Guest guest Posted April 11, 2006 Report Share Posted April 11, 2006 Dr. Boothby, I will make this very short...I was referring to the original colleagues who voiced (minority voice) their concerns following SB-1197 that our lobbyist was not effective and that Ms. Young was a problem. At the general membership meeting of the then OCPA held at WSCC the " majority voice " (me included) voted to keep both Chuck and . This caused the formation of ODOC....if you need validation of this simply ask your fellow ODOC members Siegfried, Schmidt, Platt, Widmire (sp)....or CAO member Les Feinberg. The point I was attempting to make is that we must always respect and listen to the " minority voices " in the profession hey... they could just be right! Now if you wish to be convinced that was a problem (and I liked her very much) eg., finacials, stonewalling board members relative to the budget. I recommend you speak with the likes of Shephard, Don Fox (former ODOCers who moved to CAO), or Dan Bebee as per what was discovered and yes who were successful in finally removing Ms. Young as " CAO Members. " Vern RE: " Official Public Comments > in Support of the > CJ vs CR Rules " > > > Vern; > > > > Geez, buddy!!! I write my post to suggest that > democracy doesn't > mean totalitarianism of the majority over the minority > and you pat me on > the head, not to worry, and accommodation and > inclusion of minority > viewpoints will occur. Then, Dr. Joe suggests that > the " overwhelming > majority " must not be hampered by a pesky minority and > just move forward, > and you say, " Perfectly said " . > > > > Vern, I think you are hanging around with those darn > politicians in > Salem too much. Are you speaking with forked tongue, > white man? I'm > having a crisis of confidence in interpreting the > meaning and intention > of your emails. So, what is it, Bud? Do we stick the > minority in the > patutti because the majority says its OK. Hey, maybe > you should read > something commentary about the U.S. Constitution. > Majority rule doesn't > mean minority persecution or carte blanche for the > majority. By the > way, the percentage of the U.S. population that > utilizes chiropractic > care is what, 12%. Does your enthusiasm for majority > hegemony extend in > that direction, too? > > > > S. Feinberg, D.C. > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 Dr. Boothby says : I treat many patients who haven't gotten well by members of the CAO and board members and members of manage care. I treat them cost effectively and often times less painfully then their other treatments. I would like the administrative rules in oregon to be written broad enough to include the care that I provide people with. I also suspect that many chiropractors that wrote in support of the CJ rule may not actually be providing the most effective care for their patients. Why do I know this? Because there patients are ending up in my office and are not always pleased with their previous treatment. I so my best to teach these people not to blame individual providers and to empower themselves to get the care they need. Well then, a rule affecting all of our practices should be rectified due to the one chiropractor in town that can get results when nobody else can albeit perhaps 2-3yrs down the line? Many patients bounce around providers Dr...... I wouldn't place too much stock in that. Dr. ph Medlin D.C. Spine Tree Chiropractic 1627 NE Alberta St. #6 Portland, OR 97211 Ph: 503-788-6800 c: 503-889-6204 RE: " Official Public Comments > in Support of the > CJ vs CR Rules " > > > Vern; > > > > Geez, buddy!!! I write my post to suggest that > democracy doesn't > mean totalitarianism of the majority over the minority > and you pat me on > the head, not to worry, and accommodation and > inclusion of minority > viewpoints will occur. Then, Dr. Joe suggests that > the " overwhelming > majority " must not be hampered by a pesky minority and > just move forward, > and you say, " Perfectly said " . > > > > Vern, I think you are hanging around with those darn > politicians in > Salem too much. Are you speaking with forked tongue, > white man? I'm > having a crisis of confidence in interpreting the > meaning and intention > of your emails. So, what is it, Bud? Do we stick the > minority in the > patutti because the majority says its OK. Hey, maybe > you should read > something commentary about the U.S. Constitution. > Majority rule doesn't > mean minority persecution or carte blanche for the > majority. By the > way, the percentage of the U.S. population that > utilizes chiropractic > care is what, 12%. Does your enthusiasm for majority > hegemony extend in > that direction, too? > > > > S. Feinberg, D.C. > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2006 Report Share Posted April 12, 2006 The viewpoint that is experssed here is one I remember well. It is always validating to help someone that no one else was able to help. BUT, my first lesson in Chiropractic was with an 80 year old DC on the south shore of Long Island, NY. His advice? " Never take the credit for your results. " Not only do you take credit for the patient finding you (the patient's self selection) but you assume that the same thing is not happening with some of your patients. Are these testable assumptions? No. In addition when we take credit you get the blame for those we cannot help. Are we ready for that too? No it is up to us to do our very best and measurement tools may be good feedback in the process. We use these tools and I find them helpful but not definitive. Colwell, DC RE: " Official Public Comments > > in Support of the > > CJ vs CR Rules " > > > > > > Vern; > > > > > > > > Geez, buddy!!! I write my post to suggest that > > democracy doesn't > > mean totalitarianism of the majority over the minority > > and you pat me on > > the head, not to worry, and accommodation and > > inclusion of minority > > viewpoints will occur. Then, Dr. Joe suggests that > > the " overwhelming > > majority " must not be hampered by a pesky minority and > > just move forward, > > and you say, " Perfectly said " . > > > > > > > > Vern, I think you are hanging around with those darn > > politicians in > > Salem too much. Are you speaking with forked tongue, > > white man? I'm > > having a crisis of confidence in interpreting the > > meaning and intention > > of your emails. So, what is it, Bud? Do we stick the > > minority in the > > patutti because the majority says its OK. Hey, maybe > > you should read > > something commentary about the U.S. Constitution. > > Majority rule doesn't > > mean minority persecution or carte blanche for the > > majority. By the > > way, the percentage of the U.S. population that > > utilizes chiropractic > > care is what, 12%. Does your enthusiasm for majority > > hegemony extend in > > that direction, too? > > > > > > > > S. Feinberg, D.C. > > > > > > > > __________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Dear Vern: Go on and on all you want about minority voice and majority voice and who liked or disliked whom whenever. My point is that in the end the truth will win out because it will stand up to the test of time. You suggested I speak with the likes of Shephard, Don Fox(former ODOCers who moved to CAO), or Dan Bebee as per what was discovered and yes who were successful in finally removing Ms. Young as " CAO Members. " I did even better! I have permission to publish Young's final letter from the CAO which is signed by all three. Also I think it is interesting to note that the CAO had 600 members before Young was terminated and they paid her a full years salory upon termination. The Chiropractic Association of Oregon " the second century " To Whom it May Concern: Young served as the executive director of the Chiropractic Association of Oregon from 1984 through March 1998. Ms. Young has strong skills in communication, project management, fundraising, and lobbying. She manages multiple projects with success, and is creative and resourceful. Ms. Young worked energetically during her 13 years with the CAO. She stood by the association when the Oregon chiropractic profession suffered a severe legislative and financial setback. She was a dedicated employee. During Ms. Young's tenure, the Association embarked on cutting-edge projects, including initiating a non-profit managed care organization. From 1984 through 1997, our newsletter and journal won 11 awards from the American Chiropractic Association, and we received national recognition as one of the top chiropractic associations. Ms. young was instrumental in negotiating health care contracts. She also developed a telethon the raised $90,000 for political action. In addition, Ms. Young organized our annual conventions and produced statewide continuing education teleconferences that linked our membership throughout the state. These seminars and conventions grossed over $350,000 in a three-year period. We wish Ms. Young the best in her future pursuits. Sincerely, J. , D.C. President, CAO Beebe, D.C. Board of Governors B. Shephard, D.C. Board of Governors D. Fox, D.C. Board of Governors Dennis Zimmerman, D.C. Board of Governors 2545 SW Spring Garden Street, Suite 150, Portland, Oregon 97219 --- Vern Saboe <vsaboe@...> wrote: > Dr. Boothby, I will make this very short...I was > referring to the original > colleagues who voiced (minority voice) their > concerns following SB-1197 that > our lobbyist was not effective and that Ms. Young > was a problem. At the > general membership meeting of the then OCPA held at > WSCC the " majority > voice " (me included) voted to keep both Chuck and > . > > This caused the formation of ODOC....if you need > validation of this simply > ask your fellow ODOC members Siegfried, > Schmidt, Platt, > Widmire (sp)....or CAO member Les Feinberg. > > The point I was attempting to make is that we must > always respect and listen > to the " minority voices " in the profession hey... > they could just be right! > > Now if you wish to be convinced that was a > problem (and I liked her > very much) eg., finacials, stonewalling board > members relative to the > budget. I recommend you speak with the likes of > Shephard, Don Fox > (former ODOCers who moved to CAO), or Dan Bebee as > per what was discovered > and yes who were successful in finally removing Ms. > Young as " CAO Members. " > > Vern > > > good guys /bad guys > > > > I agree with this statement by Chuck Simpson, " A > > profession (our profession that is) is about (or > > should be about) our patients, the public we > serve > > and how we can contribute to better health, impact > the > > rising tide of health care costs in the face of > > limited resources and generally be part of the > > solution. " > > > > This is a place to start or return to if there is > ever > > to be an actual vulnerable discussion about how to > > serve our patients better. Vulnerable means > actually > > caring while listening to different opinions and > > de-escalating the fight and trying to validate > some > > part of what the other side is saying to find a > common > > ground place to start. > > > > Last week I went to a fascinating lecture by a > > cardiologist who basically figured out that her > heart > > patients were having recurrences of occluded > arteries > > and started to prescribe less medicine and > encourage > > her patients to exercise and eat better. She > showed > > the Harvard study from approx. 