November 2014
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Improving Our Nation’s Health Care System

Improving Our Nation’s Health Care System: Inclusion of Chiropractic in Patient-Centered Medical Homes and Accountable Care Organizations

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Humanities 2014 (Dec);   21 (1);   49–64

William C. Meeker, DC, MPH, R.W. Watkins, MD, MPH,
Karl C. Kranz, DC, JD, Scott D. Munsterman, DC,
Claire Johnson, DC, MSEd

Palmer College of Chiropractic West,
90 E Tasman Dr,
San Jose, CA 95134
+1 408 944 6005

Objective   This report summarizes the closing plenary session of the Association of Chiropractic Colleges Educational Conference—Research Agenda Conference 2014. The purpose of this session was to examine patient-centered medical homes and accountable care organizations from various speakers’ viewpoints and to discuss how chiropractic could possibly work within, and successfully contribute to, the changing health care environment.

Discussion   The speakers addressed the complex topic of patient-centered medical homes and accountable care organizations and provided suggestions for what leadership strategies the chiropractic profession may need to enhance chiropractic participation and contribution to improving our nation’s health.

Conclusion   There are many factors involved in the complex topic of chiropractic inclusion in health care models. Major themes resulting from this panel included the importance of building relationships with other professionals, demonstrating data and evidence for what is done in chiropractic practice, improving quality of care, improving health of populations, and reducing costs of health care.

Key indexing terms:   Chiropractic, Patient-centered care, Insurance, Delivery of health care

From the FULL TEXT Article:


In its search to provide better, more affordable, and accessible health care, the United States is moving towards new models, such as patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). [1, 2]. The PCMH model aims at patient-centered, accessible, coordinated, comprehensive care, with a focus on improving quality of care and lowering costs. [1, 3]. Chiropractic care has traditionally fit this paradigm, with an aim to be patient centered, accessible, and affordable. [4-14]. The chiropractic approach to health care is particularly suited for the conservative treatment and management of spinal disorders. [15, 16]. However, we need to ask if chiropractic is well suited for the PCMH and ACO models. As health care is changing, more efforts are needed for collaboration and coordination within the overall health care system.

Continue reading Improving Our Nation’s Health Care System

Who Do You Think You Are?
Your Perception Creates Your Reality

Who Do You Think You Are?
Your Perception Creates Your Reality

The Chiro.Org Blog

SOURCE:   The Chiropractic Assistants Page

By Phil Mancuso, D.C.

“You are today where your thoughts have brought you;
you will be tomorrow where your thoughts take you.”
— James Allen

You and your buddy down the street have gone to all the same seminars,
taken the same busines management programs, learned the same techniques and formulae for success. Yet, his business is going like a Carnival Cruise liner full of MTV Spring Break revelers and yours is going ‘Titanic.’

Most times, the difference isn’t in the procedures, but in the person performing them.

Your friend down the street already knows the secret to practice and personal success.

What’s your buddy’s secret? Is he smarter than you? Is he a better person
than you? Did he go to a better school than you? Most likely not—he’s just
learned how to harness his personal power to allow him to become the
successful, self-empowered person he is. He’s learned how to create his own
breakthroughs, to allow him to move beyond his fears and limiting beliefs. He is accomplishing goals and realizing his true desires, turning dreams into reality, creating fulfilling relationships, and modeling the strategies of peak performers to produce a quantum difference in his life.

“Just what does it take to get ahead these days?

Why can’t I get motivated?

Why aren’t my personal life and career turning out the way I want?”

So, what gives? Who succeeds and why? What does it take to become the
best version of yourself possible? Is it the quality of the school you attended? Is it that grade you got on your licensing exam? The number of letters after your name?


Many of us know stories about people who were at the top of their class, yet,
somehow, never achieved success. In other instances, there are those who got mediocre grades, or didn’t go to the top schools, who become leaders in their chosen fields. It got me thinking:

Continue reading Who Do You Think You Are?
Your Perception Creates Your Reality

Happy Thanksgiving! (2014)

Happy Thanksgiving! (2014)

The Chiro.Org Blog

Happy Thanksgiving To ALL Our Friends!!!

