MAC Journal • November/December 2014 I
Transcription
MAC Journal • November/December 2014 I
MAC Journal • November/December 2014 I New Renaissance II MAC Journal • November/December 2014 contents Nutrition NOVEMBER/DECEMBER 2014 Journal Get Smart About Adding Supplements.........................................14 New Report: Michigan Has 11th Highest Adult Obesity Rate.......16 Michigan’s Chiropractic Scope on Nutrition..................................20 Common Popular Supplements...................................................38 Articles Dr. Patrick Gentempo Highlights Fall Opening Session...........4 Spring 2015 Convention.................................................................5 MAC Fall Convention Awards!........................................................6 New Award! Linda Rassel, DC, Extraordinary Impact Award.........7 What Constitutes Physical Measures and Tests?.........................10 ACA Insurance Marketplace Open Enrollment Begins Nov. 15....12 Michigan Marketplace Plan Selection .........................................13 University of Minnesota Center for Spirituality & Healing.............18 Chiropractic Summit.....................................................................22 Medicare Audits in 2014 OIG “Work Plan”...............................24 News from the F4CP....................................................................26 “Recommend One” Debuts!.........................................................26 REMINDER: ICD-10 Compliance Date is October 1, 2015..........27 MAC Webinars Available!..........................................................29 Remember to Deduct Your Dues!.................................................29 MDCH Director James Haveman: An Appreciation......................30 Is Your Practice Incorporated? A PLLC? .....................................31 Veterans: Drug-Free Approaches to Pain in US Military .............32 More on the Chiropractic Project..................................................33 The Michigan Health Recovery Program.....................................34 Tips for Preventing Data Breaches...............................................36 Sherman Awarded Military Friendly® Schools Designation.........37 CFCU Welcomes New Board Member.........................................40 Communication Strategies...........................................................42 CFCU: Announcing… A New Partnership!...................................43 Join us on FaceBook and Twitter! MAC Journal • November/December 2014 MICHIGAN ASSOCIATION OF CHIROPRACTORS REMINDER! MAC 2014 EXPRESS Convention November 22-23, 2014 Soaring Eagle, Mt. Pleasant 15 CEs Available, including all Michigan requirements! See page 40 for details! Regular Features Letter from the President................................................................3 Member Benefits............................................................................5 New Members..............................................................................39 Obituaries: Dr. Linda Rassel, Dr. George Goodman, Dr. Frank R. Sovinsky .......41 Your Money Matters.....................................................................42 Educational Programs..................................................................45 Members on the Move! Dr. John Ostergren, Dr. Miguel Ruelan ...............46 Membership Application...............................................................48 District Information.......................................................................49 Classified Ads...............................................................................50 Advertisers Cancer Treatment Centers of America...........................................2 Central Medical Imaging...............................................................53 China Gel.....................................................................................27 Chiropractic Federal Credit Union......................................7, 19, 21 ChiroSecure...................................................................................9 Genius Solutions..........................................................................33 Leslie M. Kohn, Esq.....................................................................23 Michigan X-ray.............................................................................13 MyMACWellness/MDCH..............................................................43 NCMIC..........................................................................................54 New Renaissance...........................................................................I Premier MRI.................................................................................25 Spine Align, Inc............................................................................. 11 1 Cancer Treatment Centers of America 2 MAC Journal • November/December 2014 Letter from the President MAC Executive Board President Dennis Whitford, DC Vice President Damian Palmer, DC Director of Internal Affairs Eric Hartman, DC Director of Financial Affairs Lisa Olszewski, DC Chairman Daniel Spencer, DC Editorial/Association Staff Executive Director Kristine Dowell Assistant Director Susan Palin Insurance/Government Relations Carl Alden Public Relations Tim Gaughan Administration Angela Psaros Membership/Programs Lisa Love-Smith Administrative Assistant Wes Hoffrichter Membership Assistant Seth Anderson Office Manager Chrissy Psaros Legislative Consultant Bill Wortz, Public Affairs Associates Attorney Gregory M. Nowakowski Honigman, Miller, Schwartz and Cohn, LLC MAC Vision “A healthy, knowledgeable citizenry with fair and open access to chiropractic.” MAC Mission “To improve public health through education, promotion, and protection of chiropractic.” Purpose of the MAC The purpose of the Michigan Association of Chiropractors is: • To promote the Chiropractic profession as a distinct branch of the healing arts based on the body’s inherent recuperative abilities and the role that vertebral subluxation plays in that process, and • To advocate for Michigan Doctors of Chiropractic, chiropractic patients, and the chiropractic profession to the government, the public, the business community, and the community of third party payers. Comments or letters to the editor may be sent to: Michigan Association of Chiropractors 416 W. Ionia • Lansing, MI 48933 (517) 367-2225 info@chiromi.com • www.chiromi.com MAC Vision Statement: “A healthy, knowledgeable citizenry with fair and open access to chiropractic.” MAC Mission Statement: “To improve public health through education, promotion, and protection of chiropractic.” Dear Colleagues: The Vision and Mission statements above are very present in every decision MAC leadership makes. We work on behalf of our members every day to promote and enhance the chiropractic profession in our state. On December 31, my presidency will come to an end. Dennis W. Whitford, DC President It has been my great honor and pleasure to be able to serve you these past two years. Together, we have done some critical work, work that will benefit Michigan chiropractors and our patients for years to come. Below are just a few of these accomplishments. Blue Cross Lawsuits: Major News! Earlier this year, the MAC scored two major legal victories when the Michigan Supreme Court declined to hear BCBSM and BCN’s appeal of the Michigan Court of Appeals decision allowing our lawsuits to move forward as class action lawsuits. For the past several months, MAC leadership has been in serious settlement negotiations with Blue Cross and Blue Care Network. These negotiations have led to a possible settlement! The final language is being drafted now, but the bottom line is this: Within the next few months, we believe you will be able to bill for ALL SERVICES in your scope when they are covered by Blue Cross and Blue Care Network. Chiropractors will no longer be discriminated against in coverage of their scope, if other providers are being reimbursed! I am extremely proud of the work we have done on this very important issue. Stay tuned to the MAC Journal and Week in Review for more information as it becomes available. MichiCare I am also very proud of the establishment of our Independent Physician Association (IPA), MichiCare, which will be accepting providers in the very near future. With MichiCare, we hope to better serve our members and their patients, and advocate for the future of chiropractic by informing buyers and consumers about the efficacy and cost-effectiveness of our care. There has never been a better time to push for inclusion and fair reimbursement in all health plans, and we are working daily to provide useful services and positive benefits to doctors throughout the state. Since MichiCare was announced in 2013, much work has been accomplished. After months of due diligence, we have contracted Medical Advantage Group (MAG), an administrative consulting firm with more than a decade of experience developing large patient-centered provider networks in Michigan. We are now dedicated to securing contracts that will allow patients increased access to our quality, cost-effective services. MichiCare is designed to put chiropractic – and our members – at the forefront of health care delivery in our state. Stay tuned for information on network affiliation and how to get involved! MAC Journal • November/December 2014 Continued on page 44 3 Convention Wrap-Up Dr. Patrick Gentempo Highlights Fall Convention Opening Session Kalamazoo Radisson the Site of Another Fantastic MAC Event! Last month, Michigan chiropractors gathered at the MAC Fall 2014 Convention & Exhibition at the Radisson Hotel in Kalamazoo. Hundreds of doctors, CAs, and other supporters were fired up by our keynote speaker at the Opening Session, Dr. Patrick Gentempo! His presentation, “The State of Things: A Tale of Two Professions,” provided his expert perspective on the current state of chiropractic and what the future holds for the profession. Other notable speakers included: • Dr. Francis Murphy on Polyvagal Theory • Dr. David Seaman on neurology and golf • Dr. Troy Dukowitz on freedom from insurance • Dr. Gary Jacob on the McKenzie Method • Dr. Ron Oberstein on corporate wellness programs • Dr. Craig Gill on blood chemistries • Dr. Michael Kudlas on gait analysis • Dr. Dean DePice, Dr. Lisa Olszewski, Dr. Mary Flannery, and Dr. Denise Rassel on philosophy • Dr. Joel Carmichael on PEMF Dr. Patrick Gentempo wowed ‘em at the Opening Session! 4 Along with these exceptional educational opportunities, doctors also engaged in much chiropractic camaraderie, with such events as the VIP Party, Friday Night Welcome Reception, Saturday Night Reception, alumni breakfasts for Life, Palmer, Life West, and Sherman, and more. Rather than our usual raffle, the MAC held our first-ever Silent Auction throughout the weekend, with such prizes as: • Whole Body 5.1 Massage Chair, provided by Human Touch MAC President, Dr. Dennis Whitford at the Opening Session. MAC Chairman, Dr. Dan Spencer at the Opening Session. Continued on page 5 MAC Journal • November/December 2014 MEMBER BENEFITS Convention - Continued from page 4 www.chiromi.com/membership/benefits ASEA™, (269) 353-4000 www.AdvancingLives.TeamASEA.com MAC members purchase cases of ASEA at wholesale price, and more! Benefits4Chiropractors (a Phase 4 Company) (248) 559-6980, www.phasefourltd.com MAC members receive discounts on long-term disability, long term care, pre-paid legal services, and more Biz-to Biz Network, Inc., (586) 942-5756 www.biztobiznetworkinc.com 50% reduction in chapter member fee for MAC members Body Part Chart, (888) 712-4278 www.bodypartchart.com 10% off all BPC products Dr. Patrick Gentempo at the Opening Session. • Chirobedic Sleep System, provided by Spine Align • Stationary Massage Table, provided by Great Lakes Imaging • Four days in Cancun, Mexico, provided by the MAC • Two sets of Red Wings tickets, including an overnight stay and breakfast at the Adoba Hotel, provided by our lobbyists at Public Affairs Associates (PAA) • Spartan Football Suite tickets, including free food and beverages, also provided by PAA • Reflexology Foot Massager, provided by Relax Health & Tone Thanks to all our generous vendors who provided prizes for the Silent Auction! Stay tuned for news about the prizes available next spring! Spring 2015 Convention Plans are already under way for the MAC Spring 2015 Convention, to be held at the Adoba Hotel and Conference Center in Dearborn (formerly the Dearborn Hyatt), APRIL 24-26, 2015. Watch future editions of the Journal and the website for details! Reserve Your Room for the MAC Spring 2015 Convention Today! Due to the growth of the MAC, hotel rooms in our room blocks are being increased. However, rooms at our conventions will continue to be limited. Because of this, for the MAC Spring 2015 Convention, we urge you to make your room reservations as soon as possible to ensure your ability to stay at the Adoba Hotel and Conference Center (formerly the Dearborn Hyatt). To make your room reservations, call (313) 592-3622, and let them know you are with the MAC, or go to http://adobadearborn.com/ and use the special group code “281.” MAC Journal • November/December 2014 ChiroCode Institute, (800) 944-9877 www.chirocode.com MAC Members receive a discount on the purchase of the ChiroCode Deskbook. Chiro-Connect, (763) 422-3526 www.chiro-connect.com MAC Members receive a substantial discount. ChiroHealthUSA, (888) 719-9990 www.chirohealthusa.com Discount medical plan to MAC members and their patients DAE Capital Advisors, (616) 258-5063 www.daeadvisors.com MAC members receive a free 12 month trial of iConnect, DAE’s online Wealth Management System DocApps, (248) 560-9001 www.docapps.mobi iPhone and Android apps for chiropractor to patient communication. $500 set-up fee waived for MAC members FiNet, (800) 487-5577 www.finetsolutions.com Credit card processing. MAC members receive discounted fees, waived set-up Genius Solutions, Inc., (586) 751-9080 www.geniussolutions.com MAC members receive a 5% discount on the purchase of practice management software Great Lakes Benefits, (734) 241-2811 www.greatlakesbenefitsofmichigan.com MAC members receive a 10% discount on autoowners personal lines & group commercial lines InPro Insurance Group, (248) 526-3260 www.inproagent.com MAC members are eligible for assistance with joining health plans Law office of Leslie Kohn, (248) 559-1957 kohn-law.glfpages.com MAC Club members receive a free legal consultation Nordic Naturals, (831) 724-6200 www.nordicnaturals.com 10% ongoing discount on direct purchases Spine Align, Inc., (616) 392-4565 www.chirobed.com MAC Club members receive a 10% discount on bedding products Veracity Payment Solutions, (888) 599-2209 www.midtrans.com MAC members receive discounted premium and basic rates 5 Convention Awards MAC Fall Convention Awards! Outgoing MAC President Dr. Dennis Whitford Named MAC 2014 Chiropractor of the Year At each MAC Fall Convention, we reward the hard work and dedication of our leadership and members with a number of awards, including the Visionary Award, Rising Star Award, Exemplary Service Award, the Kirk A. Lee and, of course, Chiropractor of the Year. This year, we also added a new award: the Linda Rassel Extraordinary Impact Award (see sidebar). Chiropractor of the Year: MAC President Dr. Dennis Whitford Outgoing MAC President Dr. Dennis Whitford of Mt. Pleasant was named the MAC 2014 Chiropractor of the Year “in appreciation for valuable leadership, service, and dedication above and beyond the call of duty to the chiropractic profession.” zation. He is charged with seeing that all orders and resolutions of the MAC Board of Directors are put into effect. The President also presides over Executive Committee and general membership meetings. His term began January 1, 2013, and runs through December 31, 2014. His tenure has been marked by the establishment of MichiCare, our IPA. Prior to his election as President, Dr. Whitford served two years on the Executive Committee as Vice President/Director of External Affairs. A graduate of Logan, Dr. Whitford, an Indiana native, began practicing in Michigan in 1993. Congratulations, Dr. Whitford, from the Board of Directors and the staff at the MAC! Kirk A, Lee, DC, Community Champion Award: Dr. Amanda Apfelblat In 2012, we lost a dear friend and Michigan chiropractic legend, Dr. Kirk A. Lee Dr. Dan Spencer Presents the Chiropractor of the Year Award to Dr. Dennis Whitford. Dr. Whitford serves as the organization’s Chief Executive Officer and is responsible for the general and active management of the business of the organi6 Dr. Amanda Apfelblat, recipient of the Kirk A. Lee, DC, Community Champion Award. of Albion. Dr. Lee was as active in his community in Albion as he was in the community of chiropractors not only in Michigan but nationally. His dedication to his community and profession was truly inspiring, so we established a new yearly award, the Kirk A. Lee, DC, Community Champion Award, to be given to a chiropractor “in recognition and appreciation of their unselfish commitment to serving others and their community.” This year’s Kirk A. Lee, DC, Community Champion Award went to Dr. Amanda Apfelblat of Garden City. A Life grad and President’s Club member, Dr. Apfelblat is extremely involved in her local community. Her numerous civic and community involvement and awards includes: Westland Chamber of Commerce, 2007 Westland Business Person of the Year, Garden City Business and Professional Women's Group, Westland Salvation Army, and Schoolcraft College’s Massage Therapy Program. She has spoken at Westland Middle Schools and High Schools about the field of chiropractic and also sponsors a college scholarship for William D. Ford High School students. Dr. Apfelblat serves on the MAC Board of Directors representing District 3. She has been a member of the Membership Committee since the MAC’s founding in 2007. She has served the Association in a number of capacities over the years, including as President of District 3. Dr. Apfelblat is also a founding member of the Michigan Chiropractic Pediatric Association, an organization founded to engage and serve Michigan families through the promotion of chiropractic care and public education, as well as by establishing meaningful communication with other healthcare professionals and organizations. She currently serves as a Board of Directors member of the MCPA. She is also a member of the Chiropractic Federal Credit Union Supervisory Committee, and Continued on page 8 MAC Journal • November/December 2014 New Award! Linda Rassel, DC, Extraordinary Impact Award In early September, we lost a longtime MAC member and chiropractic pioneer, Dr. Linda Rassel. She had a tremendous impact on the profession in our state, and in her honor we have established a new award, the Linda Rassel, DC, Extraordinary Impact Award. This award will be given yearly to a chiropractor “In appreciation for being a veracious chiropractic advocate, mentor, and leader.” No one exemplifies this award more than Dr. Rassel herself, who became the award’s first recipient at our Fall 2014 Convention in Kalamazoo. Dr. Rassel passed away September 5, 2014, surrounded by her loving family, including five daughters, four of whom went on to become chiropractors themselves. A magna cum laude graduate of Palmer, Dr. Rassel was deeply involved with her state associations, serving on the Board of Directors of the Michigan Chiropractic Council and on a number of key committees. She was the recipient of numerous awards and deeply appreciated for her many years of valuable service. She also served as a member of the Michigan Board of Chiropractic, the International Chiropractors Association, and on the Board of Trustees for Life University. A Diplomate of the National Board of Chiropractic Examiners, she practiced in Michigan for nearly 40 years. Her feisty, never-give-up style and passionate dedication to chiropractic will be sorely missed. CFCU (L-R) Dr. Heather Rassel, Dr. Elizabeth Rassel, Dr. Linda Rassel, Dr. Denise Rassel, and Dr. Ruth Rassel MAC Journal • November/December 2014 7 Awards - Continued from page 6 the International Chiropractic Pediatric Association. She has an advanced Board Certification in Pediatric Chiropractic. Visionary Award: Kathy Schaefer Kathy Schaefer, a partner with MAC public relations consultants Communications & Research, received the Visionary Award, “in appreciation for exceptional service and dedication to the future of the chiropractic profession.” She is the Program Administrator for WorkSafe, the MAC’s spinal health and ergonomics training program that introduces hundreds of Michigan workers to the healing power of chiropractic care every year. Kathy’s incredible proposals have led to WorkSafe handles grant evaluation, accounting, and reporting. Exemplary Service Award: Dr. Dan Spencer Outgoing Chairman of the Board Dr. Daniel D. Spencer of Hudson was given the MAC “Exemplary Service Award” for his long tenure on the MAC Executive Committee and Board of Directors. Our 2012 “Chiropractor of the Year,” Dr. Spencer’s tenure as Chair began in January 2013 and ends December 31. Prior to his tenure as Chair, he served Dr. Lisa Olszewski presents the Rising Star Award to Dr. Nick Hartop. schedule and locations. President’s Award: Angela Psaros Dr. Dennis Whitford presents the Exemplary Service Award to Dr. Dan Spencer. Dr. Eric Hartman presents the Visionary Award to Kathy Schaefer. obtaining State of Michigan Consultation Education and Training (CET) Grants for more than a decade. A collaboration between the MAC and MIOSHA, WorkSafe is offered to businesses with 100 employees or less in the fields of manufacturing, nursing home and residential care, wholesalers of nondurable goods, landscaping, and warehousing and storage. Kathy’s duties with Communications & Research also include the MAC Screenings Program, designed to put MAC doctors in the spotlight and spread the word about chiropractic. The program provides MAC members with exposure at high profile health events in their communities, and helps create many public relations opportunities. Kathy manages the work flow of most C&R projects, as C&R handles a number of associations besides the MAC. She coordinates and serves as