1997 that showed > that > > every year there were more patients visits to > > alternative doctors than to medical doctors. I > think > > that study validates a lot about alternative care > > (chiropractic included) and was the start point to > the > > CJ/CR discussion we are currently having. So then > the > > medical people decided to study our alternative > > knowledge so they could co-opt it and get the > patients > > back. This cardiologist validated that point for > me. > > They are not studying us to refer patient to us > that > > need our care. They want what we know. > > > > Now I actually think it is good thing for the > medical > > community to learn about nutrition and herbs and > all > > the things that help to get people healthy. What > I > > don't like about it is the way that this > discussion > > gets framed with some version of snake oil > salesman > > thrown into the us versus them discussion. > > > > So if there is the good guys versus the bad guys > > discussion then I do not think any progress > towards > > co-operation is actually being attempted and I > think > > this good guys bad guys talk is disrespectful to > the > > patients. > > > > Now as I am reading the list-serve today I came > across > > this post from Dr. Vern Saboe that I did not find > to > > be presenting correct information, see message 8 > below > > > > > > " Ouch, ha! Well I was referring to the special > > case...in this case > > wherein the minority (two doctors Boothby & > Cafferty) > > was involved all > > along the way but didn't like the outcome. Their > > concerns were taken > > seriously and still are, and the reality that > these > > were no minor changes the ODOCers proposed and > would > > have cause " substantial harm. " > > > > As Dr. Cafferty and I stated in our presentation > to > > the board we were representing approximately 45 > > doctors and 63 doctors send in surveys in support > of > > the CR rule. Vern in order for me to ever > consider > > that you take my concerns seriously you would have > to > > ask vulnerable questions, stop having to one up > > anything I ever post on the list serve and maybe > even > > show you know how to engage anyone else's opinion > than > > your own by demonstrating caring by saying > something > > like " oh I see your concern, let's try to come up > with > > a solution. " > > > > So let's look at your next statement Vern: > > > > " Here is an ironic example for ya.....in 1990 the > > " minority voice " > > believed the OCPA should fire the Exec. Director > Ms. > > Young and the lobbyist Chuck > > because......she couldn't be trusted and he was > > ineffective. > > > > The " majority voice " said " no " she is trustworthy > and > > he is effective....guess what the " minority voice " > was > > right and the majority wrong. The " minority > voice " > > went on to form ODOC! > > > > I cannot believe you have the gall to use the > example > > of Young in this manner since she was so > > unjustly ousted by the CAO after ODOC had already > > split off. Are you trying to blame that on ODOC > too. > > Please at least have some respect for , a > very > > hard worker, who bore the burden of much > unjustified > > blame by the CAO. It was actually because of > > > Young's mistreatment by the CAO that I quit the > CAO. > > So Vern do not blame her firing on any other > > organization than your own! Can you at least own > the > > CAO firing of Young and maybe even the > injustice > > of it and not try to put a spin on it? > > > > I treat many patients who haven't gotten well by > > members of the CAO and board members and members > of > > manage care. I treat them cost effectively and > often > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Dear Dr. Colwell I pretty much agree with what you have expressed. Now, about your statement, " No it is up to us to do our very best and measurement tools may be good feedback in the process. We use these tools and I find them helpful but not definitive. " I want to make this totally clear. I also use measurement tools. I am for clinical rational. Those of us that wrote the clinical rational rule are pro science. Now, I hope that is clear. The reason I am so passionate about the CJ/CR topic is because every once in a while I get a patient who hasn't quite made it on to the ruler yet and because of my unique clinical and life experience I might think I can help them. I want it explicitly stated in CJ/CR rule that clinical experience counts. Just saying it is included in evidence based outcomes isn't good enough. I want the words clinical experience in the rule and I want it explicit that we will be able to use the clinical rational that support our current scope of practice. Maybe there needs to be a benchmoark inserted for the benefit of third party payers. If we actually talk to each other I think we could come up with the words for that without nixing wellness care or non-neuro-musculo-skeletal care or even compassionate or wisdom based care that is within our scope of practice. Sincerely, Judith Boothby <cc48@...> wrote: > The viewpoint that is experssed here is one I > remember well. It is always > validating to help someone that no one else was able > to help. > BUT, my first lesson in Chiropractic was with an 80 > year old DC on the south > shore of Long Island, NY. His advice? " Never take > the credit for your > results. " Not only do you take credit for the > patient finding you (the > patient's self selection) but you assume that the > same thing is not > happening with some of your patients. Are these > testable assumptions? No. > In addition when we take credit you get the blame > for those we cannot help. > Are we ready for that too? No it is up to us to do > our very best and > measurement tools may be good feedback in the > process. We use these tools > and I find them helpful but not definitive. > > Colwell, DC > good guys /bad guys > > > > > > >I agree with this statement by Chuck Simpson, " A > > > profession (our profession that is) is about > (or > > > should be about) our patients, the public we > serve > > > and how we can contribute to better health, > impact the > > > rising tide of health care costs in the face of > > > limited resources and generally be part of the > > > solution. " > > > > > > This is a place to start or return to if there > is ever > > > to be an actual vulnerable discussion about how > to > > > serve our patients better. Vulnerable means > actually > > > caring while listening to different opinions and > > > de-escalating the fight and trying to validate > some > > > part of what the other side is saying to find a > common > > > ground place to start. > > > > > > Last week I went to a fascinating lecture by a > > > cardiologist who basically figured out that her > heart > > > patients were having recurrences of occluded > arteries > > > and started to prescribe less medicine and > encourage > > > her patients to exercise and eat better. She > showed > > > the Harvard study from approx. 1997 that showed > that > > > every year there were more patients visits to > > > alternative doctors than to medical doctors. I > think > > > that study validates a lot about alternative > care > > > (chiropractic included) and was the start point > to the > > > CJ/CR discussion we are currently having. So > then the > > > medical people decided to study our alternative > > > knowledge so they could co-opt it and get the > patients > > > back. This cardiologist validated that point > for me. > > > They are not studying us to refer patient to us > that > > > need our care. They want what we know. > > > > > > Now I actually think it is good thing for the > medical > > > community to learn about nutrition and herbs and > all > > > the things that help to get people healthy. > What I > > > don't like about it is the way that this > discussion > > > gets framed with some version of snake oil > salesman > > > thrown into the us versus them discussion. > > > > > > So if there is the good guys versus the bad guys > > > discussion then I do not think any progress > towards > > > co-operation is actually being attempted and I > think > > > this good guys bad guys talk is disrespectful to > the > > > patients. > > > > > > Now as I am reading the list-serve today I came > across > > > this post from Dr. Vern Saboe that I did not > find to > > > be presenting correct information, see message 8 > below > > > > > > > > > " Ouch, ha! Well I was referring to the special > > > case...in this case > > > wherein the minority (two doctors Boothby & > Cafferty) > > > was involved all > > > along the way but didn't like the outcome. > Their > > > concerns were taken > > > seriously and still are, and the reality that > these > > > were no minor changes the ODOCers proposed and > would > > > have cause " substantial harm. " > > > > > > As Dr. Cafferty and I stated in our presentation > to > > > the board we were representing approximately 45 > > > doctors and 63 doctors send in surveys in > support of > > > the CR rule. Vern in order for me to ever > consider > > > that you take my concerns seriously you would > have to > > > ask vulnerable questions, stop having to one up > > > anything I ever post on the list serve and maybe > even > > > show you know how to engage anyone else's > opinion than > > > your own by demonstrating caring by saying > something > > > like " oh I see your concern, let's try to come > up with > > > a solution. " > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Dr. Medlin: I hate to say this but you aren't making it onto my ruler and I don't think I know how to reach you. Please attempt to establish some repore before contacting me. Sincerely, Judith Boothby --- deadmed <deadmed@...> wrote: > Dr. Boothby says : > I treat many patients who haven't gotten well by > members of the CAO and board members and members of > manage care. I treat them cost effectively and > often > times less painfully then their other treatments. I > would like the administrative rules in oregon to be > written broad enough to include the care that I > provide people with. I also suspect that many > chiropractors that wrote in support of the CJ rule > may > not actually be providing the most effective care > for > their patients. Why do I know this? Because there > patients are ending up in my office and are not > always > pleased with their previous treatment. I so my best > to teach these people not to blame individual > providers and to empower themselves to get the care > they need. > > > Well then, a rule affecting all of our practices > should be rectified due to > the one chiropractor in town that can get results > when nobody else can > albeit perhaps 2-3yrs down the line? Many patients > bounce around providers > Dr...... I wouldn't place too much stock in that. > > Dr. ph Medlin D.C. > Spine Tree Chiropractic > 1627 NE Alberta St. #6 > Portland, OR 97211 > Ph: 503-788-6800 > c: 503-889-6204 > good guys /bad guys > > > >I agree with this statement by Chuck Simpson, " A > > profession (our profession that is) is about (or > > should be about) our patients, the public we > serve > > and how we can contribute to better health, impact > the > > rising tide of health care costs in the face of > > limited resources and generally be part of the > > solution. " > > > > This is a place to start or return to if there is > ever > > to be an actual vulnerable discussion about how to > > serve our patients better. Vulnerable means > actually > > caring while listening to different opinions and > > de-escalating the fight and trying to validate > some > > part of what the other side is saying to find a > common > > ground place to start. > > > > Last week I went to a fascinating lecture by a > > cardiologist who basically figured out that her > heart > > patients were having recurrences of occluded > arteries > > and started to prescribe less medicine and > encourage > > her patients to exercise and eat better. She > showed > > the Harvard study from approx. 