RE: Oregon only guidelines

April 17, 2003

Sharron:

I think you've got the idea.............

for myself,

1) I support having guidelines developed by Oregon DCs;

2) I favor modernizing them based on more recent research findings;

3) I favor OBCE facilitating the process of upgrading them;

I am reviewing Dr. Bertrand's most recent post regarding separating OBCE from OCPUG. I personally don't see the conflict and onerous aspects of what he refers to as 'government guidelines' but continue to strive to understand his point.

I share the concern of Dr. Schmidt regarding the use of the term 'medical' but as of yet have not found any specific use of that term in our Triad of Oregon Chiropractic enabling documentation: ORS, OAR, OCPUG.

yours in health,

Jack Pedersen, DC

April 17, 2003

What is maximum Chiropractic improvement?

Carl

-- Re: Oregon only guidelines

Maximun chiropractic improvement …. according to exams and professional opinions. sk

skierstyn

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@...

April 17, 2003

What is maximum Chiropractic improvement?

This is very vague. Are you talking symptoms, neurocalumeter readings, emg, postural analysis.

Neuro/ ortho tests.

This is confusing.

What's the model.

Carl

-- Re: Oregon only guidelines

Maximun chiropractic improvement …. according to exams and professional opinions. sk

skierstyn

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@...

April 17, 2003

Thank you Jack. I need to first put the 'issues' in some correct form of order before I can formulate a solution. The wrangling and confusion that goes on makes me very unsettled. At times there are true factual differences on issues of substance and value, but at others times it seems to be just wrangling for wrangling's sake or perhaps a guised attempt to divert without just speaking clearly and plainly ie... 'No, we don't want new OPUG's and here is the reason why.' Period. But not here by gosh, if things don't go to the expected or demanded outcome then it is a constant wrangle or semantic battle, then an attack , then endless diatribe and then constant hassles to make the professional process so difficult that no one in their right mind would invite such misery.

In this 'guideline' discussion one fact, as I see it, is that the process is underway and will go on. The notion put out that any involvement of the OBCE is wrong ,I think, is more of a 'guised' attempt to stop the process and divert attention by starting another process. ly, and I speak only for me, I would be afraid to walk into a room where another 'process' was going on feeling like I would have to 'pack up' like a dog just to protect myself from an uncontrolled situation. I would prefer to be at the OBCE office for just that reason, a measure of control....sorry, I guess I read too much stuff out there circulating about having to 'physically restrain' someone....

So I say, if you disagree , just say so. Make your point(s), accept that a process is underway, join the group to work for the most favorable outcome.... and then...move on.

just my opinion.

sharron fuchs dc

Re: Oregon only guidelines

Sharron:

I think you've got the idea.............

for myself,

1) I support having guidelines developed by Oregon DCs;

2) I favor modernizing them based on more recent research findings;

3) I favor OBCE facilitating the process of upgrading them;

I am reviewing Dr. Bertrand's most recent post regarding separating OBCE from OCPUG. I personally don't see the conflict and onerous aspects of what he refers to as 'government guidelines' but continue to strive to understand his point.

I share the concern of Dr. Schmidt regarding the use of the term 'medical' but as of yet have not found any specific use of that term in our Triad of Oregon Chiropractic enabling documentation: ORS, OAR, OCPUG.

yours in health,

Jack Pedersen, DC

April 17, 2003

Carl, You are asking something that isn't entirely written yet. How do you do it now?

And being concerned about it…joining in the definition and writing would make sure you input is there. Sunny

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@...

April 17, 2003

That is a good definition of what is being expressed. The frustration is that those fears are being expressed by our members who speak from fear rather than investigation or experience…they haven't even read the document or been in on the hours of talk we've already spent in expressing exactly same thing. The time that has allowed our fears to be addressed and allowed us to go forward with a 'protection' action. And ALL are invited to come to the table.

Sunny

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@... <mailto:jfsdc@...> < mailto:jfsdc@...<mailto:jfsdc@...> >

April 17, 2003

I use a guideline of a global spinal model

(Pettibon, on et. al.). The model was

contructed based on optimal structure for

form and function.

Carl Bonofiglio

-- Re: Oregon only guidelines

Carl, You are asking something that isn't entirely written yet. How do you do it now?

And being concerned about it…joining in the definition and writing would make sure you input is there. Sunny

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@...

April 17, 2003

Willard

Probably not. You are right the

Global spine is not the end point,

but a great start.

Carl Bonofiglio

-- Re: Oregon only guidelines

Carl, You are asking something that isn't entirely written yet. How do you do it now?

And being concerned about it…joining in the definition and writing would make sure you input is there. Sunny

Re: Oregon only guidelines Thank you Jim Vick Salem for the real and meaningful legal opinion. Iwould suggest you send you bill to the OBCE since they are down at thelegislature trying to get another fee increase so they can continue onfunding the guidelines process. J Schmidt, D.C. President Oregon Doctors of Chiropractic 306 Oak St. Silverton, OR 97381 phone 503-873-3641 fax 503-873-6200 E-mail jfsdc@...

April 17, 2003

Willard

I would not disagree with any of the parameters

you’ve listed as being a nice indication of certain aspects of health.

Now, with regards to subluxation and

maximum chiropractic improvement (MCI), do all need to be included for this

assessment? What are the ideal values for each of these criteria?

Where were these values published? You’ve listed (as near as I can

tell) 12 different measurements. Do all12 need to be included to

determine maximum chiropractic improvement? Can a reasonable assessment

of MCI be ascertained with two or three or even one of those measurements?

Seriously, this is good stuff. But,

wouldn’t you agree that if these are the measurements by which we are

defining what we do, we need some solid evidence that the measurements are

valid and reliable?