editor for numerous state and national industry publications. Her duties include graphic design, art direction and photography. In addition to grant writing, she also manages and 8 as President from 2011-2012. Before serving as President, he was Vice President/ Director of External Affairs. He has served the MAC on the Board of Directors since its inception, and as a member of the Government Relations Committee. Dr. Spencer was a member of the Transition Executive Committee, the body charged with acting as a liaison between the MCS and MCA as the two organizations negotiated the historic merger. He joined as a student member from Palmer in 1994. This year, Dr. Whitford decided to honor MAC Administrative Director Angela Psaros, who works with the Audit & Budget Committee to execute all daily MAC business, manage accounting/billing procedures, and prepare all budgets and tax reports. She also oversees all office operations and administrative initiatives. Angela was also the recipient of the MAC Distinguished Service Award in 2011. She has been with the association since 1998. Angela holds an undergraduate degree from Michigan State University, and an MBA from Baker College. Rising Star Award: Dr. Nick Hartop Each year, the MAC presents its Rising Star award “in appreciation of members who are stepping above and beyond for the chiropractic profession by taking on leadership roles.” This year, the MAC honored Board of Directors member Dr. Nick Hartop of Chesterfield. A graduate of Palmer, Dr. Hartop represents District 2 on the MAC Board of Directors. He also currently serves as Vice Chair of the MAC Education and Programs Committee. In his position, he is instrumental in helping to plan our conventions and seminars, including the vetting and choosing of speakers and topics, as well as our overall Dr. Dennis Whitford presents the President’s Award to Angela Psaros. MAC Journal • November/December 2014 Membership ChiroSecure MAC Journal • November/December 2014 9 Continuing Education What Constitutes Physical Measures and Tests? As part of Michigan’s updated scope of practice, signed into law in 2010, Michigan doctors of chiropractic were required to obtain continuing education pertaining to the newly allowed services outlined in the new scope. Among these requirements are: • Two (2) hours in “Physical Measures” • Two (2) hours in the “Performance and Ordering of Tests” The MAC office often gets questions from doctors wondering exactly what constitutes these categories. At their May 2010 meeting, the Michigan Board of Chiropractic, in consultation with the Michigan Department of Community Health, voted to approve the following physical measures and tests relative to the new chiropractic scope of practice. Physical Measures Physical measures used for correcting or reducing subluxations, misalignments and joint dysfunctions, including, but not limited to: • Massage: Manipulation of superficial layers of muscle and connective tissue to alleviate pain and discomfort • Mobilization: Method of manipulation, movement or stretching to increase range of motions in muscles and joints that does not involve a high-velocity thrust • Heat: Use of hot/moist packs or diathermy in an area of treatment to promote healing and restoration of function Continued on page 11 Approved Continuing Education in Michigan The MAC office often gets questions regarding what exactly constitutes “approved” continuing education in the state of Michigan for the purposes of license renewal or relicensure. Under the Michigan Board of Chiropractic’s Administrative Rules, the following all constitute approved continuing education: • The successful completion of a course or courses offered for academic credit in a chiropractic school approved by the board • Successful completion of a continuing education program offered by a chiropractic school approved by the board • A continuing education program that has been granted approval by another state’s board of chiropractic • The board also considers requests for approval of continuing education programs by sponsors who submit applications on a form provided by the department. Programs must relate to the general subject area of the practice of chiropractic, and shall not receive credit for those portions of the program covering subject areas that include practice building, marketing, or financial advancement, with the exception of content that includes the laws, rules, regulations, or policies regarding insurance billing or documentation. If you are unsure if a continuing education program falls into one of these categories, contact the Michigan Board of Chiropractic at (517) 335-0918. You can also contact the organization putting on the seminar to inquire if they have been approved for continuing education credits in Michigan. 10 MAC Journal • November/December 2014 Physical Measures - Continued from page 10 • Cold: Ice pack application in an area of treatment to promote healing and restoration of function • Light: Use of laser, infrared, ultraviolet, heat lamps, etc., to promote healing and restoration of function • Water: Use whirlpools or hydromassage for the use of treatment or rehabilitation in an area of treatment to promote healing and restoration of function • Electricity: Use of high volt, low volt or interferential current to aid in the correction of muscular/skeletal problems to promote healing and restoration of function • Sound: Use of ultrasound to aid in the correction of muscular/skeletal problems to promote healing and restoration of function • Traction: Set of mechanisms to relieve pressure on the spine and skeletal system • Decompression: Intermittent motorized or hydraulic distraction used as treatment for disc problems, low back pain or neck pain • Taping: Use of medical tape to stabilize injury or immobilize • Rehabilitative Exercises: Recommended stretches or movements intended to relieve stress on the spine or skeletal system Tests The performance, ordering or use of tests for the diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as they relate to subluxations, misalignments and joint dysfunctions. These tests shall be for the purpose of detecting those conditions and disorders or offering advice to seek treatment from other health professionals in order to restore and maintain health, including, but not limited to: • Neurologic: Evaluation of motor or sensory skills • Orthopedic: Used to identify specific nature of musculoskeletal injury or condition • Muscle Testing: Assessment of the body’s electrical system balance by pushing or pulling on various muscles and evaluating the corresponding weak- nesses • Gait: Assessment of balance, coordination and posture while walking • Blood: Use of blood tests to measure the outcome of nutritional counseling or to determine the need to continue treatment or refer to another health care provider if a patient has not responded to treatment • Urine: Use to measure the outcome of nutritional counseling or to determine the need to continue treatment or refer to another health care provider if a patient has not responded to treatment • Hair: Use to measure the outcome of nutritional counseling • Saliva: Use to measure the outcome of nutritional counseling • Ordering and use of non-invasive imaging tests, consistent with modern technology and related to spinal subluxations: May use an MRI of the spine to determine a patient’s biomechanical problems in the spine or to offer advice to seek treatment from other healthcare professionals in order to restore or maintain health if the condition is outside the scope of chiropractic Spine Align, Inc. MAC Journal • November/December 2014 11 Insurance Issues ACA Insurance Marketplace Open Enrollment Period Begins November 15! What You and Your Patients Need to Know! 2015 marks the beginning of the second year of insurance coverage under the Patient Protection and Affordable Care Act (commonly referred to as “Obamacare”). For those of your patients currently enrolled in a 2014 “Marketplace” (also commonly known as the “Exchange”) plan, 2014, and continues through February 15, 2015. If someone has not enrolled in coverage by then, they generally cannot buy Marketplace health coverage for 2015 until the open enrollment period for 2016. Anyone without health coverage in 2015 may be subject to a fee. The fee for 2015 is higher than 2014 – 2% of income or $325 per adult, $162.50 per child, whichever is greater. Anyone wishing to purchase health coverage through the Marketplace outside of the open enrollment period must qualify for a special enrollment period due to a qualifying life event, including (but not limited to): • Loss of essential health coverage • Change in family size (get married or divorced, have a child by birth or adoption, death in the family, etc.) • Change in citizenship status • Move to a new coverage area The special enrollment period generally lasts 60 days after the qualifying event. their coverage ends December 31, 2014. To continue health coverage next year, enrollees can renew their current health plan or choose a new health plan through the Marketplace during the 2015 Open Enrollment period. The Open Enrollment Period for 2015 coverage begins November 15, Michigan Information For 2015, 16 insurers will offer coverage on the Michigan Health Insurance Marketplace, up from 12 in 2014. The Marketplace will continue to be administered by the federal government, while the Michigan Department of Insurance Did You Know? • The nonpartisan Congressional Budget Office has estimated that 13 million people should be in the market in 2015, up from approximately 7.5 million in 2014. • In Michigan, more than 272,500 Michiganders selected plans on the health insurance marketplace during its first open enrollment period from October 1, 2013, through March 31, 2014. 12 Important ACA Dates to Remember! • November 15, 2014 – Open Enrollment begins. • December 15, 2014 – Applications for coverage beginning January 1, 2015, are due. Also, any changes to current plans must be completed by December 15 to avoid a lapse in coverage. • December 31, 2015 – Coverage ends for 2014 plans. • February 15, 2015 – Open Enrollment Period ends. To buy Marketplace insurance outside Open Enrollment, patients must qualify for a special enrollment period due to a qualifying life event, such as marriage, birth or adoption of a child, or loss of other health coverage. and Financial Services (DIFS) retains the responsibility of reviewing all plans to ensure compliance with state and federal laws. Information about the Marketplace is available at www.healthcare.gov. Michigan residents with health insurance questions can also visit www.michigan.gov/ difs or call DIFS toll free at 877-999-6442. Continued on page 13 MAC Journal • November/December 2014 ACA Insurance - Continued from page 12 Michigan Marketplace Plan Selection Demographic Breakdown More Michigan Information: Healthy Michigan The expansion of Medicaid is a very large part of the objective of the ACA – to reduce the number of uninsured people in the US. In Michigan, more than 400,000 people have already signed up for coverage under the Healthy Michigan plan, with an additional 100,000 expected to be covered by 2021. The Healthy Michigan plan allows individuals with incomes of up to 133 percent of the federal poverty level to sign up for Medicaid. That works out to about $15,800 a year for individuals or $32,500 for a family of four. Those eligible for Medicaid, Healthy Michigan, or the Children’s Health Insurance Program (CHIP) can enroll at any time. There is no limited enrollment period for these programs. (As of March 31, 2014) • 54 percent female, 46 percent male • 87 percent eligible for financial assistance • 13 percent bronze, 75 percent silver, 9 percent gold, 2 percent platinum and 2 percent catastrophic • 6 percent under age 18, 11 percent ages 18 to 25, 18 percent ages 26 to 34, 16 percent 35 to 44, 22 percent ages 45 to 54, and 27 percent ages 55 to 64 Source: U.S. Department of Health and Human Services Small Businesses There is no specified enrollment period for small business owners – those wishing to offer coverage to their employees can begin at any time during the year. This is true whether the employer purchases the coverage through an insurance agent or broker, the insurance company itself, or the ACA’s Small Business Health Options Program (SHOP) Marketplace. Learn more about the SHOP Marketplace at www.healthcare. gov/what-is-the-shop-marketplace/. Source: www.healthcare.gov Michigan X-ray MAC Journal • November/December 2014 13 Nutrition Get Smart About Adding Supplements In Practice, Success with Nutrition Chiefly Depends on How Much You Know and How Much You Show By Judy Weightman A growing number of chiropractors are adding nutrition to their practices, dispensing both nutritional advice and dietary supplements. Is this a direction you should explore? We gathered a panel of experts to answer the question. “Those who have a passion for and a knowledge of nutrition should pursue it” as an element in their practice, says James P. Powell, DC, consultant with Standard Process. “If you do it just to add income, you won’t succeed at the level you want.” Many, however, find that nutrition is a natural fit in chiropractic practices. The place to start is with the practitioner. Nutrition Trends for 2014 Chasse sees three main product trends ahead in 2014. • The increase in the use of probiotics for women’s health that we saw in 2013 will continue. Chasse anticipates that research will uncover more specific ways probiotics can be useful to your patients, enabling you to customize your recommendations. • As more baby boomers hit retirement age, interest in antiaging supplements, like reservatrol and other antioxidants, will continue to grow. • Consumer concern about genetically modified organisms is definitely extending from food to supplements. “We’re starting to see some products labeled as being made with non-GMO products, and I expect we’ll be seeing more and more of them,” Chasse says. 14 Key Customers Monk sees changes in who is visiting health practitioners and why. “The biggest change is the new focus on sports rehabilitation and performance medicine,” he says. Three groups in particular are part of this trend: stayat-home moms, who are increasingly involved in marathons and Ironman competitions; athletes in their 40s and older, who are more prone to injury and who don’t heal as quickly as they once did; and participants in the increasing number and variety of challenging endurance sports like mud runs. What all three of these groups have in common, Monk says, is that they don’t see themselves as sick – and, in fact, they’re not. “But if you have an athlete coming in with a pulled hamstring, seeking treatment for that, and they see you have supplements that will help them perform better, they’re going to be interested in them,” he says. Monk recommends exploring these opportunities: “Doctors need to position themselves, not just to deal with injuries, but to help with performance,” he says. “A lot of chiropractors are working with triathlete clubs and running groups – it’s one fo the biggest trends in chiropractic, and it’s working well for us.” “People don’t mention [nutrition-related] problems because they don’t realize their chiropractor can help,” Powell says. “So you have to make sure you’re asking about them” through either a check-in questionnaire or conversation during the exam. “If you don’t ask the questions, they won’t offer the information, so you can’t provide the help available,” Powell says. “Often, their primary complaint is another issue, but you can say to the patient, ‘there are nutritional approaches — would you like to explore them?’” Then, if they are interested, you can proceed with a full discussion and your recommendations. Knowledge is Power Successful practitioners need a solid foundation of knowledge about how supplements work and how to recommend them effectively. “One key attribute of nutritional superstars is their knowledge base,” says Lise Alschuler, ND, FABNO, naturopathic oncologist with Naturopathic Specialists LLC. “That knowledge translates to clinical success – and as people feel better, that translates into confidence in you, making patients more likely to follow [the regime you recommend].” Developing and maintaining that knowledge is an ongoing process: “Successful practitioners are those who pursue continuing education, whether it’s in person or through webinars; they’re active learners,” Alschuler says. “Doctors who are successful can talk about [supplements] the way they’d talk about pharmaceuticals,” says Jaclyn Chasse, ND, medical director for Emerson Ecologics. “They need to be able to explain how a particular product will help [a patient’s condition], how the patient should take it, and how to refill their supply.” Finding reliable sources of information can be its own challenge. “For most medical practitioners, that’s where their passions are, treating patients,” says Cheryl MAC Journal • November/December 2014 Media Misinformation Myers thinks a big trend in 2014 will be information – and misinformation. “I think a lot of practitioners have a love/hate relationship with the media,” she says, because they’re often a source of misleading or conflicting information. “One day, Dr. Oz says ‘eat an apple a day’ on his show, and the next day someone else comes along and says ‘wait a second, there’s cyanide in apple seeds.’” This leaves people bewildered about the appropriate nutritional path, she says. Alschuler sees a general media trend to be negative about supplements. “This feels like an attack – but it’s an opportunity for practitioners,” she says. “Doctors have the answers to the questions [the media raises]. They know which supplements do work, and for whom. Instead of the big generalized conclusions [that get published], it may be that a supplement is appropriate for a specific subset” of the patient population. sources [of information].” In addition, she says: “See what’s available through your professional network. There are some really good databases that can keep you up to date.” Practitioners who attend conventions and conferences should make it a point to talk to manufacturers exhibiting there. “Get information from them that you can take [with you] and validate by going back to original research” to confirm the claims, Alschuler advises. The Pros of Going Pro There are numerous advantages to offering professional brand supplements. “The most expensive product you’ll ever buy is the one that does absolutely nothing for you,” Myers says, and our other experts all agree with her. “With increased media coverage, patients come in asking their doctor about the benefits of particular dietary supplements,” Chasse says. “So doctors need to make sure the products have what they say they have” in terms of the active ingredients. “We [at Emerson Ecologics] do some of that work for them, so they can focus on treating their patients,” she adds. “With professional brands, you know the products are really high quality,” Alschuler says. “They go way above and beyond the current good manufacturing practices (cGMPs) requirements.” This is important, she says, because “the practi- Supplements - Continued from page 14 Myers, RN, head of education and scientific affairs for EuroPharma Inc. “They don’t have time to sit on the Internet to do buckets of research.” Myers encourages practitioners to work with supplement companies that have strong educational departments and can provide clinical data based on published research on the specific ingredient in question. In addition to providing data upfront, the company should be able to answer follow-up questions, she says. “Check out who’s on the staff, who’s on the board – are they MDs? NDs? There should be a broad spectrum of individuals; even if they’re unable to answer your question [immediately], someone in their orbit will be.” “Some of the professional brands are excellent resources,” Alschuler says. “They’re limited by the FDA in what they can say, but they can direct you to good MAC Journal • November/December 2014 tioner has lots of things in their head, with determining the right dose, and so forth. If you’re using professional quality, you don’t have to worry about whether it has contaminants,” as you do if you just suggest that your patient go to the drugstore or supermarket for something off the shelf. Contaminants are a significant issue in over-the-counter (OTC) brands. “It’s a major issue in the industry, especially around products for weight loss and sexual function – these tend to be highly contaminated,” Chasse says. The contamination often involves undisclosed pharmaceuticals with the problems stemming from the raw ingredients. “The manufacturer may be acting in good faith when buying ingredients, whether from the U.S. or China,” she says, “but the seller might have forged [the documentation] and the manufacturer might not know.” Some OTC brands “may be contaminated with drugs, or they may be less potent — or more potent — than the label indicates,” which means the patient will not get the benefits expected, Chasse adds. Distribution Details When you’re starting out with supplements, you may not want to start an in-office dispensary immediately. There are a couple of other options to consider, Alschuler says. The first is a virtual dispensary. Many companies have created Continued on page 19 Getting Started Adding nutritional counseling to your practice shouldn’t distract you from your primary therapeutic mission, says Powell. “If you decide to get into nutrition, pick a day or a half day each week – Tuesday afternoon, for instance – to devote to your nutritional patients,” leaving the rest of your week for your other patients. If your patients respond well, you may want to devote more time to nutritional counseling – or you may want to hire someone to do that while you continue to do chiropractic. “It’s difficult to succeed in both at the same time,” Powell says. “Nutrition takes time – but dollar for dollar, it can be the more lucrative part of the practice.” Consider adding a whole new department, perhaps hiring a naturopath. That’s what Powell has done: “In our office, we have four chiropractors and a naturopath [doing nutritional counseling], who has three staff people working with him. That department does as well as the chiropractic.” This is effective because of the holistic slant of Powell’s practice. “People come to the clinic for a whole variety of problems, not just pain,” he says. “I strongly believe that chiropractic, plus nutrition, plus lifestyle changes are the best way to do healthcare. We are primary care providers of natural healthcare.” 