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From: WELL – Tara Parker-Pope on Health
For Neck Pain, Chiropractic and Exercise Are Better Than Drugs
Tony Cenicola/The New York TimesWhat’s the best treatment for neck pain?
Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.
The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.
But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.
“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”
Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists.
“There was a void in the scientific literature in terms of what the most helpful treatments are,” he said.
To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.
One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at
After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.
A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.
Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”
In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”
He also expressed concern that those on medications were not as empowered or active in their own care as those in the other groups. “We think it’s important that patients are enabled to deal with as much control over their own condition as possible,” he said. “This study shows that they can play a large role in their own care.”






OnPoint Medical Solutions
E-NEWSLETTER                                                                                                                                         NOVEMBER 2011

Let's face it - physicians' offices are busy.  The phones are ringing, patients checking in, ancillary services need to be ordered, patient demographics updated and a myriad of other things.  Physicians and staff manage to take this all in stride.  In no time at all, one can forget about HIPAA violations specifically as it related to patient privacy.  Take a minute to consider the following:
  1. Are patients called up in the waiting room by their full names in front of everyone?  Using first or last names ONLY is recommended.  If at all possible, approaching the patient directly is preferable.
  2. The check-in process for patients also leaves much to be desired in terms of privacy.  It is common practice to confirm the patient demographics by asking date of birth, full name, address and insurance carrier.  In this one conversation, overheard by everyone, information is revealed that is protected health information (PHI).  Consider simply having the staff ask if anything has changed or have the patient review private information on a computer screen to confirm its accuracy.
  3. Patients should never be able to see any information relating to another patient.  This can be lab orders, ancillary orders, referral forms or charts that are left on the counter and, of course, computer screens.
  4. Some practices have started using large computer screens mounted in the reception area identifying patients by name and the assigned physician to either call the next patient up or listing the schedule for the day.  This is a clear violation.
  5. There may be a situation where someone in the office knows the patient socially.  Their visit or any information relating to the visit should never be shared outside of the office.
HIPAA rules can seem overbearing and difficult to adhere to but every office should take the time to evaluate its operations and to make sure you are protecting your patients.  Not only will your office be compliant but your patients will appreciate it!
by Sue Irwin, MCS-P 9.27.11
How many times have you heard "Do what you do best and outsource the rest?" While it makes great sense, there is always the huge fear that letting go of "control" of something will put us on a path of total destruction. There are usually three reactions to the advice:

