June 2007


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Chiropractors Serving as Primary Care Providers Decrease Costs - Study Shows

When Chiropractors serve as Primary Providers in health plans, these plans save significant amounts of money.  This according to a new study published in the May 2007 issue of the Journal of Manipulative and Physiological Therapeutics.  The study, also reported on in the June 7, 2007 Earthtimes.org could have profound implications as the US presidential campaigns seem to be dealing more with the issues related to health care and ways to make a system of universal health care affordable.

Researchers compared the costs and clinical utilization of members enrolled in a traditional health maintenance organization (HMO). The researchers reviewed data from those HMO members who had an integrative CAM Independent Physicians Association (IPA) and compared them with members who had a conventional medical IPA. In essence they look at the costs of those programs where the primary care physicians (PCPs) were exclusively doctors of chiropractic. The research, led by Richard Sarnat, MD, not only compared costs but also looked at patient satisfaction.

The results showed that over a seven year period, patients who utilized chiropractors and other CAM-oriented primary care physicians had a 60.2% decrease in-hospital admissions, 59.0% decrease in hospital days, 62.0% less outpatient surgeries and procedures, and an 85% decrease in pharmaceutical costs when compared with the total network HMO utilization rates and costs where medical physicians were the primary physicians.

Coauthor James Winterstein, DC commented on the results by saying, "Our most recent analysis supports earlier findings that patients visiting CAM (Complimentary and Alternative Medicine)-orientated primary care physicians (PCP) -- primarily chiropractors -- experienced fewer hospitalizations, underwent fewer surgeries and used considerably fewer pharmaceuticals than HMO patients who received traditional medical care."

In addition to costs savings those enrollees who utilized chiropractic consistently reported a higher satisfaction rating with their HMO than those who did not have chiropractic.  The study showed that the rates of patient satisfaction ranged between 89% and 100% and that patients consistently rated their experiences more positively than did members enrolled within the HMO's offering only conventional medical care.

Dr. Winterstein summed up the results and their impact by stating, "This study confirms that integration of allopathic, chiropractic and other complimentary and alternative medicine (CAM) providers can positively impact patient quality of care while limiting overall costs. This approach to patient care has great potential to improve the U.S. healthcare system."



Even Small Amounts of Exercise Are Beneficial

The above headline comes from the May 17, 2007 issue of Medscape and is the result of a study published in the May 16, 2007 issue of the Journal of the American Medical Association (JAMA). This study showed that much smaller amounts of exercise than previously believed can help heart health. The research showed that as little as 75 minutes of exercise per week can improve cardiorespiratory fitness levels of sedentary overweight individuals.  This level of exercise is lower than that currently recommended to produce weight loss.

This study was conducted with 464 postmenopausal women who were overweight or obese and had raised blood pressure.  These women were divided into four groups.  Three of the groups represented 50% then 100% and then 150% of the recommended exercise levels currently believed needed to lose weight, and the remaining group was a sedentary group used as a control group for comparison.

The results showed that even a modest amount of exercise showed health benefits.  The authors noted that there was little or no weight loss in the low exercise group, but there was a reduction in waist circumference which they noted was more significant. They stated, "Perhaps the most striking finding of our study is that even activity at the 4-kcal/kg per week level (approximately 72 min/wk) was associated with a significant improvement in fitness compared with women in the non-exercise control group."  They later added, "Data presented in our study show that even 72 minutes of moderate-intensity physical activity per week accumulated over about 3 days has a significant effect on fitness in previously sedentary postmenopausal women. This information can be used to support future recommendations and should be encouraging to sedentary adults who find it difficult to find the time for 150 minutes of activity per week, let alone 60 minutes per day."

In an accompanying editorial in the same issue of JAMA, I-Min Lee, MBBS, ScD, from Brigham and Women's Hospital in Boston, Massachusetts, concluded, "Although current knowledge regarding the dose-response relation between physical activity and health remains incomplete, the study by Church et al does provide important information on the dose of physical activity to improve physical fitness, a strong predictor of chronic disease and premature mortality. This may be succinctly summarized for patients and clinicians as 'Even a little is good; more may be better!"



What Replaces Those Trans Fats May be Almost as Bad for You

The above headline comes from the online June 10, and print June 18, 2007 issues of the US News and World Report. The article by Adam Voiland points out that the removal of trans fats from our food source may be a good thing, but we need to be aware of what may be taking it's place.  The issue, according to the article is that in certain cases trans fats are being replaced by saturated fats thus negating any health benefits.

Trans fats are found primarily in foods that contain partially hydrogenated oils, whose texture and longer shelf-life make them attractive to food processors.  However experts now agree that trans fats are linked to increases in the risk of heart disease and possibly the risk of sudden cardiac death and diabetes.  Even the  Pan American Health Organization, a regional arm of the United Nations World Health Organization, has called for the elimination of industrial trans fats from food supplies throughout the Americas in order to prevent heart attacks.

Dr. Robert Eckel, immediate past president of the American Heart Association, states, "People know trans fats are not good for them.  But they do not understand that replacing them with saturated fat is not a good option."

The list of companies giving up trans fats is impressive and includes, McDonald's, Kentucky Fried Chicken, Starbucks, Ruby Tuesday, and Frito-Lay among others. In some cases replacement fats such as canola and sunflower oils are being used.  However, the article points out that many manufacturers are trying to maintain flavor by using less healthy oils such as palm oil, palm kernel oil or butter.  As the article describes it, these unhealthy choices increase the intake of saturated fats well beyond the recommended amount safe for daily consumption.