Continue reading Happy Thanksgiving! (2014)

Improved Behavior and a Reduction in Violent Outbreaks in a 10-year-old Boy With Chiropractic Care

A Case Report of Improved Behavior and a Reduction in Violent Outbreaks in a 10-year-old Boy With Chiropractic Care

The Chiro.Org Blog

SOURCE:   Journal on Clinical Chiropractic Pediatrics 2014; 14 (3)

Jonathan R Cook, MChiro, DC, LRCC

Private chiropractic practice,
United Kingdom Author

Objective:   To present a single case study in which a reduction in violent behavior with a 10-year old boy was achieved when the patient underwent chiropractic treatment.

Design:   A case report. Setting: Private chiropractic practice.

Subjects:   This case involved a 10-year-old male who presented with behavioral issues, including dramatic changes from a calm manner, to suddenly becoming violent. He was also reported to have difficulty sleeping due to emotional detachment disorder and frequently suffered from panic attacks. His mother also reported that he had difficulty noticing when he was sufficiently full following eating. His behavioral changes caused him to be suspended from school. Upper cervical, thoracic and lumbopelvic dysfunction were recorded in this case.

Methods:   The patient received diversified low-force chiropractic manipulation to the spinal areas noted, including toggle-recoil and drop piece technique. His changes were recorded through the Measure Yourself Medical Outcome Profile (MYMOP) questionnaires over the course of his treatment. Treatment was provided over a 4-week, twice weekly period, with a MYMOP questionnaire being filled out after his 3rd, 6th and 8th adjustment.

Results:   A reduction in a MYMOP score of 6/6 to 1.6/6 for behavior and violent outbreaks after 8 chiropractic adjustments. Further improvements were noticed with sleep and anxiety, as well as a dramatically improved awareness of feeling full after eating.

There are similar articles like this @ our:

Chiropractic Pediatrics Page

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Assessing the Oracle at the Fountain Head: BJ Palmer and His Times, 1902-1961

Source Journal of the Association for the History of Chiropractic

bjThis article is from Volume 7, No. 1 of the Journal of the Association for the History of Chiropractic, 1987. From the text of the article, “It may be an understatement to observe that while it is quickly apparent that the opinions, writings, influence and impact of B.J. Plamer have blanketed the history and evolution of chiropractic, few objective studies have explored the inner workings of its “Developer”.

The article contains some fascinating insights . It mentions that the only in-depth interview and study of the early years comes from the research of a New York lawyer by the name of Cyrus Lerner. Lerner was a well-respected attorney and at one time had been personal counsel to Joseph Kennedy, the father of JFK. The manuscript produced in 1952 was massive, some 780 pages in length and provides insights not only into Palmer but into the state of chiropractic through the first half of the 20th century.

You can read the original paper here.

Mr. Lerner’s report as reproduced by Joseph C. Keating, Jr., Ph.D. for the Association for the History of Chiropractic can be read here.

Dr Keating’s notes for his many articles on chiropractic history are archived here at


Coenzyme Q10 Relieves Symptoms in Gulf War Veterans

Coenzyme Q10 Benefits Symptoms in Gulf War Veterans: Results of a Randomized Double-blind Study

The Chiro.Org Blog

SOURCE:   Neural Computation 2014 (Nov);   26 (11):   2594–2651

Beatrice A. Golomb, Matthew Allison, Sabrina Koperski,
Hayley J. Koslik, Sridevi Devaraj, Janis B. Ritchie

Departments of Medicine and of Family and Preventive Medicine,
University of California,
San Diego, La Jolla, CA 92093, U.S.A.


Gulf War syndrome (GWS), also known as Gulf War illness (GWI), is a chronic multi-symptom disorder affecting one-quarter to one-third of 1990-1 Gulf War veterans.   A wide range of acute and chronic symptoms have been linked to it, including fatigue, muscle pain, cognitive problems, rashes and diarrhea.

This newly published study on Gulf War veterans shows that Co-Q 10 supplementation significantly improved many symptoms of Gulf War Illness, including word recall, fatigue, and irritability.

We sought to assess whether coenzyme Q10 (CoQ10) benefits the chronic multisymptom problems that affect one-quarter to one-third of 1990-1 Gulf War veterans, using a randomized, double-blind, placebo-controlled study.

Participants were 46 veterans meeting Kansas and Centers for Disease Control criteria for Gulf War illness.