15 Wellness News New Report: Michigan Has 11th Highest Adult Obesity Rate in Nation Rates Increased in Only Six States Since Last Year As you know, in an effort to curb the high rate of adult and especially childhood obesity in Michigan, the MAC has partnered with the Michigan Department of Community Health to create the MAC Screening Program, which ties in with Governor Snyder’s “4x4 Program,” and www.MyMacWellness.com, a website that provides individuals, parents and children with free and low-cost wellness activities near their home, as well as general wellness advice. Local activities are available for nearly every region of the state. The following article shows that obesity is a major health crisis for both the state of Michigan and the United States as a whole. Initiatives like the MAC’s partnership with DCH can help alleviate this critical problem. A new study released by the Trust for America’s Health and the Robert Wood Johnson Foundation finds that Michigan is the 11th fattest state in the nation. The report, The State of Obesity: Better Policies for a Healthier America, found that the state’s obesity rate is 31.5 percent. National findings reveal that significant geographic, income, racial and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. The report also found that more than one in ten children become obese as early as ages 2 to 5. Other key findings from The State of Obesity include: After decades of rising obesity rates among adults, the rate of increase is beginning to slow, but rates remain far too high and disparities persist. • In 2005, the obesity rate increased in every state but one; this past year, only six states experienced an increase. In last year's report, only one state, Arkansas, experienced an increase in its adult obesity rate. • Obesity rates remain higher among Continued on page 17 Michigan-Specific Information • • • Michigan’s adult obesity rate has more than doubled since 1990 Michigan is one of 20 states with an obesity rate above 30 percent 10.4 percent of Michigan adults have diabetes Nationally • • • 16 Obesity rates increased in six states in the past year – Alaska, Delaware, Idaho, New Jersey, Tennessee, and Wyoming Rates did not decrease in any state Rates of obesity are above 35 percent for the first time ever in two states (Mississippi and West Virginia), are at or exceed 30 percent in 20 states, and are not below 21 percent in any state. MAC Journal • November/December 2014 Obesity - Continued from page 16 • • • • • Key Health Facts - Michigan Black and Latino communities than among Whites. Adult obesity rates for Blacks in Michigan were 39.3 percent. Overall, rates are at or above 40 percent in 11 states, 35 percent in 29 states and 30 percent in 41 states. Rates of adult obesity among Latinos in Michigan were 35.4 percent. Overall, rates exceeded 35 percent in five states and 30 percent in 23 states. Among Whites, adult obesity rates were 30.1 percent in Michigan. Overall, rates topped 30 percent in 10 states. Baby Boomers (45-to 64-year-olds) have the highest obesity rates of any age group - and 36.1 percent of Baby Boomers in Michigan are obese. Nationally, rates topped 35 percent in 17 states and 30 percent in 40 states. More than 6 percent of adults are severely obese (defined as BMI of 40 or more); the number of severely obese adults has quadrupled in the past 30 years. The national childhood obesity rate has leveled off, and rates have declined in some places and among some groups, but disparities persist and severe obesity may be on the rise. • As of 2011-2012: ◦◦ Nearly one out of three children and teens ages 2 to 19 is overweight or obese, and national obesity rates among this age group have remained stable for 10 years. ◦◦ More than 1 in 10 children become obese between the ages of 2 to 5; and 5 percent of 6- to 11-year-olds are severely obese. ◦◦ Racial and ethnic disparities emerge in childhood (ages 2-19): The obesity rates are 22.4 percent among Hispanics, 20.2 percent among Blacks and 14.1 percent among Whites. • Between 2008 and 2011, 18 states, including Michigan, and one U.S. territory experienced a decline in obesity rates among preschoolers from low-income families. Michigan Rank Total Population (2013 Census Estimate) 9,895,622 N/A % Poverty (2011-2012, two-year average) 14.3% 25 Uninsured, % All Ages (2012) 10.9 41 Uninsured, % 18 and Under (2012) 3.5 50 Michigan Rank Obesity Rates, % Adults (2012) 31.1 10 Hypertension Rates, % Adults (2011) 34.2 12 Diabetes Rates, % Adults (2012) 10.5 17 Adult Physical Inactivity (2012) 23.31 22 Obesity Rates, % High School Students (2011) 12.1 N/A Obesity Rates, % Children Age 10-17 (2007) 14.8 24 Michigan Rank 15.8 5 57,560 8 23.3 10 Michigan Rank Asthma Rates, % High School Students (2011) 24.6 N/A Infant Mortality per 1,000 Live Births (2010) 7.1 14 Low Birth Weight Babies (2012) 8.4 18 Tobacco, % of High School Students Current Tobacco Use (2011) 14.0 36 Michigan Rank 225 N/A -3,100 N/A F as in Fat 2013 Key Facts Adult Health Indicators Asthma Rates, % Adults (2010) Cancer, Estimated New Cases (2013) Tobacco, % of Adult Current Smokers (2012) Child & Adolescent Health Facts Other Public Health Indicators Health Professional Shortage Areas, Primary Care (as of 12/31/13) Nursing Shortage Estimates (2010) Source: Trust for America’s Health, http://healthyamericans.org/states/?stateid=MI MAC Journal • November/December 2014 Definitions of Obesity and Overweight Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. Overweight refers to increased body weight in relation to height, which is then compared to a standard of acceptable weight. Body mass index (BMI) is a common measure expressing the relationship (or ratio) of weight to height. Adults with a BMI of 25 to 29.9 are considered overweight, while those with a BMI of 30 or more are considered obese. Children with a BMI at or above the 95th percentile for their age are considered obese, and children with a BMI at or above the 85th percentile but below the 95th percentile are considered overweight. 17 Wellness News University of Minnesota Center for Spirituality & Healing Creates Integrative Health and Well-being Research Program Chiropractic Plays an Integral Part in Program, Funding Partially Provided by NCMIC The University of Minnesota’s Center for Spirituality & Healing, through its commitment to innovative research, recently launched their unique Integrative Health & Wellbeing Research Program. This program features a team of research faculty from diverse backgrounds, including chiropractic, epidemiology, and integrative health, who are embedded in a land grant, research-intensive institution. Capitalizing on a team science approach and the excellent research resources at the University of Minnesota, the new program will use various modes of inquiry to explore the science of wellbeing from holistic, interdisciplinary, and collaborative perspectives. The program is partially funded by the NCMIC Foundation. Lou Sportelli, DC, President of NCMIC Mutual Holding Company, said: “NCMIC provided a grant to partially fund the Center’s Integrative Health and Wellbeing Research Program because it was a fantastic opportunity to collaborate with a University whose innovative thinking is already eliminating the ‘barriers’ to health and wellbeing through interdisciplinary cooperation in clinical 18 The Research Team (from left): Pamela Jo Johnson, PhD, MPH, Gert Bronfort, DC, PhD, and Roni Evans, DC, MS, PhD. and research programs. This is truly a 21st Century innovative application to health and wellbeing, and so consistent with the chiropractic approach that the decision was really an easy one to make.” Faculty members include Gert Bronfort, DC, PhD; Roni Evans, DC, MS, PhD; and Pamela Jo Johnson, MPH, PhD. Together, they bring a complementary wealth of experience in the study of integrative approaches to a range of some of society’s most pressing health problems for culturally and age-diverse populations. “While the Center has been committed to supporting research in health and wellbeing throughout the University of Minnesota, we have not had a dedicated research core based within the Center,” says Center founder and director, Dr. Mary Jo Kreitzer, PhD, RN, FAAN. “The team will investigate the biological, psychological, social, environmental, and other dimensions of mind-body and integrative therapies. With this experienced and complementary team of researchers, fellows, and staff, the Center will be well positioned to secure original research funding, as well as fellowship and training grants vital for developing new researchers who share an integrative vision of wellbeing and health.” More information and updates about the program is available at z.umn.edu/ scienceofwellbeing Source: University of Minnesota Center for Spirituality & Healing MAC Journal • November/December 2014 Supplements - Continued from page 15 templates that the practitioner can set up to handle distribution and fulfillment, including auto-refill functions. You can also control how much of the overall inventory the patient has access to through various sign-in options. Another possibility is developing a relationship with an independent pharmacist. “Many have great inventories,” Alschuler says. The advantage here is that by working with a professional, even for over-the-counter products, you “make sure the patient is getting the right brands and can talk to someone knowledgeable about them at the time of purchase,” she adds. Most practitioners, though, sooner or later start their own dispensary. There are two advantages to dispensing supplements through your own practice: You can ensure that your patients are getting the best possible products, and you can add a lucrative revenue stream to your practice. It also enables better follow-up, since you can track whether or not a patient has refilled a prescription in a timely manner. Better compliance, of course, leads to better treatment results, further benefiting the patient. When starting a dispensary, though – start small. “Having a huge dispensary doesn’t necessarily mean you’re doing a good job,” says Timothy J. Monk, Jr., senior vice president of sales for Douglas Laboratories. “If you’re only selling six products, but you know how those six products work, you’ll have a high success rate with them, and a high rate of returning patients.” An all-too-common mistake is for practitioners to start too big, with too much, Chasse says. “Pick a few products with multiple functions” such as fish oil and probiotics. “[Unsuccessful doctors] go for something specific for every condition they might see. This is an expensive approach — if they don’t sell the products, they have to throw them out” when the expiration date passes. Chiropractic Federal Credit Union Making the Commitment Some practitioners feel hesitant, even guilty about selling supplements through their practice. They shouldn’t. “Most practitioners’ primary motivation is to help people,” Powell says, “but you also have to figure out how to make a business with it.” Altschuler agrees: “The key to success is being comfortable with the business part. There are lots of layers to being a small-business owner. If you’re not comfortable with that side, bring in an office manager to help you build an efficient, lean, effective practice.” And once you’ve decided to sell supplements, you will benefit from a full commitment from the entire staff, Monk says. “Training is critical. A well-organized and educated staff can provide information during the check- in process, in the waiting room, or at check out. Ideally, the nurse practitioner or the person at the front desk can explain the product and answer questions at the end of the appointment – the doctor is usually with another patient by then.” Judy Weightman is a writer and editor based in Philadelphia. In addition to health, she writes on higher education, gardening, and sustainability for both print and the Web. She can be contacted at jmweightman@gmail.com or followed on Twitter at JudyWEdu. “Article reprinted with permission from Vol. 60, Issue 3 (February 21, 2014), of Chiropractic Economics, your first source for news. For a free subscription, go to www.chiroeco.com/.” MAC Journal • November/December 2014 19 Nutrition What Does Michigan’s Chiropractic Scope Say About Nutrition? Chiropractic Scope Includes “Nutritional Advice,” According to Michigan Law The recent update of Michigan’s chiropractic scope of practice ensures that doctors of chiropractic in Michigan can continue to dispense nutritional advice. Under Michigan’s Public Health Code, specifically MCL 333.16401(e), the “Practice of chiropractic” means “that discipline within the healing arts that deals with the human nervous system and the musculoskeletal system and their interrelationship with other body systems.” Under the new law, the practice of chiropractic includes the following: (i) The diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as they relate to subluxations, misalignments, and joint dysfunctions. These diagnoses shall be for the purpose of detecting and correcting those conditions and disorders or offering advice to seek treatment from other health professionals in order to restore and maintain health. 20 (ii) The evaluation of conditions or symptoms related to subluxations, misalignments, and joint dysfunction through any of the following: (A) Physical examination. (B) The taking and reviewing of patient health information. (C) The performance, ordering, or use of tests. (D) The performance, ordering, or use of x-ray. (E) The performance, ordering, or use of tests that were allowed under section 16423 as of December 1, 2009. (iii) The chiropractic adjustment of subluxations, misalignments, and joint dysfunction and the treatment of related bones and tissues for the establishment of neural integrity and structural stability. (iv) The use of physical measures, analytical instruments, nutritional advice, rehabilitative exercise, and adjustment apparatus regulated by rules promulgated under section 16423. [Emphasis Added] Furthermore, even under the old restrictive scope of practice, the Michigan Supreme Court upheld the right of a doctor of chiropractic to dispense nutritional advice. In Attorney General v. Beno, the Court held that the Michigan legislature’s inclusion of the statutory provision on nutritional advice in the old scope allowed chiropractors to dispense vitamins or food supplements when employed as part of a program to correct a subluxation or misalignment of the spine. The Court held that, “We do not concur with the Court of Appeals majority on the question of the dispensing of the vitamin Nuclix; rather, we find that practice to be within the ‘nutritional advice’ aspect of chiropractic, when, as here, a non-drug and non-medicine substance is dispensed to help alleviate spinal subluxations or misalignments.” Sources: Michigan Chiropractic Scope of Practice, MCL 333.16401 Attorney General v Beno, 422 Mich 293, 344; 373 NW2d 544 (1985) MAC Journal • November/December 2014 CFCU Ohio Ad MAC Journal • November/December 2014 21 Chiropractic Summit Summit Documentation Article XVII: IF YOU GET A A REQUEST FOR RECORDS By Chiropractic Summit Documentation Committee First convened in September 2007, the Chiropractic Summit represents leadership from some 40 organizations within the profession. The Summit meets regularly to collaborate, seek solutions, and support collective action to address challenges with the common goal of advancing chiropractic. A major focus of the Summit has been to improve practitioner participation, documentation, and compliance within the Medicare system. The article that follows is the fourteenth in a series developed by RESPOND! the Chiropractic Summit Documentation Committee. In the last two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors1, 2. As noted, inadequate treatment plans and missing signatures are two of the top reasons for denial… when records are received, however, a larger problem is when the records are not received at all. Check Out the Summit’s Series of Documentation Articles! MAC Insurance Committee Recommends You Familiarize Yourself with All 17 of These Important Articles The Chiropractic Summit Documentation Committee has created a series of articles that are essential reading for any chiropractic office that wants to keep up with the latest trends regarding Medicare, proper documentation, and other topics. Articles include such topics as: • The Medicare Claim • Medicare Documentation Requirements • Medicare Audits • Medicare Appeals Process • PQRS • Medicare Enrollment and PECOS • Chiropractors’ #1 Medicare Documentation Error • Signing Notes • Medicare Record Requests For all 17 of these important articles, go to: www.chirosummit.org/ page/-Documentation-Articles.html. 22 In past reviews, non-response has frequently been the #1 reason for denial. Some examples from previous reviews are: Colorado – 57% non-response; New Mexico – 43% non-response; Oklahoma – 40% non-response; and Texas – 67% non-response. Previous CERT reviews have shown non-response rates of 73.4% and 80.6%. Last year, National Government Services noted non-response as a “key issue” for denial and, most recently, Railroad Medicare says that non-response accounted for 50% of their claim denials in the first quarter of this year. This is a huge issue. With our denial rates continually exceeding 70%, the number of chiropractic audits continues to rise. It is imperative that we learn what is required and comply with those requirements. Even more important is that we learn, when we get a request, WE MUST RESPOND. Even if you feel your notes are less than stellar, you need to submit them. Why? Because NOT responding: • Draws attention to you. If you submit your documentation, you have a chance it will be approved; if you don’t send it in, you are guaranteed a denial. If your documentation is found to be inadequate, most likely you would be given “provider education” on proper documentation; however, by not sending in your documentation at Continued on page 23 MAC Journal • November/December 2014 Records - Continued from page 22 all, it gives the impression you don’t have any. Providers who show a pattern of failing to comply with requests for documentation may be subject to corrective actions. Rather than just “education,” this could lead to payment suspension, monetary penalties, additional medical review, and/or an audit3. • Sends the wrong signal. We are the only profession with this level of nonresponse, and it makes it appear as if doctors of chiropractic are not willing to abide by the rules. Medicare contractors are authorized to request medical documentation and providers are obligated to comply (both with having the required documentation and submitting it when asked), if they expect to receive payment4. Due to the high rate of non-response, and the subsequent high error rate, you are potentially subjecting not only yourself, but the entire profession, to increased scrutiny. In addition, it makes it difficult to advance the profession into increased Medicare coverage and/or full physician parity. • Skews our denial rate. By submitting all requested records, we could lower our denial rate by as much as 40 percentage points. This, of course, is not likely (at least at first), but we could realistically lower the rate by approximately 15 percentage points. • Does not give us a clear picture of where weaknesses actually exist. Perhaps most importantly, by having a good understanding of the reasons for denial, we can learn where to focus our educational efforts and also where there may be differences between the contractors and the profession in the interpretation of regulations. Bottom line? When you receive a request for records, remember that it is in your best interest, and in the best interest of the profession, to RESPOND. As Nike says… “Just do it!” The current members of the Summit Subcommittee on Documentation are Dr. Frank Nicchi, Ms. Susan McClelland, Dr. Steven Kraus, Dr. Salvatore LaRusso, Dr. Peter Martin, Mr. Robert Moberg, and Mr. David O'Bryon. Ms. McClelland served as the principal author of this article. Citations (1) Dynamic Chiropractic; January 15, 2014; Vol. 32; Issue 02; “Our No.1 Medicare Documentation Error” (2) Dynamic Chiropractic; July 1, 2014; Vol. 32; Issue 13; “A Common Medicare Documentation Error:Are You Signing Your Notes?” (3) The Medicare Program Integrity Manual, Chapter 3, Section 7. This section also defines a “pattern” as two or more additional documentation requests that have gone unanswered. (4) The Social Security Act, Section 1833(e), states “No payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.” Section 1815(a) states “…no such payments shall be made to any provider unless it has furnished such information as the Secretary may request in order to determine the amounts due such provider under this part for the period with respect to which the amounts are being paid or any prior period.” Leslie M. Kohn, Esq. MAC Journal • November/December 2014 23 Insurance Issues Chiropractors: Medicare Audits in 2014 OIG “Work Plan” Plan Specifically Mentions Three Areas Where DCs Can Expect Audits Since its establishment in 1976, the U.S. Department of Health and Human Service’s (HHS) Office of the Inspector General (OIG) has worked to fight waste, fraud, and abuse in Medicare, Medicaid, and more than 300 other HHS programs. They accomplish this task by conducting investigations and audits. Each year, the OIG releases its “Work Plan” for the upcoming fiscal year. The Plan sets forth various projects to be addressed during the fiscal year and provides brief descriptions of activities that OIG plans to initiate or continue with respect to HHS programs and operations. The 2014 Plan specifically mentions three areas that doctors of chiropractic and their staffs should be aware of: • Portfolio Report on Medicare Part