1

The Virginia Voice Summer 2012

Join Your Colleagues

Premier Members at May 1, 2012

Dr. Daniel AtwellDr Anthony Avedisian

Dr. Jeffrey BowersDr. Jeremy BuschDr. Chris Connolly

Dr. Phillip ConnollyDr. Camille D’Amato

Dr. Gary DennisDr. Diane DeReu-Foley

Dr. David DolbergDr. William Todd Fisher

Dr. Joe FoleyDr. Christopher FreyDr. Michael GeherenDr. Jay Greenstein

Dr. Lawrence GriffithDr. Mark GutekunstDr. Tom HennesseyDr. Duane HudspathDr. Joseph KennedyDr. Elizabeth Koch

Dr. Bob Leib

Dr. Franklin LukeDr. Meredith OudtDr. Minesh PatelDr. Robert Pinto

Dr. Brad RobinsonDr. Nisha Saggar-PatelDr. Tim ScheuermanDr. Matthew Schrier

Dr. Randy ShortDr. Lonnie Slone

Dr. Will SonakDr. Sam SpillmanDr. Robert Thoma

Dr. Ray TuckDr. Kevin WalshDr. Greg Walter

Dr. Bill WardDr. Tom Wetzen

Dr. Joshua WhiteDr. M. Scott WhiteDr. Adam Wilding

Newly

Upgraded!

Valerie Hoffman, DC Elected President of

the Virginia Board of Medicine

Dr. Valerie Hoffman

of Danville was elected president of the Virginia Board of Medicine in June. She has served on the board since being appointed to it by Governor Mark Warner in 2005, and previously served as the board’s Secretary/Treasurer and Vice President. Dr. Hoffman is the first Doctor of Chiropractic to serve as board president since the practice of Chiropractic was placed under the board’s administration in 1944. Dr. Hoffman, a native of Florida, has practiced in Virginia since 1996. She is a Fellow of both the National Board of Chiropractic Examiners and Federation of Chiropractic Licensing Boards, and is an associate member the Federation of State Medical Boards. Hoffman is also a former member of the test writing committee for the National Board examination for doctors of chiropractic, and previously served as a National Board examiner. She is a Long-time member of the state association and a past chair of the Virginia C-PAC. Congratulations, Dr. Hoffman!

Fall Convention Preview

FallConvention

Program:

Page 20

Take Me to the River... Again

In response to enthusiastic feedback from an unprecdented number of last year’s

fall convention attendees, this coming meeting will return to Kingsmill Resort & Spa in Williamsburg on October 12-14. Was it the spacious, villa-inspired accommodations at fantastic rates? The comfortable meeting environment? The four golf courses, five restaurants, full service spa, pools and tennis, free shuttle to Colonial Williamsburg and Busch

Gardens, and long list of other amenities? The strong programming providing not just CEUs but inspiration and fun? Evidence suggests that it was a combination of all of the above -- and we’re determined to make this Fall Convention at Kingsmill even better than the last. For a peek at the multiple education tracks, allowing you to attend the classes that fit your interests, needs, and practice style -- and the high caliber, professional instructors bringing it all to you -- go to page 20.

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3

Patient Privacy Is Dead, & Facebook Killed It

K. Marshall Cook, Esq., Unified VCA General Counsel

An EMR vendor proclaimed at a recent physician meeting: “Patient privacy is dead . . . and Facebook killed it.” There’s

lots of truth in what the vendor says. Who cares about patient privacy these days anyway? For one, the United States Office of Civil Rights (OCR) does. Any physician or medical group staff member who ever thought about directly or indirectly posting any – repeat ANY – information about a patient on Facebook should consider:• Earlier this year, an emergency room physician in Rhode

Island was reprimanded and fined $500 by the state medical board because she posted information about a patient on Facebook. She didn’t include the patient’s name, but she wrote enough that others in her community could identify the patient.

• The General Hospital Corporation and Massachusetts General Physicians Organization, Inc. (Mass General) has agreed to pay the U.S. government $1,000,000 to settle potential violations of the HIPAA Privacy Rule. The settlement followed an extensive investigation by OCR.

• OCR has issued a Notice of Final Determination finding that Cignet Health of Prince George’s County, Maryland violated the HIPAA Privacy Rule. The U.S. Department of Health and Human Services imposed a $4.3 million civil monetary penalty for the violations, representing the first such penalty for a HIPAA violation.