I think you need to be on one of these

panels. (Seed, nominal, Delphi)

Don

-----Original

Message-----

From: Dr. Willard Bertrand, D.C. [mailto:mail@...]

Sent: Wednesday, April 16, 2003

5:28 PM

Oregon DC List

Subject: RE: Oregon

only guidelines

Dear Dr. Carl:

I am using a

Regainer table protocol to re-establish normal balanced subluxation-free

postural curves as published in Spine by on et. al.

This is not the

endpoint of care, but is part of the core requirement for health. Others would

include normal blood pressure, the presence respiratory sinus arrhythmia during

abdominal breathing, optimum %body fat, routine aerobic and strengthening

exercises to include a solid core musculature, attainment of an average VO2

Max, normal spirometry and ECG, relaxation skills verifiable by EMG, balanced

walking pattern, average reports on paper tests of daily activities, and a

normal routine physical examination including screens for cancer, diabetes,

hormonal imbalances, cardiac risk factors.

Are these all in

the OPUG’s? I wonder if we should all agree on each of these?

Willard

I use a guideline of a global

spinal model

(Pettibon, on et. al.). The

model was

contructed based on optimal

structure for

form and function.

Carl Bonofiglio

-------Original

Message-------

From: sunny kristyn

Date: Thursday,

April 17, 2003 17:23:10

drmfreeman@...; kjholzdc@...; jvick@...; JFSDC@...; Doc

Bono

Cc: vivianrockwell@...; GLOWCO1@...; rsribellia@...; sirrbe1st@...; chirodoc@...; bakfixer@...; tntchiro@...; sunchiro@...; l.g.rutherford@...; wellness@...;

drbobdc@...; cnolldc@...; goldenstaralpha@...; muffy777@...; steven_ellsworth@...; dduemling@...; dreric@...; twodocs@...; kristentraeger@...; hardentown@...; peterlind@...; lawtonchiropractic@...; Chcc@...; stefandc@...; kak@...; DSchm92293@...; Kmac@...; Pdetroitjoe@...; mail@...; tradeclimb@...; Kris_97303@...; BACDOC@...; mmmiller@...; gregghelms@...; AMDurrant@...; ehacmac@...; RPSDC@...; grsdc@...;

Subject: Re:

Oregon only guidelines

Carl, You are asking

something that isn't entirely written yet. How do you do it now?

And being concerned about

it…joining in the definition and writing would make sure you input is

there. Sunny

----- Original

Message -----

From: Doc Bono

drmfreeman@...

; kjholzdc@...

; jvick@...

; JFSDC@... ; skrndc1@...

Cc: vivianrockwell@...

; GLOWCO1@...

; rsribellia@...

; sirrbe1st@...

; chirodoc@...

; bakfixer@...

; tntchiro@...

; sunchiro@...

; l.g.rutherford@...

; wellness@... ; drbobdc@...

; cnolldc@...

; goldenstaralpha@...

; muffy777@...

; steven_ellsworth@...

; dduemling@...

; dreric@...

; twodocs@...

; kristentraeger@... ; hardentown@...

; peterlind@...

; lawtonchiropractic@... ; Chcc@... ; stefandc@...

; kak@...

; DSchm92293@...

; Kmac@... ; Pdetroitjoe@...

; mail@...

; tradeclimb@...

; Kris_97303@...

; BACDOC@... ;

mmmiller@...

; gregghelms@...

; AMDurrant@...

; ehacmac@...

; RPSDC@... ; grsdc@...

;

Sent: Thursday, April 17, 2003 4:14 PM

Subject: Re: Oregon only

guidelines

What

is maximum Chiropractic improvement?

This is very vague. Are you talking symptoms, neurocalumeter readings, emg,

postural analysis.

Neuro/ ortho tests.

This is confusing.

What's the model.

Carl

-- Re: Oregon only guidelines

Maximun chiropractic improvement .. according to exams and professional

opinions. sk

skierstyn

Re: Oregon only guidelines

Thank you Jim Vick Salem for the real and meaningful legal

opinion. I

would suggest you send you bill to the OBCE since they are down at the

legislature trying to get another fee increase so they can continue on

funding the guidelines process.

J Schmidt, D.C. President

Oregon Doctors of Chiropractic

306 Oak

St.

Silverton, OR 97381

phone 503-873-3641

fax 503-873-6200

E-mail jfsdc@...

April 23, 2003

Hello Dr.

Schmidt:

I am of the

opinion that if ODOC, CAO, OBCE, WSCC, etc. would simply post relevant agendas

to the list serve it would be a great public service for me personally. It

would take time, but it would be worth it for all concerned, since this

information would be the foundation required for intelligent communication that

could possibly lead to cooperation. Hopefully a format that would not be fodder

for litigation is available.

I think

the list serve might be the emergent association of the associations where all

can hash out differences in real time. Perhaps this could be more productive

than meetings where “everyone” gets together behind closed doors. Still, it

would require a certain level of openness, starting with publishing agendas:

legislative, OBCE related, WSCC related, marketing related, and so on, when

relevant. Once a common ground is obtained on any issue, we could send it out

by mail to the entire Oregon profession for public comment, each association

could then vote on an official position, and monies could be appropriated or

raised to fund an action, when that is necessary.

Most

importantly, each group would retain full autonomy and it would be very clear

where cooperation is possible, where divisions exist and why, and where apathy

is simply insurmountable.

Each group

could post financial needs to complete a certain project and obtain grassroots

funding outside of their dues structures.

We would

need to pay attention to the formal rules I posted earlier where arguments

occur; and, expect corrective moderation where such a set of mutually agreed

upon rules were violated.

