Journal of Chiropractic Humanities最新文献

{"title":"Pro Bono Services in 4 Health Care Professions: A Discussion of Exemplars","authors":"Kassandre Goupil MSc, DC,&nbsp;F. Stuart Kinsinger DC, MA","doi":"10.1016/j.echu.2020.10.001","DOIUrl":"10.1016/j.echu.2020.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this article is to discuss exemplars of pro bono and charity activities in health care<span> professions.</span></p></div><div><h3>Methods</h3><p>We searched PubMed and Google Scholar from inception to August 2019 using search terms “pro bono healthcare,” “medical volunteerism,” “pro bono clinics OR free clinics OR organizations,” “pro bono curriculum OR education,” “underserved OR uninsured OR underinsured OR disadvantaged OR poor populations.” Inclusion criteria were that practitioners, students, or volunteers be involved in pro bono care or education and in any discipline, including medicine, physical therapy, chiropractic<span>, or dentistry.</span></p></div><div><h3>Results</h3><p>We selected 5 exemplars to review, and determined that students can benefit from participation in pro bono or charity health care such as through a student administered clinic model. Academic curricula can play a role in building confidence and create positive attitudes and behaviors regarding pro bono and charity activities, and nonprofit organizations can help build sustainable models.</p></div><div><h3>Conclusion</h3><p>We conclude that the implementation and delivery of health care pro bono or charity services can fill a health care gap and can be applied successfully in the health professions.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Pages 21-28"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2020.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38377332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Vitalism Ethos and the Chiropractic Health Care Paradigm","authors":"John T. Thornhill DC","doi":"10.1016/j.echu.2020.10.004","DOIUrl":"10.1016/j.echu.2020.10.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purposes of this article are to describe the development of vitalism from its earliest Hellenistic form to that of a contemporary vitalism ethos and to propose the importance of vitalism in the philosophy of chiropractic and the chiropractic health care paradigm.</p></div><div><h3>Discussion</h3><p>A review of the history of vitalism is offered to clarify the use of the term within the chiropractic literature and to provide a defensible position for vitalism as a foundation for future research in the philosophy of chiropractic. The founder of chiropractic, Daniel David Palmer, drew heavily from spiritualism and vitalism in his construction of early chiropractic philosophy. As chiropractic practice and philosophy have evolved, that vitalistic foundation has become a polemic used by factions within the profession, resulting in political challenges. The controversy within chiropractic mirrors similar debates within academic philosophy regarding vitalism. The philosophy of vitalism has developed beyond its classical constructs, emerging as an ethos amenable to informing research within clinical applications and a perspective capable of informing the identity of chiropractic.</p></div><div><h3>Conclusion</h3><p>Exploring the broad historical context of vitalism may allow for an understanding of the plurality of vitalist ideas and a clarification of the concept within chiropractic literature. Adopting vitalism within the philosophy of chiropractic as an ethos based on the work of Georges Canguilhem provides a view of life as fundamentally original, adaptable, and unpredictable, and therefore not sufficiently understood in purely reductionist terms.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Pages 59-81"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2020.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38377334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic Day: A Historical Review of a Day Worth Celebrating","authors":"Claire D. Johnson DC, MSEd, PhD","doi":"10.1016/j.echu.2020.11.001","DOIUrl":"10.1016/j.echu.2020.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this paper is to review and discuss historical concepts about the celebration of Chiropractic Day.</p></div><div><h3>Discussion</h3><p>Daniel David Palmer attributed September 18, 1895 to be the day that he delivered the first chiropractic adjustment. As the chiropractic profession grew, the celebration of Chiropractic Day became more widespread throughout the United States and the world. This paper offers suggestions about how to celebrate Chiropractic Day. Activities include educating, learning, honoring, volunteering, and engaging.</p></div><div><h3>Conclusion</h3><p><span>The chiropractic profession celebrates its birth on September 18. Regardless of the many different names used over the past 125 years, including Chiropractic Founder's Day, Chiropractic Rally Day, Chiropractic Anniversary, and Chiropractic Discovery Day, the celebration of this special day provides an opportunity to reflect on how far the profession has come and how </span>chiropractors continue to help and serve their patients.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Pages 1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2020.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39054935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic in the United States Military Health System: A 25th-Anniversary Celebration of the Early Years","authors":"Bart N. Green DC, MSEd, PhD ,&nbsp;Scott R. Gilford DC ,&nbsp;Richard F. Beacham DC","doi":"10.1016/j.echu.2020.10.006","DOIUrl":"10.1016/j.echu.2020.10.006","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this report is to record noteworthy events that occurred during the early years of chiropractic in the United States Military </span>Health System (MHS).</p></div><div><h3>Methods</h3><p>We used mixed methods to create this historical account, including documents, artifacts, research papers, and reports from personal experiences.</p></div><div><h3>Results</h3><p><span>Chiropractic care was first included in the MHS in 1995, after years of legislative activity. The initial program was a 3-year study of the feasibility and advisability of integrating chiropractic in the MHS. This period was called the Chiropractic Health Care Demonstration Project; 20 pioneering </span>chiropractors<span> began their MHS journeys at 10 military bases in fiscal year 1995. The Demonstration Project was extended for 2 more years to gather research data, and 3 additional military facilities were added during those years to accomplish that purpose. The Demonstration Project concluded in 1999. In 2000, Congress approved the development of permanent chiropractic services and benefits for members of the uniformed services. These new clinics opened in 2002.