• A Wisconsin hospital and several in California have made headlines as nurses and other staff members were fired for writing about patients on Facebook or posting photographs of them online.

Consider also the ICU nurse who blogs about her

experiences in dealing with a patient, forgetting that one of the patient’s family members ─ a recent addition to her network of friends ─ has access to her blog. Or the physician whose clinical judgment is questioned because of photographs posted online showing him in progressive stages of apparent inebriation at a department holiday party. Everyone and their mother is on Facebook now. The old strategy of only friending (I’m beginning to hate that word), well, friends, as opposed to your coworkers, ministers, dentists, whomever, is a thing of the past. Physicians are people too, and anyone whose spouse makes them watch Grey’s Anatomy knows that medical workers have plenty to complain about. Ethically and legally, violating the privacy of the patients under your care may produce a much worse result than publicly insulting your boss. Creating a new platform for individual and group interaction, social networking sites like Facebook create new challenges for those working in a clinical setting. In an e-mail to medical students and faculty of Harvard Medical School, Dean for Medical Education Jules Dienstag wrote: “Caution is recommended . . . in using social networking sites such as Facebook and MySpace. Items that represent unprofessional behavior that are posted by you on such networking sites reflect poorly on you and the medical profession. Such items may become public and could subject you to unintended exposure and consequences.” Medical groups, large and small, finally are beginning to craft policies to prevent both dumb and illegal overshares. Your chiropractic practice should severely restrict, if not prohibit altogether, this conduct by both physicians and staff. Written policies regarding the use of Continued on page 5

4

5

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the U.S. Department of Labor?

If so, you may be receiving far less than the maximum allowable amount for the procedures you are billing. Our office would like to offer you a free consultation and review of your billing to the U.S. Department of Labor. By providing us with the amount you are bill-ing per CPT Code along with your office zip code, we can verify whether or not you are actually receiving the maximum allowable amount for that procedure from the U.S. Department of Labor. The review is free and you may even be entitled to more money.

If you are interested in this free billing review, or would like to discuss this further, please contact me:

David A.Testone Associates

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e-mail and social networking sites to discuss office occurrences, both during

and after office hours, should be adopted. The consequences of not limiting this conduct can be severe.

K. Marshall Cook is the Unified VCA’s general counsel and an expert in Virginia healthcare law. Mr. Cook practices in Manakin-Sabot, Virginia and can be reached by phone at (804) 784-1900. His web site is www.kmarshallcook.com.

Continued from page 3

Dr. Jennifer Rathmann Named ABWA Chapter Woman of the Year

Unified VCA Member Dr. Jennifer Rathmann was

named the 2012 Woman of the Year by the NRV Express Chapter of the American Business Women’s Association (ABWA) on June 20. Dr. Rathmann is a Senior Partner of Tuck Chiropractic Clinic. Along with an active practice in Blacksburg, she serves as the company’s Clinical Operations Manager. Dr. Rathmann has established a strong connection with the New River Valley Community. She is an active member of the Montgomery County Chamber of Commerce and Downtown Blacksburg, Inc., and served as the membership chairperson for the ABWA. She is also a board member of the Valley Interfaith Child Care Center. Dr. Rathmann has been a Rotary member, American Red Cross board member, and United Way volunteer. Congrats, Dr. Rathmann!

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Chiropractic Centers of Short PumpJames D. McLelland, D.C. / 804-523-8016

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Pulling Together

Lee Matthis, DC & Jeff Miller, DC

As we pen this article we are recovering from a tough week. The storms that passed through Virginia the last weekend of

