Guest guest Posted July 27, 2001 Report Share Posted July 27, 2001 : As I recall the law only says that the physician must be qualified in cardiopulmonary examination. Rulemaking will determine what that qualification is. We agreed to that language from the standpoint that cardiopulmonary examination is part of the Chiropratic educational cirriculum. Something the AMA lobbyist, who was fighting tooth and nail to keep us out, didn't realize, (Thank you Larry Harvey). I'm sure that our board, OBCE, in its rulemaking will recognize that we have all had that training already. There may be Doctors practicing that did not have the training within their educational process as I am not familiar with other colleges and that may be an issue for a small percentage of the DC population. Rulemaking will be the final say, however. I hope this answers your question for the moment. Dr B school physicals > Did anyone ever hear if the change they were talking about re: chiropractors > needing special cardiac training to provide school physicals went through? > > K. Carpentier, D.C., D.A.B.C.O. > Burns, OR > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2001 Report Share Posted July 27, 2001 I have been doing school physicals for the private school my kids attended for 15+ years. This year the school nurse sent me the new OSAA physical form with the " physician recommendations " for cardiac auscultation. After looking it over and discussing it with my associate, we have declined to do large scale physicals, and will only do them on kids whose families are patients of record. There is just too much liability vs my training in cardiac sounds. Give me a spinal or extremity problem, and I'lll have at it, but i'm not going to put my butt out there on some missed heart problem where a kid croaks in a football game. Ron Johansen, PDX ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2001 Report Share Posted July 27, 2001 Ron I too have been doing physicals for 10 yrs and will probably continue. Although I have not seen the form I dont think the phrase changes the liability. In other words your butts been hanging out there for 15+ yrs. We were trained in cardiac sounds at WSCC and certainly know what normal is. If I hear something I am not sure of I do not sign the form, talk to the childs parents and tell them that they will need to have their medical doctor listen and if he/she feels ok then have them sign the form. This pins the liability on the butt of the md. Charlie >From: R JohanR Johansen <drjohansen@...> >res0btan@... >CC: , carpentier@... >Subject: Re: school physicals >Date: Fri, 27 Jul 2001 09:09:35 -0700 > >I have been doing school physicals for the private school my kids >attended for 15+ years. This year the school nurse sent me the new OSAA >physical form with the " physician recommendations " for cardiac >auscultation. After looking it over and discussing it with my associate, >we have declined to do large scale physicals, and will only do them on >kids whose families are patients of record. There is just too much >liability vs my training in cardiac sounds. Give me a spinal or extremity >problem, and I'lll have at it, but i'm not going to put my butt out there >on some missed heart problem where a kid croaks in a football game. Ron >Johansen, PDX >________________________________________________________________ >GET INTERNET ACCESS FROM JUNO! >Juno offers FREE or PREMIUM Internet access for less! >Join Juno today! For your FREE software, visit: >http://dl.www.juno.com/get/tagj. _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2001 Report Share Posted July 27, 2001 Ron: You might note that the sports deaths that occurred over the last few years all had physicals. Cardiac examination does not insure that a person will not have a problem. If the patient presents with an obvious mumur or irregular heartbeat/rate then a referral could/would be appropriate. While you may decline to accept this type of case. You now have the opportunity to accept OR decline. My father in law had a heart attack 3 days after being given a full cardiac exam by his cardiologist which included an EKG. Dr B Re: school physicals > I have been doing school physicals for the private school my kids > attended for 15+ years. This year the school nurse sent me the new OSAA > physical form with the " physician recommendations " for cardiac > auscultation. After looking it over and discussing it with my associate, > we have declined to do large scale physicals, and will only do them on > kids whose families are patients of record. There is just too much > liability vs my training in cardiac sounds. Give me a spinal or extremity > problem, and I'lll have at it, but i'm not going to put my butt out there > on some missed heart problem where a kid croaks in a football game. Ron > Johansen, PDX > ________________________________________________________________ > GET INTERNET ACCESS FROM JUNO! > Juno offers FREE or PREMIUM Internet access for less! > Join Juno today! For your FREE software, visit: > http://dl.www.juno.com/get/tagj. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2001 Report Share Posted July 27, 2001 ron, could you please post the 'physician recomendations' for cardiac auscultation as per the OSAA? thanks, sharron Re: school physicals I have been doing school physicals for the private school my kids attended for 15+ years. This year the school nurse sent me the new OSAA physical form with the " physician recommendations " for cardiac auscultation. After looking it over and discussing it with my associate, we have declined to do large scale physicals, and will only do them on kids whose families are patients of record. There is just too much liability vs my training in cardiac sounds. Give me a spinal or extremity problem, and I'lll have at it, but i'm not going to put my butt out there on some missed heart problem where a kid croaks in a football game. Ron Johansen, PDX ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2001 Report Share Posted July 31, 2001 Though I will vigorously support any DC who chooses to limit his or her practice according to their personal needs and interests, this profession at large must not be shy of applying its clinical skills. All of us practice a bit differently. Basic examination skills, physical, laboratory, or electronic, are skills that have been studied and mastered by all of us. This profession is reaching a critical time in history, yes once again, in which our identities will be more decisively cast. Direct access to the patient is becoming more unusual, the average American is overspent in both time and money, this profession is becoming much less lucrative. Our playing field is far from level. Who will cast this identity? We will, by missed opportunities and failure to step up to the plate at the same time the pitcher is on the mound. This profession must represent competent physicians who are passionate about helping people and will not stand for condescension. P.S. I wonder if you can find a subluxation by detecting an organ malfunction? Steve Lumsden Re: school physicals > >Date: Fri, 27 Jul 2001 09:09:35 -0700 > > > >I have been doing school physicals for the private school my kids > >attended for 15+ years. This year the school nurse sent me the new OSAA > >physical form with the " physician recommendations " for cardiac > >auscultation. After looking it over and discussing it with my associate, > >we have declined to do large scale physicals, and will only do them on > >kids whose families are patients of record. There is just too much > >liability vs my training in cardiac sounds. Give me a spinal or extremity > >problem, and I'lll have at it, but i'm not going to put my butt out there > >on some missed heart problem where a kid croaks in a football game. Ron > >Johansen, PDX > >________________________________________________________________ > >GET INTERNET ACCESS FROM JUNO! > >Juno offers FREE or PREMIUM Internet access for less! > >Join Juno today! For your FREE software, visit: > >http://dl.www.juno.com/get/tagj. > > > _________________________________________________________________ > Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2001 Report Share Posted July 31, 2001 I completely and totally agree with this. To that end what is a primary care physician as defined by us and or the Practice Act of the State of Oregon ? or by whatever other entity wishes to define it. If there was some consensus on that and a metholology to implement the language we would save ourselves a lot of trouble having to constantly define ourselves. Clinical skills is the issue however and if we choose to limit our practice to neuromusculoskeletal/subluxation or keep it to a more broad scope practice then we must have educate ourselves as who is the best at handling the condition. Which is why I gave up the practice of Obstetrics. I was simply not the best at it. I'd be interested in hearing anyone else's opinion on what a PCP is. vty, sharron fuchs dc Re: school physicals Though I will vigorously support any DC who chooses to limit his or her practice according to their personal needs and interests, this profession at large must not be shy of applying its clinical skills. All of us practice a bit differently. Basic examination skills, physical, laboratory, or electronic, are skills that have been studied and mastered by all of us. This profession is reaching a critical time in history, yes once again, in which our identities will be more decisively cast. Direct access to the patient is becoming more unusual, the average American is overspent in both time and money, this profession is becoming much less lucrative. Our playing field is far from level. Who will cast this identity? We will, by missed opportunities and failure to step up to the plate at the same time the pitcher is on the mound. This profession must represent competent physicians who are passionate about helping people and will not stand for condescension. P.S. I wonder if you can find a subluxation by detecting an organ malfunction? Steve Lumsden Re: school physicals > >Date: Fri, 27 Jul 2001 09:09:35 -0700 > > > >I have been doing school physicals for the private school my kids > >attended for 15+ years. This year the school nurse sent me the new OSAA > >physical form with the " physician recommendations " for cardiac > >auscultation. After looking it over and discussing it with my associate, > >we have declined to do large scale physicals, and will only do them on > >kids whose families are patients of record. There is just too much > >liability vs my training in cardiac sounds. Give me a spinal or extremity > >problem, and I'lll have at it, but i'm not going to put my butt out there > >on some missed heart problem where a kid croaks in a football game. Ron > >Johansen, PDX > >________________________________________________________________ > >GET INTERNET ACCESS FROM JUNO! > >Juno offers FREE or PREMIUM Internet access for less! > >Join Juno today! For your FREE software, visit: > >http://dl.www.juno.com/get/tagj. > > > _________________________________________________________________ > Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2001 Report Share Posted August 3, 2001 The topic of primary care and chiropractic came up during previous discussions about school physicals. While I am gathering information on this, it is clear though that our strongest defense to this position is our Practice Act. We can use the title, " chiropractic physician, " our legislative privilege allows, and expects, the DC to do a differential