Guest guest Posted April 18, 2006 Report Share Posted April 18, 2006 Dear Vern and Oregon Doctors; DR. ph has a very good idea for an amendment. We have given the legislature and MLAC a lot to think about and a great deal of work do on this issue. Dr. Vern and I know that many changes will occur to this 24 and 90 concept. It would be best for the injured workers that Doctors of Chiropractic have attending status for the 90 day period. After that other considerations must be made if additional treatment is needed. At this time we should allow MLAC to propose a possible salutation, they may have a better one. Setera Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2006 Report Share Posted April 19, 2006 Work comp issues > > >> Dear Vern and Oregon Doctors; >> >> DR. ph has a very good idea for an amendment. We have given the >> legislature and MLAC a lot to think about and a great deal of work do on >> this issue. >> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept. >> It would be best for the injured workers that Doctors of Chiropractic >> have >> attending status for the 90 day period. After that other considerations >> must be >> made if additional treatment is needed. At this time we should allow >> MLAC to >> propose a possible salutation, they may have a better one. >> >> Setera >> >> >> OregonDCs rules: >> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated. >> 2. Always sign your e-mails with your first and last name. >> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 Thank you, Danno. My sentiments exactly! What do we really have to lose? I am seeing only a few (yes that means about three) cases per year. I cannot imagine any of us are basing our incomes on W/C cases. If there is one doctor among us who is, then that doc is better connected than the rest of us, and doesn't have anything to worry about. Full Attending Physicians, because that is what we are, and because we owe it to our patients. Accepting anything less is, well, groveling, IMHO. Sincerely, 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 Fw: Work comp issues Work comp issues > > >> Dear Vern and Oregon Doctors; >> >> DR. ph has a very good idea for an amendment. We have given the >> legislature and MLAC a lot to think about and a great deal of work do on >> this issue. >> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept. >> It would be best for the injured workers that Doctors of Chiropractic >> have >> attending status for the 90 day period. After that other considerations >> must be >> made if additional treatment is needed. At this time we should allow >> MLAC to >> propose a possible salutation, they may have a better one. >> >> Setera >> >> >> OregonDCs rules: >> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated. >> 2. Always sign your e-mails with your first and last name. >> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 I agree with Dr. Beebe on this subject. By voluntarily limiting ourselves and allowing an MD to decide our care plans we are bowing down to the master. I say stand up, ask for what is allowed by our practice act and go forth head up. Yes, we could be shut down and limited again, but the battle was the correct one in the continuing war. sharron fuchs dc From: [mailto: ] On Behalf Of D Beebe, D.C.Sent: Wednesday, April 19, 2006 5:22 PMoregondcSubject: Fw: Work comp issues Work comp issues>>>> Dear Vern and Oregon Doctors;>>>> DR. ph has a very good idea for an amendment. We have given the>> legislature and MLAC a lot to think about and a great deal of work do on >> this issue.>> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept.>> It would be best for the injured workers that Doctors of Chiropractic >> have>> attending status for the 90 day period. After that other considerations >> must be>> made if additional treatment is needed. At this time we should allow >> MLAC to>> propose a possible salutation, they may have a better one.>>>> Setera>>>>>> OregonDCs rules:>> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated.>> 2. Always sign your e-mails with your first and last name.>> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 Why? Danno Work comp issues > Dear Vern and Oregon Doctors; > > DR. ph has a very good idea for an amendment. We have given the > legislature and MLAC a lot to think about and a great deal of work do on > this issue. > Dr. Vern and I know that many changes will occur to this 24 and 90 > concept. > It would be best for the injured workers that Doctors of Chiropractic have > attending status for the 90 day period. After that other considerations > must be > made if additional treatment is needed. At this time we should allow MLAC > to > propose a possible salutation, they may have a better one. > > Setera > > > OregonDCs rules: > 1. Keep correspondence professional; the purpose of the listserve is to > foster communication and collegiality. No personal attacks on listserve > members will be tolerated. > 2. Always sign your e-mails with your first and last name. > 3. The listserve is not secure; your e-mail could end up anywhere. > However, it is against the rules of the listserve to copy, print, forward, > or otherwise distribute correspondence written by another member without > his or her consent, unless all personal identifiers have been removed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 Listserv, I agree with those on the listserv who feel we should ask for full gatekeeper status. I think it does a dis-service to request less. I think it would be best to ask for gatekeeper status but have a lesser fallback plan. I think it doesn't help if we say, we want gatekeeper status, but at the same meeting tell the legislators that we're willing to take 24/90. i also think it's a mistake to say: "We're asking for 24/90, but if you're willing to give us more, we'll take it." IMHO I think this gives the impression that we'll take whatever you'll toss our way. This also tips our hand to give the 'lowest' accepted request. Most of us don't have time to go before the legislature. I appreciate my colleagues that have taken the time to present requests. But could there be an agreement to consolidate the request to start with the best case scenario? What's best for the patient and the profession? full attending status. Then back down from there as the need presents itself. Comments from ? Vern? Dan Bebee? Sharron? any others? Minga Guerrero DC In a message dated 4/20/2006 2:22:34 P.M. Pacific Daylight Time, vsaboe@... writes: No! Why chiropractic physicians should be the "Gatekeepers" for all work-related spinal injuries. Chiropractic physicians have the best training of all the provider groups to handle spine related injuries/conditions. Medical family physicians and internists the current "gatekeepers" are poorly trained to handle spine related injuries/conditions. This lack of training is a "cost driver" in Oregon's Workers' Compensation System. For example the inappropriate ordering of unnecessary spinal MRIs which beyond the direct cost of this imaging ($1,000 to $1,200) also has been shown to lead to more unnecessary spinal surgeries. Drugs with narcotics being the #1 drug class prescribed within Oregon's Workers' Comp System ($400K/quarter) are both a direct and indirect cost driver. In direct cost terms the cost of drugs continues to rise with more being paid for drugs than for our entire profession per quarter. They are also a indirect cost driver in that they lead to unnecessary worker timeloss as workers cannot work while on narcotics as well as other drugs. Lastly "Adverse Drug Events" lead to further drug treatment and time loss. This is the situation wherein the supposed proper drug was prescribed by the MD to the injured worker, taken properly by the worker but they simply have a adverse reaction/complication(s) to that drug! Excessive use of physical therapy with it's inferior outcomes and unnecessary referrals to the "medical specialists" e.g.., neurologists, neuro and orthopedic surgeons are a cost driver. The reality that 80% of the cost of medical management by family physicians and internists are for ancillary services things they order out e.g.., PT, X-ray, MRI, drugs and really perform no hands on services per say. Conversely 80% of the cost of chiropractic management of spine related workers' comp injuries are for "hands on care" things we do within our clinics e.g., exam, X-rays, PT, hands on treatment and we don't prescribe drugs not the least of which include narcotics. Huge and wasteful cost shifting has occurred since the 1990 restrictions on chiropractic services. 9. Three cost comparison studies one a four year prospective study revealed huge savings with chiropractic physicians as the PCPs or "gatekeepers" and the same can be expected in Oregon's work comp system...10...a majority of the family doctors and internists don't want to deal or treat work comp injuries! 11. There is a huge medical PCP shortage coming, only 27% of new medical graduates are choosing family practices. 12. The simple fact is if chiropractic physicians in this state were the W/C gatekeepers the system would save and estimated $50 to $60 million dollars each year! How about we go on the offensive for once and expose medicines under-belly as per their pitiful training and treatment of musculoskeletal injuries. How about a bill that estabilishes DCs as the gatekeepers and the family doctors and internists are on a short 30 day least? Vern Saboe Work comp issues>>>> Dear Vern and Oregon Doctors;>>>> DR. ph has a very good idea for an amendment. We have given the>> legislature and MLAC a lot to think about and a great deal of work do on >> this issue.>> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept.>> It would be best for the injured workers that Doctors of Chiropractic >> have>> attending status for the 90 day period. After that other considerations >> must be>> made if additional treatment is needed. At this time we should allow >> MLAC to>> propose a possible salutation, they may have a better one.>>>> Setera>>>>>> OregonDCs rules:>> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated.>> 2. Always sign your e-mails with your first and last name.>> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 No! Why chiropractic physicians should be the "Gatekeepers" for all work-related spinal injuries. Chiropractic physicians have the best training of all the provider groups to handle spine related injuries/conditions. Medical family physicians and internists the current "gatekeepers" are poorly trained to handle spine related injuries/conditions. This lack of training is a "cost driver" in Oregon's Workers' Compensation System. For example the inappropriate ordering of unnecessary spinal MRIs which beyond the direct cost of this imaging ($1,000 to $1,200) also has been shown to lead to more unnecessary spinal surgeries. Drugs with narcotics being the #1 drug class prescribed within Oregon's Workers' Comp System ($400K/quarter) are both a direct and indirect cost driver. In direct cost terms the cost of drugs continues to rise with more being paid for drugs than for our entire profession per quarter. They are also a indirect cost driver in that they lead to unnecessary worker timeloss as workers cannot work while on narcotics as well as other drugs. Lastly "Adverse Drug Events" lead to further drug treatment and time loss. This is the situation wherein the supposed proper drug was prescribed by the MD to the injured worker, taken properly by the worker but they simply have a adverse reaction/complication(s) to that drug! Excessive use of physical therapy with it's inferior outcomes and unnecessary referrals to the "medical specialists" e.g.., neurologists, neuro and orthopedic surgeons are a cost driver. The reality that 80% of the cost of medical management by family physicians and internists are for ancillary services things they order out e.g.., PT, X-ray, MRI, drugs and really perform no hands on services per say. Conversely 80% of the cost of chiropractic management of spine related workers' comp injuries are for "hands on care" things we do within our clinics e.g., exam, X-rays, PT, hands on treatment and we don't prescribe drugs not the least of which include narcotics. Huge and wasteful cost shifting has occurred since the 1990 restrictions on chiropractic services. 9. Three cost comparison studies one a four year prospective study revealed huge savings with chiropractic physicians as the PCPs or "gatekeepers" and the same can be expected in Oregon's work comp system...10...a majority of the family doctors and internists don't want to deal or treat work comp injuries! 11. There is a huge medical PCP shortage coming, only 27% of new medical graduates are choosing family practices. 12. The simple fact is if chiropractic physicians in this state were the W/C gatekeepers the system would save and estimated $50 to $60 million dollars each year! How about we go on the offensive for once and expose medicines under-belly as per their pitiful training and treatment of musculoskeletal injuries. How about a bill that estabilishes DCs as the gatekeepers and the family doctors and internists are on a short 30 day least? Vern Saboe Work comp issues>>>> Dear Vern and Oregon Doctors;>>>> DR. ph has a very good idea for an amendment. We have given the>> legislature and MLAC a lot to think about and a great deal of work do on >> this issue.>> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept.>> It would be best for the injured workers that Doctors of Chiropractic >> have>> attending status for the 90 day period. After that other considerations >> must be>> made if additional treatment is needed. At this time we should allow >> MLAC to>> propose a possible salutation, they may have a better one.>>>> Setera>>>>>> OregonDCs rules:>> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated.>> 2. Always sign your e-mails with your first and last name.>> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 In lawyering one always starts at the top and begrudingly negotioates downwards. It would be folly to think that one can start low and then negotiate upwards. It just doesn't happen that way. I think that our practice act defines what we are and that any downgrading of that is against the law. But it could be done and it was done and now we must take it back , with smarts. Two mouths from two bodies from the same profession speaking different things would be negative indeed. sharron fuchs dc From: AboWoman@... [mailto:AboWoman@...] Sent: Thursday, April 20, 2006 3:52 PMvsaboe@...; ; Sharron FuchsSubject: Re: Work comp issues Listserv, I agree with those on the listserv who feel we should ask for full gatekeeper status. I think it does a dis-service to request less. I think it would be best to ask for gatekeeper status but have a lesser fallback plan. I think it doesn't help if we say, we want gatekeeper status, but at the same meeting tell the legislators that we're willing to take 24/90. i also think it's a mistake to say: "We're asking for 24/90, but if you're willing to give us more, we'll take it." IMHO I think this gives the impression that we'll take whatever you'll toss our way. This also tips our hand to give the 'lowest' accepted request. Most of us don't have time to go before the legislature. I appreciate my colleagues that have taken the time to present requests. But could there be an agreement to consolidate the request to start with the best case scenario? What's best for the patient and the profession? full attending status. Then back down from there as the need presents itself. Comments from ? Vern? Dan Bebee? Sharron? any others? Minga Guerrero DC In a message dated 4/20/2006 2:22:34 P.M. Pacific Daylight Time, vsaboe@... writes: No! Why chiropractic physicians should be the "Gatekeepers" for all work-related spinal injuries. Chiropractic physicians have the best training of all the provider groups to handle spine related injuries/conditions. Medical family physicians and internists the current "gatekeepers" are poorly trained to handle spine related injuries/conditions. This lack of training is a "cost driver" in Oregon's Workers' Compensation System. For example the inappropriate ordering of unnecessary spinal MRIs which beyond the direct cost of this imaging ($1,000 to $1,200) also has been shown to lead to more unnecessary spinal surgeries. Drugs with narcotics being the #1 drug class prescribed within Oregon's Workers' Comp System ($400K/quarter) are both a direct and indirect cost driver. In direct cost terms the cost of drugs continues to rise with more being paid for drugs than for our entire profession per quarter. They are also a indirect cost driver in that they lead to unnecessary worker timeloss as workers cannot work while on narcotics as well as other drugs. Lastly "Adverse Drug Events" lead to further drug treatment and time loss. This is the situation wherein the supposed proper drug was prescribed by the MD to the injured worker, taken properly by the worker but they simply have a adverse reaction/complication(s) to that drug! Excessive use of physical therapy with it's inferior outcomes and unnecessary referrals to the "medical specialists" e.g.., neurologists, neuro and orthopedic surgeons are a cost driver. The reality that 80% of the cost of medical management by family physicians and internists are for ancillary services things they order out e.g.., PT, X-ray, MRI, drugs and really perform no hands on services per say. Conversely 80% of the cost of chiropractic management of spine related workers' comp injuries are for "hands on care" things we do within our clinics e.g., exam, X-rays, PT, hands on treatment and we don't prescribe drugs not the least of which include narcotics. Huge and wasteful cost shifting has occurred since the 1990 restrictions on chiropractic services. 9. Three cost comparison studies one a four year prospective study revealed huge savings with chiropractic physicians as the PCPs or "gatekeepers" and the same can be expected in Oregon's work comp system...10...a majority of the family doctors and internists don't want to deal or treat work comp injuries! 11. There is a huge medical PCP shortage coming, only 27% of new medical graduates are choosing family practices. 12. The simple fact is if chiropractic physicians in this state were the W/C gatekeepers the system would save and estimated $50 to $60 million dollars each year! How about we go on the offensive for once and expose medicines under-belly as per their pitiful training and treatment of musculoskeletal injuries. How about a bill that estabilishes DCs as the gatekeepers and the family doctors and internists are on a short 30 day least? Vern Saboe Work comp issues>>>> Dear Vern and Oregon Doctors;>>>> DR. ph has a very good idea for an amendment. We have given the>> legislature and MLAC a lot to think about and a great deal of work do on >> this issue.>> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept.>> It would be best for the injured workers that Doctors of Chiropractic >> have>> attending status for the 90 day period. After that other considerations >> must be>> made if additional treatment is needed. At this time we should allow >> MLAC to>> propose a possible salutation, they may have a better one.