B Payments • Part B Payments for Non-covered Services • Questionable Billing and Maintenance Therapy While these areas are specifically mentioned for chiropractors, this does not mean they are the only areas DCs and their staffs must concern themselves with. Other areas – including requesting documentation from those who have attested to meaningful use of an electronic health records (EHR) system – may be audited as well. Portfolio Report on Medicare Part B Payments OIG will “compile the results of prior OIG audits, evaluations, and investigations of chiropractic services paid by Medicare to identify trends in payment, compliance, and fraud vulnerabilities and offer recommendations to improve detected vulnerabilities.” The Plan notes that prior OIG work “identified inappropriate payments for 24 chiropractic services that were medically unnecessary, not documented in accordance with Medicare requirements, or were fraudulent.” Keep in mind: • Medicare does not pay for items or services that are “not reasonable and necessary for the diagnosis and treatment of illness or injury or to improve the functioning of a malformed body member.” (Social Security Act, §1862(a)(1)(A)) • Part B pays only for a chiropractor’s manual manipulation of the spine to correct a subluxation if there is a neuromusculoskeletal condition for which such manipulation is appropriate treatment. (42 CFR § 410.21(b).) • CMS’s Medicare Benefit Policy Manual, Pub. No. 100-02, ch. 15, §30.5, states that chiropractic maintenance therapy is not considered to be medically reasonable or necessary and is therefore not payable. • Further, §240.1.2 of the Manual establishes Medicare requirements for documenting chiropractic services. The planned portfolio document will “offer new recommendations to improve Medicare chiropractic vulnerabilities detected in prior OIG work.” Part B Payments for Non-Covered Services OIG will “review Medicare Part B payments for chiropractic services to determine whether such payments were claimed in accordance with Medicare requirements.” The Plan notes that prior OIG work “identified inappropriate payments for chiropractic services furnished during calendar year (CY) 2006. Subsequent OIG work (CY 2013) also identified unallowable Medicare payments for chiropractic services.” Keep in mind: • Part B pays only for a chiropractor’s manual manipulation of the spine to correct a subluxation if there is a neuromusculoskeletal condition for which such manipulation is appropriate treatment (see above). • Chiropractic maintenance therapy is not considered to be medically reasonable or necessary and is therefore not payable (CMS's Medicare Benefit Policy Manual, Pub. No. 100-02, ch. 15, § 30.5B.) • Medicare will not pay for items or services that are “not reasonable and necessary.” (Social Security Act, § 1862(a)(1)(A)) Questionable Billing and Maintenance Therapy OIG will “determine the extent of questionable billing for chiropractic services” and “identify trends suggestive of maintenance therapy billing.” The Plan notes that previous OIG work has “demonstrated a history of vulnerabilities relative to inappropriate payments for chiropractic services, including recent work that identified a chiropractor with a 93-percent claim error rate and inappropriate Medicare payments of about $700,000.” It further notes: “Although chiropractors may submit claims for any number of services, Medicare reimburses claims only for manual manipulations or treatment of subluxations of the spine that provides ‘a reasonable expectation of recovery or improvement of function.’ Moreover, Medicare does not reimburse for chiropractic maintenance therapy.” Prepare! The best way to prepare is to make sure your records are in order. The ChiroContinued on page 25 MAC Journal • November/December 2014 Medicare - Continued from page 24 practic Summit Documentation Committee notes that the purpose of the medical review process is to make sure claims are paid correctly. DCs need to take certain measures to help meet this goal: • Review and read all Contractor provider publications and be aware of Local Coverage Determination (LCD) coverage requirements and billing instructions. • Make sure office staff and billing vendors are familiar with claim filing rules. • Check records against billed claims. • Perform mock record audits to ensure documentation reflects the requirements outlined in the LCD. • Educate Medicare patients regarding any specific coverage limitations or medical necessity requirements for those services provided. • The provider should keep in mind the following points: ◦◦ Documentation must be provided, when requested, for every service selected for MR ◦◦ Documentation should demonstrate that the patient’s condition warranted the type and amount of services provided ◦◦ Documentation must be legible, even if it is dictated or transcribed (be sure to include originals) ◦◦ Daily notes must be signed, and ◦◦ Each service must be coded correctly. The Chiropractic Summit Documentation Committee’s articles, “Medicare Audits – What the Chiropractor Needs to Know,” (Parts I and II), are available online at www.chiropracticsummit.com under “Documentation Articles.” Medicare Incentive Payments for Adopting Electronic Health Records (EHR) The work plan notes that OIG will “review Medicare incentive payments to eligible health care professionals and hospitals for adopting electronic health records (EHR) and the Centers for Medicare & Medicaid Services (CMS) safeguards to prevent erroneous incentive payments. OIG will review Medicare incentive payment data from 2011 to identify payments to providers that should not have received incentive payments (e.g., those not meeting selected meaningful use criteria). Medicare incentive payments are authorized over a five-year period to physicians that demonstrate meaningful use of certified EHR technology. Incentive payments began in 2011 and are scheduled to run through 2016, with payment reductions to health care professionals who fail to become meaningful users of EHRs beginning in 2015. According to Congressional Budget Office (CBO) estimates, CMS’s net spending for incentives will total about $20 billion. Any provider attesting to receive an EHR incentive payment for either the Medicare or Medicaid EHR Incentive Program potentially can be subject to an audit. For CMS information on how to make sure your office is prepared: https://questions.cms.gov/faq.php?faqId=7711. Premier MRI MAC Journal • November/December 2014 25 News from the F4CP “Recommend One” Debuts! Campaign Promotes Chiropractic as a Career, Engages DCs, Students, Colleges, Media, State Associations and Vendors The Foundation for Chiropractic Progress (F4CP) – the not-for-profit organization dedicated to raising awareness about the value of chiropractic care – recently launched the exciting new “Recommend One” campaign at the Florida Chiropractic Association National Convention & Expo. The campaign has gained the support of all national chiropractic associations – Association of Chiropractic Colleges (ACC), International Chiropractors Association (ICA), American Chiropractic Association (ACA), and Congress of Chiropractic State Associations (COCSA). “It is gratifying to witness all of the national chiropractic organizations getting behind the Recommend One campaign,” Gerard Clum, DC, and Mike Flynn, DC, said in a joint statement. “We are excited about the potential that this campaign brings to our chiropractic colleges and, subsequently, to the entire profession.” Recommend One is a targeted, cooperative campaign that encourages doctors of chiropractic to recommend a career in chiropractic to patients, family and friends. The campaign was prompted by several industry surveys that confirmed the interest of doctors in recommending chiropractic as a career, as well as the great influence of doctor recommendations. For more information, go to http://www.f4cp.com/resources/recommend-one. Progress Report: F4CP Shares Successes of Athletic TIPS™ Program F4CP is proud to share the tremendous progress of its latest program, Athletic TIPS™ (Toward Injury Prevention in Sports). Positive advancements have occurred in many areas, including: training seminars and community workshops, partnership development, and online presence. “We have carefully strategized the program’s path to success and, with each day, we continue to move forward on that journey,” says Kent S. Greenawalt, chairman, F4CP. “It is essential that Athletic TIPS™ enters the marketplace in a position to succeed. With proper execution, this program has the potential to provide the chiropractic profession with the unique opportunity to better serve society.” Athletic TIPS™ is a national, not-for-profit organization that drives expanded awareness and education around the role of multi-disciplinary care in the recognition, management, and prevention of sports-related injuries. This year, the program has achieved the following: • Published its Athletic TIPS Playbook™ • Trained more than 200 doctors of chiropractic to conduct educational community workshops • Conducted community workshops on sports-related concerns to nearly 1,000 coaches nationwide • Developed an interactive online platform capable of complex functionality • Partnered with the Women’s Premier Soccer League (WPSL), as well as Continued on page 27 26 MAC Journal • November/December 2014 Insurance Issues REMINDER: ICD-10 Compliance Date is October 1, 2015 Watch the Journal and Week in Review for Info on MAC-Sponsored ICD-10 Seminars in 2015! On July 31, 2014, the US Department of Health and Human Services (HHS) issued a rule finalizing October 1, 2015, as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10, the tenth revision of the International Classification of Diseases. This deadline allows providers time to ramp up their operations to ensure their systems and business processes are ready to go on October 1. The MAC held six ICD-10 seminars throughout the state in 2014 in anticipation of the deadline. We will be holding additional seminars – as well as refresher courses for those doctors and CAs who took the course in 2014 – in 2015. Stay tuned to the MAC Journal and Week in Review for more information as it becomes available. Why the Change? ICD-10 codes on a claim are used to classify diagnoses and procedures on claims submitted to Medicare and private insurance payers. By enabling more detailed patient history coding, ICD-10 can help to better coordinate a patient’s care across providers and over time, ICD-10 will also: • Improve quality measurement and reporting • Facilitate the detection and prevention of fraud, waste, and abuse, and • Lead to greater accuracy of reimbursement for medical services The code set’s granularity will improve data capture and analytics of public health surveillance and reporting, national quality reporting, research and data analysis, and provide detailed data to enhance health care delivery. Health care providers and specialty groups in the United States provided extensive input into the development of ICD-10, which includes more detailed codes for Recommend - Continued from page 26 the conditions they treat and reflects advances in medicine and medical technology. Using ICD-10, doctors can capture much more information and better understand important details about the patient’s health than with ICD-9-CM. Moreover, the level of detail that is provided for by ICD-10 means researchers and public health officials can better track health outcomes. ICD-10 reflects improved diagnosis of chronic illness and identifies underlying causes, complications, and conditions that contribute to a condition’s complexity. Additionally, the previous revision, ICD-9-CM, contains outdated, obsolete terms that are inconsistent with current medical practice, new technology, and preventive services. For additional information about ICD-10 from the Centers for Medicare and Medicaid Servces (CMS), go to www.cms.gov/ ICD10. Source: US Department of Health and Human Services China Gel several national and state chiropractic associations “We are eager to launch Athletic TIPS™ to the public, as it addresses the critical need to educate youth athletes, their parents/guardians, and their coaches about sports-related injuries,” says Greenawalt. “At this moment in time, the team is working diligently to reinforce core operations and carry out final preparation activities to ensure a seamless and successful roll out. In the interim, I encourage the entire profession to get involved, get ready and get excited!” For more information about Athletic TIPS™ and how to get involved, visit: www.f4cp.com/athletic-tips or www.tips4sports.org. MAC Journal • November/December 2014 27 Insurance Issues Medicare Open Enrollment Period Began October 15! Tell Your Patients to Fully Research Any New Plan Prior to Enrolling! Each year, Medicare plans change what they cost and what they will cover. Medicare’s Open Enrollment Period (OEP) – the time when Medicare beneficiaries who want to make changes to their prescription drug plans or Medicare Advantage coverage can do so – runs from October 15 through December 7. This will be the only chance most Medicare beneficiaries have to make a change to their health and prescription drug coverage for 2015. During the OEP, Medicare beneficiaries may: • Switch from Original Medicare (Medicare Parts A and B) to a Medicare Advantage (Medicare Part C) plan • Switch from a Medicare Advantage plan back to Original Medicare • Switch from one Medicare Advantage plan to another. This might involve switching from a plan without Medicare Part D prescription drug coverage to one that has it, or vice versa • Make changes to their Medicare Part D prescription drug plan, like joining a Part D plan, switching from one Part D plan to another, or dropping a Part D plan altogether Enrollment changes take effect on January 1. Once the Open Enrollment Period closes, most beneficiaries cannot make any changes to their Medicare plan until the following year. Medicare beneficiaries do not have to change enrollment each year. If they like their current coverage, and their plan is offered for 2015, they can keep their coverage as it is. However, because this time comes but once a year, it’s a good idea to encourage your Medicare patients to evaluate their coverage during the OEP every year so that they will know if they have the best coverage options available or if they need to make some changes. Medicare Part C (Medicare Advantage) Many seniors will face decisions regarding Medicare’s prescription drug benefit. Medicare beneficiaries can access this A Closer Look at Medicare Advantage • Enrollment in Medicare Advantage plans continues to grow: 30 percent of Medicare beneficiaries are now in the private plans, which typically are managed care plans. • For 2015, the number of Medicare Advantage plans available to Medicare beneficiaries is 2,450, a 3 percent drop from 2014. • Most Medicare Advantage coverage plans are HMOs. For 2015, the number of HMOs will increase by 1.5 percent, to 1,747, while the number of preferred provider organizations will drop by nearly 9 percent, to 541, according to Avalere. • About two-thirds of Medicare Advantage beneficiaries are currently in HMOs, while 31 percent are in PPOs. Source: Kaiser Health News 28 benefit in one of two ways – by subscribing to a Part D plan (a stand-alone drug plan) or by joining a Part C (managed care) plan. Because of the number and complexity of Part D plans to choose from, many seniors may move to Part C to avoid the confusion. With the new enrollment period already underway, it is now time for the entire Medicare population to revisit their care and make changes, and many may decide to join Part C. If a beneficiary elects Part D, their chiropractic coverage should remain unaffected, as Part D is simply an add-on to their typical Part B (outpatient fee-for-service) service. However, if a beneficiary joins Part C, they will join a PPO or HMO that significantly restructures the delivery of services they receive under Part B, such as greatly increasing their copays. This could cause many problems for chiropractic patients. First, chiropractors could be classified as specialists, significantly increasing the co-pay per visit. Second, many HMOs do not have DCs in their networks; rather, they offer so-called “chiropractic services” through MDs or DOs. Third, many insurers offering Part C plans are administering their chiropractic services through a network, such as ACN. Problems with networks such as these are well documented. The key is to ensure that your patients are informed of the ramifications of switching to Medicare Part C. The MAC has developed a fact sheet for you to give to your patients with Medicare. MAC members can find this on the Members Resource Pages, Under Important Forms. You may also contact Tim at the MAC office at (800) 949-1401 or tim@ chiromi.com for a copy to print, copy, and give to your Medicare patients. MAC Journal • November/December 2014 MAC Webinars Available! MAC WebEd: Distance-Learning Courses for CE Credit! The MAC has developed an incredible online resource to make our educational programs available to you 24/7, in the privacy of your own home or office! Our online courses cover a variety of topics, Our Course Library State of Michigan Required Credit Webinars • Extremities and Rehab: Maximizing the Human System (50 Minutes, 1 CE)* – Dr. Gary Blackburn • The Gait Cycle (250 minutes, 5 CEs)* – Dr. Kirk Lee • Safe, Natural Alternatives for Managing Pain (50 Minutes, 1 CE)* – Dr. George Gedevanishvili • Ethics and Boundaries (100 minutes, 2 CEs)** - Attorney Joe Barberi (available each November only) * Satisfies State of Michigan Pain and Symptom Management requirement. ** Satisfies State of Michigan Ethics requirement and Sexual Boundaries requirement. including the State of Michigan-required pain and symptom management, practice management, nutrition, and other topics critical to your practice. All of our webinars have been approved by the Michigan Board of Chiropractic for continuing education credit. For full course descriptions and registration information, go to: http://macuniversity.myicourse.com/. MAC Members receive discounted rates on all MAC Web-Ed webinars. To obtain your discount code, contact the MAC office at (517) 367-2225 or chrissy@chiromi.com. Practice Management Webinars • Workers Compensation (50 Minutes, 1 CE) – Mr. Carl Alden • Medicare (50 Minutes, 1 CE) – Dr. Christopher Dolecki • Documentation and ICD-10 (100 minutes, 2 CEs) – Mr. Carl Alden Nutrition Webinars with Dr. George Gedevanishvili • Detoxification and Cleansing with Nutritional Supplements (50 Minutes, 1 CE) • Natural Supplement Choices for Stress (50 Minutes, 1 CE) • Benefitting From a Supplemental Weight Loss Program (50 Minutes, 1 CE) Remember to Deduct Your Dues! MAC Members: Remember to deduct your dues! MAC membership dues have historically been very highly deductible. You should be able to claim 98 percent for any dues paid by December 31, 2014 – even if your payment is for 2014 dues! If you are already a member, this is a great time to upgrade your membership to one of our VIP Clubs (President’s, MAC Journal • November/December 2014 Ambassador’s, and Century) and take advantage of the additional benefits of our highest level of membership. Note to Non-Members: Now is an excellent time to join the MAC and take advantage of the excellent tax deduction our esteemed association has to offer. Not only can you be a part of the nation’s premier chiropractic association and reap the benefits of membership throughout the year, but your dues offer an excellent tax break. The tax deductibility of MAC dues is determined by the IRS and Congress and is based on the amount of money we spend on direct lobbying. Contact the MAC office at (517) 367-2225 for details on upgrading your membership or becoming a member! 