1997 that showed > that > > every year there were more patients visits to > > alternative doctors than to medical doctors. I > think > > that study validates a lot about alternative care > > (chiropractic included) and was the start point to > the > > CJ/CR discussion we are currently having. So then > the > > medical people decided to study our alternative > > knowledge so they could co-opt it and get the > patients > > back. This cardiologist validated that point for > me. > > They are not studying us to refer patient to us > that > > need our care. They want what we know. > > > > Now I actually think it is good thing for the > medical > > community to learn about nutrition and herbs and > all > > the things that help to get people healthy. What > I > > don't like about it is the way that this > discussion > > gets framed with some version of snake oil > salesman > > thrown into the us versus them discussion. > > > > So if there is the good guys versus the bad guys > > discussion then I do not think any progress > towards > > co-operation is actually being attempted and I > think > > this good guys bad guys talk is disrespectful to > the > > patients. > > > > Now as I am reading the list-serve today I came > across > > this post from Dr. Vern Saboe that I did not find > to > > be presenting correct information, see message 8 > below > > > > > > " Ouch, ha! Well I was referring to the special > > case...in this case > > wherein the minority (two doctors Boothby & > Cafferty) > > was involved all > > along the way but didn't like the outcome. Their > > concerns were taken > > seriously and still are, and the reality that > these > > were no minor changes the ODOCers proposed and > would > > have cause " substantial harm. " > > > > As Dr. Cafferty and I stated in our presentation > to > > the board we were representing approximately 45 > > doctors and 63 doctors send in surveys in support > of > > the CR rule. Vern in order for me to ever > consider > > that you take my concerns seriously you would have > to > > ask vulnerable questions, stop having to one up > > anything I ever post on the list serve and maybe > even > > show you know how to engage anyone else's opinion > than > > your own by demonstrating caring by saying > something > > like " oh I see your concern, let's try to come up > with > > a solution. " > > > > So let's look at your next statement Vern: > > > > " Here is an ironic example for ya.....in 1990 the > > " minority voice " > > believed the OCPA should fire the Exec. Director > Ms. > > Young and the lobbyist Chuck > > because......she couldn't be trusted and he was > > ineffective. > > > > The " majority voice " said " no " she is trustworthy > and > > he is effective....guess what the " minority voice " > was > > right and the majority wrong. The " minority > voice " > > went on to form ODOC! > > > > I cannot believe you have the gall to use the > example > > of Young in this manner since she was so > > unjustly ousted by the CAO after ODOC had already > > split off. Are you trying to blame that on ODOC > too. > > Please at least have some respect for , a > very > > hard worker, who bore the burden of much > unjustified > > blame by the CAO. It was actually because of > > > Young's mistreatment by the CAO that I quit the > CAO. > > So Vern do not blame her firing on any other > > organization than your own! Can you at least own > the > > CAO firing of Young and maybe even the > injustice > > of it and not try to put a spin on it? > > > > I treat many patients who haven't gotten well by > > members of the CAO and board members and members > of > > manage care. I treat them cost effectively and > often > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Dear Dr. Boothby: et al: I take pride in the fact that our esteemed colleagues on this list serve are not only the best-trained practitioners, but we deliver a unique service without equal in the NMS field. (- I authored the Comparative Education Study in 1990.) However, I think because we have divergent opinions on some issues, we sometimes lose the perspective that even the less erudite among us are actually " brighter than the average bear. " (- borrowing from Yogi...) Anyway, I simply wish to state that I consider you, and every chiropractic physician on this list serve a valued colleague. So, Dr. Boothby, with all due respect, I do not follow your logic with regard to your objections to the current clinical justification rule. To my understanding, the idea of the rule is that it allows a standard measure of conformity that we are bound to, only in the event that a purchaser of our services demands an accounting of our plan of care. Should we really be concerned that the rule, as it stands, will " nix wellness care, or non-neuro-musculoskeletal care, or even compassionate or wisdom-based care? " In what instance can you cite that a patient " who hasn't quite made it on to the ruler yet " will be unable to receive your compassionate care because of the implementation of this rule? Has a payer ever restricted your practice since the adoption of the current OCPUG guidelines? Do you realize that they suggest treatment plans beyond 12 months for a MVA injury may be considered over-utilization? It seems logical to me that if you are treating a patient for an extended period of time, he/she would by then " make it on to the ruler, " and you would be able to produce sufficient objective data to support your plan of treatment. In fact, the clinical justification rule provides us the freedom to do just that by allowing us to justify via both " ...subjective, or patient-driven information, as well as objective, provider-driven information. " Since you made it clear that you are " pro science, " I would think that you might be more in favor of the rule, because if it is invoked and objective documentation is provided, it will scientifically validate the need for the patient's protracted plan of care, and open some minds to the reality that some intractable cases may require such protracted care. As an aside, (and I am not being facetious here), your " pro science " sentiment reminded me of a conversation I had with Dr. Fred Barge in 1990 (?), wherein, he stated that he also was pro science and believed in diagnosis. However, he added that he felt that diagnosis should be limited only to the diagnosis of a subluxation... I disagree with that narrow assessment, but I admire the man and his contribution to our profession, nonetheless. Similarly, I admire your passion, but disagree that the C/J rule will have any detrimental impact on any sensible plan of care. Cordially, Glenn Glenn F. Gumaer, B.S., D.C. Chiropractic Physician Northside Chiropractic Clinic 1240 N. Riverside Avenue Medford, OR 97501-4619 541-770-1330 ofc 541-770-7090 fax Re: good guys /bad guys Dear Dr. Colwell I pretty much agree with what you have expressed. Now, about your statement, " No it is up to us to do our very best and measurement tools may be good feedback in the process. We use these tools and I find them helpful but not definitive. " I want to make this totally clear. I also use measurement tools. I am for clinical rational. Those of us that wrote the clinical rational rule are pro science. Now, I hope that is clear. The reason I am so passionate about the CJ/CR topic is because every once in a while I get a patient who hasn't quite made it on to the ruler yet and because of my unique clinical and life experience I might think I can help them. I want it explicitly stated in CJ/CR rule that clinical experience counts. Just saying it is included in evidence based outcomes isn't good enough. I want the words clinical experience in the rule and I want it explicit that we will be able to use the clinical rational that support our current scope of practice. Maybe there needs to be a benchmoark inserted for the benefit of third party payers. If we actually talk to each other I think we could come up with the words for that without nixing wellness care or non-neuro-musculo-skeletal care or even compassionate or wisdom based care that is within our scope of practice. Sincerely, Judith Boothby <cc48@...> wrote: > The viewpoint that is experssed here is one I > remember well. It is always > validating to help someone that no one else was able > to help. > BUT, my first lesson in Chiropractic was with an 80 > year old DC on the south > shore of Long Island, NY. His advice? " Never take > the credit for your > results. " Not only do you take credit for the > patient finding you (the > patient's self selection) but you assume that the > same thing is not > happening with some of your patients. Are these > testable assumptions? No. > In addition when we take credit you get the blame > for those we cannot help. > Are we ready for that too? No it is up to us to do > our very best and > measurement tools may be good feedback in the > process. We use these tools > and I find them helpful but not definitive. > > Colwell, DC > good guys /bad guys > > > > > > >I agree with this statement by Chuck Simpson, " A > > > profession (our profession that is) is about > (or > > > should be about) our patients, the public we > serve > > > and how we can contribute to better health, > impact the > > > rising tide of health care costs in the face of > > > limited resources and generally be part of the > > > solution. " > > > > > > This is a place to start or return to if there > is ever > > > to be an actual vulnerable discussion about how > to > > > serve our patients better. Vulnerable means > actually > > > caring while listening to different opinions and > > > de-escalating the fight and trying to validate > some > > > part of what the other side is saying to find a > common > > > ground place to start. > > > > > > Last week I went to a fascinating lecture by a > > > cardiologist who basically figured out that her > heart > > > patients were having recurrences of occluded > arteries > > > and started to prescribe less medicine and > encourage > > > her patients to exercise and eat better. She > showed > > > the Harvard study from approx. 1997 that showed > that > > > every year there were more patients visits to > > > alternative doctors than to medical doctors. I > think > > > that study validates a lot about alternative > care > > > (chiropractic included) and was the start point > to the > > > CJ/CR discussion we are currently having. So > then the > > > medical people decided to study our alternative > > > knowledge so they could co-opt it and get the > patients > > > back. This cardiologist validated that point > for me. > > > They are not studying us to refer patient to us > that > > > need our care. They want what we know. > > > > > > Now I actually think it is good thing for the > medical > > > community to learn about nutrition and herbs and > all > > > the things that help to get people healthy. > What I > > > don't like about it is the way that this > discussion > > > gets framed with some version of snake oil > salesman > > > thrown into the us versus them discussion. > > > > > > So if there is the good guys versus the bad guys > > > discussion then I do not think any progress > towards > > > co-operation is actually being attempted and I > think > > > this good guys bad guys talk is disrespectful to > the > > > patients. > > > > > > Now as I am reading the list-serve today I came > across > > > this post from Dr. Vern Saboe that I did not > find to > > > be presenting correct information, see message 8 > below > > > > > > > > > " Ouch, ha! Well I was referring to the special > > > case...in this case > > > wherein the minority (two doctors Boothby & > Cafferty) > > > was involved all > > > along the way but didn't like the outcome. > Their > > > concerns were taken > > > seriously and still are, and the reality that > these > > > were no minor changes the ODOCers proposed and > would > > > have cause " substantial harm. " > > > > > > As Dr. Cafferty and I stated in our presentation > to > > > the board we were representing approximately 45 > > > doctors and 63 doctors send in surveys in > support of > > > the CR rule. Vern in order for me to ever > consider > > > that you take my concerns seriously you would > have to > > > ask vulnerable questions, stop having to one up > > > anything I ever post on the list serve and maybe > even > > > show you know how to engage anyone else's > opinion than > > > your own by demonstrating caring by saying > something > > > like " oh I see your concern, let's try to come > up with > > > a solution. " > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 ....she ;also accumulated a debt for the CAO that took us 7 years to pay off. Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 344- 0509; Fx; 541- 344- 0955 From: Boothby Judith <boothbyj@...>Vern Saboe <vsaboe@...>, Subject: Re: good guys /bad guysDate: Wed, 12 Apr 2006 23:14:27 -0700 (PDT)Dear Vern:Go on and on all you want about minority voice andmajority voice and who liked or disliked whomwhenever. My point is that in the end the truth willwin out because it will stand up to the test of time.You suggested I speak with the likes of Shephard, Don Fox(former ODOCers who moved to CAO), orDan Bebee as per what was discovered and yes who weresuccessful in finally removing Ms. Young as "CAOMembers."I did even better! I have permission to publish Young's final letter from the CAO which is signed byall three. Also I think it is interesting to notethat the CAO had 600 members before Young wasterminated and they paid her a full years salory upontermination.The Chiropractic Association of Oregon"the second century"To Whom it May Concern: Young served as the executive director of theChiropractic Association of Oregon from 1984 throughMarch 1998. Ms. Young has strong skills incommunication, project management, fundraising, andlobbying. She manages multiple projects with success,and is creative and resourceful.Ms. Young worked energetically during her 13 yearswith the CAO. She stood by the association when theOregon chiropractic profession suffered a severelegislative and financial setback. She was a dedicatedemployee.During Ms. Young's tenure, the Association embarked oncutting-edge projects, including initiating anon-profit managed care organization. From 1984through 1997, our newsletter and journal won 11 awardsfrom the American Chiropractic Association, and wereceived national recognition as one of the topchiropractic associations.Ms. young was instrumental in negotiating health carecontracts. She also developed a telethon the raised$90,000 for political action. In addition, Ms. Youngorganized our annual conventions and producedstatewide continuing education teleconferences thatlinked our membership throughout the state. Theseseminars and conventions grossed over $350,000 in athree-year period.We wish Ms. Young the best in her future pursuits.Sincerely, J. , D.C.President, CAO Beebe, D.C.Board of Governors B. Shephard, D.C.Board of Governors D. Fox, D.C.Board of GovernorsDennis Zimmerman, D.C.Board of Governors2545 SW Spring Garden Street, Suite 150, Portland,Oregon 97219--- Vern Saboe <vsaboe@...