1. How hard can it be just to do it in-house?
2. The cost is not going to warrant the increase in time I'll have available to
Outsourcingme or my staff to do other things.
3. There is no way someone outside of my establishment can do a better job for me at a cheaper rate.
These reactions are all warranted, but to just stop there and not further investigate is doing a major disservice to your practice, yourself, and possibly your patients, as well.
Let's take the first objection, "How hard can it be?" In the not too distant past, the actual business functions of a medical office were not half as complicated as they are now. Some of you probably remember or have heard of the times when an insurance company would just pay you what you billed and everyone was happy. Now there are contracts with reimbursement levels that can change when you're not looking, insurance coverage which change for the patients at a whim it seems, IT needs that were never an issue prior to Bill Gates, etc. Then you can add in all the requirements that the government is now putting on medical providers and you should see that it can be pretty hard.
The next objection is that the cost doesn't warrant that you will have more time to do things like see patients, see family, have a life outside of medicine. I will fervently argue that the more time you are given because you don't have to worry about IT, 5010, ICD-10, billing, collecting, payroll and human resources is a good thing. Outsourcing opens up time for you to see more patients or, conversely, to spend more time with each of your patients. You can delegate to others who love to do what you hate and you can do what you love. Trying to figure out what you will do with more time is an excellent "problem" to have.
The last objection is that there is no way anyone else could do a better than what you or your office are already doing. Implied in that objection is that your practice can do it cheaper, better, and faster than anyone else. Let me ask a few questions: When your biller quits on you with no notice or goes on vacation, what do you do? When your IT person gets sick or the actual technology "crashes," what do you do? When it is time to negotiate for your employees health benefits, how do you know you are getting the best possible deal available? When the country switches over to 5010 and ICD-10, and your in-house coder and biller are sick or just aren't ready for the transition, do you just wait around? How much are you actually paying your staff to do those services that can be outsourced (supplies, payroll, computers, overhead, extra room you could use differently)? When you are running in and out of exam rooms, is everyone doing their own job properly and not just "chipping in" with someone else?
The good part of outsourcing is that those people you outsource go through constant continuing education. Usually their pricing is very reasonable. They want you to succeed as badly as you want to. They want you to succeed so that they'll get more business. Your office manager will actually have time to read the reports provided by the outsourcing company. 
By doing what you do best and outsourcing the rest, you should make more money, save money, have more free time and have less stress!  
The following companies serve the entire Western Region and have the highest customer satisfaction ratings.  Click on the links and contact them today.  There is no obligation.
In this day and age your website is many times the first image that new patients have of you and your office.  Your practice is your business and whether your marketing/advertising dollars are big or small you will want to make every dollar count. 
Are you sure that you are getting the best rates possible?  You can use Sterling Smith Insurance for all of your insurance needs - malpractice, property, business interruption, D&O, and E&O.  One stop for best rates and personal service.
Let the experts handle your human resource needs.  Why worry about payroll, taxes, and benefits?
Lower your costs with volume purchasing.
Reap the rewards of having many certified coders at your fingertips.  Experts that stay on top of all coding issues.
Every claim, every dollar, every day without you needing to worry about it.  OnPoint takes care of the paperwork, insurance calls and patient billing questions.  They remove the paperwork and the headaches of billing and collections.
You may think that anyone can help you set up a retirement plan but that isn't the case.  Choose someone who can truly assess what is best for you, your employees and your business.  Many think they can't plan for retirement because they don't have enough money yet.  Wrong!  You must plan today so you will have enough money.
OnPoint is proud to announce that the Castle Health Group has chosen us as their preferred provider.  Ms. Joanne Reid has been instrumental in negotiating this arrangement and we thank her for her efforts and support.  Contact us today to learn more about the special and exclusive offer for Castle Health Group physicians. 
Medical Billing and Collections
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Every claim, every dollar, every day 
TOLL FREE NUMBER - 800.594.8043
OnPoint Medical Solutions | P.O. Box 372082 | Honolulu | HI | 96837-2082







OnPoint Medical Solutions


E-NEWSLETTER                                                                                                                                         SEPTEMBER 2011




All physicians, chiropractors, other health care professionals, and payers that submit HIPAA transactions will be required to use ONLY the 5010 transactions as of January 1, 2012.  That's just about 90 days away.  In order to meet this deadline you should have already made software modifications and be well into testing.  If you are not ready, you risk claim rejections and interrupted cash flow.


This also applies to those who electronically submit administrative  transactions, such as checking a patient's eligibility, filing a claim, or receiving a remittance advice, either directly to a health insurance payer or through a clearinghouse.  


Now if this sounds like a gibberish or something you just don't have the time to worry about and you are already an OnPoint client then you don't need to worry.  OnPoint is pleased to announce that we are on schedule to have all 5010 ready payers in our network by the end of October!  You do not have to engage in payer testing as that is being performed on your behalf.  So when you hear your colleagues talk about testing or worrying about compliance - well you can just say, "I don't have to worry about it because OnPoint is taking care of it for me".


Key target dates include:


  • By September 30, all Medicare payers will be live or approved for live.
  • By September 30, United Healthcare, Aetna, Michigan BlueCross Blue Shield, Humana and Pennsylvania BlueCross Blue Shield
  • By October 31, all 5010 payers who are able to support 4010 and 5010 in production will be live.  For our Hawaii clients, this should be HMSA assuming they are ready.

OnPoint Clients we got you covered!


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