This list

serve, is often off topic and rarely completes a discussion thread to a reasonable

set of conclusions. Perhaps another list serve might be more appropriate for

such carefully targeted discussions? Whatever floats your boat.

Willard

Bertrand

-----Original Message-----

If 10 to 20 people with ODOC philosophy

on political issues such as guidelines would get on this list serve and start

directing intelligent conversation . . . [remaining message deleted by WB]

Schmidt

April 24, 2003

To Jack

You have extrapolated from my comments on "Oregon only guidelines", that I would advocate restricting appropriate enforcement of the legislatively mandated responsibilities for control and oversight of the chiropractic profession. That is simply not true. The language and guidelines for professional behavior existing in our law are presently very adequate and have served as a guideline for enforcement for many years. I did not make any statement that we should abandon the present methods of legislatively mandated control and oversight of this profession. I do feel that they are adequate and that the intention to use OBCE enforcement powers and actual use of monetary funds coming directly from our yearly licensing fees is an extremely liberal over interpretation of the legislative intent and authority of our licensing law.

Once again we (ODOC) have never stated that we are against guidelines. We have published in our newsletter, testified in the legislature, and submitted to the OBCE our position that we support and endorse various national guidelines, and in fact have recently encouraged the OBCE to retain and not abandon the current OCPUG.

The OCPUG is distincly different from the document currently under construction.

Schmidt, DC

306 Oak St.

Silverton, OR 97381

phone 503-873-3641

fax 503-873-6200

E-mail jfsdc@ aol.com

April 25, 2003

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only when no other state agency or licencing board in this country feels it is within their authority to do the same thing? I think the answer is obvious and that is lack of legal authority and inappropriate activity. We have national guidelines for treatment parameters on frequency of care. We have the OCPUG - The use of OPUG was written into the rules instead of as a guideline, thus when an investigation was performed on a complaint, the treatment parameters given where "law" and as such did not allow for individual case differences. That fact made leniency in treatment parameters difficult and put treatment into a box instead of looking at each case clinically. The new project, as I understand it, would be guidelines only and are for practitioner and public use. They will not be written into the Admin Rules as our current OPUG is.

The leaders of our profession for years operated under the philosophy that we should define our profession by what we do not do namely the practice of medicine and surgery. - Times have changed. If we wish to treat more than 7 - 9% of the population and expose more people to chiropractic treatment, then we must define what we do, rather that defining us as "non-medical". Many things are "non-medical", acupuncture, massage therapy, and truck driving, just to name a few. Now that we are considered, or wish to be considered, a more popular choice for healthcare, we must identify our area of treatment that the rest of the population can understand. The thought process you put forth above is left over from the days when DC's were arrested for 'Practicing medicine" and had to make those statements to avoid jail. Times have changed.

Opportunity for the growht and development then comes to a halt. - Growth and development comes from professional discussion and critical thinking within the profession. Identity of our practice parameteres is necessary to have a baseline of discussion for growth and developement.

Opportunity for the legal and insurance community to use the proposed document for restriction thenbecomes a probability

If you as a practitioner, can clinically rationalize your treatment, then you really have little to worry about. All practitioners are having a difficult time with reimbursement. An orthopedist next door get's 40 cents on the dollar for his charges and must bill patients many times for services not covered or denied by PI and WC. We aren't the only ones getting hacked. We got stuffed in 1990, but we need to go on and get over it.

Again, if this concerns you so much, why don't you pariticipate in the development of these guidilines?

I anticipate your reply.

P. Thille, D.C., FACORedmond, Oregon

Re: Oregon only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only when no other state agency or licencing board in this country feels it is within their authority to do the same thing? I think the answer is obvious and that is lack of legal authority and inappropriate activity. We have national guidelines for treatment parameters on frequency of care. We have the OCPUG. The leaders of our profession for years operated under the philosophy that we should define our profession by what we do not do namely the practice of medicine and surgery. To define what we do establishes a list of conditions treated and places us in the medical model. Opportunity for the growht and development then comes to a halt. Opportunity for the legal and insurance community to use the proposed document for restriction thenbecomes a probability. Schmidt, DC306 Oak St. Silverton, OR 97381phone 503-873-3641fax 503-873-6200E-mail jfsdc@ aol.com

April 25, 2003

Hello Dr.

Thille:

Can you

say then that we need the new practice guidelines to do away with the present administrative

OPUG or is this to be another “layer”?

Willard Bertrand

-----Original

Message-----

From: Dr Thille

[mailto:mtdc@...]

Sent: Friday, April 25, 2003 11:12

AM

Subject: Re: Oregon

only guidelines

Why

Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only when no

other state agency or licencing board in this country feels it is within their

authority to do the same thing?

- The use of OPUG was written into the rules instead of as a

guideline, thus when an investigation was performed on a complaint, the

treatment parameters given where " law " and as such did not allow for

individual case differences. That fact made leniency in treatment parameters

difficult and put treatment into a box instead of looking at each case

clinically. The new project, as I understand it, would be guidelines only and

are for practitioner and public use. They will not be written into the Admin

Rules as our current OPUG is.

April 28, 2003

Dr. Bertrand -

It is my understanding that these will replace the current OPUG and the language in the Admin Rules that makes the old guidelines standards will be changed. Mr. McTeague or a board member may shed more light on this if I am wrong, but I belive that is the general direction the board is taking this. This will not be another layer.

The board, (based upon Peer Review Committee concerns), found that the OPUG guidelines, (that became rules because of some language in the Admin Rules), did not allow enough leeway in treatment parameters to make valued judgements. Most complaints the PR committee saw were (alleged) overtreatment, substandard treatment, billing disputes with patients, etc. It became very difficult to put everyone into the current OPUG treatment guidelines as at times OPUG did not allow enough treatment and at other times, too much.