> wrote:> Dr. Boothby, I will make this very short...I was> referring to the original> colleagues who voiced (minority voice) their> concerns following SB-1197 that> our lobbyist was not effective and that Ms. Young> was a problem. At the> general membership meeting of the then OCPA held at> WSCC the "majority> voice" (me included) voted to keep both Chuck and> .>> This caused the formation of ODOC....if you need> validation of this simply> ask your fellow ODOC members Siegfried, > Schmidt, Platt,> Widmire (sp)....or CAO member Les Feinberg.>> The point I was attempting to make is that we must> always respect and listen> to the "minority voices" in the profession hey...> they could just be right!>> Now if you wish to be convinced that was a> problem (and I liked her> very much) eg., finacials, stonewalling board> members relative to the> budget. I recommend you speak with the likes of> Shephard, Don Fox> (former ODOCers who moved to CAO), or Dan Bebee as> per what was discovered> and yes who were successful in finally removing Ms.> Young as "CAO Members.">> Vern>>> good guys /bad guys>>> > I agree with this statement by Chuck Simpson, "A> > profession (our profession that is) is about (or> > should be about) our patients, the public we> serve> > and how we can contribute to better health, impact> the> > rising tide of health care costs in the face of> > limited resources and generally be part of the> > solution."> >> > This is a place to start or return to if there is> ever> > to be an actual vulnerable discussion about how to> > serve our patients better. Vulnerable means> actually> > caring while listening to different opinions and> > de-escalating the fight and trying to validate> some> > part of what the other side is saying to find a> common> > ground place to start.> >> > Last week I went to a fascinating lecture by a> > cardiologist who basically figured out that her> heart> > patients were having recurrences of occluded> arteries> > and started to prescribe less medicine and> encourage> > her patients to exercise and eat better. She> showed> > the Harvard study from approx. 1997 that showed> that> > every year there were more patients visits to> > alternative doctors than to medical doctors. I> think> > that study validates a lot about alternative care> > (chiropractic included) and was the start point to> the> > CJ/CR discussion we are currently having. So then> the> > medical people decided to study our alternative> > knowledge so they could co-opt it and get the> patients> > back. This cardiologist validated that point for> me.> > They are not studying us to refer patient to us> that> > need our care. They want what we know.> >> > Now I actually think it is good thing for the> medical> > community to learn about nutrition and herbs and> all> > the things that help to get people healthy. What> I> > don't like about it is the way that this> discussion> > gets framed with some version of snake oil> salesman> > thrown into the us versus them discussion.> >> > So if there is the good guys versus the bad guys> > discussion then I do not think any progress> towards> > co-operation is actually being attempted and I> think> > this good guys bad guys talk is disrespectful to> the> > patients.> >> > Now as I am reading the list-serve today I came> across> > this post from Dr. Vern Saboe that I did not find> to> > be presenting correct information, see message 8> below> >> >> > "Ouch, ha! Well I was referring to the special> > case...in this case> > wherein the minority (two doctors Boothby & > Cafferty)> > was involved all> > along the way but didn't like the outcome. Their> > concerns were taken> > seriously and still are, and the reality that> these> > were no minor changes the ODOCers proposed and> would> > have cause "substantial harm."> >> > As Dr. Cafferty and I stated in our presentation> to> > the board we were representing approximately 45> > doctors and 63 doctors send in surveys in support> of> > the CR rule. Vern in order for me to ever> consider> > that you take my concerns seriously you would have> to> > ask vulnerable questions, stop having to one up> > anything I ever post on the list serve and maybe> even> > show you know how to engage anyone else's opinion> than> > your own by demonstrating caring by saying> something> > like "oh I see your concern, let's try to come up> with> > a solution."> >> > So let's look at your next statement Vern:> >> > "Here is an ironic example for ya.....in 1990 the> > "minority voice"> > believed the OCPA should fire the Exec. Director> Ms.> > Young and the lobbyist Chuck > > because......she couldn't be trusted and he was> > ineffective.> >> > The "majority voice" said "no" she is trustworthy> and> > he is effective....guess what the "minority voice"> was> > right and the majority wrong. The "minority> voice"> > went on to form ODOC!> >> > I cannot believe you have the gall to use the> example> > of Young in this manner since she was so> > unjustly ousted by the CAO after ODOC had already> > split off. Are you trying to blame that on ODOC> too.> > Please at least have some respect for , a> very> > hard worker, who bore the burden of much> unjustified> > blame by the CAO. It was actually because of> > > Young's mistreatment by the CAO that I quit the> CAO.> > So Vern do not blame her firing on any other> > organization than your own! Can you at least own> the> > CAO firing of Young and maybe even the> injustice> > of it and not try to put a spin on it?> >> > I treat many patients who haven't gotten well by> > members of the CAO and board members and members> of> > manage care. I treat them cost effectively and> often>=== message truncated ===__________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 Vern, Point in fact : Ms. Young had a good lawyer to negotiate her exit from the CAO. Any 'compensation' or letters of recommendation were also part of that 'negotiation' process. Nothing else can be read into the money, letters or signatures at the bottom of the letter. Nothing. sharron fuchs dc From: [mailto: ] On Behalf Of Boothby JudithSent: Wednesday, April 12, 2006 11:14 PMVern Saboe; Subject: Re: good guys /bad guys Dear Vern:Go on and on all you want about minority voice andmajority voice and who liked or disliked whomwhenever. My point is that in the end the truth willwin out because it will stand up to the test of time. You suggested I speak with the likes of Shephard, Don Fox(former ODOCers who moved to CAO), orDan Bebee as per what was discovered and yes who weresuccessful in finally removing Ms. Young as "CAOMembers."I did even better! I have permission to publish Young's final letter from the CAO which is signed byall three. Also I think it is interesting to notethat the CAO had 600 members before Young wasterminated and they paid her a full years salory upontermination.The Chiropractic Association of Oregon"the second century"To Whom it May Concern: Young served as the executive director of theChiropractic Association of Oregon from 1984 throughMarch 1998. Ms. Young has strong skills incommunication, project management, fundraising, andlobbying. She manages multiple projects with success,and is creative and resourceful.Ms. Young worked energetically during her 13 yearswith the CAO. She stood by the association when theOregon chiropractic profession suffered a severelegislative and financial setback. She was a dedicatedemployee.During Ms. Young's tenure, the Association embarked oncutting-edge projects, including initiating anon-profit managed care organization. From 1984through 1997, our newsletter and journal won 11 awardsfrom the American Chiropractic Association, and wereceived national recognition as one of the topchiropractic associations.Ms. young was instrumental in negotiating health carecontracts. She also developed a telethon the raised$90,000 for political action. In addition, Ms. Youngorganized our annual conventions and producedstatewide continuing education teleconferences thatlinked our membership throughout the state. Theseseminars and conventions grossed over $350,000 in athree-year period.We wish Ms. Young the best in her future pursuits.Sincerely, J. , D.C.President, CAO Beebe, D.C.Board of Governors B. Shephard, D.C.Board of Governors D. Fox, D.C.Board of GovernorsDennis Zimmerman, D.C.Board of Governors2545 SW Spring Garden Street, Suite 150, Portland,Oregon 97219--- Vern Saboe <vsaboe@...> wrote:> Dr. Boothby, I will make this very short...I was> referring to the original> colleagues who voiced (minority voice) their> concerns following SB-1197 that> our lobbyist was not effective and that Ms. Young> was a problem. At the> general membership meeting of the then OCPA held at> WSCC the "majority> voice" (me included) voted to keep both Chuck and> .> > This caused the formation of ODOC....if you need> validation of this simply> ask your fellow ODOC members Siegfried, > Schmidt, Platt,> Widmire (sp)....or CAO member Les Feinberg.> > The point I was attempting to make is that we must> always respect and listen> to the "minority voices" in the profession hey...> they could just be right!> > Now if you wish to be convinced that was a> problem (and I liked her> very much) eg., finacials, stonewalling board> members relative to the> budget. I recommend you speak with the likes of> Shephard, Don Fox> (former ODOCers who moved to CAO), or Dan Bebee as> per what was discovered> and yes who were successful in finally removing Ms.> Young as "CAO Members."> > Vern> > > good guys /bad guys> > > > I agree with this statement by Chuck Simpson, "A> > profession (our profession that is) is about (or> > should be about) our patients, the public we> serve> > and how we can contribute to better health, impact> the> > rising tide of health care costs in the face of> > limited resources and generally be part of the> > solution."> >> > This is a place to start or return to if there is> ever> > to be an actual vulnerable discussion about how to> > serve our patients better. Vulnerable means> actually> > caring while listening to different opinions and> > de-escalating the fight and trying to validate> some> > part of what the other side is saying to find a> common> > ground place to start.> >> > Last week I went to a fascinating lecture by a> > cardiologist who basically figured out that her> heart> > patients were having recurrences of occluded> arteries> > and started to prescribe less medicine and> encourage> > her patients to exercise and eat better. She> showed> > the Harvard study from approx. 1997 that showed> that> > every year there were more patients visits to> > alternative doctors than to medical doctors. I> think> > that study validates a lot about alternative care> > (chiropractic included) and was the start point to> the> > CJ/CR discussion we are currently having. So then> the> > medical people decided to study our alternative> > knowledge so they could co-opt it and get the> patients> > back. This cardiologist validated that point for> me.> > They are not studying us to refer patient to us> that> > need our care. They want what we know.> >> > Now I actually think it is good thing for the> medical> > community to learn about nutrition and herbs and> all> > the things that help to get people healthy. What> I> > don't like about it is the way that this> discussion> > gets framed with some version of snake oil> salesman> > thrown into the us versus them discussion.