Category Archives for "Cultural Authority"

Apr 19

Putting the patient first: Choosing Wisely

By Kanwal Sood | Cultural Authority , Primary Spine Provider , Spine Care , Value-Based Healthcare

A call to action for the chiropractic profession

Choosing Wisely is a campaign of the American Board of Internal Medicine to educate patients about services that have the potential to be misused and overused, so that patients are comfortable opening dialogue with their providers about the most appropriate course of action to take.

The participation of the chiropractic profession in this program is a major leap forward in demonstrating professional maturity. Chiropractic participation is a definitive statement that chiropractors put the interests of the patients at the forefront of clinical decision-making.

We encourage you to share these links with your colleagues and most importantly, with your patients.

Choosing Wisely for Doctors

Choosing Wisely for Patients

Mar 06

Meeting Dr Don Murphy #2 – Physical therapy as part of an integrated spine program

By admin | Clinical Pathways , Cultural Authority , Disruptive Innovation , Low Back Pain , Primary Spine Provider , Spine Care , Spine Pathway , Spine Related Disorders , Value-Based Healthcare , Videos

Following on from part 1 introduction to Dr Don Murphy’s Rhode Island Spine Centre, here is #2 where Dr Murphy takes us through to the larger room used for more extensive exercises and discusses the role of physical therapists in an integrated spine pathway. Sign up to take our PSP course online which covers these topics fully:

Meeting Dr Don Murphy #2 – Physical therapy as part of an integrated spine program

Following on from yesterday's intro video to Dr Don Murphy's Rhode Island Spine Centre, here is #2 where Dr Murphy takes us through to the larger room used for more extensive exercises and discusses the role of physical therapists in an integrated spine pathway. Sign up to take our PSP course online which covers these topics fully: https://www.spinecloud.org/courses/Some key questions that are answered here:What hi-tech equipment is used in the facility?What is the most important aspect (i.e.” the one thing”) of any PSP & pathway facility & services?Is there any animosity between Chiros and Physios in the program?How do they work together in this program? What is the baseline authority?

Posted by Spine Cloud International on Tuesday, March 6, 2018

Some key questions that are answered here:

  • What hi-tech equipment is used in the facility?
  • What is the most important aspect (i.e.” the one thing”) of any PSP & pathway facility & services?
  • Is there any animosity between Chiros and Physios in the program?
  • How do they work together in this program? What is the baseline authority?
Mar 05

Meeting Dr Don Murphy #1 – A private practice as part of an integrated spine program

By admin | Clinical Pathways , Cultural Authority , Disruptive Innovation , Low Back Pain , Primary Spine Provider , Spine Care , Spine Pathway , Spine Related Disorders , Value-Based Healthcare

In January, I met with Dr Don Murphy at his practice (Rhode Island Spine Centre) in Rhode Island.  His practice began as a chiropractic practice, grew in size and reputation, and at Care New England‘s invitation,  was embedded into a fully integrated, interdisciplinary spine care pathway/program, with Dr Murphy as Director of the Program.  He took me on a tour of his facilities, and I asked him a bunch of questions – see video below.  We expect to have Dr Murphy on upcoming webinars and mentorship sessions. Sign up for exclusive access!  Dr David Peyton, DC, South Africa.

Meeting Dr Don Murphy #1 – A private practice as part of an integrated spine program

In January, I met with Dr Don Murphy at his practice (Rhode Island Spine Centre) in Rhode Island. Rhode Island Spine Centre began as a chiropractic practice, grew in size and reputation, and at Care New England's invitation, was embedded into a fully integrated, interdisciplinary spine care pathway/program, with Dr Murphy as Director of the Program. He took me on a tour of his facilities, and I asked him a bunch of questions – see video below. We expect to have Dr Murphy on upcoming webinars and mentorship sessions. Sign up for exclusive access! https://www.spinecloud.org/membership –Dr David Peyton, DC, South Africa.

Posted by Spine Cloud International on Monday, March 5, 2018

  • What are the fundamentals of this approach?
  • Why have an integrated pathway- i.e. what is it that patients really want?
  • How does the patient flow work at this facility?
  • Who manages the patients?
  • What modalities does the primary spine practitioner use?
  • How much space is needed?

 

Jan 28

The Choosing Wisely® Campaign- NCLC 2018

By Kanwal Sood | Clinical Pathways , Cultural Authority , Primary Spine Provider , Spine Care , Spine Related Disorders , Value-Based Healthcare

The Choosing Wisely® campaign was developed by the American Board of Internal Medicine Foundation to facilitate informed and collaborative discussions between doctors and patients about the necessity, efficacy and risks and benefits of common tests and procedures. The Choosing Wisely initiative looks to doctors and the societies representing them to underpin these efforts by identifying a “Top Five” list of evidence-based recommendations that draw attention to potentially unnecessary tests or therapies. ACA‘s Choosing Wisely list was developed after several months of careful consideration and thorough review, using the most current evidence about management and treatment options.