29 Government Relations MDCH Director James Haveman: An Appreciation In August, Governor Snyder announced that he had accepted the resignation of Michigan Department of Community Health (MDCH) Director Jim Haveman, effective September 12. Director Haveman resigned to focus on his health after suffering a mild stroke on Memorial Day. “Director Haveman’s leadership has been instrumental as we’ve navigated an ambitious health and wellness agenda that Jim Haveman, Dr. Dennis Whitford, and Dr. Christophe Dean at the September MAC Board Meeting. has led to inclusive, bipartisan support to implement a number of key health initiatives that are making a real difference in Michiganders’ lives,” Governor Snyder said. “Jim’s commitment to the health and wellness of our residents has been evident in all that we’ve accomplished and I am grateful for his work. I understand and respect his decision to focus on his health and wish him and his family all the best.” Despite his resignation, Director Haveman attended the September MAC Board of Directors meeting, highlighting how important DCH considers our partnership through the MAC Screenings Program, which is designed to get MAC members 30 into their local communities talking about chiropractic wellness while also promoting Governor Snyder’s “4x4 Program.” During his most recent tenure at DCH, Haveman led the State in the “4x4 Plan” and other important health initiatives, including the implementation of Healthy Michigan, the State’s expansion of Medicaid under Obamacare. In a press release, the State of Michigan noted that through these and other efforts, Michigan has moved from the fifth to the tenth most obese state in the nation, the movement toward better integrated mental health and substance abuse treatment into the health care delivery system has continued, and more than 375,000 residents are already enrolled in the Healthy Michigan Plan after only five months. Director Haveman joined the Snyder Administration in 2012, becoming the Governor’s second DCH Director. He was no stranger to the issues surrounding health care and state government, as he previously served as Director under Governor John Engler from 1996-2003. He also served as Governor Engler’s DiContinued on page 31 MAC Journal • November/December 2014 MDCH - Continued from page 30 rector of the Department of Mental Health from 1991 to 1996. Meet the New Director of DCH: Nick Lyon Looking to ensure a seamless transition from Director Haveman to his replacement, Governor Snyder appointed Havemen’s Chief Deputy Director, Nick Lyon, who has been with DCH in a variety of Financial Is Your Practice Incorporated? A PLLC? Be Sure to File Your Annual Report/ Statement with the State of Michigan Michigan law requires corporate entities to file an annual report and limited liability companies to file an annual statement each year. Current and prior year annual reports or annual statements for the following types of entities in good standing may be filed online: • Michigan corporations (including professional service corporations) • Michigan and foreign limited liability companies (including professional service limited liability companies) Easy Filing With FILEOnline positions since 2003. He became Deputy Director in 2011. “It is the faith that I have in Nick Lyon as my successor that I feel comfortable stepping away in September,” Haveman said of his replacement. “Nick and I have worked extremely well together over the past two years and I know he will be an outstanding and dedicated Director of the Michigan Department of Community Health.” Prior to joining DCH, Lyon served as the Director of the Office of Budget Development and General Government within the State Budget Office. He previously served as the Finance Officer for the Department of Attorney General. Born and raised in the Lansing area, he earned a Bachelor of Arts degree in Economics and Political Science from Yale University in 1990. Congratulations, Director Lyons, on your new appointment, and we look forward to continuing our fruitful partnership with DCH! Source: State of Michigan, www.michigan.gov MAC Journal • November/December 2014 Annual statements and reports may be filed online with the state of Michigan through their easy-tonavigate FILEOnline feature, found at www.michigan.gov/fileonline. You must have a valid Visa or MasterCard to file a report online, and the corporation or limited liability company must be in “good standing.” When submitting annual reports and statements, only include what is required on the report or statement. Inclusion of non-required confidential information will delay the filing of the annual report or statement. When is the first report or statement due? • Profit corporations (including PCs): May 15 after the year of incorporation • Nonprofit corporations: October 1 after the year of incorporation • Limited Liability Companies (including PLLCs): February 15 after the year of formation or qualification, unless organized or qualified after September 30, in which case the LLC need not file a statement on the February 15 immediately succeeding its formation or qualification. Fees and Late fees The following late fees apply if the state of Michigan does not receive the necessary annual report or statement by the required date. • Professional Limited Liability Companies. The fee for submitting an annual statement is $75. If submitted after February 15, a late fee of $50 will be assessed. • Corporations (profit). The fee for submitting an annual report for a for-profit corporation is $25. Late Fees are as follows: ◦◦ May 16 – May 31 = $10 ◦◦ June 1 – June 30 = $20 ◦◦ July 1 – July 31 = $30 ◦◦ August 1 – August 31 = $40 ◦◦ September 1 and after = $50 (maximum) Online filing for the next report or statement owed is available beginning approximately 90 days prior to the due date. Once submitted online, the filed report should appear on the web within one hour. Use the state of Michigan Business Entity Search, found online at: http://www. dleg.state.mi.us/bcs_corp/sr_corp. asp, to view and/or print any filed documents or reports. Certified copies of documents may be obtained by calling the Business Services section at 517-241-6470, MondayFriday, 8am-5pm. Source: Michigan Department of Licensing & Regulatory Affairs (LARA) 31 National News – Veterans Issues NIH and VA Focusing on Drug-Free Approaches to Pain in US Military Chiropractic Treatment Model Among 13 Research Projects Funded to Explore Non-Drug Approaches to Managing Pain and Related Health Conditions In late September, the National Institutes of Health (NIH) and Department of Veterans Affairs (VA) announced the funding of 13 research projects totaling approximately $21.7 million over five years to explore non-drug approaches to managing pain and related health conditions, such as posttraumatic stress disorder (PTSD), drug abuse, and sleep issues. The effort seeks to enhance options for the management of pain and associated problems in U.S. military personnel, veterans, and their families. Among the funded projects is an effort at Palmer to develop an innovative and collaborative treatment model between chiropractors, primary care providers, and mental health providers for veterans with spine pain and related mental health conditions. This project is funded by the NIH’s National Center for Complementary and Alternative Medicine (NCCAM). “Pain is the most common reason Americans turn to complementary and integrative health practices,” said Jose- phine P. Briggs, MD, Director, NCCAM. “The need for nondrug treatment options is a significant and urgent public health imperative. We believe this research will provide much-needed information that will help our military and their family members, and ultimately anyone suffering from chronic pain and related conditions.” The men and women of our Armed Forces make incredible sacrifices in service to our country, and conservative (no drugs or surgery) approaches to pain management like chiropractic care are especially important and beneficial for our veterans, considering the following statistics: • Recent VA data [Analysis of VA Health Care Utilization Among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans] cite “diseases of Musculoskeletal System/Connective System,” such as back pain, as the number one ailment of Iraq/Afghanistan veterans accessing DVA treatment. • A 2013 Center for Investigative Reporting special report outlined data from the VA which found that prescriptions for four highly addictive painkillers have surged by 270 percent since the war in Afghanistan began. • VA research from 2011 revealed that the fatal overdose rate among veteran patients is nearly double the national average. • A June 2014 report in JAMA Internal Medicine showed an alarmingly high rate of chronic pain – 44 percent – among members of the U.S. military after combat deployment, compared to 26 percent in the general public. Additionally, 15 percent of U.S. military post-deployment use opioids, Continued on page 46 32 MAC Journal • November/December 2014 More on the Chiropractic Project Palmer Center for Chiropractic Research and Partners Receive 3-Year Grant to Study Veterans with Musculoskeletal Pain Palmer has been awarded a $718,241 grant by the National Institutes of Health’s National Center for Complementary and Alternative Medicine. The grant will fund a three-year research planning project to address questions about how chiropractic care might be best integrated into existing Veterans Health Administration (VHA) clinical practice guidelines for veterans with a combination of musculoskeletal pain and mental health conditions. “Chiropractic has been demonstrated to be both effective and safe in the treatment of musculoskeletal disorders,” said Principal Investigator Christine Goertz, DC, PhD, Palmer College of Chiropractic’s vice chancellor for research and health policy. “This led the DoD/VA Pain Management Task Force to recommend chiropractic as a Tier 1 treatment within its comprehensive pain-management pro- gram. However, the appropriate role for chiropractic in veteran populations, especially those with musculoskeletal pain and mental health disorders, requires further investigation.” U.S. military veterans report high levels of musculoskeletal pain, including back pain, neck pain, and headache, and have high rates of many mental-health conditions. The study team will: • Develop an integrative-care model that includes doctors of chiropractic in multidisciplinary teams treating patients with both musculoskeletal pain and mental-health conditions in the VHA. • Tailor existing chiropractic guidelines and best practices to link with current VHA pain-management initiatives. • Conduct a pilot clinical trial of this integrated-care model in caring for veterans with both musculoskeletal pain and mental health conditions. Source: Palmer College of Chiropractic Genius Solutions MAC Journal • November/December 2014 33 Legal Issues The Michigan Health Recovery Program Preventing Impaired Practice… Confidential & Effective Treatment By Dean Bender, DC Former Chiropractic Representative, Health Professional Recovery Committee Health care professionals are not immune to substance use and/or mental health disorders by virtue of their training or experience. These conditions can lead to impaired practice and the loss of health or life for the health care professional. Stress, long hours, and genetic predisposition can cause these problems to develop. Substance use and mental health disorders are treatable conditions. Appropriate treatment, followed by structured aftercare and monitoring, allows most health care professionals to return to a normal life and utilize their education and experience once again. What is the Health Professional Recovery Program (HPRP)? The Michigan HPRP was established by legislation in 1993. The program is designed to encourage health professionals to seek treatment for substance use and/ or mental health disorders before their impairment harms a patient or damages their careers through disciplinary action. The program is operated by a private sector contractor to maintain participant confidentiality and operates under the authority of the Health Professional Recovery Committee (HPRC). The chiropractic representative to the Committee is longtime MAC member Dr. Gordon Roberts of Hamilton. The Michigan Department of Licensing and Regulatory Affairs, Bureau of Health Care Services provides administrative services to the HPRC, as well as funding for the contract. How the Program Works The HPRP is a caring, supportive program that promotes recovery through evaluation for the presence of a substance use 34 disorder and/or mental health problem, design a recovery program that is specific for the individual, and actively monitors the individual's progress. The typical steps involved for participation in the HPRP are: REFERRAL Referrals to the program may come in the form of a self-referral from the individual licensee or from colleagues, partners, patients, family members or the State. Any of the health licensing boards, including the Michigan Board of Chiropractic, may also refer licensees to the HPRP for similar monitoring as part of a board order. INTAKE/EVALUATION After the initial intake, the licensee is referred to a qualified evaluator. The purpose of the evaluation is to determine eligibility for the program, the nature of the problem and to help the HPRP contractor to design a recovery plan. TREATMENT If the evaluation indicates a substance use and/or mental health disorder that represent a possible impairment, the HPRP makes referrals for treatment services to an approved provider. MONITORING The HPRP will work with the licensee to develop a written monitoring agreement that defines the requirements of participation and will typically last one to three years. The monitoring agreement may include elements such as: • Treatment • Limitations on practice • Random drug screens • Group/individual therapy • Medical oversight • Monthly/quarterly reports During the monitoring period, the HPRP will communicate with the licensee and their provider team in order to support the licensee's continued work in their professional setting. COMPLETION An HPRP participant will be released from the HPRP upon successful completion of the recovery monitoring agreement. All records are destroyed five years after the date of successful completion of the program. However, once a health professional is accepted into the program, he or she may be released for failure to comply with the agreement. Noncompliant participants are reported to the Bureau of Health Care Services as required by law, which could result in subsequent disciplinary actions. Confidentiality Participation in the HPRP is confidential. If a licensee is referred to the program, has a qualifying diagnosis, and complies with the HPRP requirements, his or her name will not be disclosed to state regulatory authorities or the public. Provided there is no readmission, records of HPRP participants are destroyed five years after successful completion. The names of those reporting suspected violations are also kept confidential unless testimony is needed at a later disciplinary hearing. Cost of Participation The total cost of participation may vary depending on an individual's diagnosis, severity of condition, insurance coverage, length of time in the HPRP, and compliance with HPRP requirements. An HPRP participant is responsible for the costs of evaluation, treatment, drug testing, and other services. REMEMBER Under Section 333.16223 of the Public Health Code, licensed/ registered health professionals are required to make good faith reports of suspected violations of the Code to the Department of Licensing and Regulatory Affairs, Bureau of Health Care Services. However, for purposes of substance abuse or mental illness, a report Continued on page 35 MAC Journal • November/December 2014 HPRP - Continued from page 34 to the HPRP meets the legal reporting requirement. If you suspect impairment, please call the HPRP at 1-800-453-3784 For more information on the Michigan Health Professional Recovery Program and how it works, go to www.hprp.org. Source: Michigan Health Professional Recovery Program Dr. Dean Bender served on the Health Professional Recovery Committee from 2006-2010. A 1981 graduate of Palmer, Dr. Bender is a longtime member of the Association, joining the Michigan State Chiropractic Association in 1982. He has served as a member of the MAC Board of Directors and as a district officer, and he currently serves on the MAC Education & Programs Committee. He also chairs the Membership Recruitment & Benefits Committee’s Member Benefits Subcommittee. He owns the Lawton Ridge Winery and has been in private practice in Kalamazoo for more than 30 years. Prior to becoming a chiropractor, he earned an MA in Counseling-Psychology from Western Michigan. Meet the Chiropractic Representative to the HRPR: Dr. Gordon Roberts Longtime MAC member Dr. Gordon Roberts of Hamilton serves as the Michigan Board of Chiropractic’s representative to the Health Professional Recovery Committee, the body charged with overseeing the program. A 1980 graduate of Palmer, Dr. Roberts has served on the Committee since 2011. His term expires December 31, 2015. A staff member of Allegan General Hospital, Dr. Roberts works in the Integrative Health Services department with an acupuncturist and massage therapist. Dr. Roberts has served on the ICA sports and fitness council, was awarded the excellence in international relations award for his participation in the ’88 Olympics in Seoul, and has been in private practice for more than 30 years. He is a member of the American Academy of Spine Physicians and the American Academy of Hospital Chiropractors. The Health Professional Recovery Committee is made up of representatives from the State of Michigan boards that oversee the professions served by the program, including the Board of Chiropractic, Board of Medicine, Board of Dentistry, Board of Acupuncture, Board of Osteopathic Medicine and Surgery, and more. MAC Journal • November/December 2014 Potential Signs of Impairment These are common signs of impairment due to substance use or mental health disorders. A health care professional who exhibits several of these common signs may be impaired: Emotional/Behavioral Changes • More withdrawn socially or professionally • More irritable, anxious, jealous, angry, depressed or moody • More defensive - becoming angry when someone mentions their use of drugs, drinking or emotional stability • Denying or expressing guilt or shame about personal use • Other mental health concerns that directly impact work performance Change in Work Habits • Missing work or frequently tardy • Failing to keep scheduled appointments • Late submissions of reports or assignments • Asking others to cover hours or errors • Unacceptable error rates Physical Changes • A deterioration in personal hygiene • Changes in eating patterns or body weight • Changes in sleeping patterns Substance Use/Addiction • Observed intoxicated behavior within the workplace • Reports of positive drug screen • Behavior that indicates impairment or addiction • Documented convictions or legal issues related to alcohol and/or other drugs Source: Michigan Health Professional Recovery Program 35 Financial Issues Tips for Preventing Data Breaches By Anne Heraghty With data breach stories so prevalent in the news, security is on the minds of most merchants and customers. Reviewing security policies and potential issues with employees is more important than ever. Reinforcing clear security practices with staff will go a long way. The National Cyber Security Alliance recommends that merchants take these specific steps to maintain cyber security in their businesses. 1. Have a strong security policy in place. First, always screen potential hires for their trustworthiness and ability to understand and stick to the rules. Those rules should be built around the compliance requirements of the Payment Card Industry Data Security Standard (PCI DSS). 2. Integrate your policy with a complete and documented cyber security plan. Cyber security means protecting your data and your systems from attack as well as maintaining card transaction vigilance. Your plan should be based on an assessment of your risks and vulnerabilities, with defined processes for monitoring threats and protecting customers in the event of a data breach. The FCC has a great tool called the Small Biz Cyber Planner to help generate a plan to suit your business: www.fcc.gov/ cyberplanner. 3. Train employees. Make it a priority to train employees in securely handling in-person and card-not-present transactions. Employees should also understand key basic security procedures, 36 such as how to create strong passwords, not clicking on links and attachments in emails, and what to do if they’re suspicious about any transactions. Make them aware of the activities that should arouse suspicion for a fraudulent transaction, like multiple transactions on a single card, several cards using the same address, rush delivery requests, very large quantities ordered and international orders. 4. Follow through and maintain constant vigilance. Criminals are constantly adapting their strategies — and they’re persistent in their efforts. So we have to adapt and persist, too. It’s vital that you stay abreast of cybercrime activity and continuously monitor employee adherence to your policies. Krebs is an excellent source to receive cyber security updates, including breaches: www. krebsonsecurity.com. 5. Finally, carry out spot checks on employees to ensure they’re following security procedures and, if you do suffer a card fraud incident, find out how it happened and communicate the lessons learned. For monthly news related to security and other industry issues, sign up for Veracity’s free eNewsletter: www.veracity. updatesfrom.co/subscribe. And, of course, use Veracity as a resource: 866-944-0055. Veracity Payment Solutions is a credit card processing company located in Lansing. For details on which mobile payment solutions best fit your business and how to make your systems EMV-compatible, call Veracity at (888) 944-0055. MAC Journal • November/December 2014 News from the Chiropractic Colleges Sherman College Awarded 2015 Military Friendly® Schools Designation Victory Media has named Sherman College of Chiropractic to the coveted Military Friendly® Schools list, a designation given to the top 15 percent of colleges, universities, and trade schools in the country that are doing the most to embrace military students, and to dedicate resources to ensure their success in the classroom and after graduation. Victory Media is the leader in successfully connecting the military and civilian world. A U.S. Navy veteran, Sherman College President Dr. Edwin Cordero said the Military Friendly® Schools designation has special meaning to him. “Sherman College has a tremendous opportunity to serve and honor our military service members who give so much to our country,” Dr. Cordero said. “We are eager to reach more military members and share with them a health care career that embraces their commitment to serving others. I think it is especially fitting, since Sherman College of Chiropractic holds service to others as a major component of its mission.” Inclusion on the list of Military Friendly Schools® shows a commitment to providing a supportive environment for military students, according to Victory Media. The need for education is growing, and Victory Media’s mission is to provide the military community with transparent, world-class resources to assist in their search for schools. The Military Friendly Schools® media and website (www.militaryfriendlyschools.com) feature the list, interactive tools, and search functionality to help military students find the best school to suit their needs and preferences. The institutions on this year’s list exhibit leading practices in the recruitment and retention of students with military experience. These schools have outstanding programs and policies for student support on campus, academic accreditation, credit policies, flexibility and other services to those who served. Now in its sixth year, the Military Friendly® Schools designation and list by Victory Media is the premier, trusted resource for post-military success. Military Friendly® provides service members transparent, data-driven ratings about post-military education and career opportunities. The methodology used for making the Military Friendly® Schools list has changed the student veteran landscape to one much more transparent, and has played a significant role over the past six years in capturing and advancing best