staff. This would be better appreciated.

Informed Consent Form: explains risk factors. Does your practice need one?

These are but a few highlights from the seminar. The bottom line is that we are in the best CORRECTIVE HEALTH CARE FIELD in the world!!!

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