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HEALTHBEAT SHOW NOTES .... Episode #167 - Recorded September 19, 2008  

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast, and Proud to be the #1 Search Result for Chiropractic Podcasts in the iTunes Podcast Directory.

In this week’s news:  We’ll Look At –

  • Chiropractic in the Mainstream

  • Update on CCGPP Guidelines

  • Colon Cancer Standards Not Met

  • And Finally, a story about Knee Surgery Being Overused for Arthritis

For HealthBeat, This is Dr. Todd Eglow!

Welcome to HealthBeat Podcast #167, recorded September 19, 2008.

HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

This week’s Episode is sponsored by DaVinci Laboratories.  Please surf to our web site at www.ChiropracticRadio.com and click on the DaVinci link for your Health and Nutritional needs.

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Chiropractic in the Mainstream

A study in the online journal Chiropractic and Osteopathy, posted an interesting study recently to present a perspective on the current state of the chiropractic profession and to make recommendations as to how the profession can look to the podiatric medical profession as a model for how a non-allopathic healthcare profession can establish mainstream integration and cultural authority.

The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic’s longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society.

There are several key areas in which the podiatric medical profession has succeeded and in which the chiropractic profession has not. The authors contend that it is in these key areas that changes must be made in order for our profession to overcome its shrinking market share and its present low status amongst healthcare professions. These areas include public health, education, identity and professionalism.

The study concluded that the chiropractic profession has great promise in terms of its potential contribution to society and the potential for its members to realize the benefits that come from being involved in a mainstream, respected and highly utilized professional group.

However, there are several changes that must be made within the profession if it is going to fulfill this promise. Several lessons can be learned from the podiatric medical profession in this effort.

Surf to our Show Notes for a link to the full study – http://www.chiroandosteo.com/content/pdf/1746-1340-16-10.pdf

 

Update on CCGPP Guidelines

Continuing COT HealthBeat’s continuing coverage of the CCGPP Chiropractic Guidelines and Practice Parameters -

The CCGPP continues to pursue its initial project of developing literature syntheses on the various anatomic regions defined in our initial project. Those literature syntheses are progressing as anticipated and all are nearing completion.

Currently, there are two chapters posted on the Internet at www.ccgpp.org for public commentary. The "Lower Extremity Conditions" chapter was posted on June 15, 2008 for a 60 day public comment period, closing August 15, 2008.

 "Soft Tissue, Part 3: Tendinopathies" was initially posted on August 1, 2008 and is also open for public commentary until November 1, 2008.

The chapter on the thoracic spine is currently nearing completion and is hoped to be posted later this fall. After substantive literature review, the cervical spine team has elected to adopt new guidelines recently released and based on the latest available literature. They will be presenting their report this month. A report addressing diagnostic imaging guidelines is also scheduled to be released in the near future.

The CCGPP did complete its Delphi consensus process regarding chiropractic low back care. Its report, "Chiropractic Management of Low Back Conditions", was also posted on the Internet on June 15, 2008 for a 60 day public comment period. That policy has, in part, been subsequently referenced in the Occupational Disability Guidelines (ODG), resulting in commensurate changes to that document.

The Rapid Response Team also provided assistance to the ACA Insurance Committee as they provided background information to the New York Attorney General regarding proper application of guidelines and dosaging, relative to an investigation into the payment policies of a third-party payer. Additional requests have been considered and/or are being currently worked on.

For example, the CCGPP has been contacted directly by the New York Chiropractic Association (NYCA) for assistance in developing guidelines for utilization in their workers compensation program. They are looking for logistical direction to accomplish this goal, based on our success in a similar process in the California's workers compensation system. This is a boding trend that is continuing to arise in various states across the nation. The CCGPP is currently considering this request.

Further information can be found at www.ccgpp.org

 

Colon Cancer Standards Not Met

Two new studies contain disappointing news for people who've undergone colon cancer treatment.

The first study, published in the Sept. 9 online edition of the Journal of the National Cancer Institute (JNCI), found that just 38 percent of U.S. hospitals sampled were testing enough lymph nodes after colon cancer surgery to accurately assess the extent to which the disease had spread.

The second study, in the Oct. 15 issue of the journal Cancer, found that only 40 percent of people who'd been successfully treated for colon cancer were receiving all of the recommended follow-up tests.

The second study "isn't the first that has shown a lack of adequate surveillance after treatment. This study shows the importance for patients to be educated about their initial care and follow-up. It behooves patients to know what is the appropriate follow-up."

Colon cancer is the second-leading cause of cancer death in the United States, according to background information in the JNCI study. As many as 80 percent of people diagnosed with colon cancer have localized disease, which means at the time of surgery, it appears that the cancer hasn't spread to other sites.

Also, the second study didn't look at the reasons behind the lack of follow-up, so it's not clear whether doctors aren't recommending the appropriate follow-up or if patients are choosing not get the recommended follow-up care.

Surf to our Show Notes for a link to this article - http://www2.healthtalk.com/go/cancer/colon-cancer/news/colon-cancer-treatments-need-improvements

 

Knee Surgery Overused for Arthritis

Many older arthritis patients may be undergoing arthroscopic knee surgery unnecessarily. That's the conclusion of two studies recently published in the New England Journal of Medicine.

The first study looked at some 200 patients with moderate-to-severe osteoarthritis in the knee. Half of the patients were treated with medication and weekly physical therapy for three months and twice-daily exercises to do at home. The other half got those treatments plus arthroscopic surgery.

After two years, pain levels, physical function and quality of life were the same in both groups.

The second study looked at MRI knee scans from 991 people, aged 50 to 90, from Framingham, Mass. The MRIs revealed a tear or other damage to the meniscus in about one-third of patients, with prevalence increasing with age.

However, nearly two-thirds of those with tears reported no pain or stiffness during the previous month.

The Associated Press quotes experts who say arthroscopic surgery may still benefit patients with milder cases of osteoarthritis, who have symptoms for a shorter time or had a recent injury, but not for people with advanced arthritis.

Surf to our Show Notes for a link to these Studies - http://content.nejm.org/cgi/content/short/359/11/1097

http://content.nejm.org/cgi/content/short/359/11/1108

http://content.nejm.org/cgi/content/extract/359/11/1169

 

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show.

And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

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Finally, I leave you with the following quote:

"When you feel in your gut what you are and then dynamically pursue it - don't back down and don't give up - then you're going to mystify a lot of folks."
– Bob Dylan

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

 

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