> >> > So if there is the good guys versus the bad guys> > discussion then I do not think any progress> towards> > co-operation is actually being attempted and I> think> > this good guys bad guys talk is disrespectful to> the> > patients.> >> > Now as I am reading the list-serve today I came> across> > this post from Dr. Vern Saboe that I did not find> to> > be presenting correct information, see message 8> below> >> >> > "Ouch, ha! Well I was referring to the special> > case...in this case> > wherein the minority (two doctors Boothby & > Cafferty)> > was involved all> > along the way but didn't like the outcome. Their> > concerns were taken> > seriously and still are, and the reality that> these> > were no minor changes the ODOCers proposed and> would> > have cause "substantial harm."> >> > As Dr. Cafferty and I stated in our presentation> to> > the board we were representing approximately 45> > doctors and 63 doctors send in surveys in support> of> > the CR rule. Vern in order for me to ever> consider> > that you take my concerns seriously you would have> to> > ask vulnerable questions, stop having to one up> > anything I ever post on the list serve and maybe> even> > show you know how to engage anyone else's opinion> than> > your own by demonstrating caring by saying> something> > like "oh I see your concern, let's try to come up> with> > a solution."> >> > So let's look at your next statement Vern:> >> > "Here is an ironic example for ya.....in 1990 the> > "minority voice"> > believed the OCPA should fire the Exec. Director> Ms.> > Young and the lobbyist Chuck > > because......she couldn't be trusted and he was> > ineffective.> >> > The "majority voice" said "no" she is trustworthy> and> > he is effective....guess what the "minority voice"> was> > right and the majority wrong. The "minority> voice"> > went on to form ODOC!> >> > I cannot believe you have the gall to use the> example> > of Young in this manner since she was so> > unjustly ousted by the CAO after ODOC had already> > split off. Are you trying to blame that on ODOC> too.> > Please at least have some respect for , a> very> > hard worker, who bore the burden of much> unjustified> > blame by the CAO. It was actually because of> > > Young's mistreatment by the CAO that I quit the> CAO.> > So Vern do not blame her firing on any other> > organization than your own! Can you at least own> the> > CAO firing of Young and maybe even the> injustice> > of it and not try to put a spin on it?> >> > I treat many patients who haven't gotten well by> > members of the CAO and board members and members> of> > manage care. I treat them cost effectively and> often> === message truncated ===__________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 That’s a fact! S. Feinberg, D.C. From: [mailto: ] On Behalf Of Sharron Fuchs Sent: Thursday, April 13, 2006 9:01 AM Subject: RE: Re: good guys /bad guys Vern, Point in fact : Ms. Young had a good lawyer to negotiate her exit from the CAO. Any 'compensation' or letters of recommendation were also part of that 'negotiation' process. Nothing else can be read into the money, letters or signatures at the bottom of the letter. Nothing. sharron fuchs dc From: [mailto: ] On Behalf Of Boothby Judith Sent: Wednesday, April 12, 2006 11:14 PM Vern Saboe; Subject: Re: good guys /bad guys Dear Vern: Go on and on all you want about minority voice and majority voice and who liked or disliked whom whenever. My point is that in the end the truth will win out because it will stand up to the test of time. You suggested I speak with the likes of Shephard, Don Fox(former ODOCers who moved to CAO), or Dan Bebee as per what was discovered and yes who were successful in finally removing Ms. Young as " CAO Members. " I did even better! I have permission to publish Young's final letter from the CAO which is signed by all three. Also I think it is interesting to note that the CAO had 600 members before Young was terminated and they paid her a full years salory upon termination. The Chiropractic Association of Oregon " the second century " To Whom it May Concern: Young served as the executive director of the Chiropractic Association of Oregon from 1984 through March 1998. Ms. Young has strong skills in communication, project management, fundraising, and lobbying. She manages multiple projects with success, and is creative and resourceful. Ms. Young worked energetically during her 13 years with the CAO. She stood by the association when the Oregon chiropractic profession suffered a severe legislative and financial setback. She was a dedicated employee. During Ms. Young's tenure, the Association embarked on cutting-edge projects, including initiating a non-profit managed care organization. From 1984 through 1997, our newsletter and journal won 11 awards from the American Chiropractic Association, and we received national recognition as one of the top chiropractic associations. Ms. young was instrumental in negotiating health care contracts. She also developed a telethon the raised $90,000 for political action. In addition, Ms. Young organized our annual conventions and produced statewide continuing education teleconferences that linked our membership throughout the state. These seminars and conventions grossed over $350,000 in a three-year period. We wish Ms. Young the best in her future pursuits. Sincerely, J. , D.C. President, CAO Beebe, D.C. Board of Governors B. Shephard, D.C. Board of Governors D. Fox, D.C. Board of Governors Dennis Zimmerman, D.C. Board of Governors 2545 SW Spring Garden Street, Suite 150, Portland, Oregon 97219 --- Vern Saboe <vsaboe@...> wrote: > Dr. Boothby, I will make this very short...I was > referring to the original > colleagues who voiced (minority voice) their > concerns following SB-1197 that > our lobbyist was not effective and that Ms. Young > was a problem. At the > general membership meeting of the then OCPA held at > WSCC the " majority > voice " (me included) voted to keep both Chuck and > . > > This caused the formation of ODOC....if you need > validation of this simply > ask your fellow ODOC members Siegfried, > Schmidt, Platt, > Widmire (sp)....or CAO member Les Feinberg. > > The point I was attempting to make is that we must > always respect and listen > to the " minority voices " in the profession hey... > they could just be right! > > Now if you wish to be convinced that was a > problem (and I liked her > very much) eg., finacials, stonewalling board > members relative to the > budget. I recommend you speak with the likes of > Shephard, Don Fox > (former ODOCers who moved to CAO), or Dan Bebee as > per what was discovered > and yes who were successful in finally removing Ms. > Young as " CAO Members. " > > Vern > > > good guys /bad guys > > > > I agree with this statement by Chuck Simpson, " A > > profession (our profession that is) is about (or > > should be about) our patients, the public we > serve > > and how we can contribute to better health, impact > the > > rising tide of health care costs in the face of > > limited resources and generally be part of the > > solution. " > > > > This is a place to start or return to if there is > ever > > to be an actual vulnerable discussion about how to > > serve our patients better. Vulnerable means > actually > > caring while listening to different opinions and > > de-escalating the fight and trying to validate > some > > part of what the other side is saying to find a > common > > ground place to start. > > > > Last week I went to a fascinating lecture by a > > cardiologist who basically figured out that her > heart > > patients were having recurrences of occluded > arteries > > and started to prescribe less medicine and > encourage > > her patients to exercise and eat better. She > showed > > the Harvard study from approx. 1997 that showed > that > > every year there were more patients visits to > > alternative doctors than to medical doctors. I > think > > that study validates a lot about alternative care > > (chiropractic included) and was the start point to > the > > CJ/CR discussion we are currently having. So then > the > > medical people decided to study our alternative > > knowledge so they could co-opt it and get the > patients > > back. This cardiologist validated that point for > me. > > They are not studying us to refer patient to us > that > > need our care. They want what we know. > > > > Now I actually think it is good thing for the > medical > > community to learn about nutrition and herbs and > all > > the things that help to get people healthy. What > I > > don't like about it is the way that this > discussion > > gets framed with some version of snake oil > salesman > > thrown into the us versus them discussion. > > > > So if there is the good guys versus the bad guys > > discussion then I do not think any progress > towards > > co-operation is actually being attempted and I > think > > this good guys bad guys talk is disrespectful to > the > > patients. > > > > Now as I am reading the list-serve today I came > across > > this post from Dr. Vern Saboe that I did not find > to > > be presenting correct information, see message 8 > below > > > > > > " Ouch, ha! Well I was referring to the special > > case...in this case > > wherein the minority (two doctors Boothby & > Cafferty) > > was involved all > > along the way but didn't like the outcome. Their > > concerns were taken > > seriously and still are, and the reality that > these > > were no minor changes the ODOCers proposed and > would > > have cause " substantial harm. " > > > > As Dr. Cafferty and I stated in our presentation > to > > the board we were representing approximately 45 > > doctors and 63 doctors send in surveys in support > of > > the CR rule. Vern in order for me to ever > consider > > that you take my concerns seriously you would have > to > > ask vulnerable questions, stop having to one up > > anything I ever post on the list serve and maybe > even > > show you know how to engage anyone else's opinion > than > > your own by demonstrating caring by saying > something > > like " oh I see your concern, let's try to come up > with > > a solution. " > > > > So let's look at your next statement Vern: > > > > " Here is an ironic example for ya.....in 1990 the > > " minority voice " > > believed the OCPA should fire the Exec. Director > Ms. > > Young and the lobbyist Chuck > > because......she couldn't be trusted and he was > > ineffective. > > > > The " majority voice " said " no " she is trustworthy > and > > he is effective....guess what the " minority voice " > was > > right and the majority wrong. The " minority > voice " > > went on to form ODOC! > > > > I cannot believe you have the gall to use the > example > > of Young in this manner since she was so > > unjustly ousted by the CAO after ODOC had already > > split off. Are you trying to blame that on ODOC > too. > > Please at least have some respect for , a > very > > hard worker, who bore the burden of much > unjustified > > blame by the CAO. It was actually because of > > > Young's mistreatment by the CAO that I quit the > CAO. > > So Vern do not blame her firing on any other > > organization than your own! Can you at least own > the > > CAO firing of Young and maybe even the > injustice > > of it and not try to put a spin on it? > > > > I treat many patients who haven't gotten well by > > members of the CAO and board members and members > of > > manage care. I treat them cost effectively and > often > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 13, 2006 Report Share Posted April 13, 2006 good guys /bad guys >>> >>> >>> > I agree with this statement by Chuck Simpson, " A >>> > profession (our profession that is) is about (or >>> > should be about) our patients, the public we >>> serve >>> > and how we can contribute to better health, impact >>> the >>> > rising tide of health care costs in the face of >>> > limited resources and generally be part of the >>> > solution. " >>> > >>> > This is a place to start or return to if there is >>> ever >>> > to be an actual vulnerable discussion about how to >>> > serve our patients better. Vulnerable means >>> actually >>> > caring while listening to different opinions and >>> > de-escalating the fight and trying to validate >>> some >>> > part of what the other side is saying to find a >>> common >>> > ground place to start. >>> > >>> > Last week I went to a fascinating lecture by a >>> > cardiologist who basically figured out that her >>> heart >>> > patients were having recurrences of occluded >>> arteries >>> > and started to prescribe less medicine and >>> encourage >>> > her patients to exercise and eat better. She >>> showed >>> > the Harvard study from approx. 