by Rima Bedevian

ANJC Revises Scope of Practice
On November 19, 2005, the Association of New Jersey Chiropractors (ANJC) Board voted 15–0 in favor of a revised chiropractic scope of practice that defines subluxation and prohibits anyone but a DC from performing a spinal adjustment or manipulation on an individual to correct a subluxation.

“This was a daunting process, but an updated scope of practice is something that the chiropractic profession in New Jersey has been asking for and desperately needs,” says Steven Clarke, DC, ANJC legislative chairman.

The proposed scope of practice also states that only a New Jersey-licensed DC can provide an opinion on the course of care for a chiropractic patient in New Jersey. The scope also requires that each licensed DC complete 24 continuing education (CE) credits during each 2-year period, (New Jersey is the only state that does not have a CE requirement.)

At this point, the proposed scope of practice will advance through the following legislative steps: Sponsors in the state Assembly and Senate will sign on to the proposed legislation, and it will receive a bill number. It will then be sent to the committees in each House for review; the two committees will vote on the bill, and if passed out of each committee, they will send it to the Assembly and Senate floors for a final vote. Lastly, if passed by the Assembly and the Senate, the bill will arrive on the governor’s desk to be signed into law.

President Signs Legislation to Reverse Medicare Fee Cuts
On February 8, 2006, President George W. Bush signed legislation to reverse the current 4.4% Medicare physician payment reduction. The legislation, which was included in the Deficit Reduction Act, went into effect January 1, 2006, but claims retroactive to that date will be reprocessed.

“The return to the 2005 rate is at least partial recognition by Congress that health care providers face significant challenges in today’s practice environment,” says Richard G. Brassard, DC, president of the American Chiropractic Association (ACA).

The Centers for Medicare & Medicaid Services (CMS) said it expects contractors to begin paying new claims using 2005 rates within 2 days of the legislation’s enactment. Doctors of chiropractic do not need to resubmit existing claims between January 1, 2006, and February 8, 2006. Contractors will automatically reprocess any claims that used the rates effective January 1, 2006, and will use the 0% update retroactive to January 1.

CMS, recognizing that the physician-payment adjustment could increase beneficiaries’ copayments and deductibles for previously billed services, has suggested to the US Department of Health and Human Services (HHS) that if a beneficiary’s copayment changed on January 1, 2006, a physician waiver of the amount now owed by the beneficiary should not be considered inducement.

“The ACA will continue to lobby on behalf of its members for fair reimbursement of Medicare services,” Brassard says. “It is imperative that Congress and HHS develop a permanent solution to the physician fee schedule, because those most affected by this annual dilemma are not doctors, but patients.”

NYCC Receives Candidate Status for Acupuncture Programs New York Chiropractic College (NYCC) has been approved as a candidate for accreditation of its Master of Science in Acupuncture and Master of Science in Acupuncture and Oriental programs. The candidacy status is considered by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) and indicates that the programs meet nationally accepted standards for quality education and training. To apply for candidacy, NYCC submitted an eligibility report to ACAOM describing the curriculum, faculty, qualifications, admission requirements, finances, administration, facilities, and learning resources. The college was then visited by an ACAOM site team, which reported that the set of educational objectives developed for the program by the program’s academic leadership are commendable, according to NYCC. To date, NYCC has enrolled 95 acupuncture and oriental medicine students, who will be the first class to graduate in August 2006.

Massages Grow in Popularity
According to the American Massage Therapy Association’s 2005 consumer survey, 47 million people had a massage in the past 12 months. This is an increase of 2 million from 2004. The overall benefits of massage continue to be strong: 90% of adults believe that massage can be beneficial to their health, and 93% believe that it can be effective for reducing pain.

When asked what form of therapy gave the survey participants the greatest relief from pain, massage and medication tied (28%), followed by chiropractic therapy (11%), physical therapy (8%), and acupuncture (3%). This represents a big gain for the effectiveness of massage for pain relief (compared to 21% in 2004) and a drop for medication (33% in 2003).

The survey was taken from a sample of 1,014 adults—of 506 men and 508 women, 18 years of age and older. The participants responded to a variety of questions about their use of and their views about massage therapy.

Heat-Wrap Therapy Eases Low Back Pain
According to a Johns Hopkins study published in the December 2005 issue of The Journal of Occupational and Environmental Medicine, the use of continuous low-level heat wrap therapy (CLHT) significantly reduces acute low back pain and improves occupational performance of employees in physically demanding jobs suffering from acute low back pain.

The study included 43 patients, ages 20 to 62, who visited an occupational injury clinic for low back pain. The patients were randomized into one of two intervention groups: 18 patients received education regarding back therapy and pain-management alone; while 25 patients received education regarding back therapy and pain-management combined with 3 consecutive days of CLHT for 8 hours continuously.

During the 3 treatment days, all groups were assessed for levels of pain intensity and pain-relief levels four times per day, followed by measures for pain intensity and pain-relief levels obtained in three follow-up visits on days 4, 7, and 14 from the beginning of the treatment.

The study found that patients who received CLHT for low back pain over a 3-day period in conjunction with pain- management education experienced rapid and significant reduction in pain intensity and greater pain relief when compared to patients who received only pain education. Patients on CLHT showed a 52% reduction in pain intensity and a 43% improvement in pain relief within 1 day of treatment.

Additionally, the benefits of pain relief and pain-intensity reduction were maintained at a significant level in the CLHT patients in a follow-up period on day 4 and day 14 after treatment was discontinued.

The New York Times Examines Increased Popularity of CAM
According to The New York Times, an estimated 48% of US adults used at least one alternative or complementary treatment in 2004, compared with 42% in 1994. Health care experts state that the rate continues to increase "for reasons that have as much to do with increasing distrust of mainstream medicine and the psychological appeal of nontraditional approaches as with the therapeutic properties of herbs or other supplements.”

According to the Feb. 3, 2006 article, “When Trust in Doctors Erodes, Other Treatments Fill the Void,” straying from conventional medicine is “often rooted in a sense of disappointment, even betrayal, many patients and experts say.” Haggles with insurance providers and conflicting findings from medical studies feed the disaffection, the article states.

Whatever the benefits and risks of the methods, patients agree that alternative medicine offers patients the promise of affectionate care, unhurried service, freedom from prescription-drug side effects, and the potential for feeling spiritually charged, according to the Times article.