Thille

P. Thille, D.C., FACORedmond, Oregon

Re: Oregon only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only when no other state agency or licencing board in this country feels it is within their authority to do the same thing?

- The use of OPUG was written into the rules instead of as a guideline, thus when an investigation was performed on a complaint, the treatment parameters given where "law" and as such did not allow for individual case differences. That fact made leniency in treatment parameters difficult and put treatment into a box instead of looking at each case clinically. The new project, as I understand it, would be guidelines only and are for practitioner and public use. They will not be written into the Admin Rules as our current OPUG is.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

April 28, 2003

Dear :

This is exactly the legal problem that occurs with PUG’s. I think all

will find that eliminating the current OPUG’s will leave us better off. Then,

instead of new guidelines, which will most certainly be at odds with evolving

research, e.g., the on spinal models, the minimum diagnostic standards

for subluxation complicated by diabetes mellitus, etc. The OPUG’s would be best

to determine the minimum quality for chart notes to support care for any

condition, rather than trying to describe the mode and meter of care for each

condition known. This seems the best fit to meet OBCE administrative

requirements, which appear to be hampered at times by the current OPUGs. Still,

I would let other institutions sponsor continuation of the guideline

development, and the OBCE can contribute the same meeting space and $$ as it

does now.

Willard

-----Original

Message-----

From: Dr Thille

[mailto:mtdc@...]

Sent: Monday, April 28, 2003 7:52

AM

Subject: Re: Oregon

only guidelines

Dr.

Bertrand -

It is

my understanding that these will replace the current OPUG and the language in

the Admin Rules that makes the old guidelines standards

will be changed. Mr. McTeague or a board member may shed more light on this if

I am wrong, but I belive that is the general direction the board is taking

this. This will not be another layer.

The

board, (based upon Peer Review Committee concerns), found that the OPUG

guidelines, (that became rules because of some language in the Admin Rules),

did not allow enough leeway in treatment parameters to make valued

judgements. Most complaints the PR committee saw were (alleged) overtreatment,

substandard treatment, billing disputes with patients, etc. It became very

difficult to put everyone into the current OPUG treatment guidelines as at

times OPUG did not allow enough treatment and at other times, too much.

Thille

P.

Thille, D.C., FACO

Redmond, Oregon

-----

Original Message -----

From: Dr. Willard

Bertrand, D.C.

Sent: Friday, April 25, 2003

4:08 PM

Subject: RE:

Oregon only guidelines

Hello Dr. Thille:

Can you say then that we

need the new practice guidelines to do away with the present administrative

OPUG or is this to be another “layer”?

Willard Bertrand

Re: Oregon

only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for

Oregon only when no other state agency or licencing board in this country feels

it is within their authority to do the same thing?

- The use of OPUG was

written into the rules instead of as a guideline, thus when an

investigation was performed on a complaint, the treatment parameters given

where " law " and as such did not allow for individual case

differences. That fact made leniency in treatment parameters difficult and put

treatment into a box instead of looking at each case clinically. The new

project, as I understand it, would be guidelines only and are for practitioner

and public use. They will not be written into the Admin Rules as our current

OPUG is.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

April 28, 2003

Hi Willard,

Thank you for your last note … it demonstrates exactly why you should be observing the process. That observations would show that what you are assuming is occurring is not at all what is actually occuring.

No comparison of techniques is occurring therefore your insult of " …new guidellines…will most certainly be at odds with evolving research" is unfounded and shows a lack of research I'm surprised to see from a scientist of your ilk.

You are miles off base, sir. It would appear you are attempting to cast aspersions without knowing of which you speak. Having your presence at the table would show you that 'determin(ing) the minimum quality for chart notes to support care for any condition" is what we are doing, using every bit of evidence we can get from the current files, and your help would be appreciated

That would seem a far better use of your skills than believing that we would assume to 'try to describe the mode and meter of care for each condition known'. Now that would be an impossible mission! Sunny ;'-)))

skierstyn

Re: Oregon only guidelinesWhy Dr. Thille do we in Oregon need to debvelop guidelines for Oregon onlywhen no other state agency or licencing board in this country feels it iswithin their authority to do the same thing?- The use of OPUG was written into the rules instead of as a guideline,thus when an investigation was performed on a complaint, the treatmentparameters given where "law" and as such did not allow for individual casedifferences. That fact made leniency in treatment parameters difficult andput treatment into a box instead of looking at each case clinically. The newproject, as I understand it, would be guidelines only and are forpractitioner and public use. They will not be written into the Admin Rulesas our current OPUG is.OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However,it is against the rules of the listserve to copy, print, forward, orotherwise distribute correspondence written by another member without his orher consent, unless all personal identifiers have been removed.

April 28, 2003

Willard -

I think we can agree to disagree on this point. I do not feel that the new guidelines will hamper reasonable practice, no matter what method, philosophy or spinal model you use. The public deserves standars of safety for their health, and these new guidelines should assist in providing that, or at least a common base from which to begin a clinical conversation. The public expects that by going to a doctor (of any kind) that they will obtain a clinical examination that will find most serious problems for appropriate referral if necessary. They also expect a reasonable clinical thought process that will come to a treatment plan specific for their clinical problem, a.k.a. a good NMS, chiropractic physical exam. These things are what need to be agreed to and written down for a baseline competent exam and treatment protocal. Our Admin Rules state that the board is able to help with this. The docs involved in this undertaking are invited from all groups and as such will more than likely represent a true baseline that all are comfortable with. Any other sponsoring institutions may have a particular slant somewhat differrent from others. This appears to be a democratic rather than autocratic method of determing guidelines for tx.