June left many of us with property damage and without electricity. Utilities other than electrical power were also affected. Water, phone and cable television services were lost in many areas. The problems were then compounded by abnormally high temperatures making the lack of air conditioning much worse than it would have been with our normal weather patterns. Despite what some thought of the power companies’ response in the situation, we actually felt sorry for them as they dealt with the situation. They had to deal with a great number of calls, complaints and demands from hot desperate residents and business owners. It was a tough week for them, too. As we traveled during the week, we frequently saw convoys of utility trucks heading to troubled areas. Most of these convoys were made up of trucks and linemen from other regions and states. One news report stated that sixty percent of equipment and linemen from Kentucky were sent to Virginia immediately after the storms. You may have noticed the convoys as we did or you may be aware of the utility companies’ cooperation through your patients. You have probably treated linemen and utility workers who disappeared for weeks following large storms in other areas. They pack up and head out to help knowing the favor will be returned for their communities when a severe storm strikes. You have to appreciate the hard work of these folks and their cooperative efforts are a great example for everyone. Chiropractic can take a lesson here. While we have made great strides in our cooperative efforts through unification and the formation of The Unified Virginia Chiropractic Association, we have more work to do. Too many chiropractors still do not belong to the UVCA. We are not pulling together enough during the storms and there are always storms. One way to address this is by using our knowledge of marketing. We all know that external marketing (radio, newspaper and other ads) can bring in new patients, but the best source of new patients comes from established patients. The personal referral of a friend or family member is strong and effective. Information from the UVCA through e-mails, newsletters, websites, press releases and other media are effective in keeping members up to date and recruiting new members and the UVCA staff does a very excellent job with these tools. The members however, can help by making personal referrals. If every member took a colleague who does not belong to the UVCA to lunch or dinner this month and invited the colleague to be a member, it could go a long way toward increasing membership. Would you make this commitment? It is a small effort that can have significant results. The worst thing that can happen is the doctor will say, “No”. And if he or she does say, “No”, remember they are still one of us. Agree to disagree and don’t widen the gap between the members and non-members. While we want everyone to participate, realistically some will never join. Despite this, if you know your neighbors and colleagues are having trouble weathering the storm, help them. Ultimately, we are all in this together.

Drs. Lee Matthis and Jeff Miller are Unified VCA members practicing in Christiansburg and Blacksburg with Tuck Chiropractic. Dr. Matthis is the association’s district director for southwest Virginia and chair of the philosophy/ethics committee. Dr. Miller has presented at several conventions.

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D.C.s Spend Their NCMIC Premium Dividend Checks

Let Me Count The Ways …

I stay with NCMIC because, unlike some other malpractice insurance companies, they support the chiropractic profession. My premium dividend check, in effect, lowers my premium.Mary Rutkowki, D.C., D.A.B.C.O. | Center Valley, Pennsylvania

I donate to chiropractic research because I think it will be vital to sustain and advance our profession.Tracy J. Smith, D.C. | Sioux Falls, South Dakota

With the economy, expenses can be tough. I don’t know of any other companies that give back through a premium dividend. With NCMIC, you support the company and they support you.John D’Amanda, D.C. | Crossroads, TX

I really appreciate the fact that NCMIC pays dividends every year. I usually attend CE seminars that are within driving distance, but this year I used my dividend check to fly to Las Vegas for a sports chiropractic seminar.Doug Berry, D.C. | Puyallup, Washington

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Find out how you, too, can become eligible for NCMIC premium dividends along with the many other ways you can benefit from the NCMIC Malpractice Insurance Plan.

Call 1-800-769-2000, ext. 3120.

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Ensuring the Continuation of Your Business

Kristine Lansing, Financial Advisor, Virginia Asset Management, LLC

You hope your chiropractic practice has become a reflection of yourself: it’s an efficient, dependable, and well-run operation

that follows through on your customers’ wants and needs. But what would happen if a change in ownership was necessary, perhaps due to unmanageable costs or even the death of you or your business partner? Could the surviving partner pay for unforeseen expenses? Could the practice retain its employment base? Whether your practice is just emerging, flourishing, or maturing, your business and personal financial needs are unique. But sooner or later, most small business owners ask themselves three basic questions:1. How do I prepare for the problems that come with changes in

ownership?2. As the owner of my chiropractic practice, is there a way to use

business dollars to pay for some personal expenses?3. Am I getting the most I can out of my employee benefit dollars? Each of these situations can be dealt with through adequate business planning.

Strategies for Changes in OwnershipIf you or a business partner died, it would be comforting to know now that your chiropractic practice would continue to run smoothly. There are several options to ensure its continuity. One method is a buy/sell agreement. This establishes the value of your practice and assures a ready market for your share in the practice after the death or an owner. With life insurance funding the agreement, the surviving partner(s) are assured of the means to buy out heirs and retain control over the practice, and the deceased owner’s stock can be converted into cash for the heirs.

If you should lose a key employee, you may lose considerable time and money trying to find and train a replacement. Key employee life insurance provides you with the funds you need to keep the practice running smoothly during this difficult period. Another option is to carefully incorporate your business needs into a total estate plan. This way you’ll avoid severe liquidity problems for the heirs of your estate after your death. At the same time, you’ll be able to meet your estate tax and liquidity needs while you preserve the full value of your practice for your family and associates.

