Monthly Archives: March 2010

Clarification Re Insurance Industry Policy vs. The Administration of Laser Therapy

03/26/10

 

Insurance carriers appear to demonstrate an undue level of concern with the designation of healthcare professionals administering Laser Therapy. This article is designed to clarify this issue. First it should be noted that Laser Therapy can be administered by a duly trained physician, physiotherapist or chiropractor, based on the knowledge and expertise acquired at our certification course, complemented of course with subsequent experience. Moreover, the above designated healthcare professionals can perform an assessment and prescribe the protocols as required. They can then administer Laser Therapy directly or delegate it to any certified laser therapist under their supervision, someone who may not be licensed to diagnose. Despite this, some carriers will pay a physiotherapist but not the other designations and other carriers will pay the chiropractor but not the other two professionals and so forth. To anyone with a functional IQ, this would appear to be irrational and indeed qualifies under that category. In essence, there is no logical or legal foundation for this position.

At Meditech, a team of healthcare professionals participate in the process of assessment, protocol prescription and the actual administration of the therapy. All the individuals involved in the process are qualified laser therapists and are able to integrate this technology into their therapeutic programmes, as clinically indicated. At our facility, laser therapy is generally utilized as the basic treatment platform, although sometimes complemented by other technologies.

Within the team concept, the various disciplines work collaboratively to provide the “best practice” standard in order to achieve an optimal clinical outcome. It is important that everyone, particularly insurance carriers, clearly understand this process, designed to protect the patients best interests.

To summarize – At Meditech, we offer a comprehensive therapeutic programme designed on an individual basis in order to achieve an optimal clinical outcome. This may include periodic participation by the physician, the physiotherapist and/or the chiropractor, along with those who apply the therapy under supervision. The latter include kinesiologists, laser therapists, massage and exercise therapists, again working on a collaborative basis.

A Commentary on the Professional Fundraising Industry

03/19/10

Each year the National Post, the Globe and Mail and other national newspapers contain an eight page insert, advertising the wonderful works performed by the Arthritis Society. I always review these publications with great interest, particularly as our clinic administers up to eight hundred treatments each week, many of them for the treatment of arthritis. Despite this and the fact that Laser Therapy is currently being adopted by clinicians who are passionate about wanting to help their patients, laser therapy has never been mentioned in any of these elegant treatises. Indeed, over 70% of the patients that we treat at our clinic suffer from degenerative osteoarthritis, rheumatoid arthritis, systemic arthritis and a number of arthritides of varying etiologies.

Our technology is currently utilized in over forty countries worldwide including hospitals, clinics, rehabilitation centres and other health care facilities. Moreover, our organization conducts a significant body of scientific research and annually contributes thousands of dollars to worthwhile organizations anonymously. In addition, we provide many thousands of dollars of treatment annually without charge, primarily to needy, elderly citizens, who are often neglected.

It should not be a surprise that I am somewhat perplexed by these newspaper ads whose intent, after many years of reading, I am unable to grasp. I expect it is designed to increase the funds raised for reasons that are largely undisclosed. This organization, much like other fundraising groups, maintains an extensive staff, spends considerable resources on advertising and like most corporations attempts to increase their annual gross, presumably to reward management with generous bonuses, commensurate with their fundraising efforts. At the same time my research and experience leads me to believe that the not inconsiderable contributions, do not appear to provide any direct or indirect benefits to arthritis sufferers. Does anyone ever question what happens to these funds, i.e. where do they end up and why? – nor have I ever seen explanations provided by management. For instance, the most recent insert in the National Post dated January 2010, on its cover features an elegant sketch of the skeletal outline of the spine. At the bottom of the same page, it recommends the use of Rub A535, described as the #1 pharmacist recommended brand. Moreover, it is advertised as being recognized as the most arthritis friendly product and is recommended by the Arthritis Society. What is Rub A535 and what benefit does it actually provide?

On Page 2, it begins with an article written by the President and CEO of the Arthritis Society. In essence, it states that “arthritis is a problem” in our society. It quotes a number of statistics which are meaningless. On most of the pages, there are advertisements which may be misleading, repetitive and appear to have no relevance. Osteoporosis is extensively discussed and we all know that this is a disease associated with aging, lack of activity and poor dietary habits. There are many simple preventative measures that can be followed on a daily basis, to effectively counteract the negative aspects of this condition; i.e. a healthy balanced diet, some vitamin and mineral supplements and a minimum of 30 minutes or more of vigorous daily activity, yet none of these are stressed.