</span></p></div><div><h3>Conclusion</h3><p>This is the first article to chronicle the history of chiropractic in the MHS, and highlights some of the important events in the early years of chiropractors working within the MHS. Because of the efforts of the early MHS chiropractors to pave the way for a permanent chiropractic benefit for the deserving members of the United States uniformed services, chiropractic care is now offered at more than 60 United States military facilities.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Pages 37-58"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2020.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38865841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-Coverage Chiropractic in Medicare: A Proposal to Eliminate Inequities, Improve Outcomes, and Reduce Health Disparities Without Increasing Overall Program Costs","authors":"Robert A. Leach DC, MS","doi":"10.1016/j.echu.2020.10.002","DOIUrl":"10.1016/j.echu.2020.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this article is to discuss evidence that supports the resolution of inequities for Medicare beneficiaries who receive chiropractic care.</p></div><div><h3>Discussion</h3><p><span><span>Medicare covers necessary examinations, imaging, exercise instruction, and treatments for beneficiaries with </span>back pain<span><span><span> when provided by medical doctors, osteopaths, and their associated support staff such as nurse practitioners, </span>physician assistants, </span>clinical nurse specialists, and physical therapists. However, if the same patient with back pain presents to a </span></span>chiropractor<span>, then the only service that is covered by Medicare is manipulation of the spine. Current evidence does not support this inequity in Medicare beneficiary service coverage. There is no evidence to show an increase in serious risks associated with chiropractic treatment of neck or back pain in Medicare beneficiaries. Chiropractors support national public health<span> goals and endorse safe, evidence-based practices. Chiropractic care for Medicare beneficiaries has been associated with enhanced clinical outcomes such as faster recovery, fewer back surgeries a year later, reduced opioid-associated disability, fewer traumatic injuries and falls, and slower declines in activities of daily living and disability over time. Further evidence points to lower costs, fewer medical physician visits for low back pain, less opioid-related expense, and less back-surgery expense with chiropractic utilization. Use is lower among vulnerable populations: seniors, lower income women, and black and Hispanic beneficiaries who may be most affected by current inequities associated with the limited coverage. In this era of evidence-based and patient-centered care, beneficiaries who receive chiropractic care are very satisfied with the care they receive.</span></span></p></div><div><h3>Conclusion</h3><p>The current evidence suggests a need for change in US policy toward chiropractic in Medicare and support for HR 3654. Ending inequities by providing patients full coverage for chiropractic services has the potential to enhance care outcomes and reduce health disparities without increasing program costs.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Pages 29-36"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2020.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38377333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ed Board","authors":"","doi":"10.1016/S1556-3499(20)30010-3","DOIUrl":"https://doi.org/10.1016/S1556-3499(20)30010-3","url":null,"abstract":"","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"27 ","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1556-3499(20)30010-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136591108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Orientation and Gender Identity in Patients: How to Navigate Terminology in Patient Care","authors":"Suzanne D. Lady DC ,&nbsp;Kara D. Burnham PhD","doi":"10.1016/j.echu.2019.08.005","DOIUrl":"10.1016/j.echu.2019.08.005","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this paper is to describe how health care providers can improve their practice environments to be more welcoming for patients on the spectrum of gender and sexual identity.</p></div><div><h3>Methods</h3><p>Literature searches were performed in WorldCat, PubMed, and nongovernmental organizations and Gallup polls. The years searched were from 2005 to 2018. Key words used included <em>sexual orientation</em>, <em>transgender</em>, and <em>health care</em>. The PubMed MeSH termed searched included <em>gender identity</em> and <em>sexuality</em>, both in combination with <em>patient care</em>.</p></div><div><h3>Results</h3><p>Terminology that patients use to identify their gender may vary. Understanding the terminology that patients use to self-identify is a first step to becoming more sensitive to the needs of gender and sexual minority patients. Minority patients on the spectrum of gender and sexual identity experience discrimination when accessing health care. Therefore, an accepting doctor–patient relationship especially benefits these patients. When communication competency and fluency is established, health care providers provide a more inclusive, accepting environment. Addressing patients based on their preferences and using inclusive forms and patient handouts are some recommendations that are made to create an open, patient-centered environment.</p></div><div><h3>Conclusion</h3><p>This article provides health care providers with terminology that facilitates communication and the healing environment for sexual and gender minority patients. Understanding and using this may create a more welcoming environment to all patients.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"26 ","pages":"Pages 53-59"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2019.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38851731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tale of Specialization in 2 Professions: Comparing the Development of Radiology in Chiropractic and Medicine","authors":"Kenneth J. Young DC, DACBR, PhD","doi":"10.1016/j.echu.2019.09.001","DOIUrl":"10.1016/j.echu.2019.