A.S. Chiropractic friend ? s. fuchs dc

[Guest guest]

Quote is from article below. And people still think Arnold is ok on issues effecting Chiropractic ?

'A change initially proposed in Gov. Schwarzenegger's reform proposal would have stripped chiropractors of the ability to diagnose and determine disability as primary physicians to injured workers. The profession fought that and a slew of other changes that representatives of the California Chiropractic Association said would shut them out of the system.'

-----Original Message-----From: Vern Saboe DC [mailto:vas@...]Sent: Monday, April 19, 2004 6:35 AMOregondcs Subject: Fw: [CFSgroup] CA WC

Has any one wondered just what the average cost per claim for a lower back injury was in the California Worker's Comp system for medical care? This article states that the average claim cost for chiropractic treatment is $3,235.

So here are a few questions I have;

What's the average total cost per low back claim for physical therapy? What's the total cost per lower back claim for MD/DO prescribed medications? What's the total cost per lower back claim for MD/DO ordered X-rays and for their Board Certified Radiologists to read them? What's the total cost per lower back claim for MD/DO ordered special imaging eg., MRI ?? What's the total cost per lower back claim for specialty referrals from MD/DO PCPs to neurologists, orthopedic and neurological surgeons....you know when the drugs and PT don't work....and it is the spine surgeons the family physician and internist perceive as really knowing backs? What percentage of medically managed lower back injuries end up having some form of spinal surgery vs those managed by a chiropractic physician...and what are the subsequent direct and indirect cost totals for each provider group?

.....and my last question to you dear colleagues on the Oregon and ACA-Member list serves....everyone out there in cyberspace raise their hands if you think the case average for a lower back injury managed medically might just be slightly (by a factor of X 4 or 5!) higher than $3,235??????

Is it not time to go on the offensive? Like the first in the nation (to my knowledge);

Prospective Randomized Cost Comparison Study of Chiropractic vs Medical Treatment of Common Musculoskeletal Injuries Within the Oregon Worker's Compensation System

....or as a Portland colleague said; We are going to "rock" here in Oregon!

Have a wonderful week dear colleagues!

Vern Saboe, DC., DACAN., FICC., DABFP

President Chiropractic Association of Oregon

915 SE 19th Ave

Albany, Oregon 97322

(541)926-3162 Clinic

(541)928-2742 Fax

[CFSgroup] CA WC

Chiropractors remain physicians

REFORM: But practitioners say the details of workers' comp legislation could still hurt them.

11:54 PM PDT on Friday, April 16, 2004

By PAUL HERRERA / The Press-Enterprise

As far as the labor code and workers' compensation laws are concerned, chiropractors will remain physicians.

A change initially proposed in Gov. Schwarzenegger's reform proposal would have stripped chiropractors of the ability to diagnose and determine disability as primary physicians to injured workers. The profession fought that and a slew of other changes that representatives of the California Chiropractic Association said would shut them out of the system.

In the course of a more-than-month-long, closed-door negotiation between key lawmakers, the bill changed at least partially in chiropractors' favor.

This week, as the bill passed overwhelmingly through the Legislature, the CCA rolled out a list of remaining concerns that it says might still threaten their role with workers' compensation patients.

While the group fears its demons could still lie within the complicated details of a workers' compensation reform scheduled to be signed into law on Monday, the state's largest organization representing chiropractors had some good news to offer its membership this week.

"That language, we believe, would have kicked us out of the system," said Wayne Whalen, a San Diego-area chiropractor and former CCA president. "But the devil is still in the details. Much of this we're going to have to wait and see."

In addition to retaining physician status, chiropractors theoretically will be part of the pools of physicians that insurers and employers can choose to treat injured workers. However, the law also includes panels of doctors in an HMO-inspired dispute system called Independent Medical Review. Under IMR a panel of doctors will form the final line on each decision.

"If the panel approach goes through and chiropractors are included in the system, we hope that we are not just theoretically there," Whalen said. "One of the problems we've had in some systems is that chiropractors are in the panel but you just can't get to them."

Whalen said legislators assured the CCA that their intent was not to elbow them out of the system.

Chiropractors came under heavy scrutiny early in the effort to reform workers' compensation. As costs topped $20 billion in California and growth of medical costs in particular outpaced the rest of the country, a study from a Massachusetts-based research group found that injured workers in California were visiting chiropractors at more than twice the rate of other states.

The Workers' Compensation Research Institute determined that among employees who miss more than seven days of work, those in California averaged 34 visits. The median among 12 states studied was 16.6. The figures were based on data from 2000. A year later, the California figure had climbed to 37.9.

With that data and anecdotal evidence of particularly abusive cases where chiropractors had billed hundreds of treatments for the same case, legislators passed a 24-visit cap as part of a broad-ranging workers' compensation-reform bill passed last September aimed at controlling medical costs. Chiropractors had successfully lobbied to stave off a 15-limit cap proposed by Sen. Jackie Speier, D-Hillsborough.

The CCA has argued that it has been singled out as a weak target and disproportionately blamed for the rising costs. In 2001, WCRI, the Massachusetts research group, pegged chiropractic costs at 7 percent of the total system with an average of $3,235 per claim.

As initially written, the workers' compensation-reform bill would have forced chiropractors to work under the diagnoses and referrals of medical doctors. Some remnants of that scenario might still remain if chiropractors are excluded from the medical-review panels.

The CCA wants to see chiropractors included on those panels to avoid situations where medical doctors are reviewing the work of chiropractors.

"It looks like this IMR will be done by medical doctors, which means that medical doctors will be the ones to decide when chiropractic treatment is necessary," said Bueler, a chiropractor with a practice in Crestline. "We've fought this before and been successful in other types of health care, because we don't feel one specialty should be allowed to judge another."

While the reform bill is scheduled to be signed Monday, most observers say that future bills will be necessary to clean up unintended problems in the massive reform package. Those bills will give critics an opportunity to revisit some of the issues that they object to in the current deal.

On Friday, CCA president echoed the concerns of most opponents, including the California Applicants' Attorneys Association, by attacking provisions that he said will make employers and insurers gatekeepers for care in workers' compensation.

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