The 8-page compendium in the newspaper reveals nothing that is unknown, provides no effective solutions and concludes with a full page ad sponsored by Abbott Immunology. This infers that Abbott Pharmaceuticals can provide help in these situations, although there is nothing included that specifically states how.

Six years ago, a member of my organization made contact with the CEO of the Arthritis Society. After several discussions, a representative from the society was sent to our offices to explore our technology. Clearly, this was not someone at a significant managerial level and this individual spent most of an hour bemoaning the fact that her boyfriend was moving out of their joint residence and she did not know how to deal with this. She had no knowledge whatsoever of arthritis, laser therapy or medicine.

If the Arthritis Society were truly focused on helping people with arthritis, they would be exploring new therapeutic avenues and actually attempt to help the afflicted, rather than simply raising funds, which to all intents and purposes seem to disappear into the great nowhere.

The Global Crisis in Healthcare

03/1/10

Insurer Steps Up Fight to Control Health Care Cost, by ANEMONA HARTOCOLLIS

Recently an article in the New York Times dated January 25, 2010 caught my attention; the title – “Insurer Steps Up Fight to Control Health Care Cost”. With regard to this publication, I state as President Obama did in his healthcare speech late last year, “that this issue must be resolved before healthcare can be delivered with the primary objective of providing the best possible care available, directly to patients.”

Increasingly, in my office practice the single most pervasive and negative factor each day are the therapeutic restrictions imposed by insurance carriers. In my personal opinion, patients are entitled to the best care available for any particular problem. This should be the basic platform of quality healthcare, yet insurance carriers have become increasingly obstructive in allowing this process to take its course. If the proposed mode of treatment is not covered, permission to initiate treatment is invariably delayed. Consequently, the healing process is prolonged, is generally less effective, the condition may become chronic and the cost of care is substantially increased. Currently, my office requires one full-time secretary to assist patients in attempting to resolve these issues in order to permit the initiation of proper treatment.

For example – just 3 weeks ago, a patient presented on a Saturday morning having sustained a severe skiing injury to the right shoulder on the previous day. At the resort where this occurred, an X-ray had been taken and interpreted as being normal. The patient was provided with analgesics and a sling and was sent home. On the Saturday morning following the injury of the previous day, the patient presented at our clinic in acute distress. Over the next 3 weeks, 12 laser therapy sessions were administered. This resulted in complete resolution of the problem.

An orthopedic consult, requested initially, has still not reached the head of the waiting line. An MRI performed 2 weeks after treatment had been initiated, reported the presence of a Hill-Sachs fracture and extensive ligamentous and other soft tissue damage.

If the parents of this 15 year old boy had not been willing to short-circuit the system, institution of therapy would have been delayed, the course of treatment prolonged with undoubtedly a less than an optimal outcome. This is a clear-cut example where early treatment consistently applied and monitored can achieve an optimal result, devoid of any other considerations. It has still not been determined whether there is insurance coverage although both parents are high level professionals and are “supposedly” covered by several insurance policies. Incidentally, the patient has made a complete recovery, including a normal pain-free range of motion of the left shoulder, while the insurance battle rages on.

The hours of secretarial time wasted on paperwork and telephone calls required in order to stimulate carriers to honour their obligation is becoming increasingly complex and invasive. As we all know from personal experience insurance companies and their sales minions are happy to sell policies and collect premiums. Their glowing ads promise security, unlimited benefits and infiltrate the media at all levels. At the same time, the series of hurdles imposed on the way to compensation is becoming insurmountable. These imposed economics overshadow the need for both urgent and high quality care, which should be the primary concern. The result – an impasse in the delivery of healthcare, strangled by carriers primarily interested in profit margins. The ramifications of this state of affairs are negative from every perspective, particularly when an immediate and positive approach is so essential. No one appears to be pro-active in the struggle to correct these deficiencies, which play a major role in the breakdown of healthcare delivery systems. Before we can continue to move forward in a positive manner, this impediment must be removed.