1997 that showed >>> that >>> > every year there were more patients visits to >>> > alternative doctors than to medical doctors. I >>> think >>> > that study validates a lot about alternative care >>> > (chiropractic included) and was the start point to >>> the >>> > CJ/CR discussion we are currently having. So then >>> the >>> > medical people decided to study our alternative >>> > knowledge so they could co-opt it and get the >>> patients >>> > back. This cardiologist validated that point for >>> me. >>> > They are not studying us to refer patient to us >>> that >>> > need our care. They want what we know. >>> > >>> > Now I actually think it is good thing for the >>> medical >>> > community to learn about nutrition and herbs and >>> all >>> > the things that help to get people healthy. What >>> I >>> > don't like about it is the way that this >>> discussion >>> > gets framed with some version of snake oil >>> salesman >>> > thrown into the us versus them discussion. >>> > >>> > So if there is the good guys versus the bad guys >>> > discussion then I do not think any progress >>> towards >>> > co-operation is actually being attempted and I >>> think >>> > this good guys bad guys talk is disrespectful to >>> the >>> > patients. >>> > >>> > Now as I am reading the list-serve today I came >>> across >>> > this post from Dr. Vern Saboe that I did not find >>> to >>> > be presenting correct information, see message 8 >>> below >>> > >>> > >>> > " Ouch, ha! Well I was referring to the special >>> > case...in this case >>> > wherein the minority (two doctors Boothby & >>> Cafferty) >>> > was involved all >>> > along the way but didn't like the outcome. Their >>> > concerns were taken >>> > seriously and still are, and the reality that >>> these >>> > were no minor changes the ODOCers proposed and >>> would >>> > have cause " substantial harm. " >>> > >>> > As Dr. Cafferty and I stated in our presentation >>> to >>> > the board we were representing approximately 45 >>> > doctors and 63 doctors send in surveys in support >>> of >>> > the CR rule. Vern in order for me to ever >>> consider >>> > that you take my concerns seriously you would have >>> to >>> > ask vulnerable questions, stop having to one up >>> > anything I ever post on the list serve and maybe >>> even >>> > show you know how to engage anyone else's opinion >>> than >>> > your own by demonstrating caring by saying >>> something >>> > like " oh I see your concern, let's try to come up >>> with >>> > a solution. " >>> > >>> > So let's look at your next statement Vern: >>> > >>> > " Here is an ironic example for ya.....in 1990 the >>> > " minority voice " >>> > believed the OCPA should fire the Exec. Director >>> Ms. >>> > Young and the lobbyist Chuck >>> > because......she couldn't be trusted and he was >>> > ineffective. >>> > >>> > The " majority voice " said " no " she is trustworthy >>> and >>> > he is effective....guess what the " minority voice " >>> was >>> > right and the majority wrong. The " minority >>> voice " >>> > went on to form ODOC! >>> > >>> > I cannot believe you have the gall to use the >>> example >>> > of Young in this manner since she was so >>> > unjustly ousted by the CAO after ODOC had already >>> > split off. Are you trying to blame that on ODOC >>> too. >>> > Please at least have some respect for , a >>> very >>> > hard worker, who bore the burden of much >>> unjustified >>> > blame by the CAO. It was actually because of >>> >>> > Young's mistreatment by the CAO that I quit the >>> CAO. >>> > So Vern do not blame her firing on any other >>> > organization than your own! Can you at least own >>> the >>> > CAO firing of Young and maybe even the >>> injustice >>> > of it and not try to put a spin on it? >>> > >>> > I treat many patients who haven't gotten well by >>> > members of the CAO and board members and members >>> of >>> > manage care. I treat them cost effectively and >>> often >>> >> === message truncated === >> >> >> >> __________________________________________________ >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2006 Report Share Posted April 14, 2006 Exactly! Dr. ph Medlin D.C. Spine Tree Chiropractic 1627 NE Alberta St. #6 Portland, OR 97211 Ph: 503-788-6800 c: 503-889-6204 RE: " Official Public Comments >> > in Support of the >> > CJ vs CR Rules " >> > >> > >> > Vern; >> > >> > >> > >> > Geez, buddy!!! I write my post to suggest that >> > democracy doesn't >> > mean totalitarianism of the majority over the minority >> > and you pat me on >> > the head, not to worry, and accommodation and >> > inclusion of minority >> > viewpoints will occur. Then, Dr. Joe suggests that >> > the " overwhelming >> > majority " must not be hampered by a pesky minority and >> > just move forward, >> > and you say, " Perfectly said " . >> > >> > >> > >> > Vern, I think you are hanging around with those darn >> > politicians in >> > Salem too much. Are you speaking with forked tongue, >> > white man? I'm >> > having a crisis of confidence in interpreting the >> > meaning and intention >> > of your emails. So, what is it, Bud? Do we stick the >> > minority in the >> > patutti because the majority says its OK. Hey, maybe >> > you should read >> > something commentary about the U.S. Constitution. >> > Majority rule doesn't >> > mean minority persecution or carte blanche for the >> > majority. By the >> > way, the percentage of the U.S. population that >> > utilizes chiropractic >> > care is what, 12%. Does your enthusiasm for majority >> > hegemony extend in >> > that direction, too? >> > >> > >> > >> > S. Feinberg, D.C. >> > >> > >> > >> > __________________________________________________ >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 14, 2006 Report Share Posted April 14, 2006 Making it onto your ruler? I'm sorry, but I don't understand. Are you saying that you wish to ignore opposition to your ideas? Must we all develope a rapport in order to sustain dialague or only with you. I believe I'm not the only one you are having trouble " reaching. " Is there something about my remarks to you that you wish I'd clarify? Blatantly ignoring my reactions to your comments is becoming a habit for you. One post you responded by saying that you won't dignify it with a response and now this. I wonder how you would feel if people on the listserve did this to you. But, they don't. They respond and treat you as a professional not as kid who they just can't get through to anymore. This type of action is counterproductive and runs across the grain of what this listserve is about. Unfortunately it seems you feel I have personal feelings one way or another about you. I do not. It is your ideas that I find contrary to logic. I'm sure you are a beautiful person, but knowing this will not change the way I read your posts. When you continue to tout yourself as a separate and this last time superior member of our profession, it will indeed spurn a bit of animosity. Does that make your ruler? Dr. ph Medlin D.C. Spine Tree Chiropractic 1627 NE Alberta St. #6 Portland, OR 97211 Ph: 503-788-6800 c: 503-889-6204 good guys /bad guys >> >> >> >I agree with this statement by Chuck Simpson, " A >> > profession (our profession that is) is about (or >> > should be about) our patients, the public we >> serve >> > and how we can contribute to better health, impact >> the >> > rising tide of health care costs in the face of >> > limited resources and generally be part of the >> > solution. " >> > >> > This is a place to start or return to if there is >> ever >> > to be an actual vulnerable discussion about how to >> > serve our patients better. Vulnerable means >> actually >> > caring while listening to different opinions and >> > de-escalating the fight and trying to validate >> some >> > part of what the other side is saying to find a >> common >> > ground place to start. >> > >> > Last week I went to a fascinating lecture by a >> > cardiologist who basically figured out that her >> heart >> > patients were having recurrences of occluded >> arteries >> > and started to prescribe less medicine and >> encourage >> > her patients to exercise and eat better. She >> showed >> > the Harvard study from approx. 1997 that showed >> that >> > every year there were more patients visits to >> > alternative doctors than to medical doctors. I >> think >> > that study validates a lot about alternative care >> > (chiropractic included) and was the start point to >> the >> > CJ/CR discussion we are currently having. So then >> the >> > medical people decided to study our alternative >> > knowledge so they could co-opt it and get the >> patients >> > back. This cardiologist validated that point for >> me. >> > They are not studying us to refer patient to us >> that >> > need our care. They want what we know. >> > >> > Now I actually think it is good thing for the >> medical >> > community to learn about nutrition and herbs and >> all >> > the things that help to get people healthy. What >> I >> > don't like about it is the way that this >> discussion >> > gets framed with some version of snake oil >> salesman >> > thrown into the us versus them discussion. >> > >> > So if there is the good guys versus the bad guys >> > discussion then I do not think any progress >> towards >> > co-operation is actually being attempted and I >> think >> > this good guys bad guys talk is disrespectful to >> the >> > patients. >> > >> > Now as I am reading the list-serve today I came >> across >> > this post from Dr. Vern Saboe that I did not find >> to >> > be presenting correct information, see message 8 >> below >> > >> > >> > " Ouch, ha! Well I was referring to the special >> > case...in this case >> > wherein the minority (two doctors Boothby & >> Cafferty) >> > was involved all >> > along the way but didn't like the outcome. Their >> > concerns were taken >> > seriously and still are, and the reality that >> these >> > were no minor changes the ODOCers proposed and >> would >> > have cause " substantial harm. " >> > >> > As Dr. Cafferty and I stated in our presentation >> to >> > the board we were representing approximately 45 >> > doctors and 63 doctors send in surveys in support >> of >> > the CR rule. Vern in order for me to ever >> consider >> > that you take my concerns seriously you would have >> to >> > ask vulnerable questions, stop having to one up >> > anything I ever post on the list serve and maybe >> even >> > show you know how to engage anyone else's opinion >> than >> > your own by demonstrating caring by saying >> something >> > like " oh I see your concern, let's try to come up >> with >> > a solution. " >> > >> > So let's look at your next statement Vern: >> > >> > " Here is an ironic example for ya.....in 1990 the >> > " minority voice " >> > believed the OCPA should fire the Exec. Director >> Ms. >> > Young and the lobbyist Chuck >> > because......she couldn't be trusted and he was >> > ineffective. >> > >> > The " majority voice " said " no " she is trustworthy >> and >> > he is effective....guess what the " minority voice " >> was >> > right and the majority wrong. The " minority >> voice " >> > went on to form ODOC! >> > >> > I cannot believe you have the gall to use the >> example >> > of Young in this manner since she was so >> > unjustly ousted by the CAO after ODOC had already >> > split off. Are you trying to blame that on ODOC >> too. >> > Please at least have some respect for , a >> very >> > hard worker, who bore the burden of much >> unjustified >> > blame by the CAO. It was actually because of >> >> > Young's mistreatment by the CAO that I quit the >> CAO. >> > So Vern do not blame her firing on any other >> > organization than your own! Can you at least own >> the >> > CAO firing of Young and maybe even the >> injustice >> > of it and not try to put a spin on it? >> > >> > I treat many patients who haven't gotten well by >> > members of the CAO and board members and members >> of >> > manage care. I treat them cost effectively and >> often >> > === message truncated === > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2006 Report Share Posted April 16, 2006 Dear Dr. Medlin: What's the point of critique unless it will help to create new avenues for cooperation. The reason to try to establish rapport is to try to evoke a process that strengthens us towards collaborating. Let's move away from fighting and move towards intelligent disagreement. So, for example, we both agree with Colwell's comment therefore we already have a starting point. Sincerely, Judith Boothby --- deadmed <deadmed@...