>>>> Setera>>>>>> OregonDCs rules:>> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated.>> 2. Always sign your e-mails with your first and last name.>> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 Thank you, Danno. My sentiments exactly! What do we really have to lose? I am seeing only a few (yes that means about three) cases per year. I cannot imagine any of us are basing our incomes on W/C cases. If there is one doctor among us who is, then that doc is better connected than the rest of us, and doesn't have anything to worry about. Full Attending Physicians, because that is what we are, and because we owe it to our patients. Accepting anything less is, well, groveling, IMHO. Sincerely, 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 Fw: Work comp issues Work comp issues > > >> Dear Vern and Oregon Doctors; >> >> DR. ph has a very good idea for an amendment. We have given the >> legislature and MLAC a lot to think about and a great deal of work do on >> this issue. >> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept. >> It would be best for the injured workers that Doctors of Chiropractic >> have >> attending status for the 90 day period. After that other considerations >> must be >> made if additional treatment is needed. At this time we should allow >> MLAC to >> propose a possible salutation, they may have a better one. >> >> Setera >> >> >> OregonDCs rules: >> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated. >> 2. Always sign your e-mails with your first and last name. >> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2006 Report Share Posted April 21, 2006 Yes! Speaking of pit bulls.... Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204 Work comp issues>>>> Dear Vern and Oregon Doctors;>>>> DR. ph has a very good idea for an amendment. We have given the>> legislature and MLAC a lot to think about and a great deal of work do on >> this issue.>> Dr. Vern and I know that many changes will occur to this 24 and 90 >> concept.>> It would be best for the injured workers that Doctors of Chiropractic >> have>> attending status for the 90 day period. After that other considerations >> must be>> made if additional treatment is needed. At this time we should allow >> MLAC to>> propose a possible salutation, they may have a better one.>>>> Setera>>>>>> OregonDCs rules:>> 1. Keep correspondence professional; the purpose of the listserve is to >> foster communication and collegiality. No personal attacks on listserve >> members will be tolerated.>> 2. Always sign your e-mails with your first and last name.>> 3. The listserve is not secure; your e-mail could end up anywhere. >> However, it is against the rules of the listserve to copy, print, >> forward, or otherwise distribute correspondence written by another member >> without his or her consent, unless all personal identifiers have been >> removed.>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2006 Report Share Posted April 21, 2006 I would love full attending service also but....I value the opinion of one Setera who has been battling in the trenches on this issue for many years. As a father of teenages(plural) I am learning there is more than one way to skin a cat. A direct assault is sometimes the worst possible approach. Perhaps can give us a bit more detail on why he thinks we shoud go slowly on this issue. , can you help us here? Will Schneider PDX ---- Work comp issues > > > > > >> Dear Vern and Oregon Doctors; > >> > >> DR. ph has a very good idea for an amendment. >We have given the > >> legislature and MLAC a lot to think about and a great >deal of work do on > >> this issue. > >> Dr. Vern and I know that many changes will occur to >this 24 and 90 > >> concept. > >> It would be best for the injured workers that Doctors >of Chiropractic > >> have > >> attending status for the 90 day period. After that >other considerations > >> must be > >> made if additional treatment is needed. At this time >we should allow > >> MLAC to > >> propose a possible salutation, they may have a better >one. > >> > >> Setera > >> > >> > >> OregonDCs rules: > >> 1. Keep correspondence professional; the purpose of >the listserve is to > >> foster communication and collegiality. No personal >attacks on listserve > >> members will be tolerated. > >> 2. Always sign your e-mails with your first and last >name. > >> 3. The listserve is not secure; your e-mail could end >up anywhere. > >> However, it is against the rules of the listserve to >copy, print, > >> forward, or otherwise distribute correspondence >written by another member > >> without his or her consent, unless all personal >identifiers have been > >> removed. > >> Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.