Using Business Dollars for Personal ExpensesThere are also ways to provide benefits for yourself by using your business’ checkbook. The fact is, you can actually pay some of your personal expenses using your practice’s money, and receive favorable tax treatment at the same time. Your practice can help you pay for your own life insurance by “advancing” you money to pay the annual premium. The cost is low and the advance is paid back from the insurance proceeds. This benefit can also be extended to your key employees. As with any tax strategy, you should consult with your tax advisor regarding your specific tax situation. Disability insurance is always a desired form of insurance to have when owning a chiropractic practice since the likelihood of a career-ending disability is far greater than a premature death. Your practice can provide you and your employees with personal disability insurance that continues a portion of your salary when you’re unable to earn it, and the premiums (in most cases) are tax deductible. Continued on page 11

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In addition, your practice may be able to help you pay your estate taxes and

settlement costs if your stock is worth more than 35 percent of your adjusted gross estate. The practice can redeem some of the stock from your estate and produce cash to meet your estate’s obligations.

How to Use Employee Benefits to Increase Income and Improve Key Employees’ Retention

Can you keep your employee benefits competitive yet still affordable? One way to do this is with a salary continuation strategy. With a salary continuation strategy in place, you have the financial means to protect your key employees, your practice, and yourself from the adverse financial consequences of disability. In many cases, if the program is funded with disability insurance policies, the premium payments are tax deductible as a necessary business expense of your company. In addition, company-sponsored employee pension and profit-sharing plans are a necessity when retaining your best employees and ensuring the success of your practice long after you’re gone. Employees may save pre-tax dollars and invest them on a tax-deferred basis for retirement. Any contributions you make to the plan are tax deductible. Other benefits that can help you retain key employees include executive bonus plans, which are methods of providing life insurance to employees and a current income tax deduction for your company, and personal financial analysis, which helps them effectively manage their money while achieving their financial goals. Finally, when trying to attract new employees (as well as retain existing ones) keep in mind that today’s employees look for and expect strong insurance programs, especially for medical, disability, and life insurance, as a part of the entire compensation package. In return, you’ll receive tax deductions for the premiums you pay out. An effective business strategy will help you achieve the best of both worlds: overall reduced business costs to retain your competitive edge in the current marketplace, and the retention of effective, highly motivated employees who can provide the financial strength and stability to your practice that will ensure its continuation long after you’re gone.

[This information is a general discussion of the relevant federal tax laws. It is not intended for, nor can it be used by any taxpayer for the purpose of avoiding federal tax penalties. This information is provided to support the promotion or marketing of ideas that may benefit a taxpayer. Taxpayers should seek the advice of their own tax and legal advisors regarding any tax and legal issues applicable to their specific circumstances.]

Kristine Lansing is a financial advisor at Virginia Asset Management, a Unified VCA Supporting Supplier. She can be reached at (804) 327-0432, email kristine.lansing@vamllc.com.

Continued from page 9

Victory on a PI Case Using Unified VCA Assignment of Benefits Materials

From Mark Gutekunst, DCPosted on VCAdoctalk, 7/18/2012

Thank you to those that created the Unified VCA assignment of benefits form, as well as for the Attorney General letter. Literally

just got off the phone with Allstate in reference to an outstanding large bill on a PI case where they sent a reduced negotiated sum to the patient and she subsequently file bankruptcy. Normally that would have [negatively impacted] me, but not with the lien. Oh, the insurance company tried to say they didn’t get it. We produced the ‘return receipt’ from the post office and the signed lien they DID receive. They tried to explain that the minimal damage negated the injury amount and hence the large bill (it wasn’t that large, 3k). I then gave her some studies over the phone from Arthur Croft and told her that I will be more than happy to see them in court if they find it cost effective to do so. She then said that a check would be forth coming in full if I would not file suit. I said sure, as soon as I receive said check in my hand. Victory.

Lesson:1. Use VCA form2. Send with a copy of the AG letter3. Send certified return receipt

Dr. Mark Gutekunst, a Unified VCA member, runs Chesapeake Wellness Center in Chesapeake.