The author of the article notes that many types of food and baked goods are trying to reduce trans-fats while keeping saturated fats to a minimum.  In some cases, such as baked goods this is not quite as simple without a sacrifice in the flavor and texture of some common foods. Some experiments using fully hydrogenated oils (as opposed to partially hydrogenating oil previously used) have shown not to produce trans fats but may instead increase stearic acid which is a saturated fat.



Migraine Sufferers Helped by Chiropractic Reported in News Stories

Several news stories appeared in the general press citing cases of migraine sufferers being helped by chiropractic care. One such story appeared on the June 7, 2007 WIStv.com, one in the June 6th Times Plus of Wisconsin and still another on the June 4, 2007 Boston channel 2 news. These stories noted that migranes affect nearly 28 million people and cost an estimated $13 billion a year in reduced productivity.

One of these stories describes the plight of Pam Delrosso a woman who suffered from debilitating migraines for 25 years.  Ms. Delrosso described her life with migranes by saying, "My quality of life just went downhill. I'd be in bed for days on end." 

A second migraine sufferer, Adriana Grassi was a personal trainer who was very much into physical fitness.  She describes her passion for fitness by saying, "This is my job, my career. I love doing what I do. I think I can help people change their lives."  Unfortunately, Grassi's career almost came to an end due to the onset of migraines.  She remembers, "I had a problem training my clients because I had terrible migraines. I couldn't talk, I couldn't even see, sometimes, the light."

According to the two stories both women went to neurologists, both had MRIs, CAT scans, and both were given a variety of medications.  In both cases, medical care did not work.  Fortunately, both women turned to chiropractic care.

Both articles report that the two women underwent a form of chiropractic care known as Orthogonal Chiropractic. According to Dr. Ryan Alther, a chiropractor interviewed for these stories, "Ortho meaning 90 degrees. We're trying to get the skull 90 degrees to the atlas, which is the top vertebrae, and the atlas at 90 degrees to the rest of the neck."   Dr. Alther explains that when the head and neck are not at right angles, it can cause nerve interference and alter blood flow, resulting in  severe headaches, neck and back pain.

For Pam Delrosso the results from chiropractic care were life changing.  She states, "They don't devastate me like they did before. I'll get an occasional headache -- maybe once a month, every 2 months. It goes away in an hour and it doesn't put me in bed for three days."

Adriana Grassi also had a life changing experience because of her chiropractic care. The articles note that she's been headache free for months. She commented, "I would definitely say it's a miracle."



Canadians and Chiropractic

From a June 4, 2007 news brief published by Media in Canada comes an article that examines the growing use of Chiropractic care by Canadians.  This report follows a study released by an independent research organization, The Fraser Institute, that more than half of all Canadians in 2006 were using some form of what that study called, "alternative medicine".

The Media in Canada article noted that 3.6 million (13%) of Canadians have visited a chiropractor in the past 6 months. They also reported that Canadians who went to a Chiropractor were 4 times more likely to have also visited a homeopath or naturopath in the past 6 months. Looking at the demographics this article explained that Canadians who go to Chiropractors were 40% more likely to live in the prairies and 45% less likely to live in Atlantic Canada than the average Canadian.

The report by The Fraser Institute took a broader view and look at Canadians usage of non medical forms of healthcare. This report was based on a survey in 2006 which was compared to a similar one done in 1997.  This report showed that 54 per cent of those responding to the survey used at least one form of alternative or complementary therapy in the prior year.  This represented a 4% increase over the 1997 survey.  Nadeem Esmail, the Fraser Institute's Director of Health System Performance and author of the report commented, "This increased use of alternative therapies is another indicator of Canadians' desire to have more choice and control over their health care options."

The Frazier Institute study noted one interesting fact that most alternative and complementary treatments are not covered by government health insurance plans, yet a large number of people choose those options.  In response to this finding Nadeem Esmail, commented, "When it comes to health and well-being, a significant number of Canadians are willing to spend their own money."

The Media in Canada article added some interesting information about Canadians who utilize chiropractic showing their general interest in health. They also noted that Chiropractors' patients are 2.5 times more likely to have used a smoking cessation patch or gum in the past 30 days than average Canadians. They also noted that Canadians who have visited a chiropractor are 2.6 times more likely to own orthopedic supports and/or braces as average Canadians.



Four-Legged Athletes Benefit from Chiropractic

A human (or maybe non-human) interest story appeared in the May 14, 2007 issue of the Contra Costa Times from California.  This article discussed how chiropractic care was helping  horses deal with health issues and achieve optimum performance. This story follows Dr. Mike Painter as he cares for his equine patients.  Dr. Painter is shown caring for two horses at the Pleasanton's Buena Amor Ranch. Both these horses are regular chiropractic patients according to the Contra Costa Times story.

One of the horses is a 5-year-old gelding named Meike and the other is a 17-year-old Arabian saddle breed called Smokey.  The story notes that Dr. Painter cares for horses with a variety of health issues including injury-related neck problems and back problems due to age.  The story comes with a picture of Dr. Painter with Meike (by Bob Pepping/Contra Costa Times), and demonstrates how he slowly gains the horses trust before giving an adjustment.

Owner of the horses, Harriet Merritt, shows her confidence in her equine chiropractor by saying, "He has a very good knowledge of the skeletal structure of a horse. He understands animals well. He treats them as a whole."

According to the article Dr. Painter views these horses as athletes. He noted,  "My personal philosophy is that my equine patients are elite athletes who perform better and are stronger, faster and more coordinated in their movements when their bodies are balanced."  The story reports that 90% of his horse patients are involved in competition.

Dr. Painter does maintain a practice on humans and also cares for dogs and other animals.  However, he did note in the article his preference for horses when he said, "I prefer large animals because I'm in an office all day and it gives me an excuse to be outdoors."



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