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this article is to describe the development of radiology<span> as a specialty in chiropractic with a comparison to the development of the specialty of radiology in medicine.</span></p></div><div><h3>Discussion</h3><p><span><span>Specialization in medicine has been notably successful, with advanced training and enhanced capabilities in specialized skills leading to better outcomes for patients and increased prestige for practitioners. However, with chiropractic, as with other complementary and alternative medicine<span> professions, no specialization has been recognized within it. Specialist radiology training in chiropractic bears a resemblance to that of medicine, with competitive entry for residencies, certification exams, and the creation of a journal and specialist professional organizations. To facilitate the comparison, I have divided the development of radiology into 4 phases from the chiropractic perspective. Phase 1 started with the discovery of x-rays in 1895, in which medicine adopted them but chiropractic did not. Phase 2 began in 1910 when B. J. Palmer introduced radiography to show chiropractic </span></span>subluxations. Phase 3 started in 1942 when Waldo Poehner advocated for the mainstream diagnostic use of radiography in addition to subluxation analysis. Phase 4 started in 1957 when an examining board for certification in </span>diagnostic radiology<span> was assembled and many chiropractors began to embrace the mainstream medical use of radiography.</span></p></div><div><h3>Conclusion</h3><p>In this tale of 2 professions, radiology gained official specialty designation in the field of medicine. The medical profession had a monopoly on health care, and thus had few internal and external barriers to overcome. Chiropractic was oppressed by organized medicine, which helped to create the unofficial specialty of chiropractic radiology but which also later helped to limit the specialty. Chiropractic radiology has maintained its independence and autonomy, but also remains on the fringe of mainstream health care.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"26 ","pages":"Pages 3-18"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2019.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid","authors":"John R. McGowan PhD ,&nbsp;Leonard Suiter DC, FICC","doi":"10.1016/j.echu.2019.08.004","DOIUrl":"10.1016/j.echu.2019.08.004","url":null,"abstract":"<div><h3>Objectives</h3><p>The objectives of this study were to critically evaluate the methodology and conclusions of the fiscal notes prepared by the state of Missouri for including doctors of chiropractic<span> (DCs) under Missouri Medicaid and to develop a dynamic scoring model that calculates the savings if DCs were allowed to offer treatment under Missouri Medicaid.</span></p></div><div><h3>Methods</h3><p>We used a secondary analysis to determine the cost-saving assumptions to be incorporated into a dynamic model. We reviewed the literature on efficiency and effectiveness of DC-delivered care regarding the most reliable assumptions concerning cost savings and utilization. The assumptions for percentage savings from DC-provided care and the avoidance of spinal surgeries were then combined in the dynamic scoring model to determine projected cost savings from adding DCs as covered providers under Missouri Medicaid. The actual cost of opioid abuse in Missouri was then determined as a basis to measure cost savings from adding DC care as an alternative therapy for the management of neck and low back pain.</p></div><div><h3>Discussion</h3><p>The Missouri Health Division initially used the static scoring approach to evaluate proposals to cover DC care under Missouri Medicaid. This approach only considers added costs from a legislative change. Because of this, we proposed that the Missouri Health Division used flawed methodology and data in their calculations for the fiscal note regarding the cost of including care from DCs under Missouri Medicaid. After consideration of the approach used in this study, the Committee adopted some important elements of dynamic scoring. Based on our computations and the dynamic scoring model, we determined that there would be a cost savings to the state of Missouri of between $14.1 and $49.2 million once DCs are included as covered providers under Missouri Medicaid. This study also supports the proposition that treatment by DCs for neck and lower back pain may reduce the use and abuse of opioid prescription drugs.</p></div><div><h3>Conclusion</h3><p>Policymakers may unintentionally rely on flawed assumptions and methodologies such as static scoring, which we propose results in flawed conclusions. Legislative options involve some additional cost. The issue is whether proposed legislative options offer more effective outcomes along with more efficient cost. Using a dynamic scoring model to incorporate savings from 3 primary sources, we found that (1) chiropractic care provides better outcomes at lower cost, (2) chiropractic treatment and care leads to a reduction in cost of spinal surgery, and (3) chiropractic care leads to cost savings from reduced use and abuse of opioid prescription drugs.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"26 ","pages":"Pages 31-52"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2019.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-ray Use in Chiropractic: Call for Papers","authors":"Claire D. Johnson DC, MSEd, PhD","doi":"10.1016/j.echu.2019.08.001","DOIUrl":"10.1016/j.echu.2019.08.001","url":null,"abstract":"<div><p>In 1910, radiology was an emerging field when x-rays first came into use by chiropractors. Much has changed in the body of knowledge about ionizing radiation and the spine since the early 1900s. There is little in the peer-reviewed literature on the topic of x-ray use in the chiropractic profession. Therefore, the <em>Journal of Chiropractic Humanities</em> has an open call for papers to investigate the topic of x-ray use in chiropractic and reveal what is myth and what is fact. Accepted papers will be published in a special section of the journal dedicated to this topic.</p></div>","PeriodicalId":39103,"journal":{"name":"Journal of Chiropractic Humanities","volume":"26 ","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.echu.2019.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45691889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}