The National Chiropractic Leadership Conference presents Am I Choosing Wisely? How to Implement Choosing Wisely in Your Practice on Saturday, March 3. Join us as we discuss the background of Choosing Wisely and the development of the ACA Choosing Wisely statements. Additionally, attendees will hear how the panelists are implementing the recommendations into their practices.

Register here

Apr 22

Constructive Disruptive Innovation: First Touch and Spine Care

By John Ventura | Cultural Authority , Disruptive Innovation , Spine Care , Spine Related Disorders

Written by John M. Ventura, DC, Spine Care Partners, LLC, and Michael Allgeier, DC, medical director, Mercy Spine and Back Care, Mercy Hospital Chicago, IL | Wednesday, 02 July 2014, originally published in Becker’s Spine Review.

When it comes to new technology, Christensen’s model of disruptive innovation can be fairly well understood.

New markets with added value are created by the introduction of a new business model (not just a new technology), which disrupts the existing market. The transistor radio is a classic example of a disruptive innovation. (1)  However, when we discuss a system built upon process, like healthcare, the notion of defining disruptive innovation becomes more challenging. Perhaps O’Ryan’s description of constructive disruptive innovation becomes more relevant. In this construct the goal is to create a model that is less expensive but more creative, more useful, more impactful while still being scalable. Constructive disruptive innovation combines ‘off the shelf’ technology/ideas with the novel and original to improve the process. (2)

It goes without saying that the field of spine care is replete with variation, waste and misuse. Direct costs for spine care have risen almost exponentially over the past three decades, while indirect costs (those typically associated with lost productivity) have followed suit. (3) In spite of these exorbitant expenditures on spine care, our outcomes as measured by disability are worsening.  Many investigators have identified spine-related disorders as one of the costliest health conditions society faces. The need for change is obvious, but what change and how do we get there?Read more

Apr 22

Spine Care: An Unlimited Opportunity for Chiropractors

By John Ventura | Cultural Authority , Primary Spine Provider , Spine Related Disorders

By Michael Schneider, DC, PhD, Donald Murphy, DC, DACAN, David Seaman, DC, MS, DABCN, John Ventura, DC, DABCO, Ian Paskowski, DC, Richard E. Vincent, DC and Stephen M. Perle, DC, MS.  Originally published in Dynamic Chiropractic 2012.

The American health care system is in crisis. We have an unsustainable growth in health care expenditures that will consume 20 percent of our gross domestic product within the next five years.

Last year, this crisis culminated in passage of the Patient Protection and Affordable Care Act by Congress. Although parts of this act are currently being legally challenged, the health care reform train has left the station. The question is whether chiropractors are going to board this train, watch it pass by, or be run over by it.

There is a specific “subcrisis” within the broader health care crisis; the medical mismanagement of spine problems. Back and neck pain, as well as related disorders such as radiculopathy and cervicogenic headache, continue to be the most common reason for disability in American adults and the second most common condition for which patients seek medical care. Patients are faced with an environment in which a wide variety of practitioners offer a disparate array of diagnostic tests and treatments, many of which are completely unnecessary.

In addition, there is little or no coordination of services and no central resource to which patients can turn for guidance through the spine care maze. Spine surgery rates are higher in the U.S. than in any other nation in the world, inappropriate use of imaging and injections is rampant, and the number of Americans addicted to prescription pain medications is at an all-time high.Read more

Apr 22

Achieving Cultural Authority as a Spine Care Provider

By John Ventura | Cultural Authority , Primary Spine Provider , Spine Related Disorders

 

Authors: John M Ventura, DC, Jay Triano, DC, Ph.D., Michael Hubka, DC

 

The ability of medicine to achieve cultural authority in the early 1900s was a “confluence of factors encompassing professionalism, the Industrial Age, and an incentive-­skewed market.” (1) What may be most remarkable, given the almost exponential growth of health care costs through the 20th century, was the duration that medical cultural authority went unchecked. Medicine was said to have achieved “professional sovereignty.” Overextending its reach to protect self-interest, medicine squandered its public trust, encouraging the managed care movement and losing authority along the way. The relevance for the chiropractic profession is that cultural authority is defined by society through its structural operations and is granted to professions to the extent that trust is earned.

Cultural authority may best be defined as the accumulation of public trust that warrants the progressive granting or relative autonomy and ability to self-­‐regulate based upon the demonstration of legitimacy and competency by a professional group. Once achieved, cultural authority allows a profession, through its body of abstract knowledge, to define its own professional truth. The profession decides what is fact and what is fiction and the public accepts the rules set forth. Cultural authority is characteristically unique in “having authority without having to overtly exercise it” as opposed to social authority, which is the ability to command people. The two primary features of cultural authority, competency and legitimacy must be achieved collectively as a group. While individuals may acquire local reputation, it is the profession’s aggregate which conveys meaningful warrant of trust and authority. Competency is the exercise of advanced abstract knowledge in the demonstration of technical expertise. Legitimacy is achieved through the competent advance of public health.

 

If we can agree that achieving cultural authority is in the best interests of the chiropractic profession and the public we serve, then what steps can be taken to enhance cultural authority? By the collective efforts of the profession as a whole, the following recommendations by Enzman to medical profession also serve the chiropractic profession:Read more

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