Senate Bill May Eliminate Chiropractic Coverage
Washington chiropractors could see a significant drop in business from employees under health plans if the state House passes Senate Bill 5521.

Approved 29–20 in the state Senate, the new bill makes health insurance cheaper for small businesses—at the price of eliminating a requirement that coverage include alternative care. The bill would exempt health plans covering 50 or fewer people from many state coverage requirements, including chiropractic care.

According to the Associated Press, business groups and Republican lawmakers support the bill, arguing that more companies could afford to offer health insurance with fewer required coverage categories, but opponents worry the bill discriminates against people who use alternative caregivers, among others penalized by the change. CP

Study Tracks Whiplash Pain
According to a study appearing in the March 11 issue of Neurology, the scientific journal of the American Academy of Neurology, the intensity of whiplash pain is low, but its frequency is high, and compared to similar types of pain from ankle injury, it lasts longer and produces more disability.

The study, the first observational study of whiplash injury to use a control group, interviewed and examined 141 patients with whiplash-related pain, and 40 patients with acute ankle injury as a control. Patients were seen 1 week, and 1, 3, 6, and 12 months after their injury. All patients scored their pain intensity on a 100-point scale, from no pain to unbearable pain. Patients were asked to rate their overall upper-body pain and separately rate pain in the lower back, the neck, the shoulders and arms, and headache pain.

Both groups reported initial similar global pain from their injuries, but pain was more frequent in the whiplash-injured patients. No significant difference in the intensity of pain between the two groups in their global pain ratings, despite the confinement of the ratings to the upper body, however a significant difference was seen over time. Pain in ankle-injured patients declined rapidly, falling from an initial average of 15 to near zero within the first month. In contrast, pain in whiplash-injured patients fell from an average of 20 points initially to only 14 points after one year.

“Pain in the neck, head, shoulder, arm, and lower back are frequent complaints in the first year after whiplash injury,” said lead study author Helge Kasch, a neurologist at the Aarhus University Hospital in Denmark.

The investigators also found that patients with more pain also had more nonpainful neurological complaints, including forgetfulness, irritability, and dizziness. This correlation was not found in ankle-injured patients. After one year, all ankle-injured patients and 90% of whiplash-injured patients had returned to work. CP

Malpractice Suits Limit Access to Affordable Health Care
Filing a malpractice suit may hurt patients more than the physician being sued. According to a new report from the Department of Health and Human Services titled “Addressing the New Health Care Crisis,” more patients are having a hard time getting health care due to the lawsuits against providers.

The House on March 13 passed medical malpractice reform legislation (HR 5), which would place a $250,000 cap on noneconomic damages in medical malpractice cases and limit punitive damages as well. The Administration argues that skyrocketing settlements have sent malpractice insurance premiums through the roof, making it difficult for patients to find affordable, high-quality health care. CP

Alternative Medicine Usage Rises for Brain Injury Patients
According to a recent survey, chiropractic care was among the most commonly utilized complementary and alternative medicine (CAM) therapies sought out by patients with traumatic brain injuries to supplement conventional medical care. The study found that though CAM therapies are used by an increasing number of patients with traumatic brain injuries, the majority are not discussing their use of CAM therapy with their physicians.

“A lot of patients are embarrassed to tell their doctors, while others don’t even realize that the vitamin supplements and other substances they are using can be as active as drugs, which can affect their medical treatment,” says co-investigator Sharon McDowell, MD, a lecturer in the University of Michigan’s (UM) Health System’s Department of Physical Medicine and Rehabilitation.

In order to assess the use of CAM therapies among individuals with traumatic brain injuries, McDowell, and co-investigator Asma Rafeeq, a student at the UM Medical School, surveyed 130 randomly selected patients from a group of patients treated at the UM Trauma Burn Center for a traumatic brain injury. Patients were questioned about the injury-related factors that lead to their use of CAM therapies and their perceived effectiveness of CAM. More than half of the subjects interviewed said that they had used at least one CAM therapy, with more than one-third using two or more CAM therapies.

In addition to chiropractic care, massage therapy, meditation, and herbal medicine were the most commonly utilized CAM therapies. Both massage therapy and chiropractic care were used by patients to treat pain, while meditation was practiced for affective disorders and herbal medicine was taken for cognitive deficits. Although there were trends in CAM therapy for certain chronic symptoms resulting from their injury, it did not necessarily dictate which CAM therapies a patient would turn to for their specific type of injury. McDowell also points out that there was very little evidence found that could predict which factors—severity of brain injury, time after injury, gender, or ethnicity—would determine if a patient with a traumatic brain injury was more likely to use CAM therapies to supplement his or her conventional care. However, younger patients with higher education levels were more likely to use CAM.

The study results were presented at the American Academy of Neurology’s (AAN) annual meeting in Honolulu. An estimated 5.3 million Americans currently live with disabilities resulting from traumatic brain injury—damage to the brain caused by a sudden physical assault on the head—according to the Centers for Disease Control. The recovery process can take months or years, depending on the severity of the injury. Patients with traumatic brain injury often experience chronic motor and cognitive impairment, in addition to seizures, and sensory and visual deficits, which affect mental and physical functioning.CP