Since we as a profession do not have hospitals from which to lose priveliges, we are out on our own, doing whatever we like. For public respect and trust, we need some method of determining baseline treatment, otherwise anybody can do anything and call it chiropractic.

Sincerely,

Thille

P. Thille, D.C., FACORedmond, Oregon

Re: Oregon only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only when no other state agency or licencing board in this country feels it is within their authority to do the same thing?

- The use of OPUG was written into the rules instead of as a guideline, thus when an investigation was performed on a complaint, the treatment parameters given where "law" and as such did not allow for individual case differences. That fact made leniency in treatment parameters difficult and put treatment into a box instead of looking at each case clinically. The new project, as I understand it, would be guidelines only and are for practitioner and public use. They will not be written into the Admin Rules as our current OPUG is.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

April 28, 2003

Hello All:

Dr. Sunny has brought up an important point. Until I participate in the

process, I cannot easily form an analysis of its importance. She has stood on

this ground so long that I have finally decided to examine it more carefully.

Still, I must emphasize that attendance of public meetings is not a valid

requirement for an opinion. Therefore, I propose that the written output of the

committee be reviewed before further discussion on my part. To that end, here

are the links that lead to the documentation available. If there is more than

this, please, advise me of the whereabouts, and the methods of procurement of the

same.

http://www.obce.state.or.us/pdfs/pg_develop.pdf

http://www.obce.state.or.us/pdfs/pu_guide.pdf

Willard

-----Original

Message-----

From: Dr Thille

[mailto:mtdc@...]

Sent: Monday, April 28, 2003 12:16

PM

Subject: Re: Oregon

only guidelines

Willard

-

I think

we can agree to disagree on this point. I do not feel that the new guidelines

will hamper reasonable practice, no matter what method, philosophy or spinal

model you use. The public deserves standars of safety for their health, and

these new guidelines should assist in providing that, or at least a common base

from which to begin a clinical conversation. The public expects that by going

to a doctor (of any kind) that they will obtain a clinical examination that

will find most serious problems for appropriate referral if necessary. They

also expect a reasonable clinical thought process that will come to a treatment

plan specific for their clinical problem, a.k.a. a good NMS, chiropractic

physical exam. These things are what need to be agreed to and written down for

a baseline competent exam and treatment protocal. Our Admin Rules state that

the board is able to help with this. The docs involved in this undertaking are

invited from all groups and as such will more than likely represent a true

baseline that all are comfortable with. Any other sponsoring institutions may

have a particular slant somewhat differrent from others. This appears to be a

democratic rather than autocratic method of determing guidelines for tx.

Since

we as a profession do not have hospitals from which to lose priveliges, we are

out on our own, doing whatever we like. For public respect and trust, we need

some method of determining baseline treatment, otherwise anybody can do

anything and call it chiropractic.

Sincerely,

Thille

P.

Thille, D.C., FACO

Redmond, Oregon

-----

Original Message -----

From: Dr. Willard

Bertrand, D.C.

Dr Thille ;

Sent: Monday, April 28, 2003

11:01 AM

Subject: RE:

Oregon only guidelines

Dear

:

This is

exactly the legal problem that occurs with PUG’s. I think all will find that

eliminating the current OPUG’s will leave us better off. Then, instead of new

guidelines, which will most certainly be at odds with evolving research, e.g.,

the on spinal models, the minimum diagnostic standards for subluxation

complicated by diabetes mellitus, etc. The OPUG’s would be best to determine

the minimum quality for chart notes to support care for any condition, rather

than trying to describe the mode and meter of care for each condition known.

This seems the best fit to meet OBCE administrative requirements, which appear

to be hampered at times by the current OPUGs. Still, I would let other

institutions sponsor continuation of the guideline development, and the OBCE

can contribute the same meeting space and $$ as it does now.

Willard

Re: Oregon

only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for

Oregon only when no other state agency or licencing board in this country feels

it is within their authority to do the same thing?

- The use of OPUG was

written into the rules instead of as a guideline, thus when an

investigation was performed on a complaint, the treatment parameters given

where " law " and as such did not allow for individual case

differences. That fact made leniency in treatment parameters difficult and put

treatment into a box instead of looking at each case clinically. The new

project, as I understand it, would be guidelines only and are for practitioner

and public use. They will not be written into the Admin Rules as our current

OPUG is.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

April 28, 2003

Hello Dr.

Kristyn:

I have

read the Meridel Gatterman, D.C. paper at http://www.obce.state.or.us/pdfs/pg_develop.pdf

.. Is there additional record or testimony on the guideline process so far? If

there is, please tell me how to get access.

Guidelines

for development of patient-centered evidence based guidelines are presented in

the paper. The language is concise, yet purely theoretical, and thus obscure in

meaning in the absence of concrete applications. Nonetheless, this is what we

have at present as a foundation for a rational discussion.

Stated

objectives in the paper are presented in this word for word excerpt in red:

1. To develop patient-centered guidelines

grounded on the best available evidence and structured consensus methods that

provide a knowledge base for decision-making about appropriate health care for

specific clinical circumstances.

2. To involve a broad range of

representative chiropractors in the development of seed and nominal consensus

statements validated further by chiropractors and external reviewers through a

Delphi process.

3. To disseminate these patient-centered,

evidence-based practice guidelines for use as educational tools.

4. To develop and disseminate a quick

reference guide with summary points of prevention, diagnosis, and

treatment/management as a ready reference for clinicians for use on a

day-to-day basis (index to primary document).

5. To develop and disseminate a patient's

guide that features those aspects of the guidelines that provide a knowledge

base for the patient to be an active partner in care.

6. To establish a program for implementation of the

guidelines in the State of Oregon.

7. To identify tools and methods to measure guideline

compliance and quality assurance.