practices to support military students across the country. The survey captures more than 50 leading practices in supporting military students and is available free of charge to the more than 8,000 schools approved for Post-9/11 GI Bill funding. The Military Friendly® Schools designation process includes extensive research and a data-driven survey of schools nationwide approved for Post-9/11 GI Bill funding. The school survey, methodology, criteria and weightings are developed with the assistance of an independent Academic Advisory Board comprised of educators from schools across the country. Source: Sherman College of Chiropractic MAC Journal • November/December 2014 Mark Your Calendar! MAC Spring 2015 Convention April 24-26, 2015 Adoba Eco, Dearborn, MI www.chiromi.com/macS15 37 Nutrition Common Popular Supplements Vitamin Chief Function Good Sources Plays an important role in vision, bone growth, reproduction, cell Vitamin A (Provitamin, division, and cell differentiation (in which a cell becomes part of the brain, muscle, lungs, etc.); helps regulate the immune sysCarotene) tem, which helps prevent or fight off infections by making white blood cells that destroy harmful bacteria and viruses Whole eggs, milk, liver, carrots, spinach, kale, cantaloupes, sweet potatoes; most fat-free milk and dried nonfat milk solids sold in the US are fortified with vitamin A to replace the amount lost when the fat is removed Vitamin B1 (Thiamin) Aids in carbohydrate metabolism; essential for normal digestion and appetite; vital for nervous system, cardiovascular, and muscle function Whole-grain cereals, peas, beans, oranges, peanuts, many other fruits, vegetables and nuts, as well as heart, liver, and kidney Vitamin B2 (Riboflavin) Helps the body release energy from protein, fat, and carbohydrates during metabolism; required for red blood cell formation and respiration, antibody production, and for regulating human growth and reproduction; essential for healthy skin, nails, hair growth and general good health, including regulating thyroid activity Milk, cheese, leafy green vegetables, legumes, liver, yeast, almonds, and mature soybeans (Note: exposure to light will destroy the riboflavin in these natural sources; foods with riboflavin should not be stored in glass containers that are exposed to light) Vitamin B3 (Niacin) Helps the body to convert carbohydrates into glucose (sugar), which is “burned” to produce energy; essential in the breakdown of fats and protein; plays an important role in the health of the nervous system, skin, hair, eyes, mouth, and liver; also plays an important role in ridding the body of toxic and harmful chemicals Beats, wheat germ, brewer’s yeast, beef liver, beef kidney, pork, turkey, chicken, veal, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Biotin (Vitamin H) Used in cell growth, the production of fatty acids, metabolism of fats, proteins, and amino acids; also helpful in maintaining a steady blood sugar level; plays a role in process in which energy is released from food Cheese, beef liver, cauliflower, eggs, mushrooms, egg yolks, chicken breasts, salmon, spinach, brewer's yeast, nuts, bananas, tomatoes, and whole grains Vitamin C Acts as an antioxidant, a nutrient that protects cells against the effects of free radicals, potentially damaging by-products of energy metabolism (Free radicals can damage cells and may contribute to the development of cardiovascular disease and cancer); required for the growth and repair of tissues in all parts of the body; necessary to form collagen, an important protein used to make skin, scar tissue, tendons, ligaments, and blood vessels; essential for the healing of wounds, and for the repair and maintenance of cartilage, bones, and teeth Citrus fruits and juices, green peppers, strawberries, tomatoes, broccoli, turnip greens and other leafy greens, sweet and white potatoes, cantaloupe, papaya, mango, watermelon, brussel sprouts, cauliflower, cabbage, winter squash, red peppers, raspberries, blueberries, cranberries, and pineapples Calcium More than 99% of total body calcium is stored in the bones and teeth, where it functions to support their structure; the remaining 1% is found throughout the body in blood, muscle, and the fluid between cells; needed for muscle contraction, blood vessel contraction and expansion, the secretion of hormones and enzymes, and sending messages through the nervous system Milk, yogurt cheese, Chinese cabbage, kale, spinach, watercress, liver, seafood (salmon, sardines, and shellfish), calcium-fortified orange juice Vitamin D Major biologic function is to maintain normal blood levels of calcium and phosphorus; helps to form and maintain strong bones; works in concert with a number of other vitamins, minerals, and hormones to promote bone mineralization Vitamin D is made in the body after exposure to ultraviolet (UV) rays from the sun; sunshine is a significant source of vitamin D because UV rays from sunlight trigger vitamin D synthesis in the skin; also found in cod liver oil, fish (salmon, mackerel, sardines), and fortified dairy products Vitamin E Acts as an antioxidant (see Vitamin C); might help prevent or delay the development of such chronic diseases as cancer and cardiovascular disease; has also been shown to play a role in immune function, DNA repair, and other metabolic processes Vegetable oils, nuts, green leafy vegetables, broccoli, whole-grain and fortified cereals Echinacea Traditionally been used to treat or prevent colds, flu, and other infections. Believed to stimulate the immune system to help fight infections. Less commonly, echinacea has been used for wounds and skin problems, such as acne or boils. The aboveground parts of the plant and roots of echinacea are used fresh or dried to make teas, squeezed (expressed) Continued on page 39 38 MAC Journal • November/December 2014 New Members Steven Antoniotti DC, 1820 S Westnedge Ave Suite 1, Kalamazoo, MI 49008. Logan College. Licensed since 2013. First Year Member. District 6. Levi Bernath DC, 713 Capital Ave., Ste. 3, Battle Creek, MI 49015. Palmer College. Licensed since 2008. Century Club. District 6. Jerod Bradley, 855 N. Cass Ave., Vassar, MI 48768. Palmer College of Chiropractic. Expected date of graduation 2008. Mervin Brown DC, 824 W. Maumee St., Adrian, MI 49221. Palmer College. Licensed since 1972. Retired Member. District 4. Kenneth Cooper DC, 693 Capital Ave. SW, Battle Creek, MI 49015. Life University. Licensed since 2001. Century Club. District 6. Natalie Dabrowny DC, 4101 John R. Rd., Ste. 300, Troy, MI 48085. Palmer College. Licensed since 2014. First Year Member. District 3. Brianna Donnelly, 7882 Carson Rd., Brockway Twp., MI 48097. Life Univer- Dr., Kimball, MI 48074. Life University. Licensed since 2014. First Year Member. District 2. Michael Meath DC, 2730 Carpenter Rd., Ste. 3, Ann Arbor, MI 48108. Licensed since 2005. Century Club. District 4. sity. Expected date of graduation 2018. Student Member. District 2. David Gavron DC, 1469 Cranberry Ct., Wixom, MI 48393. Life University. Licensed since 2014. First Year Member. District 3. Justin Jwad, 6970 Golden Ct., West Bloomfield, MI 48322. National University. Expected date of graduation 2014. Student Member. District 3. Ronald Keller DC, 6580 Academy Dr., Brighton, MI 48116. Parker College. Licensed since 2008. Century Club. District 4. Paul Kelly DC, 1689 S. 37 Rd., Cadillac, MI 49601. Palmer College. Licensed since 1987. Retired Member. District 8. Mark Kinnard DC, 393 S. Main St., Romeo, MI 48065. Sherman College. Licensed since 1989. Century Club. District 2. Kenneth Large DC, 28629 Hoover Rd., Warren, MI 48093. Lincoln College. Licensed since 1969. Regular Member. District 2. Ryan Newcombe DC, 3060 W. Coldwater Rd., Mt. Morris, MI 48458. Palmer College. Licensed since 2014. First Year Member. District 6. Franklin Norton DC, 37211 Harper Ste. 9B, Clinton Twp., MI 48036. Life University. Licensed since 2014. First Year Member. District 2. Anthony Paternoster DC, 42428 Clinton Place Dr., Clinton Twp., MI 48038. Cleveland College. Licensed since 2012. First Year Member. District 2. Ronald Rabineau, 1530 Clearview Ln., Gaylord, MI 49735. Logan University. Expected date of graduation 2015. Student Member. District 8. Melanie Waskevich DC, 901 E. Indian St., Midland, MI 48640. Palmer College. Licensed since 2003. Century Club Member. District 5. Alyssa Zeglen DC, 33225 Grand River Ave., Farmington, MI 48336. Palmer College. Licensed since 2014. First Year Member. District 3. Christopher Mangin DC, 2824 Stable Common Supplements - Continued from page 38 Fish Oil/ Omega-3 Fatty Acids Most often used for conditions related to the heart and blood system. May lower blood pressure or triglyceride levels (fats related to cholesterol). Fish oil has also been tried for preventing heart disease or stroke. May help with depression, psychosis, attention deficit-hyperactivity disorder (ADHD), Alzheimer’s disease, and other thinking disorders. Magnesium Green vegetables such as spinach, some legumes Helps maintain normal muscle and nerve function, keeps heart (beans and peas), nuts and seeds, and whole, rhythm steady, supports a healthy immune system, and keeps bones strong. Also helps regulate blood sugar levels and promote unrefined grains. normal blood pressure. There is also an increased interest in the role of magnesium in preventing and managing disorders such as hypertension, cardiovascular disease, and diabetes. Zinc Helps the immune system fight off invading bacteria and viruses. Makes proteins and DNA, the genetic material in all cells. During pregnancy, infancy, and childhood, the body needs zinc to grow and develop properly. Zinc also helps wounds heal and is important for proper senses of taste and smell. Fish, including mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout, and menhaden. Oysters (the best source of zinc), red meat, poultry, seafood such as crab and lobsters, and fortified breakfast cereals. Also, beans, nuts, whole grains, and dairy products, which provide some zinc. Sources: National Institutes of Health, Office of Dietary Supplements National Center for Complementary and Alternative Medicine (NCCAM) MAC Journal • November/December 2014 39 News from CFCU Chiropractic Federal Credit Union Welcomes New Board Member Dr. Amanda Apfelblat Joins CFCU Supervisory Committee By Margie Brace Vice Chair, Board of Directors Chiropractic Federal Credit Union Chiropractic Federal Credit Union (CFCU) is proud to announce the addition of Dr. Amanda Apfelblat of Garden City to our CFCU Board of Directors as a member of our Supervisory Committee. Dr. Apfelblat – a MAC President’s Club member – serves on the MAC Board of Directors representing District 3, which is comprised of Oakland County. At the MAC’s Fall 2014 Convention, she was given the Kirk A. Lee Community Champion Award “in recognition and appreciation of [her] unselfish commitment to serving others and [her] community.” Dr. Apfelblat also serves a Chair of the MAC Membership Committee. She has been a member of the Membership Committee since the MAC’s founding in 2007. Additionally, she has served the Association in a number of capacities over the years, including as President of District 3. A graduate of Life University, Dr. Apfelblat is a founding member of the Michigan Chiropractic Pediatric Association, an organization founded to engage and serve Michigan families through the promotion of chiropractic care and public education, as well as by establishing meaningful communication with other healthcare professionals and organizations. She currently serves as a Board of Directors member of the MCPA. She is also a member of the International Chiropractic Pediatric Association who has an advanced Board Certification in Pediatric Chiropractic. Civic and community involvement and awards include: Westland Chamber of Commerce, 2007 Westland Business Person of the Year, Garden City Business and Amanda Apfelblat, DC JOIN US! 2014 EXPRESS Convention! CEse! 5 1 sibl s o P MAC Be sure to join us for the MAC 2014 Express Convention for a fun, relaxed, educational weekend! Our excellent speakers include: Carl Alden�������������������������������������CA Roundtable Aaron Berish, Robert Iwrey, ���������An Ounce of Prevention (DCs & CAs) Jessica Gustafson James Bowen�������������������������������Reducing Taxes & Increasing Income Dr. Sol Cogan�������������������������������Caring for Elite Athletes (Physical Measures, Pain Management, Tests, Technique) Bharon Hoag��������������������������������Running a Successful Practice Edie Hofmann�������������������������������HIPAA Compliance Greg Nowakowski �����������������������Ethics & Boundaries (Ethics & Boundaries) Dr. Steve Simmons�����������������������Philosophy in the 21st Century Dr. Kevin Wong�����������������������������Spinal & Lower Extremity Analysis (Tests, Pain Management, Physical Measures, Technique) REGISTER NOW! For more information and to register, go to http://www.chiromi.com/ expressconvention 40 Margie Brace Professional Women’s Group, Westland Salvation Army, and Schoolcraft College’s Massage Therapy Program. She has spoken at Westland Middle Schools and High Schools about the field of chiropractic and also sponsors a college scholarship for William D. Ford High School students. MAC Journal • November/December 2014 Obituaries Dr. Linda Rassel (1943-2014) Longtime MAC member and Michigan chiropractic legend Dr. Linda Rassel of Okemos passed away September 5, 2014, surrounded by her loving family, including five daughters, four of whom went on to become chiropractors themselves. She was 70. At the MAC Fall Convention in Kalamazoo, Dr. Rassel was posthumously honored with the first-ever MAC “Extraordinary Impact Award,” in appreciation for being a “veracious chiropractic advocate, mentor, and leader” (See article on page 7). In future years, this award will be presented in her honor. A magna cum laude graduate of Palmer, Dr. Rassel was deeply involved with her state associations, serving on the Board of Directors of the Michigan Chiropractic Council and on a number of key committees. She was the recipient of numerous awards and deeply appreciated for her many years of valuable service. She also served as a member of the Michigan Board of Chiropractic, the International Chiropractors Association, and on the Board of Trustees for Life University. A Diplomate of the National Board of Chiropractic Examiners, she practiced in Michigan for nearly 40 years. She served as a mentor for numerous young people who went on to become chiropractors themselves. Dr. Rassel is survived by her daughters, Dr. Denise Rassel, Dr. Elizabeth Rassel, Dr. Ruth Rassel, Dr. Heather Rassel, and Kelly Kossuth. She had 11 grandchildren and four great-grandchildren. Her feisty, never-give-up style and passionate dedication to chiropractic will be sorely missed. Dr. George Goodman (1944-2014) Dr. George Goodman, DC, the sixth and longest-serving president of Logan, passed away September 8, 2014. He was 70. Dr. Goodman served as Logan President from 1992 until his retirement in 2013. His tenure as President was marked by great success and progress. A 1968 graduate of Logan, his career at the school as an educator and administrator spanned 45 years. Prior to becoming President, he served as Vice President of Chiropractic Affairs, Clinic Director, and Dean of the School of Postgraduate Education. Among his numerous awards and distinctions are the Distinguished Service Award of the Logan College Alumni Association in 1982, Logan Alumni of the Year in 1989, elected a Fellow of the International College of Chiropractors in 1983, and he was presented a Distinguished Service award by the Canadian Council on Chiropractic Education in 1992. Current Logan President Dr. Clay McDonald said of his passing “The loss of Dr. Goodman and his dedication to the chiropractic profession and Logan is a huge loss. We pass along our thoughts and prayers to Dr. Goodman’s family.” Dr. Frank R. Sovinsky (1951-2014) Longtime chiropractic mentor, consultant, speaker, and author passed away August 31. He was 63. A 1981 graduate of Palmer, Dr. Sovinsky was a co-founder of DC Mentors, a leadership training and business consulting company for chiropractors. Prior to co-founding DC Mentors, he practiced in Lodi, California, from 1982-1997. He is the author of Life: The Manual and co-author of The E-Myth Chiropractor. He was a Fellow in the Palmer Academy of Chiropractic, inducted in 2011. MAC Journal • November/December 2014 41 Communication Strategies By Anne Blain, CEO Chiropractic Federal Credit Union I recently read an article discussing how technology is evolving rapidly and how it has affected the way we communicate with each other. With the changing environment we all need to stay in touch and enhance what we know to be valuable communication skills. As business owners and as parents we still need to converse face to face in our professional and personal lives and we want to be successful in our verbal exchanges. I believe that every day it is my job to lead and inspire people and I must rely on my skills. Below are a few simple tips I use to help me be successful. • Be a good listener. tion is intolerable. When complaining have a solution. • When you share something with others and when you are finished, ask others to share with you. • It can be annoying if you interrupt and do not listen to what others have to say. • If you have no passion and do not care about what you’re saying, it may be a good time to stay silent. • If you don’t take others seriously, then expect your words to roll off their back when their words roll of yours. • If we are too long-winded, people get bored. • If you do not get to the point, minds wander when your words wander. • If you do not follow through when making a point, you will not be taken seriously. • When you have no goal or higher purpose, people will tune you out. • People don't have the same values and therefore what matters to you may not matter to them. Understanding this, you can still find the common ground. • Whining without a solution or ac42 • If it’s all about you and not about them, people quickly stop listening when they realize this. • When addressing a group encourage questions and comments. If you are disconnected, it may appear that you just stepped out of your ivory tower to address the huddled masses. • Don’t expect enthusiastic responses to ambiguous messages. Anne Blain, CEO of Chiropractic Federal Credit Union If you have a financial question, please forward to: ablain@chirofcu.org or contact us at 800.422.6424, Subject: “Your Money Matters” MAC Journal • November/December 2014 CFCU: Announcing… A New Partnership! Now Serving the Chiropractic Profession in Ohio! Chiropractic Federal Credit Union (CFCU) has been meeting the financial needs of Michigan chiropractors, their employees, and family members since 1950. In 2013, CFCU expanded their charter and began operating in Minnesota. Now, CFCU is further expanding and opening membership to members of the Ohio State Chiropractic Association. “For 64 years, CFCU has been meeting the financial needs of the chiropractic pro- fession, and we have been a pioneer in the credit union industry in the development and introduction of services for our members’ businesses,” said Dr. Philip Knight, Chair, CFCU Board of Directors. “We are very excited to now offer our exclusive services to members of the OSCA, and we are looking forward to meeting [their] business and personal financial needs.” CFCU is the only credit union exclusively serving the chiropractic profession. In addition to the full range of personal financial products, CFCU specializes in offering business services and loans to members, including equipment loans, commercial real estate, and more. “The OSCA is very excited about the new partnership with Chiropractic Federal Credit Union (CFCU),” said Bharon Hoag, Executive Director, Ohio State Chiropractic Association. “For decades financial institutions have found it difficult to work with chiropractors because they did not understand our profession. It is very different than other healthcare fields in the manner of education to the business startup. We feel that CFCU will provide a wonderful option to our members to get funding and have a better banking experience. We encourage all of our members to reach out to CFCU to see what they can do for you. This is an all chiropractic financial institution and they understand your reality!” Source: Chiropractic Federal Credit Union, www.chirofcu.org MyMACWellness/MDCH MAC Journal • November/December 2014 43 President’s Letter - Continued from page 3 Positioning Chiropractic in Obamacare With the expansion of Medicaid a major part of the Patient Protection and Affordable Care Act (ACA) – commonly referred to as “Obamacare” – chiropractic inclusion in the Michigan Department of Community Health budget has been more important than ever before. Between April 1 and August 25, more than 373,000 Michiganders signed up for the new Healthy Michigan Plan, with an additional 100,000 expected to be covered by 2021. With this expansion, Michigan’s uninsured population is expected to drop by about 46 percent. Our Government Relations team has been closely following national efforts by organized medicine to dismantle Section 2706(a) of the ACA This critical provision prohibits discrimination against chiropractors and our patients. Statewide, we have monitored all plans offered under the new health insurance exchange to ensure their proper inclusion of chiropractic care. Coverage under these plans began last January 1. As new plans are offered through the exchanges, know that the MAC is vigilantly monitoring them for chiropractic inclusion! Legislative Agenda We have also worked hard to set the stage for legislation that would require insurers to pay for all services allowed under the new scope (Patient Equity Act) and bills that would eliminate burdensome deductibles and co-pays (Transparency in Coverage Act). This important legislation will be re-introduced in the next legislature. Public Relations – Getting Out the “Conservative Care First” Message! I am proud to have overseen not just a continuation of our fruitful collaboration with the Michigan Department of Community Health, but an expansion of it with our MAC