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Seven Reasons to Take Posture Pictures along with X-rays

By Dr. Steven Weiniger

Posture pictures are an essential tool for the musculo-skeletal professional, perhaps as

important as x-rays! DCs once routinely took 14x36 films to observe whole body distortions, but for a variety of reasons most DCs today depend on 14x17 films, which means they can rely less on radiographic findings of the whole body bio-mechanics to guide their adjustments and treatment. Even for adherents of techniques that rely on x-rays, reducing exposure and expense is appreciated. And while x-rays are invaluable to screen for osseous pathology, rule out red flags or observe disc degeneration or other level specific tissue changes, and MRIs are an even better (albeit expensive) diagnostic tool, Posture Pictures are inexpensive and complement x-rays in some surprisingly significant ways.

#1 - OBSERVING GlobalBio-Mechanics of Posture

Structural screenings, especially looking at the 4 PostureZones (the weight bearing zones of posture-head, torso, pelvis and lower extremities), is easier from a whole body gridded image than just looking at a specific region on an x-ray. If you agree that posture is important, then carefully examining a photo of the overall body posture gives you the opportunity to correlate symptoms, exam, palpation and other findings with their body mechanics. And tie it all together in a narrative explaining the problem...which creates value for reason #2.

#2 - COMMUNICATING andEngaging Patients

I’ve shown many people the curves and spurs of their spine. Early in my career that was how DCs explained to a patient what was wrong. To my frustration, many patients didn’t care. Patients then and now wanted to know, “Can you help me”. Think about this: When you see yourself in a photograph of 5 people, who do you look at first...and hardest? Right: YOU. We are wired to look at ourselves. People are intently interested in your words when you “connect the dots” between their problem and a picture of their body, using biomechanics as a framework to explain your objective findings. A report analyzing their posture -- software generated or using a felt-tip marker and a ruler on a printout -- is a great reminder to help them understand and retell that narrative, which creates value for reasons #3 and 4.

#3 - DEMONSTRATING ProgressPeople are engaged and want to see changes when you retake Posture Pictures -- at the end of a phase of care, or when you compare this year’s annual posture picture to prior ones. A digital photo against a grid to track progress makes sense, and can be done far more often than x-rays to assess

any changes and build body awareness.Continued on page 13

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#4 - DOCUMENTING for Insurance Carriers and Other Third Parties

Pre- and post-treatment Posture Pictures of a patient can show change and demonstrate real value....even to a skeptical claims examiner.

#5 - AFFORDABLE Expense, No Radiation ExposurePosture Pictures only require a camera and printer. Evidence-based care communities support less x-rays, and insurance guidelines have diminished the value and reimbursement of x-rays. While adherents of some techniques strongly disagree with insurance companies (actually, most everyone disagrees with insurance companies) it makes sense to minimize exposure and unnecessary expense, as well as improve patients’ understanding of their own bodies.

#6 - Positioning a PracticeTeaching patients to be aware of their posture reinforces the importance of chiropractic adjustments in maintaining their ability to stand tall and aligned and move full range with symmetry. And the first step in strengthening posture awareness is with a photograph -- which people often show to friends and family when they talk about their “posture doc”.

#7 - Positioning the Chiropractic ProfessionChiropractors do not agree about many things, and many people do not agree with anything about chiropractic. However, no responsible voice in healthcare argues with the benefits of standing up straight vs. slouching. And especially as boomers slump into their senior years, posture will grow in relevance and is a potential unifying branding message for the chiropractic profession. Posture is functional and dynamic, so improving posture does not merely mean standing up straighter. Improving...or strengthening... posture means improving the balance and alignment of the body, and maximizing moving with stability (e.g., avoiding injury) in the tradeoff between flexibility and stability, between motion and effort. But that’s the subject of another article. Bottom Line: Posture Pictures create value by engaging and educating patients. PRACTICE TIP: Put up an office sign saying “Have You Had Your Annual Posture Picture?”

Dr. Steven Weiniger is author of Stand Taller ~ Live Longer: An Anti-Aging Strategy, and lectures internationally on exercise & posture rehab -- including the Unified VCA’s Spring 2012 Convention and July seminar. Dr Weiniger has been featured in numerous articles on posture, anti-aging and exercise as well as media including FOX News, Oprah’s Oxygen network, Natural Health Magazine, American Fitness and Bottom Line Health. He promotes the brand identity of Posture Expert for DCs and serves as Managing Partner of BodyZone.com which provides posture, c h i r o p r a c t i c and wellness i n f o r m a t i o n and referrals to CPEPs (Certified Posture Exercise Professionals).

Continued from page 12

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Welcome, New Members!

The following individuals have joined the Unified VCA since the preceding issue was published.