8. To identify self-assessment instruments for use as

educational tools to raise standards of quality.

Although I would like

to comment at a later time on each of these objectives, I will limit this

discussion to continue our thread thus far to the singular objective, item #4.

I do not believe that

the OPUG committee can develop a meaningful quick reference guide to the top 60

conditions presenting in daily practice, and perhaps to the single most common

condition, spinal subluxation. The idea of a quick reference sounds so, well,

quick. I was under the assumption, Dr. Kristyn, that the OPUG was not going to “describe

the mode and meter of care for each condition known” as you stated in your post

below. But, here it is a stated objective in the published guideline as

objective #4. Perhaps, my observations (Which you should not take as an insult,

because your description of my observations as insults suggests my observations

are based upon capricious emotional outbursts, which I assure the reader that they

are not. If I did not respect the OBCE OPUG committee’s efforts, I would not

spend a moment commenting upon them.) ; so stated again: perhaps, my

observations could be weakened by my lack of understanding the true nature of

the OPUG committee’s intent, but when the objectives are written and published,

as they are here, that becomes a more difficult criticism. This strengthens the

critique I have previously offered to be, surprisingly, substantially

supported by the committee’s own report. You may search the link yourself

and read the above excerpt from page 2 of the document.

Perhaps this published

report does not represent the OPUG’s committee’s present intentions. In that

case, what documentation can you offer that would clearly state the OPUG

committee’s present position on developing a “quick reference guide” covering

every condition presenting in a chiropractor’s office as stated in item #4

above?

Thank you for your

continued patience and perseverance in this discussion. I do sincerely

appreciate your efforts in the service of the chiropractors in the state and

remember favorably our joint efforts at getting signatures for the statewide Patient

Freedom of Choice initiative. Energy in the service of the public is such a

limited commodity that I would very much wish to assist in its application to

problems that are presently lacking the strength of such service, possibly the

legislative coverage sought by the President of the CAO.

Willard Bertrand

-----Original

Message-----

From: sunny kristyn

[mailto:skrndc1@...]

Sent: Monday, April 28, 2003 11:42

AM

Dr Thille; ; Dr.

Willard Bertrand, D.C.

Subject: Re: Oregon

only guidelines

Hi

Willard,

Thank

you for your last note … it demonstrates exactly why you should

be observing the process. That observations would show that what you are

assuming is occurring is not at all what is actually occuring.

No

comparison of techniques is occurring therefore your insult of " …new

guidellines…will most certainly be at odds with evolving research " is

unfounded and shows a lack of research I'm surprised to see from a

scientist of your ilk.

You

are miles off base, sir. It would appear you are attempting to cast

aspersions without knowing of which you speak. Having your presence at the

table would show you that 'determin(ing) the minimum quality for chart notes to

support care for any condition " is what we are doing,

using every bit of evidence we can get from the current files, and your

help would be appreciated

That

would seem a far better use of your skills than believing that we

would assume to 'try to describe the mode and meter of care for each condition

known'. Now that would be an impossible mission!

Sunny ;'-)))

skierstyn

-----

Original Message -----

From: Dr. Willard

Bertrand, D.C.

Dr Thille ;

Sent: Monday, April 28, 2003

11:01 AM

Subject: RE:

Oregon only guidelines

Dear

:

This is exactly the legal problem that occurs with PUG's. I think all will

find that eliminating the current OPUG's will leave us better off. Then,

instead of new guidelines, which will most certainly be at odds with

evolving research, e.g., the on spinal models, the minimum diagnostic

standards for subluxation complicated by diabetes mellitus, etc. The OPUG's

would be best to determine the minimum quality for chart notes to support

care for any condition, rather than trying to describe the mode and meter of

care for each condition known. This seems the best fit to meet OBCE

administrative requirements, which appear to be hampered at times by the

current OPUGs. Still, I would let other institutions sponsor continuation of

the guideline development, and the OBCE can contribute the same meeting

space and $$ as it does now.

Willard

Re: Oregon only guidelines

Dr. Bertrand -

It is my understanding that these will replace the current OPUG and the

language in the Admin Rules that makes the old guidelines standards will be

changed. Mr. McTeague or a board member may shed more light on this if I am

wrong, but I belive that is the general direction the board is taking this.

This will not be another layer.

The board, (based upon Peer Review Committee concerns), found that the OPUG

guidelines, (that became rules because of some language in the Admin Rules),

did not allow enough leeway in treatment parameters to make valued

judgements. Most complaints the PR committee saw were (alleged)

overtreatment, substandard treatment, billing disputes with patients, etc.

It became very difficult to put everyone into the current OPUG treatment

guidelines as at times OPUG did not allow enough treatment and at other

times, too much.

Thille

P. Thille, D.C., FACO

Redmond, Oregon

Re: Oregon only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only

when no other state agency or licencing board in this country feels it is

within their authority to do the same thing?

- The use of OPUG was written into the rules instead of as a guideline,

thus when an investigation was performed on a complaint, the treatment

parameters given where " law " and as such did not allow for individual

case

differences. That fact made leniency in treatment parameters difficult and

put treatment into a box instead of looking at each case clinically. The new

project, as I understand it, would be guidelines only and are for

practitioner and public use. They will not be written into the Admin Rules

as our current OPUG is.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or

otherwise distribute correspondence written by another member without his or

her consent, unless all personal identifiers have been removed.

April 28, 2003

Dr. Bertrand:

I am not sure exactly what part of items from Gatterman you find objectionable.

If I may focus on item #4 per your comment, from the context of the rest of your discussion my conclusion is perhaps the word 'guide' is at issue.

I have extracted this from dictionary.com:

8 entries found for guide.

guide ( P ) Pronunciation Key (gd)n.