Screenings Program. This innovative program is designed to get MAC members into their local communities talking about chiropractic wellness. This bold, aggressive PR campaign uses MAC resources, such as a beautiful, professionally designed booth, coordinated printed material, turn-key scripts, co-branding with the Michigan Department of Community Health, and assistance in finding and scheduling events, to allow our members 44 to promote chiropractic, wellness, and their practices in their communities. For more information, or to register for an upcoming event in your area, go to www. MACScreenings.com. National Efforts – F4CP We are extremely proud of the fact that the MAC is the highest monthly contributor among state associations to the Foundation for Chiropractic Progress (F4CP), a national, not-for-profit organization dedicated to raising awareness about the value of chiropractic care. The great public relations and educational activities spearheaded by the Foundation are extremely beneficial to the future of our great profession. MAC members have access to a new national directory and to all the great marketing materials developed by F4CP. Call the MAC at (517) 367-2225 for more information. Member Advocacy Program (MAP) This new program is geared toward helping our members “map their futures” through such events as philosophy nights, a mentorship program, programs specifically for woman DCs, special webinars, the MAC Sports Council, the Health Screenings Program, our patient newsletter, Real Health, business resources, and the MAC WorkSafe Program. Working with the Insurance Committee, our MAP seminars at our conventions are designed to be relevant for every chiropractor, from the new graduate to the most seasoned professional. Sky’s the Limit in 2015! Finally, I want to thank you for the opportunity to serve. Leaving my position as president of this incredible organization is bittersweet. The future of our profession is very strong, and I look forward to working with our new president the next two years as Chairman of the MAC Board of Directors. Early next year, we will be gathering to chart our strategic course for the next two years in many important areas, including government relations, legal affairs, public relations, and more. Watch for notice of this important strategic planning meeting. Please consider attending and making your voice heard. If we all work together, we can work to make a brighter future for chiropractic generations to come! And, if you are not a member of the MAC, please get involved TODAY! NOW is the time to show your commitment to the profession! Sincerely, Dennis W. Whitford, DC President Conventions, Seminars, and Webinars: Providing YOU with the CE You Need! The Committee takes very seriously its mission of providing exceptional educational opportunities for Michigan doctors of chiropractic. We strive to put on the most impressive conventions and seminars in the nation, with national speakers routinely contact us regarding speaking slots. We are consistently adding to our online library of webinars available for continuing education credit, MAC Web-Ed, giving doctors a quick, easy, lowcost way to pick up credits during a lunch hour and before and after work. All of these programs are designed to provide the classes you need to stay current with your continuing education. You can count on the MAC to provide you with the education you need when you need it! Mark Your Calendar! MAC Spring 2015 Convention April 24-26, 2015 Adoba Eco, Dearborn, MI www.chiromi. com/macS15 MAC Journal • November/December 2014 November 2014 January 2015 November 6 • Insurance Ellen Berra, Dr. Jody Smith, Carl Alden Saginaw January 17 • Nutrition Dr. Davis Brockenshire November 15 • Nutrition, Ethics & Boundaries Dr. Paul Kraft, Carl Alden Plymouth November 22-23 • Express Convention Various Speakers Soaring Eagle, Mt. Pleasant For more information and to register, go to www.chiromi.com/seminars or www.chiromi.com PRESIDENTS & AMBASSADORS CLUB PRESIDENTS CLUB Dr. Adam Apfelblat Dr. Amanda Apfelblat Dr. Solomon Cogan Dr. Henry Cousineau Dr. Eric Duncan Dr. William Goss Dr. R. James Gregg Dr. David Guzzardo Dr. Nick Hartop Dr. Thomas Klapp Dr. Michael Kwast Dr. Brian Loranger Dr. Anna Loranger Dr. Joseph Lupo Dr. Eric Marshall Dr. Bradley McMath Dr. John Mufarreh Dr. Rodney Nagel Dr. Randolph O’Dell Dr. Lisa Olszewski Dr. Damian Palmer Dr. Donald Reno Dr. J. Alan Robertson, MD Dr. Corey Rodnick Dr. Shelley Shepherd Dr. Daniel Spencer Dr. Lewis Squires Dr. Kirk Steketee Dr. Donald Towers Dr. Walter Tumlinson Dr. Dennis Whitford AMBASSADORS Dr. Virginia Beetham Dr. Jeffrey Buller Dr. Sam Caruso Dr. Eric DiMartino Dr. Angela DiMartino Dr. Christopher Dolecki Dr. James Duncan, II Dr. Leigh Elceser MAC Journal • November/December 2014 Dr. Charles Gilcher Dr. Craig Gilling Dr. William Gischia Dr. Daniel Gordon Dr. Eric Hartman Dr. Chad Hickey Dr. John A. Hofmann Dr. John M. Hofmann Dr. Keith Hohf Dr. Ronald House, II Dr. Erik Hudak Dr. Heather Hudak Dr. Kenneth Hughes Dr. Kevin Karadeema Dr. Paul Kraft Dr. Marc Lukosavich Dr. Toby Mitchell Dr. Jeromy Myers Dr. Rachelle Myers Dr. Thomas Palmer Dr. Brian Parkhurst Dr. Karla Parkhurst Dr. David Paschket Dr. Kirby Perrault Dr. Renee Pethtel Dr. Tony Purdy Dr. Jeffrey Rauch Dr. James Ribley Dr. Angela Scarffe Dr. Eric Seif Dr. Tanya Seif Dr. Robert Shaner Dr. Ian Shaw Dr. Patrick Sheeran Dr. Steve Sheldon Dr. Steven Simmons Dr. Jody Smith Dr. Cheryl Snyder-Hughes Dr. Dennis Stepanovich Dr. Ronald VanKints Dr. Randal Wilcox 45 Members on the Move! Dr. John Ostergren Marks 65 Years in Practice! Longtime MAC member Dr. John Ostergren of Midland recently celebrated his 65th year in practice in Michigan. “I don’t intend to quit for a while,” he told the Midland Daily News, which did a story on his impressive longevity. “I still love what I do, as I always have.” Dr. Ostergren got into the profession after a chiropractor provided him relief from migraine headaches. “I was getting no help until I had chiropractic care and it helped steer me into this profession,” he told the News. “It did the job.” He began practicing in Greenville in 1949 before taking over an office in Alma in 1950. In 1964 he began practicing in Midland, and his current office opened in Midland in August 1966. At the time, he says, he was one of only two chiropractors in the region. When he started, house calls and $2 or $3 office visits were the norm. Dr. Ostergren told the News he likes the philosophy behind chiropractic care: “We put nothing in and take nothing out. We take care of what’s there.” Dr. Ostergren told the News he doesn’t intend to retire for a while: “I still love what I do, as I always have… One of these days I suppose I’ll want to hang it up, but I still enjoy being in my office and working. I just play it slow and easy, and enjoy helping people.” Source: Midland Daily News, “Midland Chiropractor Marks 65 Years,” July 9, 2014 Veterans - Continued from page 32 compared to 4 percent of the general public. These sobering facts demonstrate the need for conservative, drug-free approaches to pain care at the VA. The national organizations, together with prochiropractic lawmakers in the US House and Senate, have pushed legislation that would provide access to chiropractic care, but, despite these efforts, as of January 2014, the VA provides access to a chiropractor at only 48 major DVA treatment facilities within the U.S. In 46 Michigan, only one of the state’s five medical centers – the Oscar G. Johnson VA Medical Center in Iron Mountain – has an on-site chiropractor. “VA currently provides access to a DC at more than 45 major treatment facilities within the U.S. However, the overwhelming majority of eligible veterans continue to be denied access to chiropractic services because VA has failed to take any significant action to provide access at around 100 other VA facilities,” said ACA President Anthony Hamm, DC. “Action is needed to ensure that all the brave men and women who have put their lives on the line for our country have access to as much health care as they need when they get back home, regardless of the provider they wish to see.” Watch the MAC Journal and Week in Review for information on how you can get involved as pro-chiropractic legislation affecting our military, their families, and our veterans moves through the national legislative process. Sources: National Institutes of Health Department of Veterans Affairs American Chiropractic Association MAC Journal • November/December 2014 Dr. Miguel Ruelan World Record Setting DC! Longtime Century Club member Dr. Miguel Ruelan, Jr., recently set a world bench-pressing record, lifting an incredible 451 pounds! A power-lifter specializing in bench press, Dr. Ruelan has been the owner of Flushing Back & Neck Care Center since 2001. After his world-record setting lift, Dr. Ruelan, a 1998 graduate of Palmer, was profiled in My City magazine, a publication for the Greater Flint Area highlighting community, business, events, arts, history, and more. He set the record at the Michigan American Powerlifting Federation’s 3rd Annual Can-Am Bench Press Championships in Detroit. Weighing in at only 177 pounds, Dr. Ruelan’s lift on his second attempt set a new Masters World Record for his weight class. Dr. Ruelan began power-lifting in 1987 in his home state of New Jersey, where at a gym he was trained by a former Olympic power-lifter, who convinced him to enter a fundraising competition at the gym, which he won. He did not compete while at Palmer, but returned to competitive lifting after coming to Michigan to practice in 2001. Dr. Ruelan and his wife, Heather – a personal trainer at the Flushing YMCA and professional figure competitor herself – have two children. For the full My City magazine profile on Dr. Ruelan, go to http:// mycitymag.com/raising-the-barlocaldoctor-sets-world-record/. If you would like to be featured in the MAC Journal “Members on the Move,” simply contact Tim at the MAC at (517) 367-2225, or email tim@chiromi.com. MAC Journal • November/December 2014 47 416 W. Ionia St. • Lansing, Michigan 48933 www.chiromi.com • e-mail info@chiromi.com (517) 367-2225, (800) 949-1401, Fax (517) 367-2228 MEMBERSHIP APPLICATION MAC Mission: To improve the health and well being of the public by advancing and protecting the practice of chiropractic. Purpose of the MAC: The purpose of the Michigan Association of Chiropractors is: • To promote the Chiropractic profession as a distinct branch of the healing arts based on the body’s inherent recuperative abilities and the role that vertebral subluxation plays in that process, and • To advocate for Michigan Doctors of Chiropractic, chiropractic patients, and the chiropractic profession to the government, the public, the business community, and the community of third party payers. PLEASE PRINT OR TYPE Please fill out this application in its entirety for approval of the Board of Directors. Date _____________________ Name __________________________________________________Birth Date_________________ Male Female Office Name_________________________________________________________________________________________ Office Address _______________________________________________________________________________________ City/State/ZIP _____________________________________________________________ County ___________________ Home Address _______________________________________________________________________________________ City/State/ZIP _______________________________________________________________________________________ Phone Numbers: Office ( ) _____________________ Home ( ) ___________________ Fax ( ) _________________ Email Address _______________________________________ Web Site _______________________________________ Techniques Practiced _________________________________________________________________________________ ________________________________________________________________________________________________ Chiropractic College _______________________________________________ Graduation Date _____________________ Date of First Licensure ___________ Date Licensed in Michigan ____________ License Number _____________________ Membership Types and Fees Student ............................................ FREE First year (of Michigan licensure) ............ FREE Second year (of Michigan licensure) .......$ 360 Third year (of Michigan licensure) ............$ 480 Fourth year+ (of Michigan licensure) ........$ 720 Century Club* ................................$1,200 Ambassadors Club* .......................$2,220 Presidents Club* ............................$3,420 Spouse member ................................. TBD (1/2 of primary member not to exceed $600.00) Associate/Part time............ ...............$ 600 (15 hours or less/week) Semi-Retired ....................................$ 200 Retired ..............................................$ 50 (25 yrs in practice, 15 hrs or less/week) Vendor member ................................$ 300 Out-of-state member ........................$ 200 *Century, Ambassadors and Presidents Clubs include two (2) free conventions/year, discounts on seminars, and more. Please go to www.chiromi.com/members/member_benefits for details, or call the MAC office at (800) 949-1401. Dues Payment Options: Set up automatic recurring billing on my credit card Please bill my credit card: Monthly Quarterly Semi-Annually Annually Bill my credit card one time Check for Dues enclosed: $ ______________ Please bill me: Monthly Quarterly Semi-Annually Annually $ ____________________ CC# ____________________________________________________ Exp. date _______________ I hereby attest to the accuracy of the foregoing information. I agree to abide by the By-laws and Code of Ethics of the MAC, and Chiropractic Statutes of Michigan. I understand that my failure to remit dues will result in suspension of all rights and privileges and will result in the loss of membership. Dues are paid in advance. Signature _______________________________________________________________ Date________________________ MEMBERSHIP IS CONTINUOUS UNLESS CANCELLED For Office Use ONLY Date Approved ____________________ District # _____________________ Dues Received ________________ PLEASE SEND YOUR FIRST QUARTER PAYMENT AND A PHOTOGRAPH WITH YOUR APPLICATION. 12/2012 SQP 48 MAC Journal • November/December 2014 District Information Your MAC district meeting is YOUR local source for important, exclusive updates and information. Many of the districts feature guest speakers, and some of the programs are approved for CE credits. For more information about your district meetings, please contact your District President, or go to www.chiromi.com/districts. District 1 District 3 Meetings are the 2nd Wednesday of each month at Amigos Mexican Restaurant, Taylor Meetings are the 2nd Wednesday of each month at Pasquale’s Restaurant, Royal Oak John M. Hofmann, DC Board Representative & President 313-386-1050 • doc@hofmanndc.com Sara Whedon, DC President 248-652-1461 • whedonse@gmail.com Jeromy Myers, DC President, Board Representative 269-964-1441 • jmyers@doctor.com Timothy Thomas, DC Vice President 734-284-8600 • chirokare@aol.com Amanda Apfelblat, DC Board Representative 734-838-0353 • spynfxr@comcast.net Doug Lynes, DC Board Representative 269-324-1449 • DC_Doug@yahoo.com Glenn Caudell, DC Board Representative 313-563-0530 • thehealer@comcast.net Robert Levine, DC Board Representative 248-855-2666 • drboblevine@yahoo.com District 7 District 2 District 4 Meetings are the 2nd Wednesday of each month at Pasquale’s Restaurant, Royal Oak Meetings are the 2nd Wednesday of each month at the Hard Knock Grill, Jackson Elra Morgan, DC President elramorgan@hotmail.com Lisa Olszewski, DC Board Representative & President 734-433-9564 • lisa_Olszewski@yahoo. com Becky Gennero, DC Vice President 586-504-1044 • drbeckym@yahoo.com Kenneth Murkowski, II, DC Vice President 517-784-9123 • dr.murkowski@gmail.com Eric DiMartino, DC Board Representative 586-949-9248 • edimartino@sbcglobal.net Harold (Skip) Book, DC Board Representative 248-684-2551 • haroldbook@comcast.net Nick Hartop, DC Board Representative 586-201-9020 • mhartopdc@gmail.com Brooke Sharp, DC Secretary 734-944-2090 • drbrooke@newerasaline. com Kellie Treichel, DC Secretary 989-684-0018 • treichel_k@hotmail.com District 6 Meetings are the first Thursday of each month. Locations rotate. Please watch for your District Newsletter via email, or go to www.chiromi.com/districts/district_7 Therese House, DC President 616-399-3563 • houseth@hotmail.com James Chichester, DC Vice President 616-897-8284 • dr.chichester@gmail.com Eric Hartman, DC Board Representative 616-457-1168 • hartmandc@hotmail.com Ron Wilcox, Jr., DC Board Representative 616-784-5433 • debrawmi@aol.com Lawrence Doran, DC Secretary 616-895-5499 • doran@altelco.net Daniel Painter, DC Treasurer 517-787-4513 • dan.painter@gmail.com John Wallace, DC Treasurer 231-755-3333 • jrwii82@aol.com District 5 District 8 Meetings are the last Tuesday of each month at the Pi’s Chinese Restaurant, Midland Brandon Turino, DC President 906-486-6901 • treens19@aol.com Paul Rodnick, DC President 989-792-7246 • pjrod87@yahoo.com Lewis Squires, DC Board Representative 231-757-3356 • drsquires@sbcglobal.net Steven Simmons, DC Board Representative & Vice President 989-923-2225 • hioc1c2@aol.com Bruce Turino, DC Board Representative 906-486-6901 • turinob@aol.com Robert Markle, DC Board Representative 989-684-3200 • salzburgchiro@yahoo.com MAC Journal • November/December 2014 49 Classified Ads Seeking a full-time, self-motivated, ambitious, detail oriented chiropractor with PI experience. Competitive salary, paid malpractice, and benefits included. Please send your CV and contact information if interested. markobender@gmail.com. Practice Sales. info@prochirosales.com (734) 735-0768. For Sale, fully equipped chiropractic office and practice in Allen Park, MI. Call Dr. Kalis for more information at (313) 382-5222. Owner will stay through the transition. Farmington Hills Clinic for Sale. Excellent location, 1,000 sq. ft., 6 rooms, equipment with x-ray facility. Great way to get started. Retiring. Same location 32 years. Truly great opportunity. Resume lease, very inexpensive. Great deal. Asking $45,000. Cash buyers. Dr. Carlini. (248) 342-5858. 40 Year Old Practice with thousands of patient records, 6 treatment rooms, 3 adjustment rooms, 3 disc distraction rooms, four station rehab therapy room with three 1st tables, ultrasound, electro stim therapy, hot pack units (x2), cold pack unit, full x-ray, exam suite with full spine bone density unit. Laundry. Three thousand square foot office in independent building with over 20 car parking on busymain street in city with 100 ft. of building exposure. Active in the community for 40 years. Has massage therapy and two independent contractors. Will work transition to new owner’s specifications. Please call (248) 542-3492, cell (248) 752-2220. Madison Heights, Michigan. Perfect “Turn Key” Opportunity in White Lake! Ideal location. High traffic/high visibility/easy access. Exceptionally equipped & staffed. Current DC retiring. Price Negotiable. Call (248) 698-9141, or email dramielarison@ gmail.com. Practice for sale: Midland. Established for over 20 years. Spinal decompression. DRX-9000. Hundreds of active patient files. Many different options available from associate to buy-in/buy-out. Midland has a good economy and is family oriented. Email gotime43@yahoo. com. Temperance, Michigan: 38 year practice for sale. All equipment, 3,000 sq. foot building 20 car parking lot. Dr. retiring. Call MWF, (734) 847-1111, or email backdoc@totalink.net. 32 year central Michigan Practice for Sale. Within one hour drive to Lansing or Grand Rapids. 3,600 square foot freestanding building. Please email to centralmichchiro@gmail.com with your contact information, and I will discuss details with you. Chiropractor wanted to start his/her own practice in Western Michigan (Sparta) in a well established, 1,400 sq ft, Chiropractic office on busy, 4-lane Sparta Ave., equipped with two Zenith Hilo adjustment tables with drop sections, an Eurotech flexion/distraction table (all recently re-covered and look new), a Fischer 300x125 X-ray machine. High speed Internet is available. You pay gas and electric. Plenty of well-lit parking and signage for your signs. All this for only $700 per month! I’d like to keep this as a Chiropractic office, otherwise, I’ll rent to another profession for $1,000 per month. Call Carol at (616) 916-0731 or (616) 874-7871 or e-mail, drguyandcarol@aol.com. Newly Opened Practice For Sale In Grandville - Costs of suite buildout, front desk, advertising. (616) 6483025 PRACTICES FOR SALE IN THE FOLLOWING cities: Allen Park, Battle Creek, Cadillac, Canton, Carleton, Clarkston, Dearborn, Eastpointe, Flat Rock, Fraser, Garden City, Grand Rapids, Jackson (2), Kalamazoo, Lansing, Plymouth, South Haven, St. Clair Shores, Swartz Creek, Tawas City, Temperance, Warren, Westland and Toledo, OHIO. Details: Dr. Tim Cartwright, C-21 - Professional 50 Busy Canton office looking for motivated associate with potential partnership opportunity. Newer office, fully equipped including massage therapy. Email CantonChiropractor3@gmail.com. None. Rochester Chiropractic has an outstanding opportunity for Associate D.C., Build your practice within our facility with no overhead. Please email resume to jkatchuba@gmail.com. Office for sale. Central Michigan location, Mt. Pleasant. Doctor retiring. Building and equipment. (989) 772-4269. Chiropractic Office Building in St. Clair Shores for over 30 years with 2 separate suites. Asking price $98,500. Call Dr. Kennedy at Res. (586 226-1880, cell (586) 212-2748. Michigan office space for rent 1,100 plus SQ FT already set up for Chiro. Current Chiro moving to another location. Absolutely must at least take a look if in market. Contact Dr. Brian at glfchiro@btc-bci.com for info. LCCW senior graduating in December. Seeking subluxation based associate or IC position near Plymouth or Ann Arbor. Please e-mail DCMommy13@gmail.com for more information. I can help find you a chiropractic office that fits your needs and the needs of the doctor. Placements in many cities around Michigan. 