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Coenzyme–Q10 (Co–Q10) Page

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Chiropractic Use in the Medicare Population

Chiropractic Use in the Medicare Population: Prevalence, Patterns, and Associations With 1-Year Changes in Health and Satisfaction With Care

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2014 (Oct); 37 (8): 542-551

Paula A.M. Weigel, PhD, Jason M. Hockenberry, PhD, Fredric D. Wolinsky, PhD

Research Associate,
Department of Health Management and Policy,
College of Public Health,
The University of Iowa, Iowa City, IA.

OBJECTIVE:   The purpose of this study was to examine how chiropractic care compares to medical treatments on 1-year changes in self-reported function, health, and satisfaction with care measures in a representative sample of Medicare beneficiaries.

METHODS:   Logistic regression using generalized estimating equations is used to model the effect of chiropractic relative to medical care on decline in 5 functional measures and 2 measures of self-rated health among 12170 person-year observations. The same method is used to estimate the comparative effect of chiropractic on 6 satisfaction with care measures. Two analytic approaches are used, the first assuming no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS:   The unadjusted models show that chiropractic is significantly protective against 1-year decline in activities of daily living, lifting, stooping, walking, self-rated health, and worsening health after 1 year. Persons using chiropractic are more satisfied with their follow-up care and with the information provided to them. In addition to the protective effects of chiropractic in the unadjusted model, the propensity score results indicate a significant protective effect of chiropractic against decline in reaching.

Continue reading Chiropractic Use in the Medicare Population

The Stress Test

The Stress Test

The Chiro.Org Blog

I’m not sure exactly how it works, but this is an amazingly accurate test.
The attached photo (see below) has 2 virtually identical dolphins in it.

It was used in a case study on stress levels at St. Mary’s Hospital.

Look at both dolphins jumping out of the water.

The dolphins are identical.

A closely monitored, scientific study of a group revealed that in spite of the fact that the dolphins are identical, a person under stress would observe some differences between the two dolphins.

If there are many differences found between both dolphins, it means that the person is experiencing a greater amount of stress.

Look at the photograph, and if you find more than one or two differences, you may need to take a vacation. (Keep scrolling down)

Continue reading The Stress Test

The Evidence Informed Chiropractic Challenge

Source The Evidence Informed Chiropractic Challenge

What’s the Buzz

A recent social media posting has generated a bit of a buzz in the world of chiropractic. It seems that a short essay by chiropractor Rob Sinnott on October 16th elucidating the role that chiropractic and the subluxation play in the regulation of the immune system created some disagreement among the ranks. To demonstrate his thesis Dr Sinnott chose a timely example. Ebola. As you read his piece you may have some doubts as to the wisdom of this choice. You can read his original post here.

At any rate, Dr Dave Newell, Director of Research at the AECC and long time chiropractic academic with over 25 years experience in the sciences and clinical research, felt the need to protest the claims presented by Dr Sinnott. Dr Newell expressed his concerns regarding Sinnott’s post in an email to the Annals of Vertebral Subluxation Research (AVSR), which is published by the Foundation for Vertebral Subluxation, where Sinnott is an advisory board member. You can read that letter here.

The Sinnott piece was then, in turn, defended by Dr Matthew McCoy in an article on his website, The Chronicles of Chiropractic – The source for news on conservative, traditional chiropractic. You can read that reply here.

The Evidence Informed Chiropractic Challenge

And so, the evidence-based group is convinced that the view expressed by Drs McCoy and Sinnott is a minority position and are challenging chiropractors to take a stand. Are you for or against the original article that they claim damages the profession as a whole.

You can cast your vote here.

Effects of Chiropractic Care on Dizziness,
Neck Pain, and Balance

Effects of Chiropractic Care on Dizziness, Neck Pain,
and Balance: A Single-group, Preexperimental, Feasibility Study

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2009 (Dec);   8 (4):   156–164

Richard G. Strunk, DC, Cheryl Hawk, DC, PhD

Assistant Professor,
Clinical Sciences/Research,
Cleveland Chiropractic College,
Overland Park, KS.

OBJECTIVE:   This feasibility study was conducted to further the development of a line of investigation into the potential effects of spinal manipulation/manual therapy on cervicogenic dizziness, balance, and neck pain in adults.

METHODS:   A single-group, preexperimental, feasibility study was conducted at a chiropractic college health center and a senior fitness center with a target sample size of 20 patients (40 years or older). Patients were treated by either a clinician or a chiropractic student intern for 8 weeks. The Dizziness Handicap Inventory was the primary outcome measurement, with the Short Form Berg Balance Scale (SF-BBS) and the Neck Disability Index used as secondary outcome measurements.

RESULTS:   Twenty-seven patients were recruited over a period of 13 months. Twenty-one patients enrolled in the study; but because of 2 dropouts, 19 patients completed the treatment. A median Dizziness Handicap Inventory change score of +7 points was calculated for those dizziness patients, with 3 patients improving by at least 18 points, indicating a clinically meaningful change. Seven of the 15 patients who performed the SF-BBS attained at least a 4-point improvement with an effect size of 1.2. A median Neck Disability Index change score of +1 was calculated for those patients with neck pain. Twelve minor adverse reactions were reported by 8 patients, with 3 of those reactions lasting longer than 24 hours.

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Vertigo, Balance and Chiropractic Page

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Neck Pain, and Balance

Straighten Up for World Spine Day: New Free App Launches to Help All Ages Improve Posture and Spinal Health


Source Newswire

Musculoskeletal issues are the cause of one-third of missed work − second only to the common cold; poll reveals almost half of Canadians suffered from four or more MSK conditions in the last year.

TORONTO, Oct. 16, 2014 /CNW/ – The Canadian Chiropractic Association (CCA), in partnership with the 10 provincial chiropractic associations, has launched a new app today to mark World Spine Day. The 2014 World Spine Day theme is “Straighten Up and Move”, and the aptly named Straighten Up Canada app aims to accomplish just that—improve posture and spinal health through simple preventative posture exercises. It is the first free Canadian app of its kind.

The Straighten Up Canada app provides users with 12 short exercise videos as well as a tracking feature to monitor progress and share with others through social media. It also includes a “Find a Chiropractor” search function to locate musculoskeletal (MSK) experts nearby.

“Canadians are becoming more sedentary and are experiencing postural issues at an earlier age, due to the increased use of technology in both their personal and professional lives,” explains Dr. Robert David, Chair, Canadian Chiropractic Association. “What most people don’t know is that practising simple exercises daily to adjust poor posture habits is one of the best ways to reduce aches and pains.”

Musculoskeletal conditions account for one-third of missed work in Canada.
Each year, over 11 million Canadians suffer from at least one musculoskeletal condition.1 In fact, low back pain and other MSK conditions account for one-third of missed work in Canada − second only to the common cold. Many MSK problems are the product of poor posture, resulting from using poor body mechanics while engaging in everyday activities, like hunching over computers, tablets or smartphones, lifting children, slouching at a desk or even carrying heavy purses, laptop bags and groceries. Sitting for prolonged periods at work and heavy manual labour can put further strain on the body’s MSK system.

Alison Dantas, Chief Executive Officer, Canadian Chiropractic Association, explains that adopting good posture habits early on is key to minimizing and even avoiding chronic MSK pain in some cases. “As a vital part of every Canadian’s healthcare team, chiropractors are experts in musculoskeletal health and can provide people with preventative measures to promote and maintain a healthy spine. The posture exercises in the Straighten Up Canada app are not only fast and easy, they will help people of all ages prevent, and in some cases even eliminate, their habits around poor posture.”

Almost half of Canadians were afflicted by more than four MSK ailments in the last 12 months; leading symptoms are back pain, stiffness, headaches/migraines, neck and joint pain.
According to research conducted by Ipsos Reid on behalf of the CCA, 43% of Canadians have suffered from four or more MSK issues within the last year. The leading health concerns are back pain and stiffness (53 per cent), headaches and migraines (44 per cent), neck pain (35 per cent) and joint pain (35 per cent). In fact, MSK disorders account for the highest disability costs among all chronic conditions in Canada ($15 billion). 2

“The main goal of the Straighten Up Canada app is to help people become regularly aware of their posture so they can start to correct it themselves,” explains Dr. David. “Another advantage of this app is these exercises can take as little as three minutes to help you reset and become more mindful of your posture. Everyone can find three minutes in their day, and if they do, it may just help them lead a more active and healthy lifestyle resulting in a wide range of long-term health benefits.”

The Straighten Up Canada app is available for free download through the Apple App Store, Google Play Store and on

Assessment of Patients With Neck Pain

Assessment of Patients With Neck Pain: A Review of Definitions, Selection Criteria, and Measurement Tools

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2010 (Jun);   9 (2):   49–59

Victoria Misailidou, Paraskevi Malliou, Anastasia Beneka,
Alexandros Karagiannidis, and Georgios Godolias

Laboratory Instructor, Department of Physical Therapy,
Technological Educational Institute of Thessaloniki,
57400, Thessaloniki, Greece

OBJECTIVE:   The purpose of this literature review was to synthesize the existing literature on various definitions, classifications, selection criteria, and outcome measures used in different studies in patients with neck pain.

METHODS:   A literature search of MEDLINE and CINAHL through September 2008 was performed to gather articles on the reliability, validity, and utility of a wide variety of outcome measurements for neck pain.

RESULTS:   Different types of definitions appear in the literature based on anatomical location, etiology, severity, and duration of symptoms. Classifications according to severity and duration of pain and the establishment of selection criteria seem to play a crucial role in study designs and in clinical settings to ensure homogeneous groups and effective interventions. A series of objective tests and subjective self-report measures are useful in assessing physical abilities, pain, functional ability, psychosocial well-being, general health status, and quality of life in patients with neck pain. Self-administered questionnaires are commonly used in clinical practice and research projects.

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Outcome Assessment Questionnaires Page

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Outcomes For Adult Scoliosis Patients
Receiving Chiropractic Rehabilitation

Outcomes For Adult Scoliosis Patients
Receiving Chiropractic Rehabilitation:
A 24-month Retrospective Analysis

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2011 (Sep);   10 (3):   179–184

Mark W. Morningstar, DC

Private Practice, Grand Blanc, MI

OBJECTIVES:   The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded.

METHODS:   A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up.

RESULTS:   A total of 28 patients fit the inclusion criteria for the study. The average beginning primary Cobb angle was 44° ± 6°. Patients received the same chiropractic rehabilitation program for approximately 6 months. At the end of active treatment, improvements were recorded in Cobb angle, pain scores, spirometry, and disability rating. All radiographic findings were maintained at 24-month follow-up.

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Scoliosis and Chiropractic Page

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Receiving Chiropractic Rehabilitation

Vertebral Artery Dissection in a Patient Practicing Self-manipulation of the Neck

Vertebral Artery Dissection in a Patient Practicing Self-manipulation of the Neck

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2011 (Dec);   10 (4):   283–287

John S. Mosby, DC, MD, Stephen M. Duray, PhD

Division of Clinics,
Palmer College of Chiropractic,
Davenport, IA 52803, USA

OBJECTIVE:   The purpose of this case report is to describe a patient who regularly practiced self-manipulation of her neck who presented with shoulder and neck pain and was undergoing a vertebral artery dissection.

CLINICAL FEATURES:   A 42-year-old female patient sought care for left shoulder pain with a secondary complaint of left lower neck pain. Twelve days prior, she had had “the worst headache of her life,” which began in her left lower cervical spine and extended to her left temporal region. The pain was sudden and severe, was described as sharp and burning, and lasted 3 hours. She reported nausea, vomiting, and blurred vision.

INTERVENTION AND OUTCOME:   Initial history and examination suggested that the patient’s head and neck pain was not musculoskeletal in origin, but vascular. She repeatedly requested that an adjustment be performed, but instead was referred to the local emergency department for further evaluation. Magnetic resonance angiogram revealed a dissection of the left vertebral artery from C6 to the C2-C3 interspace and a 3-mm dissecting pseudoaneurysm at the C3 level. She underwent stent-assisted percutaneous transluminal angioplasty combined with antiplatelet therapy (clopidogrel) and experienced a good outcome.

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Stroke and Chiropractic Page

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Methicillin-resistant Staphylococcus aureus:
An Overview for Manual Therapists

Methicillin-resistant Staphylococcus aureus:
An Overview for Manual Therapists

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Medicine 2012 (Mar);   11 (1):   64–76

Bart N. Green, MSEd, DC, Claire D. Johnson, MSEd, DC,
Jonathon Todd Egan, DC, MPH, Michael Rosenthal, PT, DSc, ATC, CDR,
Erin A. Griffith, DO, Marion Willard Evans, DC, PhD

Chiropractor, Chiropractic Division,
Department of Physical and Occupational Therapy,
Naval Medical Center, San Diego, CA

OBJECTIVE:   Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.

METHODS:   PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors’ libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.

RESULTS:   Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.

CONCLUSION:   Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.

From the FULL TEXT Article:


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An Overview for Manual Therapists