One who shows the way by leading, directing, or advising. One who serves as a model for others, as in a course of conduct.

A person employed to conduct others, as through a museum, and give information about points of interest encountered.

Something, such as a pamphlet, that offers basic information or instruction: a shopper's guide. A guidebook.

Something that serves to direct or indicate. A device, such as a ruler, tab, or bar, that serves as an indicator or acts to regulate a motion or operation.

A soldier stationed at the right or left of a column of marchers to control alignment, show direction, or mark the point of pivot. v. guid·ed, guid·ing, guides v. tr.

To serve as a guide for; conduct. To direct the course of; steer: guide a ship through a channel. To exert control or influence over. To supervise the training or education of. v. intr.

To serve as a guide.

[Middle English, from Old French, from Old Provençal guida, from guidar, to guide, of Germanic origin. See weid- in Indo-European Roots.]

guida·ble adj. guider n. Synonyms: guide, lead, 1pilot, shepherd, steer, 1usherThese verbs mean to conduct on or direct to the way: guided me to my seat; led the troops into battle; a teacher piloting students through the zoo; shepherding tourists to the bus; steered the applicant to the third floor; ushering a visitor out.

guide

P guide: log in for this definition of guide and other entries in Merriam-Webster Medical Dictionary, available only to Dictionary.com Premium members.

guide

Gide \Gide\, Guide \Guide\, n. [OF. guide, guiche.] (Anc. Armor) The leather strap by which the shield of a knight was slung across the shoulder, or across the neck and shoulder. --Meyrick (Ancient Armor).

guide

\Guide\, n. [OE. giae, F. guide, It. guida. See Guide, v. t.] 1. A person who leads or directs another in his way or course, as in a strange land; one who exhibits points of interest to strangers; a conductor; also, that which guides; a guidebook.2. One who, or that which, directs another in his conduct or course of lifo; a director; a regulator.He will be our guide, even unto death. --Ps. xlviii. 14.3. Any contrivance, especially one having a directing edge, surface, or channel, for giving direction to the motion of anything, as water, an instrument, or part of a machine, or for directing the hand or eye, as of an operator; as: (a) (Water Wheels) A blade or channel for directing the flow of water to the wheel buckets. ( (Surgery) A grooved director for a probe or knife. © (Printing) A strip or device to direct the compositor's eye to the line of copy he is setting.4. (Mil.) A noncommissioned officer or soldier placed on the directiug flank of each subdivision of a column of troops, or at the end of a line, to mark the pivots, formations, marches, and alignments in tactics. --Farrow.Guide bar (Mach.), the part of a steam engine on which the crosshead slides, and by which the motion of the piston rod is kept parallel to the cylinder, being a substitute for the parallel motion; -- called also guide, and slide bar.Guide block (Steam Engine), a block attached in to the crosshead to work in contact with the guide bar.Guide meridian. (Surveying) See under Meridian.Guide pile (Engin.), a pile driven to mark a place, as a point to work to.Guide pulley (Mach.), a pulley for directing or changing the line of motion of belt; an idler. --Knight.Guide rail (Railroads), an additional rail, between the others, gripped by horizontal driving wheels on the locomotive, as a means of propulsion on steep gradients.

guide

\Guide\, v. t. [imp. & p. p. Guided; p. pr. & vb. n. Guiding.] [OE. guiden, gyden, F. guiaer, It. guidare; prob. of Teutonic origin; cf. Goth. ritan to watch over, give heed to, Icel. viti signal, AS. witan to know. The word prob. meant, to indicate, point to, and hence, to show the way. Cf. Wit, Guy a rope, Gye.] 1. To lead or direct in a way; to conduct in a course or path; to pilot; as, to guide a traveler.I wish . . . you 'ld guide me to your sovereign's court. --Shak.2. To regulate and manage; to direct; to order; to superintend the training or education of; to instruct and influence intellectually or morally; to train.He will guide his affairs with discretion. --Ps. cxii. 5.The meek will he guide in judgment. --Ps. xxv. 9.

guide

n 1: someone employed to conduct others [syn: usher] 2: someone who shows the way by leading or advising 3: something that offers basic information or instruction [syn: guidebook] 4: a model or standard for making comparisons [syn: template, templet] 5: someone who can find paths through unexplored territory [syn: scout, pathfinder] v 1: direct the course; determine the direction of travelling [syn: steer, maneuver, manouevre, direct, point, head] 2: take somebody somewhere; "We lead him to our chief"; "can you take me to the main entrance?"; "He conducted us to the palace" [syn: lead, take, direct, conduct] 3: be a guiding force, as with directions or advice; "The teacher steered the gifted students towards the more challenging courses" [syn: steer] 4: use as a guide; "They had the lights to guide on" [syn: guide on] 5: guide or pass over something; "He ran his eyes over her naked body." "She ran her fingers along the carved figurine." [syn: run, pass]

guide

GUIDE: in Acronym Finder

Obviously one can season one's meaning with a wide choice of inflection from this simple word.

If the word 'guide' is of such extended possibilities in common useage, surely there are equal concerns extending to the hugely debated (well, huge in some chiropractic circles) use of the word "subluxation".......some DCs even support the notion 'there ain't no such animal'....... While I personally am content to relie on a common definition of the concept of 'subluxation', others will seriously contend, no matter how closely defined, the theoretical and therefore obscure meaning of the term, regardless of the presence of concrete applications in our daily clinical rounds. Of course the question has to then become 'what is it we are doing by the chiropractic adjustment?'

I have not found a way to resolve these types of issues, and therefore strive to eschew etymological obfuscation.

As usual, your comments are thought provoking and challenging.