Camidge, DC, Craig Tuck Chiropractic Clinic Roanoke, VA Phone: 540-774-4443ccamidge@tuckclinic.comFourth Year or more DC

CHIROPRACTIC TRAFFIC Prados, Matt Laguna Hills, CA Phone: 714-486-1854matt@chiropractictraffic.comAllied SupplierInternet marketing

Cho, DC, Jong HeeActive Care Chiropractic & AcupunctureFairfax, VAPhone: 703-539-8822jonghee64@hotmail.comFourth Year or more DC

Chow, DC, WilliamUnited Wellness CenterHerndon, VAPhone: 703-437-8195amcintyre@unitedwellnesscenter.comART, Graston Technique, Kinesio Taping First Year DC

Connor, DC, Sean MSpine Align, LLCAshburn, VAPhone: 703-729-3622doctorseanconnor@yahoo.comPalmer PackageSecond Year DC

Hall, DC, John Richmond, VA Phone: 804-321-7756johnwhalldc@yahoo.comPettibon, Palmer PackageFourth Year or more DC

Haselhorst, DC, Kevin Milestone Chiropractic Ctr Fredericksburg, VA Phone: 540-656-2885Third Year DCFull spine, myofascial release, pregnancy, pediatricsReferred by Dr Jeff Bowers

Hudgins, DC, Shawnté Skyline Wellness Center Alexandria, VA Phone: 703-879-5144Second Year DC

KAIZENOVATION CONSULTING Greenstein, DC, CCSP, Jay Ft Washington, MD Phone: 301-518-1006drjay@kaizenconsult.comAllied SupplierClinical CE, on-site practice building consulting, virtual building management, MasterMind memberships, Sport & Spine Rehab franchisee training & implementation

Shahverdi, DC, Keyvan Fairfax, VA Phone: 703-961-9046Fourth Year or more DCDiversified, Licensed Acupuncturist

Smith, DC, Jeffrey Smith Chiropractic Norfolk, VA Phone: 757-588-0609jds.dc@att.netFourth Year or more DC

SPINAL REFLEX INSTITUTE, INTL.Jarrell, DC, FrankDurango, COPhone: 970-259-5520info@spinalreflex.comAllied SupplierCE workshops, software

Wright, DC, Sherri Wright Spine & Sports Health Yorktown, VA Phone: 757-223-5444drwright@wrightspine.comMember Type: Fourth Year or more DC

 

Helping members make lifelong decisions….. 

 Serving the Chiropractic Community since 2005

Short Term Disability Insurance

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Long Term Disability Insurance

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Business Overhead Insurance

10,000/month with 2 year benefit 10% discount for members

Other Services

Small Business Retirement Planning Individual Retirement Accounts College Planning 

 

Endorsed by: 

Dana Harrison is your endorsed agent through 

the Unified Virginia Chiropractic Association.   Dana is here to help you make lifelong decisions about the future of your business.  The plans Dana puts in place for you will allow you to get paid even if you are temporarily or permanently unable to work.    

We know you are busy running your business, 

let us partner with you and take the burden of researching plans and policies from you as you continue running a successful practice.  A solid foundation of disability insurance and life insurance will make certain you are taking care of the ones who mean the most.     

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Another Unified VCA Member Benefit Program!

