RE: Fw: Proposed Excessive Tx Admin Rule Draft #5

[Guest guest]

What happened to the rule/law that Washington State enacted?

Dr Beebe

"Proposed Excessive Tx Admin Rule Draft #5"

Dear Colleagues:

Attached is the fifth draft of the proposed administrative rule language regarding excessive treatment or over-utilization. Legal council has apparently instructed the OBCE that having this apply only to "Casualty Insurance Cases" will not fly. I was originally of this opinion as well but due to the concerns of two valuable colleagues on this listserve regarding "wellness" care, I added the term casualty insurance.

In my opinion and that of others using the term "curative" chiropractic treatment handles this concern. Curative indicates that you are treating a specific occurrence (accident or injury) or a specific condition and as such would not apply to "wellness care."

There are also changes relative to using the term "provocative" examination procedures as many of the exam tests we perform are not provocative. The term "physical" exam has been inserted.

I welcome your feeback.

Vern Saboe, DC

President Chiropractic Association of OregonOregonDCs 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. 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.

[Guest guest]

Hello Vern:

Sorry that the lawyers found that the

language we thought so highly of was clearly inappropriate. Now we must rework

the new draft rapidly to achieve the same result.Isn’t

it interesting that the lawyers couldn’t have just rewritten a draft to

accomplish the same result and submitted it for approval? That guarantee for endless repetition is

what I find is the primary strength of the legal profession.

Any way here is my new rendition:

Rewrite: the introduction:

“Evidence based outcomes management shall determine whether the

frequency and duration of curative chiropractic treatment has been reasonable

and necessary.”

“Evidence based outcomes management shall determine whether the

frequency and duration of curative chiropractic treatment for accidental injuries

of the neuromusculoskeletal system has been

reasonable and necessary.

Rewrite “3. Deem the patient at maximal

chiropractic/medical improvement.”

To read: 3. Deem the patient as clinically

stationary and, at the patient’s written request. initiate

a wellness care plan to prevent or minimize degenerative changes and optimize

health.

Well, that is a good start to reach the same finish. Somehow I believe

that the lawyers do not want us to end up at the same finish as we are seeking.

They want us to end up at the proper legal finish. In the legal world

time is not a legally definable entity except

as measure of hourly rate of pay and therefore all injuries have no time

component since impairment ends all hourly pay for the patient.

where an

injury is permanent the impairment cannot be legally projected into the geriatric

years which therefore voids any logic that would ever accurately assess

the impairment’s effect on morbidity and mortality as the injured

patient ages

chiropractic assessment violates both of

these priniciples and so must self-regulate to

eliminate this legal ignorance, aka, “Proposed

Excessive Tx Admin Rule Draft #5”.

I say you cannot get a maggot to appreciate fresh food.

Willard Bertrand, D.C.

Fw: Fw:

" Proposed Excessive Tx Admin Rule Draft #5 "

" Proposed Excessive Tx Admin Rule Draft #5 "

Dear Colleagues:

Attached is the fifth draft of the

proposed administrative rule language regarding excessive treatment or

over-utilization. Legal council has apparently instructed the OBCE that

having this apply only to " Casualty Insurance Cases " will not

fly. I was originally of this opinion as well but due to the concerns of

two valuable colleagues on this listserve regarding " wellness " care,

I added the term casualty insurance.

In my opinion and that of others

using the term " curative " chiropractic treatment handles this

concern. Curative indicates that you are treating a specific occurrence

(accident or injury) or a specific condition and as such would not apply to

" wellness care. "

There are also changes relative to

using the term " provocative " examination procedures as many of the

exam tests we perform are not provocative. The term " physical "

exam has been inserted.

I welcome your feeback.

Vern Saboe, DC

President Chiropractic Association

of Oregon

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.

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.

[Guest guest]

Would ya' all quit utilizing shalls and musts... this leaves no room for advances that may come into play in the future and limits the boards ability to make reasonable interpretations of a Doctor's intent and focus.

Dr B

"Proposed Excessive Tx Admin Rule Draft #5"

Dear Colleagues:

Attached is the fifth draft of the proposed administrative rule language regarding excessive treatment or over-utilization. Legal council has apparently instructed the OBCE that having this apply only to "Casualty Insurance Cases" will not fly. I was originally of this opinion as well but due to the concerns of two valuable colleagues on this listserve regarding "wellness" care, I added the term casualty insurance.

In my opinion and that of others using the term "curative" chiropractic treatment handles this concern. Curative indicates that you are treating a specific occurrence (accident or injury) or a specific condition and as such would not apply to "wellness care."

There are also changes relative to using the term "provocative" examination procedures as many of the exam tests we perform are not provocative. The term "physical" exam has been inserted.

I welcome your feeback.

Vern Saboe, DC

President Chiropractic Association of Oregon

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. 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. 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.

[Guest guest]

Hi Verne:

Since you are so

close to requiring an immediate solution to the Excess treatment rule it seems

that a few points should be cleared to avoid creating a new

definition for chiropractic in Oregon:

the rule should apply to acute NMS

injuries only. If it applies to all of chiropractic care then it would

create an impossible barrier to reasonable care. For example, Oswestry scores do not apply to insomnia,

hypertension, pregnancy, and most of the conditions within our scope. These

are all associated with subluxations, however,

which leads to the next point

subluxation is not always associated with symptoms of pain and neuropathy,

once the OBCE establishes standards that imply that certain examinations

and subjective complaints are required to verify the existence of

subluxation you ceate a narrowing of the scope

of practice by default, since subluxation in the absence of those findings

would not be defined.

These reasons among others would clearly

result in a change in the scope of practice in Oregon if the excessive treatment language is adopted. You say that Washington has this law, but I suggest that if we adopt this language we will

in effect be creating the same scope of practice in Oregon as they have in Washington. If that is your desired result, then this is the best way to do

it. It flies under the radar of the profession under the guise of “protection

against overutilization” when it is really a

strike against our scope of practice, however unintentional the harm may be, it is still threatens to become a major self-inflicted blow

to our scope.

Sincerely hoping that

expediency will not overcome necessity.

Willard Bertrand, D.C.