diagnosis. The triage and treatment of ambulatory patients is what we do. Patients often do not know what is wrong with them and because of that, the burden of diagnosis is ours. How many times have we seen angina and its musculoskeletal components, acute gall bladders and ulcers with shoulder pain, bowel, iron deficiency, diabetes, and bladder conditions to name a very few? We are often the portal of entry. Some of these internal conditions are wonderfully managed, both clinically and administratively, by the DC. If I understand the stats correctly(maybe someone out there has the actual data) musculoskeletal conditions comprise a huge portion of all doctor visits in the US, second only to the common cold(which we can care for as well as anyone). It is also my understanding that allopathic primary care providers are not at all comfortable with the management of musculoskeletal complaints. On the basis of these two issues alone, I believe that DC's can do an excellent job of caring for patients as primary care providers. I also believe that we(DC's) must leave this " box " that has been placed around us(by politics and cash flow) in order to apply our perspectives, science, and art, to an increasingly larger number of people in need of excellent basic health care--wellness care first, disease care last. We haven't even scratched the surface of all those who would benefit from sound chiropractic care, be it musculoskeletal or full scope. Let us remove some artificial barriers and help some people! More later....Steve Lumsden Re: school physicals > > > Sharron, I have asked my office manager to scan the OSAA physician > recommendations for auscultation and forward them to you. I didn't > realize how much emotion there would be on this subject, and I appreciate > the effort by ya'll. My decision to quit doing physicals on a large > scale was purely a business decision. When I guest lecture every term at > WSCC, I always point out to students that there is probably 10 law > students i n class to every one of them, and they all will want to make > aliving, so make your clinical decisionswith that in mind. All the more > reason to be up on the literature, and tobecome proficient in a non force > technique. An aside: my wife is a property manager, and while showing a > house this week, mentioned that I was a Chiro; the client started into a > diatribe about how he was suing a PDX chiro for alleged disc injury from > a forceful rotary lumbar manipulation. Its getting harder and harder to > keep what little you make from practice, and I'm forced to protect my > ass..ets as much as think about whats good for the patient. Ron Johansen > ________________________________________________________________ > GET INTERNET ACCESS FROM JUNO! > Juno offers FREE or PREMIUM Internet access for less! > Join Juno today! For your FREE software, visit: > http://dl.www.juno.com/get/tagj. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2008 Report Share Posted August 27, 2008 Good luck on billing, when I was doing them it was cash only. Recent changes in OSAA rules and cardiac liability issues led me to stop doing them, except for a student that I have previously treated, just not worth the risk. R Johansen D.C.,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818-- johncc48 <johncc48@...> wrote: I need some advice.We did a school physical yesterday and need to bill the insurance. The proce3dure code is easy but how have you worked out the diagnosis coding? This 14 year old had no problems and no subluxations either. Colwell ____________________________________________________________ Free quote and debt consolidation information. Click Here. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2008 Report Share Posted August 27, 2008 The cardiac liability is the same for everyone unless you do an echo cardiograph. Reasearch shows the physical is an ineffective screen for sudden cardiac death. The OSAA changes are to team physicians, not physicals. Ted Forcum, DC, DACBSP ACA Sports Council, 2nd Vice President Back In Motion Sports Injuries Clinic, LLC 11385 SW Scholls Ferry Road Beaverton, Oregon 97008 503.524.9040 www.bimsportsinjuries.com The information contained in this electronic message may contain protected health information confidential under applicable law, and is intended only for the use of the individual or entity named above. If the recipient of this message is not the intended recipient, you are hereby notified that any dissemination, copy or disclosure of this communication is strictly prohibited. If you have received this communication in error, please notify Back In Motion Sports Injuries Clinic, LLC at 11385 SW Scholls Ferry Road, Beaverton, OR-97008. and purge the communication immediately without making any copy or distribution. From: [mailto: ] On Behalf Of drjohansen@... Sent: Wednesday, August 27, 2008 9:11 AM johncc48@... Cc: Subject: Re: School physicals Good luck on billing, when I was doing them it was cash only. Recent changes in OSAA rules and cardiac liability issues led me to stop doing them, except for a student that I have previously treated, just not worth the risk. R Johansen D.C.,DABCO Chiropractic Life Center 12762 SE Stark Street Portland Oregon 97233 Voice 5032557746,Fax 5032550818 -- johncc48 <johncc48charter (DOT) net> wrote: I need some advice. We did a school physical yesterday and need to bill the insurance. The proce3dure code is easy but how have you worked out the diagnosis coding? This 14 year old had no problems and no subluxations either. Colwell ____________________________________________________________ Free quote and debt consolidation information. Click Here. Quote Link to comment Share on other sites More sharing options...
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