Yours in health,

Jack Pedersen

from

Re: Oregon only guidelinesWhy Dr. Thille do we in Oregon need to debvelop guidelines for Oregon onlywhen no other state agency or licencing board in this country feels it iswithin their authority to do the same thing?- The use of OPUG was written into the rules instead of as a guideline,thus when an investigation was performed on a complaint, the treatmentparameters given where "law" and as such did not allow for individual casedifferences. That fact made leniency in treatment parameters difficult andput treatment into a box instead of looking at each case clinically. The newproject, as I understand it, would be guidelines only and are forpractitioner and public use. They will not be written into the Admin Rulesas our current OPUG is.OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However,it is against the rules of the listserve to copy, print, forward, orotherwise distribute correspondence written by another member without his orher consent, unless all personal identifiers have been removed.

April 29, 2003

Hi Willard,

You almost had me there … then you veered off course. Oh well … maybe you;lkl be willing to personaly investigate one day.

Couldn't connect with the links…they only pulled up gobblegook (software code) … probably operator error: a computer whiz I'm not. Were you connecting us with OPUGS or with the written chapters of the educational manual. I have both so please let me know what you were attempting to demonstrate to us. Thanks, Sunny

skierstyn

Re: Oregon only guidelinesWhy Dr. Thille do we in Oregon need to debvelop guidelines for Oregon onlywhen no other state agency or licencing board in this country feels it iswithin their authority to do the same thing?- The use of OPUG was written into the rules instead of as a guideline,thus when an investigation was performed on a complaint, the treatmentparameters given where "law" and as such did not allow for individual casedifferences. That fact made leniency in treatment parameters difficult andput treatment into a box instead of looking at each case clinically. The newproject, as I understand it, would be guidelines only and are forpractitioner and public use. They will not be written into the Admin Rulesas our current OPUG is.OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However,it is against the rules of the listserve to copy, print, forward, orotherwise distribute correspondence written by another member without his orher consent, unless all personal identifiers have been removed.

April 29, 2003

Lest you all forget.... Dr Gatterman was one of the prominent IME Doc's of the 80's. Round hole, square peg.

Dan Beebe

Re: Oregon only guidelinesWhy Dr. Thille do we in Oregon need to debvelop guidelines for Oregon onlywhen no other state agency or licencing board in this country feels it iswithin their authority to do the same thing?- The use of OPUG was written into the rules instead of as a guideline,thus when an investigation was performed on a complaint, the treatmentparameters given where "law" and as such did not allow for individual casedifferences. That fact made leniency in treatment parameters difficult andput treatment into a box instead of looking at each case clinically. The newproject, as I understand it, would be guidelines only and are forpractitioner and public use. They will not be written into the Admin Rulesas our current OPUG is.OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However,it is against the rules of the listserve to copy, print, forward, orotherwise distribute correspondence written by another member without his orher consent, unless all personal identifiers have been removed.

April 29, 2003

Dr. Beebe,

Could you expand on this? Was there a difference in the IME's of the 80's vs. the paper reviewers and pre-certifiers of the 90's and today?

Is there a value to knowing who has done major damage to our colleagues?

Abrahamson, D.C.

From: " D Beebe, D.C. " <res0btan@...>

Date: Tue, 29 Apr 2003 08:14:23 -0700

" " < >, " Dr. Willard Bertrand, D.C. " <mail@...>

Subject: Re: Oregon only guidelines

Lest you all forget.... Dr Gatterman was one of the prominent IME Doc's of the 80's. Round hole, square peg.

Dan Beebe

Re: Oregon only guidelines

Why Dr. Thille do we in Oregon need to debvelop guidelines for Oregon only

when no other state agency or licencing board in this country feels it is

within their authority to do the same thing?

- The use of OPUG was written into the rules instead of as a guideline,

thus when an investigation was performed on a complaint, the treatment

parameters given where " law " and as such did not allow for individual case

differences. That fact made leniency in treatment parameters difficult and

put treatment into a box instead of looking at each case clinically. The new

project, as I understand it, would be guidelines only and are for

practitioner and public use. They will not be written into the Admin Rules

as our current OPUG is.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or

otherwise distribute correspondence written by another member without his or

her consent, unless all personal identifiers have been removed.

April 29, 2003

Hi Willard,

Dr. Gatterman's paper was a beginning for us … obviously she is writing the definition of an 'ideal' document. July 3 appears to be the next Nominal Panel meeting. At that time, the Nominal Panel will have seed material from the Record Keeping chapter. That would be a good chance for you to see the process in action.

And it is my understanding that the fully consensitized drafts of the first three chapters are just about ready for the profession. Perhaps Mr. McTeague could get a copy to you.

Sunny

PS: my last name is Kierstyn…the incorrect spelling that is going out with each e-mail is the mistake of our new computer person who installed it incorrectly and now can't seem to find the spot to correct it completely. Please watch for further changes. Sunny Kierstyn ;'-)))

Re: Oregon only guidelinesWhy Dr. Thille do we in Oregon need to debvelop guidelines for Oregon onlywhen no other state agency or licencing board in this country feels it iswithin their authority to do the same thing?- The use of OPUG was written into the rules instead of as a guideline,thus when an investigation was performed on a complaint, the treatmentparameters given where "law" and as such did not allow for individual casedifferences. That fact made leniency in treatment parameters difficult andput treatment into a box instead of looking at each case clinically. The newproject, as I understand it, would be guidelines only and are forpractitioner and public use. They will not be written into the Admin Rulesas our current OPUG is.OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However,it is against the rules of the listserve to copy, print, forward, orotherwise distribute correspondence written by another member without his orher consent, unless all personal identifiers have been removed.

Sign In

RE: Oregon only guidelines

Recommended Posts

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest