your commentary

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How fresh to have a listserve member who straightens up their spinal column and speaks out against the inherent failure of the managed care leadership... particularly in such a paranoid-cultish environ that Oregon chiros have brewed-up for themselves.

Eeeeghad.

Are we back to Kansas yet???

Great analysis.

scott s.

www.shephardfox.com

Re: Managed care/chironet [ Double-click this line for list subscription options ] I enjoy 's comments re. Chironet although this does not mean i agree with all of them, just most. I have been on the chironet panel about a year and i don't have vast experience with managed care but I read alot about what is out there around the country and the chironet self-refferal stuff is better than most, but maybe that is because what is out there is just pure and cheap rip off contracts where chiro-competitors have chiseled each other down to the kind of watered down "orthopractic-like?" version of our profession that perhaps is suggesting. As a panel member here is my biggest complaint to the board members ...consider this an open letter to the Chironet board members if you will....... The biggest mistake Chironet or any chiropractic HMO/PPO can make is to sign a contract wherein there is NOT direct access (self-referral)to the chiropractor and/or the utilization review is not controlled by chiropractors. Hello, we are a seperate and distinct profession from medicine ladies and gentleman!!!. This is the NUMBER one SELL OUT of our fine profession this is where all chiropractic organizations, all chiropractors need to toe the line ABSOLUTELY. NO ONE BUT A CHIROPRACTOR HAS THE KNOWLEDGE AND TRAINING TO DETERMINE IF/WHEN CHIROPRACTIC EVALUATON AND TREATMENT IS INDICIATED. We are slowly detroying and devaluing our profession when we allow absolutely clueless physician assistants, nurse practitoners and MDs to have the SOLE and BINDING authority to "refer" ( read PRESCRIBE) "chiropractry" (as it is described on Providence's local website). I don't think closed panels are such a crime by definition, in fact, they are a tool that can and has helped groups of chiros infiltrate otherwise closed markets...there are many panels that are closed to me and i don't worry about them for a second, most of them i wouldn't join anyway....no closed panels aren't the real problem. THE REAL CRIME IS Chiropractic HMO's/PPOs CAVING IN ON THE REFERRAL REQUIREMENT AND SIGNING THESE CONTRACTS... As in the Kaiser contract, we, the Chironet panel members, are Kaiser's "bus- boys" cleaning the scraps and crumbs off of their table when the are done with their meal. I would never have aggreed to such a contract. Not to mention, the care that patients receive for spine-related and NMS stuff within Kaiser borders on TRAGIC. They are clueless. I have had a number of pts. come to me only after they near;ly begged thier PCP for a referral after many months of pain....then they get 3 visits authorised and Chironet has the Gall in their provider manual to say that the orignal referral will usually be sufficient to take care of the problem...it is always 3 visits no matter how acute etc., they (Kaiser) have a physiatrist MD who reviews the appropriateness of any further "extended" (that's what they call care beyond 3 visits) care and let me tell you this guy is a real "EXPERT" on chiropractic care, oh he is very expert....(not).... We don't get covered for x-ray so i send them back to kaiser for films and the dopey Radtechs at Kaiser tell my patients that "standing" L-spine x-rays are stupid and not normally done and that only chiropractors "still" use them and the Physician assistant PCP (which my patient assumes is a doctor and even calls her doctor "so and so" and the P.A. never has corrected him re. her title) says that 9 visits (I requested) to a chiropractor is "Highly Unsual" and that she is "not prepared to authorize more at this time, sorry" because it is so "highly unusual"....JEEZ-LOUISE ...this authorization would have been a no-brainer for any middle-of-the-road-chiro. yes, we (Chironet) are kaiser's 'enablers'...we enable them to sell a plan to an employer which includes "chiropractic" Of course, the employer says...hey , wow, that sounds great....we'll take it. Heh heh. was dead-on right about that. Do i sound like i enjoy this? I actually do love my practice and we are pretty busy around here, but it isn't due to chironet, i can assure you. Hey you non-chironet members, god bless all of you, you're not missing much. Heh heh. One last salvo, the chironet contract with Providence Medicare is also actually laughable and I would never have aggreed to such a thing. It requires a referral by the Providence PCP and they (the PCP) have to make the DX of subluxation etc. The chiropractic utilization within Providence managed care is ALMOST ZERO as opposed to approx 8-9% within medicare part B. Providence gets its money regardless of how much 'chiropractry" is performed and as of right now, i am the only guy i know who actually has successfully gotten more than one refferal within this plan. Oh well.....my next post will be pure-positive energy. J. , DC Springbrook Chiropractic & Natural Health Center 1015 N. Springbrook Rd. Newberg, OR 97132 503-538-0618 "Chiropractic, At Its Best" ------- End of forwarded message ------- ------- End of forwarded message ------- ------- End of forwarded message ------- ------- End of forwarded message -------Art

503-282-8582 (O)

503-225-0745 (H)