> wrote: > Making it onto your ruler? I'm sorry, but I don't > understand. Are you saying > that you wish to ignore opposition to your ideas? > Must we all develope a > rapport in order to sustain dialague or only with > you. I believe I'm not > the only one you are having trouble " reaching. " Is > there something about my > remarks to you that you wish I'd clarify? Blatantly > ignoring my reactions to > your comments is becoming a habit for you. One post > you responded by saying > that you won't dignify it with a response and now > this. I wonder how you > would feel if people on the listserve did this to > you. But, they don't. They > respond and treat you as a professional not as kid > who they just can't get > through to anymore. > > This type of action is counterproductive and runs > across the grain of what > this listserve is about. Unfortunately it seems you > feel I have personal > feelings one way or another about you. I do not. It > is your ideas that I > find contrary to logic. I'm sure you are a beautiful > person, but knowing > this will not change the way I read your posts. > When you continue to tout > yourself as a separate and this last time superior > member of our profession, > it will indeed spurn a bit of animosity. Does that > make your ruler? > > > Dr. ph Medlin D.C. > Spine Tree Chiropractic > 1627 NE Alberta St. #6 > Portland, OR 97211 > Ph: 503-788-6800 > c: 503-889-6204 > RE: " Official Public Comments > > in Support of the > > CJ vs CR Rules " > > > > > > Vern; > > > > > > > > Geez, buddy!!! I write my post to suggest that > > democracy doesn't > > mean totalitarianism of the majority over the minority > > and you pat me on > > the head, not to worry, and accommodation and > > inclusion of minority > > viewpoints will occur. Then, Dr. Joe suggests that > > the " overwhelming > > majority " must not be hampered by a pesky minority and > > just move forward, > > and you say, " Perfectly said " . > > > > > > > > Vern, I think you are hanging around with those darn > > politicians in > > Salem too much. Are you speaking with forked tongue, > > white man? I'm > > having a crisis of confidence in interpreting the > > meaning and intention > > of your emails. So, what is it, Bud? Do we stick the > > minority in the > > patutti because the majority says its OK. Hey, maybe > > you should read > > something commentary about the U.S. Constitution. > > Majority rule doesn't > > mean minority persecution or carte blanche for the > > majority. By the > > way, the percentage of the U.S. population that > > utilizes chiropractic > > care is what, 12%. Does your enthusiasm for majority > > hegemony extend in > > that direction, too? > > > > > > > > S. Feinberg, D.C. > > > > > > > > __________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2006 Report Share Posted April 16, 2006 Dear Dr Gumaer: You stated, " So, Dr. Boothby, with all due respect, I do not follow your logic with regard to your objections to the current clinical justification rule. To my understanding, the idea of the rule is that it allows a standard measure of conformity that we are bound to, " only " (I added quotes) in the event that a purchaser of our services demands an accounting of our plan of care. Should we really be concerned that the rule, as it stands, will " nix wellness care, or non-neuro-musculoskeletal care, or even compassionate or wisdom-based care? " Thankyou for stating what my concern is so elequently. That is my concern and during the first board meeting on the CR rule Joyce McClure spoke directly to Vern Saboe and stated that even though he says everything is included in the CJ rule the words to that extent are not in there. I think the CJ rule is missing the " only " . I am hoping we can add those missing words to clarify the CJ/CR rule at the administrative rule meeting in May. Then you stated, " In what instance can you cite that a patient " who hasn't quite made it on to the ruler yet " will be unable to receive your compassionate care because of the implementation of this rule? " I'm sure everyone on the listserve will groan a bit as I bring up my one example again and no I do not currently have as extreeme of an example to offer. So I have a patient where it took me one year before I was able to produce the outcome measures. What I had during that year was my positive intention to help her and I was discriminating in my care meaning I consulted with her MD to make sure we were not missing something and I refered her to counseling and when no free counseling services would take her in, because she was too depressed, I personally found a counselor to work with her for a very low fee. Another thing I had that first year was my sense that I was helping her to free up an awful lot of dural and cranial adhesions. But she was so emotionally depressed and her nervous system was so adhered and her balance was so off that she did not have any improved ROM's or other positive outcomes for one year. It also took a year before she was able to say that she could notice a change. I'm not saying that I could provide this service for every person in the above mentioned predicament but I would like to be able to provide this service knowing explicity how to be included in the IN group in the CJ/CR rule. This wouldn't be hard to change the rule to accomodate this case. Also my patient's MD didn't seemed to be concerened about overutilizing and she also didn't have any positive measures. I think the CJ rule will bias chiropractors away from trying to help people with tougher problems because of uncertainty of how to be included in the IN group and who needs the additional stress. You then asked, " Has a payer ever restricted your practice since the adoption of the current OCPUG guidelines? Mostly it has been the individual IME doctors that have cut off care for my patients. I don't recall them ever citing OCPUG as the reason. You said, " Do you realize that they suggest treatment plans beyond 12 months for a MVA injury may be considered over-utilization? " I think that is what we are talking about isn't it. Most people I work on can wrap up their MVA'a in well less than a year and I can generate lots of proof of their improvement. But some poeple can't and we need to consider those people too. You said, " It seems logical to me that if you are treating a patient for an extended period of time, he/she would by then " make it on to the ruler, " and you would be able to produce sufficient objective data to support your plan of treatment. In fact, the clinical justification rule provides us the freedom to do just that by allowing us to justify via both " ...subjective, or patient-driven information, as well as objective, provider-driven information. " I think for the more complicated cases then we need to consider the chiropractors intention and their relevant clinical expertise and training in addition to the S and the O. I am pro science and I know there are limits to science. I think we should all keep pertinent chart notes and I do not think the diagnosis should only be limited to the diagnosis of a subluxation. On the other hand I don't think we should have to turn someone away if they only have a subluxation. Functional healthcare is a tricky thing because it is easy to only look at function and miss a medically pathological diagnosis and on the other side it is easy to only diagnose and miss the person. Consider this example. I have been diagnosed with cancer three times. I am acutely aware how hard it is to discover that a person has cancer. So how many people are we adjusting that are growing cancer somewhere? Many. It took me about a year of medical and chiropractic appointments before my cancer was discovered the first time. Finally I just ordered my own xray. Then the medical doctor I went to did not do the right contrast studies which caused a lot of uncertainty in knowing what to do about the treatment. Luckily I had worked in the cancer department of Massachusetts General Hospital prior to getting my diagnosis and I could call up my prior boss late at night and she would be able to get their top lymphoma specialist to call me first thing in the morning to discuss whatever concern I had. But ultimately no one knew what to do and I had to chart my own path with in the presented options. It was a hair raising time but you know what? One day my chiropractor told me that no matter what happened he was going to hang in their with me and help me try to optimize the results. So, he didn't really promise me a cure or make a false claim and I knew at the time he had no evidence based proof to what he was saying, and he did not charge me an arm and a leg for his care, but at a time when the health care providers are all saying the bad news and no good news it was heartening to have someone willing to go the course with me. Maybe that could be another category of care, willing to go the course. This category would be more dependent on a code of ethics and values than outcomes. So far in my life I have avoided about 10 CT scans, 2 series of radiation therapy, 1 series of chemotherapy, and 1 bone marrow transplant. I'm not sure I could have lived through all those evidence based cures. And at the same time I am well aware of how many of my close chiropractic friends have died from their cancers. Ultimately there are just a lot of tough personal choices to be made in life and everyones path is unique. Science is just a tool and we should use it whenever it applies, unfortunately there are challenges that are still bigger than science. I think the CJ rule will bind too much of our care to a standard measure of conformity and restrict our ability as doctors to apply our clinical expertise to care providedin certain instances, (not all instances). Please lets keep discussing this and get a rule that includes all of us and adresses the insurance issues without putting a box around us. Thankyou for expressing your concerns. Sincerely, Judith Boothby Message: 2 Date: Thu, 13 Apr 2006 03:42:14 -0700 From: " Glenn F. Gumaer, D.C. " <gfgdc@...> Subject: RE: good guys /bad guys Dear Dr. Boothby: et al: I take pride in the fact that our esteemed colleagues on this list serve are not only the best-trained practitioners, but we deliver a unique service without equal in the NMS field. (- I authored the Comparative Education Study in 1990.) However, I think because we have divergent opinions on some issues, we sometimes lose the perspective that even the less erudite among us are actually " brighter than the average bear. " (- borrowing from Yogi...) Anyway, I simply wish to state that I consider you, and every chiropractic physician on this list serve a valued colleague. So, Dr. Boothby, with all due respect, I do not follow your logic with regard to your objections to the current clinical justification rule. To my understanding, the idea of the rule is that it allows a standard measure of conformity that we are bound to, only in the event that a purchaser of our services demands an accounting of our plan of care. Should we really be concerned that the rule, as it stands, will " nix wellness care, or non-neuro-musculoskeletal care, or even compassionate or wisdom-based care? " In what instance can you cite that a patient " who hasn't quite made it on to the ruler yet " will be unable to receive your compassionate care because of the implementation of this rule? Has a payer ever restricted your practice since the adoption of the current OCPUG guidelines? Do you realize that they suggest treatment plans beyond 12 months for a MVA injury may be considered over-utilization? It seems logical to me that if you are treating a patient for an extended period of time, he/she would by then " make it on to the ruler, " and you would be able to produce sufficient objective data to support your plan of treatment. In fact, the clinical justification rule provides us the freedom to do just that by allowing us to justify via both " ...subjective, or patient-driven information, as well as objective, provider-driven information. " Since you made it clear that you are " pro science, " I would think that you might be more in favor of the rule, because if it is invoked and objective documentation is provided, it will scientifically validate the need for the patient's protracted plan of care, and open some minds to the reality that some intractable cases may require such protracted care. As an aside, (and I am not being facetious here), your " pro science " sentiment reminded me of a conversation I had with Dr. Fred Barge in 1990 (?), wherein, he stated that he also was pro science and believed in diagnosis. However, he added that he felt that diagnosis should be limited only to the diagnosis of a subluxation... I disagree with that narrow assessment, but I admire the man and his contribution to our profession, nonetheless. Similarly, I admire your passion, but disagree that the C/J rule will have any detrimental impact on any sensible plan of care. Cordially, Glenn Glenn F. Gumaer, B.S., D.C. Chiropractic Physician Northside Chiropractic Clinic 1240 N. Riverside Avenue Medford, OR 97501-4619 541-770-1330 ofc 541-770-7090 fax Re: good guys /bad guys Dear Dr. Colwell I pretty much agree with what you have expressed. Now, about your statement, " No it is up to us to do our very best and measurement tools may be good feedback in the process. We use these tools and I find them helpful but not definitive. " I want to make this totally clear. I also use measurement tools. I am for clinical rational. Those of us that wrote the clinical rational rule are pro science. Now, I hope that is clear. The reason I am so passionate about the CJ/CR topic is because every once in a while I get a patient who hasn't quite made it on to the ruler yet and because of my unique clinical and life experience I might think I can help them. I want it explicitly stated in CJ/CR rule that clinical experience counts. Just saying it is included in evidence based outcomes isn't good enough. I want the words clinical experience in the rule and I want it explicit that we will be able to use the clinical rational that support our current scope of practice. Maybe there needs to be a benchmoark inserted for the benefit of third party payers. If we actually talk to each other I think we could come up with the words for that without nixing wellness care or non-neuro-musculo-skeletal care or even compassionate or wisdom based care that is within our scope of practice. Sincerely, Judith Boothby <cc48@...> wrote: > The viewpoint that is experssed here is one I > remember well. It is always > validating to help someone that no one else was able > to help. > BUT, my first lesson in Chiropractic was with an 80 > year old DC on the south > shore of Long Island, NY. His advice? " Never take > the credit for your > results. " Not only do you take credit for the > patient finding you (the > patient's self selection) but you assume that the > same thing is not > happening with some of your patients. Are these > testable assumptions? No. > In addition when we take credit you get the blame > for those we cannot help. > Are we ready for that too? No it is up to us to do > our very best and > measurement tools may be good feedback in the > process. We use these tools > and I find them helpful but not definitive. > > Colwell, DC Message truncation __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 17, 2006 Report Share Posted April 17, 2006 Dr. Boothby, As I attempted to indicate to you some time ago off list, but received no reply, Judith I do believe we can address most of your concerns and that of Dr. Cafferty in the OBCE's " Policy Statements " document. This document can be used to further delineate the true intent of the " Clinical Justification Rule. " Incidentally, the newer language relative to " Evidence Based Outcomes Management " is what I first proposed to the CAO Exec. Board and that which after a consensus process was adopted Feb. 1, 2005. The PARTS portion was written by another group of colleagues and adopted by the OBCE some four years ago. The Oregon Practice and Utilization Guidelines still another group of hard working colleagues and adopted back in 1991. Anywho it is my sincere hope and clear anticipation we will be able to come up with some policy statements to address some if not most of your concerns...see you on the 11th. Vern Saboe Re: good guys /bad guys > > Dear Dr. Colwell > > I pretty much agree with what you have expressed. > > Now, about your statement, " No it is up to us to do > our very best and measurement tools may be good > feedback in the process. We use these tools and I find > them helpful but not definitive. " > > I want to make this totally clear. I also use > measurement tools. I am for clinical rational. Those > of us that wrote the clinical rational rule are pro > science. > > Now, I hope that is clear. > > The reason I am so passionate about the CJ/CR topic is > because every once in a while I get a patient who > hasn't quite made it on to the ruler yet and because > of my unique clinical and life experience I might > think I can help them. I want it explicitly stated in > CJ/CR rule that clinical experience counts. Just > saying it is included in evidence based outcomes isn't > good enough. I want the words clinical experience in > the rule and I want it explicit that we will be able > to use the clinical rational that support our current > scope of practice. Maybe there needs to be a > benchmoark inserted for the benefit of third party > payers. If we actually talk to each other I think we > could come up with the words for that without nixing > wellness care or non-neuro-musculo-skeletal care or > even compassionate or wisdom based care that is within > our scope of practice. > > Sincerely, Judith Boothby > > > <cc48@...> wrote: > > > The viewpoint that is experssed here is one I > > remember well. It is always > > validating to help someone that no one else was able > > to help. > > BUT, my first lesson in Chiropractic was with an 80 > > year old DC on the south > > shore of Long Island, NY. His advice? " Never take > > the credit for your > > results. " Not only do you take credit for the > > patient finding you (the > > patient's self selection) but you assume that the > > same thing is not > > happening with some of your patients. Are these > > testable assumptions? No. > > In addition when we take credit you get the blame > > for those we cannot help. > > Are we ready for that too? No it is up to us to do > > our very best and > > measurement tools may be good feedback in the > > process. We use these tools > > and I find them helpful but not definitive. > > > > Colwell, DC > > Message truncation > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 17, 2006 Report Share Posted April 17, 2006 Dear Vern: In the spirit of cooperation I hope you will arrive at the rule meeting with openness for more than adapting an OBCE policy. Sincerely,Judith Boothby --- Vern Saboe <vsaboe@...> wrote: > Dr. Boothby, > > As I attempted to indicate to you some time ago off > list, but received no > reply, Judith I do believe we can address most of > your concerns and that of > Dr. Cafferty in the OBCE's " Policy Statements " > document. This document can > be used to further delineate the true intent of the > " Clinical Justification > Rule. " > > Incidentally, the newer language relative to > " Evidence Based Outcomes > Management " is what I first proposed to the CAO > Exec. Board and that which > after a consensus process was adopted Feb. 1, 2005. > The PARTS portion was > written by another group of colleagues and adopted > by the OBCE some four > years ago. The Oregon Practice and Utilization > Guidelines still another > group of hard working colleagues and adopted back in > 1991. > > Anywho it is my sincere hope and clear anticipation > we will be able to come > up with some policy statements to address some if > not most of your > concerns...see you on the 11th. > Vern Saboe > good guys /bad guys > > > > > > > > Dear Dr Gumaer: > > > > You stated, " So, Dr. Boothby, with all due > respect, I > > do not follow your logic with regard to your > > objections to the current clinical justification > rule. > > To my understanding, the idea of the rule is that > it > > allows a standard measure of conformity that we > are > > bound to, " only " (I added quotes) in the event > that a > > purchaser of our services demands an accounting of > our > > plan of care. Should we really be concerned that > the > > rule, as it stands, will " nix wellness care, or > > non-neuro-musculoskeletal care, or even > compassionate > > or wisdom-based care? " > > > > Thankyou for stating what my concern is so > elequently. > > That is my concern and during the first board > meeting > > on the CR rule Joyce McClure spoke directly to > Vern > > Saboe and stated that even though he says > everything > > is included in the CJ rule the words to that > extent > > are not in there. I think the CJ rule is missing > the > > " only " . > > > > I am hoping we can add those missing words to > clarify > > the CJ/CR rule at the administrative rule meeting > in > > May. > > > > Then you stated, " In what instance can you cite > that a > > patient " who hasn't quite made it on to the ruler > yet " > > will be unable to receive your compassionate care > > because of the implementation of this rule? " > > > > I'm sure everyone on the listserve will groan a > bit as > > I bring up my one example again and no I do not > > currently have as extreeme of an example to offer. > So > > I have a patient where it took me one year before > I > > was able to produce the outcome measures. What I > had > > during that year was my positive intention to help > her > > and I was discriminating in my care meaning I > > consulted with her MD to make sure we were not > missing > > something and I refered her to counseling and when > no > > free counseling services would take her in, > because > > she was too depressed, I personally found a > counselor > > to work with her for a very low fee. Another > thing I > > had that first year was my sense that I was > helping > > her to free up an awful lot of dural and cranial > > adhesions. But she was so emotionally depressed > and > > her nervous system was so adhered and her balance > was > > so off that she did not have any improved ROM's or > > other positive outcomes for one year. It also > took a > > year before she was able to say that she could > notice > > a change. > > > > I'm not saying that I could provide this service > for > > every person in the above mentioned predicament > but I > > would like to be able to provide this service > knowing > > explicity how to be included in the IN group in > the > > CJ/CR rule. This wouldn't be hard to change the > rule > > to accomodate this case. Also my patient's MD > didn't > > seemed to be concerened about overutilizing and > she > > also didn't have any positive measures. > > > > I think the CJ rule will bias chiropractors away > from > > trying to help people with tougher problems > because of > > uncertainty of how to be included in the IN group > and > > who needs the additional stress. > > > > You then asked, " Has a payer ever restricted your > > practice since the adoption of the current OCPUG > > guidelines? > > > > Mostly it has been the individual IME doctors that > > have cut off care for my patients. I don't recall > > them ever citing OCPUG as the reason. > > > > You said, " Do you realize that they suggest > treatment > > plans beyond 12 months for a MVA injury may be > > considered over-utilization? " > > > > I think that is what we are talking about isn't > it. > > Most people I work on can wrap up their MVA'a in > well > > less than a year and I can generate lots of proof > of > > their improvement. But some poeple can't and we > need > > to consider those people too. > > > > > > You said, " It seems logical to me that if you are > > treating a patient for an extended period of time, > > he/she would by then " make it on to the ruler, " > and > > you would be able to produce sufficient objective > data > > to support your plan of treatment. In > > fact, the clinical justification rule provides us > the > > freedom to do just that by allowing us to justify > via > > both " ...subjective, or patient-driven > information, as > > well as objective, provider-driven information. " > > > > I think for the more complicated cases then we > need to > > consider the chiropractors intention and their > > relevant clinical expertise and training in > addition > > to the S and the O. > > > > I am pro science and I know there are limits to > > science. I think we should all keep pertinent > chart > > notes and I do not think the diagnosis should only > be > === message truncated === __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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