38 yearsw as a chiropractor and 10 years at Century 21-Professional Practice Sales. Call Dr. Tim Cartwright (734) 735-0768 or email info@prochirosales.com. I’m a soon-to-be DC, who will be graduating September 26. I’m looking to be an asset to your practice. I’m a good adjuster (Diversified, Thompson, Cox, Activator) and also have special interest in pediatric adjusting. I’m very motivated to help the practice I land in flourish. If interested, please contact me at amdoerr1@gmail.com. December Graduate looking to move to northern Michigan seeking associate position. Well versed in Thompson, Diversified, Gonstead, Activator and much more. email mattpeacockdc14@hotmail.com for more info. Busy Clinic Seeking Associate to join the team. Seeking an energetic, self-motivated chiropractic associate in Jackson, MI for busy family practice. Base pay, bonuses, and malpractice coverage. Email resume and questions to: livingwell@cassitychitoptractic.com. Michigan Chiropractic practice seeks motivated and dedicated associate doctors and students who need preceptorships for its Upper Peninsula location. HealthQuest is the official chiropractor of the NFL Detroit Lions and has multiple offices throughout Michigan. Please send your CV/resume to resumes@healthquest.us. Successful chiropractic group looking for hard working and energetic Associate Doctors to supplement offices in Detroit/Flint areas. Applicant must be practice ready, self-motivated, and enjoy working in a team environment. Please send your CV/resume to resumes@healthquest.us. Motivated Doctor WanteD to join friendly, successful CASH practice! Ann Arbor. One-on-one coaching included. Attractive terms. Call (734) 971-BACK (2225). Send resume drsheila@cummingschiropractic.com. Fax (734) 971-2530. Serious inquiries only. Petoskey, Michigan. All the basics. Smart, funny, quick learner, hard worker, fully committed, great adjusting skills, and even better people skills. But what we want most is someone who wants to grow with us, and stay with us. Interested? Write a cover letter specifically for this job and include a CV or resume to breathoflifechiropractic@gmail. com. Provide earning expectations. Send a photo. Send 3 times that work for a 25 minute initial phone conversation. (231) 622-8828. Busy Grand Rapids office looking for a long term associate with excellent adjusting & patient management skills. Email resume (616) 304-7800. Ferndale: Associate Doctor wanted for our new state of the art Wellness Center. Competitive pay & benefits. Must be confident, motivated & wellness driven! Email CV to badevlin@Hotmail.com. Looking for full or part time associate to work Owosso, MI office. Please email me at renaissancedc@hotmail.com. Waterford: Looking for a happy, enthusiastic, outgoing Associate Chiropractor to join our newly expanded practice. Salary, health insurance, SEP account and malpractice covered. If you can say you love being a Chiropractor you found the right office! Fax resume: (248) 618-3515. Email adjustn@comcast.net. Garden City: Looking for a happy, enthusiastic, outgoing Associate Chiropractor to join our newly expanded practice. Salary, health insurance, IRA, & malpractice covered. If you can say you love being a chiropractor, you found the right office!Fax resumes to (734) 838-0359, or email spynfxr@comcast.net. Independent Contractor Wanted; Doctor needed to share office space. Work Tuesdays, Thursday, Saturdays. Optional buy out. Fully equipped state of art clinic in Oakland Co. on busy street. 18 year estb. in community. Call (248) 681-3090 or email harborfamilychiro@yahoo. com. SW Michigan Independent Contractor/Associate wanted for rapidly expanding wellness and rehabilitation clinics. Must have good personality and manual adjusting skills. Rehab knowledge a definite plus. Great opportunity for the right person. Email resume to Spinedoc1998@yahoo.com. Premier West Bloomfield/Commerce Chiropractic Office looking for an enthusiastic and highly motivate MAC Journal • November/December 2014 Classified Ads associate. Great communication skills and strong personal character are a must. If you are thankful everyday for being a chiropractor then this is the office for you. Email resume to info@gordondc.com. INDEPENDENT CONTRACTOR/ASSOCIATE DOCTOR WANTED: Buy-out preferred, 2 year transition in established practice located in Livingston County MI. Email CV/ resume to ChiroDocMI@gmail.com. Rochester: Newly built modern office available for sharing. Evalution Dt decompression, K-laser, RMT, IST, Digital xray, 4 adjusting rooms. 2,000 sq ft total. Ideal for start up doc or doc looking to slash overhead. Call Dr. Goss (586) 212-7014 or drgoss@gosschiro.com. Associate Doctor wanted to join our High Volume, Fun, Lifetime Wellness Based Family Practice in Clarkston, MI. Excellent Opportunity, Part Time (two afternoons per week), Flat Rate plus Eligible for Individual and Team Bonuses. Please fax resume to (248) 623-6443 or email to info@lifepointechiropractic.com. Associate Wanted To Join a high-volume family-oriented practice. Must have a passion to learn how to educate patients about subluxation correction and lifetime chiropractic wellness care. Salary plus bonuses and malpractice insurance. Call Gregg Chiropractic at (734) 5258422. Ask for Lisa, or email resume to rjg@greggchiro. com. Offering an extraordinary opportunity for a doctor looking to exceed their career experience. Learn from one of the professions leaders in chiropractic healthcare. Known for having one of the largest practices in Michigan. Our Flint, MI 4,000 square foot facility is state of the art. We are a subluxation based practice which incorporates neurology, biomechanics, physical measures, rehabilitation, as well as Non Surgical Spinal Decompression for a total patient experience. We change peoples lives. Salary plus bonus as well as benefits. If your passionate about chiropractic and up tone, I’ll provide the rest. Send resume to nuspine@mac.com. Associate Doctor wanted to assist well established Chiropractor with overflow and new patient growth. We have state-of -the art equipment and facilities, rehabilitative exercise, massage therapy, nutritional counseling, pharmaceutical grade supplements, cold laser, acoustic compression, spinal decompression and much more. If you are interested, contact kristen@harrisonchiro. com. Associate Chiropractor wanted to join a successful Mid Michigan clinic. A great experience & competitive salary plus bonus, malpractice, seminars and vacation time. Email resume to Tricitychiropractic1@gmail.com. Chiropractic Office for Lease between Ann Arbor and Ypsilanti. Newly renovated/updated wellness center is available for lease on Monday, Wednesday and Friday when primary chiropractor is at another location. I am most interested in health minded, frteindly and professional chiropractors. Office is on a very busy street with good signage and parking. This is an affordable opportunity for someone relocating with an existing patient base, or initiating a practice from scratch. Any further details will be discussed when we meet. Call Dr. Eric (734) 904-7931. Wonderful opportunity to join busy, upbeat chiropractic team in Great Lakes Bay Region, Michigan. State of the art chiropractic practice seeking ambitious associate with a great attitude. Very competitive compensation package including health insurance and retirement fund. Jenhortondc@gmail.com. Midland associate doctor with buy-in/out intention. Will train for success. 20 year established practice with DRX-9000. I am ready to groom a successful doctor. Call Dr. Rodney Nagel (989) 906-4781. VERY REWARDING associate position with partnership option in Plymouth & West Bloom. Potential to earn six figure salary. Both owners were associates and know how difficult it can be, we treat our staff with the up most respect. Serious inquires only; Full time/Benefits/401K/Paid Vaca/ more -- visit our website under the “Contact Us” tab for full details -- www.letsachievehealth.com. Lansing, Great Opportunity for a great associate. Salary, excellent incentives and unbeatable percentage. Email CV to scoreleader@hotmail.com. MICHIGAN FAMILY PRACTICE:Christian Chiropractic Office next to MSU in East Lansing. Just expanded! CBP Join our team! Base pay + bonus + malpractice. Nutrition interest a plus. Dr. Denise Rassel DRDRASSEL@aol.com. INNATE BASED DC wanted for a busy, family-oriented practice in Grand Ledge (Lansing area). Email CV to demete@aol.com. Associate Chiropractor wanted for well established wellness center in Plymouth; that offers a wide variety of integrative services: chiropractic, laser therapy, massage, nutrition. Great setting to use talents and grow. Send resume to: resumes4health@gmail.com. Busy chiropractic office is seeking an energetic associate to work in Kimball, MI. Position is immediately available. Office hours and salary are negotiable. Please fax resume or CV to (810) 966-1901. Soldano Family Chiropractic Center is hiring motivated, passionate doctors who are willing to learn from an ELITE team. We are expanding very quickly in the Southwest Michigan area and are looking to hire several doctors over the next year. We are offering some of the best compensation packages seen in the profession. If you are willing to learn and be pushed to reach your fullest potential please email your resume at Soldanofamilychiro@ gmail.com. Ferndale Chiropractic is looking for a growth oriented Chiropractor. Great opportunity for the right Doctor. Please call (248) 709-2447 for more information. Expanding Western Michigan clinic has an opportunity for a full-time associate. Position includes a retirement program, health insurance, paid coaching, marketing team, malpractice insurance and more! Email resume to westmichirojobs@gmail.com. Associate Chiropractor position available in our state of the art office in Livonia. We are a busy wellness and correction based office. Candidate must possess a vitalistic, big picture chiropractic philosophy, be self motivated, success driven and have a passion for saving lives through lifetime chiropractic care. Benefits include: paid training, 401K, malpractice insurance, paid vacation time, salary plus bonuses, and partnership opportunities after two years. If you possess the confidence and passion to change the world through chiropractic, send your resume to chiroresume05@yahoo.com. We are seeking a licensed, or soon to be licensed, chiropractor to join our busy 2 doctor practice in suburban Detroit. We are looking for a long term, mutually beneficial relationship. We enjoy a reputation for clinical excellence, providing effective chiropractic services in Birmingham for the past 30 years. In addition, our clinic is remarkably well organized, with modern furnishings and equipment. The practice uses primarily manual adjusting techniques, with an emphasis on corrective exercise and active patient care. We practice continuing education and strive to provide the highest level of care to our patients. Base pay + bonus + malpractice insurance. Please email your resume or CV in confidence to davidchiro@yahoo. com. MAC Journal • November/December 2014 Are you looking to practice in a beach community with big city amenities? Only 25 miles from Grand Rapids, Michigan, Holland is nestled along beautiful Lake Michigan and was rated one of the 5 best places to live in the US. Lakeshore Family Chiropractic was founded in 2006 and recently renovated a 4,600 square foot state-of-the-art facility that uses digital x-ray, Myovision, and touch screen computers. The clinic specializes in family, wellness, and preventative care, and provides massage therapy. This successful office is seeking associate doctors with a passion for serving the public through chiropractic care and are willing to learn with a positive attitude. Applicants must have excellent people skills, be willing to be coached, and open to learning the latest marketing techniques and business procedures. The office provides a fully trained staff and practice representative who will get new patients for you. This would be a tremendous opportunity for anyone considering new opportunities in chiropractic care. This is an ownership opportunity associate position. www.lakeshorefamilychiropractic.com. Busy Grand Rapids office looking for a long term associate with excellent adjusting & patient management skills. Email resume@GRChiro.com. Greater Lansing area. Established, respected multidisciplinary clinic seeking associate doctor. Specializing in Cox and Gonstead. Email resume to backman888@ yahoo.com. Associate wanted to join a well established practice in Northern Macomb County. Subluxation based. Family wellness center. Salary plus bonuses, and malpractice insurance. Call (586) 286-6616. Doc for a Day is hiring part time contractors for coverage work. Great pay, flexible hours. Must have insurance, transportation, license, and have graduated 3 years ago. Call (847) 367-9641 or email daleslachman@gmail. com. Seeking a full-time, self motivated, ambitious, detail-oriented chiropractor with PI experience. Competitive salary, paid malpractice, and benefits included. BiLingual is a plus. Send resume and cover letter to Mark at markbender@gmail.com. Award winning pediatric, pregnancy and sports clinic located in Western Michigan has an opportunity for a full-time associate. Position includes matching 401k retirement, health insurance, paid professional coaching, practice representatives, digital x-ray, Chirotouch software, malpractice insurance, chiropractic technicians and more! To apply for this position: 1) Go to www.bthcwc.com, 2) Look for the heading “Employment Opportunities” on the top of the page, 3) Follow the instructions. INDEPENDENT CONTRACTOR WANTED: Great opportunity for the right doctor in a beautiful fully equipped state-of-the-art office with digital x-ray, massage therapy, cold laser. Call (248) 650-2225 or email info@peerchiro. com. Looking to grow your practice or start your own in an amazing location in Rochester Hills, Michigan. Visit us at www.peerchiro.com. Associate Position Available, Full/Part time in Macomb, MI. We are looking for a caring, outgoing person who loves the principle of chiropractic and has a passion for serving and helping others. A well-suited candidate for this position must: have a strong chiropractic philosophy and approach, be coachable, excellent communication skills, and enjoy working with families. Send resumes to: backdr1895@yahoo.com Build a successful practice with less overhead in downtown Rochester. Available: EMR, Laser, Foot Levelers 3D Scanner. Email sharedchirocare@aol. com. 51 Classified Ads Looking for a Licensed Massage Therapist Part or Full Time available. Excellent opportunity to live in beautiful Northern Michigan. Fax resume (989) 732-0629. Reno Chiropractic Center in Sterling Heights, MI is looking for a licensed and certified massage therapist. Part-time (6 hrs./wk). Send resume to sreno26@hotmail.com. On site experienced billing and front desk help needed for two practices in Livingston County. Need solid, honest, dependable team members for expanding offices. sue@onthemillpond.com Experienced Chiropractic Assistant needed in a busy multi clinic office in Grand Rapids area. Salary is negotiable, based on experience.(616) 940-4647 or sandy@chirounlimited.com. Reliable Office Coverage. 26 year, experienced DC available for short and long term coverage. Diversified, activator, AK, Nutrition and more. Call Dr. Kathleen Akin at (800) 528-4223 for locations, references and rates. Chiropractor With 20 Years of chiropractic relief experience. Well versed in many techniques. Very reasonable half day and full day rates. MAC membership discount. References upon request. (586) 201-9020. It’s easier than you think to take the time off that you need. Office Coverage State Wide Since 1986. Full and half day rates. Emergency, maternity, short, and long term coverage. Large selection of licensed and insured chiropractors. We can help with your coverage and associate needs. Call for a FREE quote. 1 (800) 501-6111. www.mmachiropractors.com. Young and talented chiropractor available state wide work relief and coverage. Contact for rates and availability. 218-205-6141 or stephanmoje@gmail.com. Female DC available again for long and short term fill-in coverage in SE Michigan. Many years experience. Diversified, Activator, AK, Thompson Drop, therapy, nutrition. Reasonable rates and references. Call Dr. Lori at (734) 646.2045. bucky, bin, Flash Label. Like new, $9,500. (810) 6295566. $225.00. Call me at (248) 563-8771 to discuss further or for pics of the items. Bennett Linear 3,300ma, 125kv Bucky, cassettes, Developer Film bin, Flash ID, Darkroom light. Developer regular maintainence schedule. $6,200. You move and bear costs. Pics: winnersgroupinc@hotmail.com. Barnes flexion table with pneumatic drops. Cervical raise/lower/ I-S drop, Thoracic, Lumbar and Pelvic drop. Comes with T bar and air compressor. Newly upholstered. Email drszagesh@health1stchiropractic. com for information. FOR SALE: BIOMERIDIAN Vantage $3,500.00. Description: 2008 Vantage System, MSAS 2008 Software, Epic Stylus with Sure Touch Tip & Cable, Handmass & Extra Handmass Cable, Standard Probe and Cable, Power Supply Cord, Vantage Accessory Arm, Vantage Test Plate, External CD Drive, Battery (installed) & extra Battery, Quick Start Guide, Instruction Manuals, BioMeridian Brochures, Patient Waiting Room DVD, Practice Management CD, Large Pull Up Advertising Banner. Call Anne (586) 228-0270. ML830 class 3b Laser 4 yr. old, works excellent plus Station. Excellent support. $2,499 Dr. Manela. drmanela@gmail.com (248) 544 2400. Sale: Myovision 8000 sEMG, Zenith Hi Lo Table, Back Specialist Flexion Distraction, Proadjuster, Footleveler Orthotic Scanner, Ultrasound Stim Combo, Practice Management Program DVDs Manual, Banners and Videos. Call (586) 907-8113, email goodhealthdc@gmail. com. Brand New Erchonia Low Level Laser w/ Base station 3LT-complete system. Price is negotiable. Contact Tom at (313) 590-7997 or 4healthresume@gmail.com. Hill Table HA90C with all auto drops (cervical, thoracic, lumbar and pelvic drops, break away chest) Heritage fabric upgrade, slate blue, tan base, dual touch strips, $2,900. Call (517) 676-0788. Erchonia Laser PL5000 For Sale. 3 years old. Works Great. Recently serviced with new battery. Doctor does not have enough time to use and doesn’t want to hire additional staff to run it. $8,500 Call (616) 889-7182. Chattanooga Ergo Style elevation table with cervical, thoracic, lumbar pelvic drops. Slate blue. In good condition. $1,200. (734) 930-6990. Hill Anamotor cervical and lumbar traction. Good condition. $900. Call Dr. Terebelo (248) 593-8282. Barnes used flexion distraction elevation table with all drops and a swivel headpiece for sale. Black and slightly worn head piece. Selling for $2,500. Please email me at chirojobmi@gmail.com or text me at (906) 322-8212. Hill Anatomotor Table for sale. Like new. All attachments included. $1,500. email krystalrsiminski@ gmail.com. Exam Room Small 2-door metal cabinet, $300. (248) 593-8282. Light Force X, Deep Tissue Laser, 15 watt, includes 4 lenses, travel kit, marketyig material, training manual, $14,900. Call (248) 681-6804. Chattanooga stainless steel cold pack machine on caster wheels. Works great. $1,800.00 New. Sell for $400.00 or best (586) 719-0933. Zenith 230 HiLo. Pierce key dimensional. Headpiece, cervical, pelvic drop. New Heritage, excellent condition. $5,200. (313) 277-3766. Chiropractic channel letter sign. Neon letters 17.5” High 16ft 8” long. Mint condition, lights up brite with no issues. $1,999.00. Call (586) 719-0933. Mini Med Processor, 2 - 8x10 and 3 - 14x17 Green Cassettes, unused film. vaughnclinic@sbcglobal.net. Best Offer. Chirotouch EMR Software. New never used. Half price. Contact nuspine@mac.com. Zenith 260 Hylo Elevation Table, very good condition, $2,900 pick up only, text or call (231) 590-3704. Zenith ll 440 HILO for sale. Teal Heritage Covers. $3,900.00. Call (734) 672-2087 or email doc@hofmanndc.com. X-ray view boxes for sale: 4 double panel view boxes (14X17 EACH PANEL) from Star X-ray. They are in great shape. $50.00 each or all four for 175.00 . Flat bench table with arm rests Slate blue in mint condition Universal HP500 high frequency x-ray w/ 52 Wanted: An arthrostim or an electric or manual adjustment instrument. Please contact me at drmanela@gmail.com – Dr. Manela. Need Myovision surface emg-thermographyscannner. Call (734).454.5600 and ask for Vickie or Dr. Sisk or email model, how old and price to: 4healthresume@gmail.com. ChiroTouch EMR/EHR Software license. Purchased new for $11,250. Will sacrifice for $6,000 (approx. $2,500 in costs from ChiroTouch to install, transfer data, tech support & training buyer is responsible for.) glchiro@ chartermi.net. Reduce Overhead, Share space, Share Staff, Very affordable. Operate within a well equiped, CBP traction, decompression office that borders Wayne-Oakland county. without worrying about running the office. Livonia, 8 Mile and Farmington. Very accessible to I-275, M5 and I-96. Call Dr. Greg with inquiries (248) 615-1533. Is your Activator or Impulse device broken, misfiring, works when IT wants to? Drawer full of “spare” devices with known issues? www.tabledoc.com can fix those devices. Save money over new. All work warrantied. (517) 268-8089. Located in Lansing, MI. Is your table upholstery tired/ripped/covered with duct tape? Let our re-upholstery service cover that for you. www.tabledoc.com or (517) 268-8089. The Table Doctor. All colors available, foam extra. Work done onsite. Located in Lansing, MI. Measure the effectiveness of your treatments, phase angle from Bioelectrical Impedance Analysis objectively measures cellular level improvements to illustrate improvement. Don’t over pay for your BIA, call CellMetRx today, (989) 724-5631, www.vitalityanalyzer. com, $600.00, ongoing clinical support, independent peer-reviewed publications available. FREE Cold water film processor, bucky and bucky stand, (3)14 x 17, (2) 7 x 17, (1) 14 x 14 and (1) 8 x 10 rare earth cassettes and lots of film to a DC starting up. (248) 545-8550. Royal Oak. Place Your Classified Ad online at www.chiromi.com/classifieds MAC Journal • November/December 2014 Central Medical Imaging MAC Journal • November/December 2014 53 NCMIC 54 MAC Journal • November/December 2014