15

Robert BowieSociety

($1000+)Dr. Jeremy Busch

Dr. Doug CoxDr. Chris DeGrawDr. David Dolberg

Dr. Elliot EisenbergDr. Joe Foley & Dr. Diane

DeReu-FoleyDr. Jay GreensteinDr. Noah Malavolti

Dr. Bibhu MisraDr. Mathias PastoreDr. Brad RobinsonDr. Sam Spillman

Dr. Ray TuckUnified VCA Auxiliary

Dr. Kevin WalshDr. Gregory WalterDr. William Ward

Dr. M. Scott WhiteDr. Adam Wilding

Gold

($600 to $999)Dr. Jeff Bowers

Dr. Philip ConnollyDr. Gary Dennis

Drs. Sandy & Adam ElbaumDr. Michael Haas

Dr. Darlene HollandDr. Linda LarsenDr. Susan Martin

Dr. Cory McKinleyDr. Minesh Patel & Dr. Nisha

Saggar-PatelDr. Keith SchrefflerDr. Steven TraubenDr. Kevin WestbyDr. Tom Wetzen

Drs. Lee & Wendy Willis

Silver

($400-$599)Dr. Jennifer Rathmann

Dr. Susan SweetenDr. Robert ThomaDr. Carrie Welch

Emerald

($200 to $399)Dr. Scott BanksDr. Paul Cronk

Dr. Janice Piedmont DunlapDr. Louis Fernandez

Dr. Wayne FuscoDr. Robert Hedgepath

Dr. Ronda LykensDr. Jeffrey MartinDr. Lee Matthis

Dr. Katrina Mayes & Dr. Tess GrafDr. Meredith Oudt

Dr. Misty Paul

Virginia Chiropractic Political Action Committee2012 Contributors

Based on Amount Collected as of 7/23/2012 or Pledged for 2012

NOTE TO CONTRIBUTORS:Thank you for your support!

We are pleased to introduce our new bookkeeper, Mr. Stevik Kretzmann, along with new systems to enhance our record keeping and contributor recognition.

We want to make sure that all contributors and pledges have been properly maintained through this transition.

Please review this contributor list. If you are listed and feel that any adjustments need to be made -- or if you feel you should be listed but your name does not appear -- please contact Stevik at 540-932-3100 (M/W/F).

The Future of Chiropractic Starts TODAYI want to advance and defend my profession by contributing to VA-CPAC, which worksdiligently to support Pro-chiropractic candidates in the State of Virginia.

I wish to contribute $________ Monthly until further notice OR $_________ One Time(Every contribution is personal. As a reference point, the minimum suggested donation is $70 per month.)

Name:___________________________________________________ Signature: ________________________________________

Personal Credit Card Payment Info for Monthly OR One-Time Contributions (as specified above): _____Visa or _____MC

Account #:_________________________________________________________________ Exp Date:_________________ Auth Code on Back:_____________

Billing Street:______________________________________________________ City:____________________________________ State:____ Zip:___________

Personal Check Payment Info (1-Time Contributions): Check #:__________ Name on Check:_________________________________________

Street Address:____________________________________________________ City:_____________________________________ State:____ Zip:___________

Date:___________________________ Mail to VA-CPAC, PO Box 15, Afton, VA 22920 or Fax to 540-932-3101.

Dr. Thomas RoselleDr. Melanie Six

Dr. Martin SkoppDr. Garnett Stover, IIIDr. Garrett Thompson

Bronze

(Up to $199)Dr. Brian Dolomat

Dr. Ellen FitzenriderDr. Michael Payton

Drs. Eric & Susan SantjerDr. Nick TriandosDr. Kathryn Young

16

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ClassifiedsUpdated 7/23/2012; Listings from 4/15/2012

Events

SRA DIAGNOSTICS WITH ENHANCED LASER PROTOCOLS - Learn to control neurology w/1 system & just 30 second to incredible outcomes w/Frank Jarrell, DC & Nelson Marquina, DC (laser & non-laser protocols). Includes software w/spine, soft tissue & laser treatment charts, nutritional correlates, ProScan Unit, 2-day workshop, certification & more. 12 CECs. Sept 15-16, Williamsburg. Visit SRAChiro.com or call 1-970-259-5520 (laser not required to attend class). [5/25/12]

Coverage

COVERAGE: State wide, maternity, vacation & emergency relief work so you can keep your office open. Since 1993. All major techniques. Fluent in ChiroTouch software. Willing to parrot your methods. CV, NCMIC insured, rates. Margaret Newton, DC, 678-938-5712, email 1drnewton@gmail.com. [7/13/12]

NEED TIME OFF or emergency help? Keep your office open w/an NCMIC

insured, reliable dr w/13 yrs exp. Knows all major techniques, covers statewide, trusted by drs. Great rates! Contact today! Refs available. 757-813-7926 or traveldoc@gmail.com. [6/11/12]

VACATION RELIEF SVCS: Keep your ofc open. Your practice run your way. 24 yrs exp ofc coverage. Proficient in many techniques. NCMIC insd. Statewide coverage. Refs. Reasonable rates. Call J Terry Fowler, DC at 770-597-2872 (cell), or email jtfowlerdc@yahoo.com.

STATEWIDE TEMP OR PERMANENT OFFICE COVERAGE: Since 1986. Emergency, vacation, maternity, short & long term coverage. Full, half day, wkly rates. Lg selection of licd/insd DCs. Can help w/your coverage & assoc needs. Call 800-501-6111 for a free quote. Ask about our satisfaction guarantee. See our web site: www.mmachiropractors.com. [thru 3/15/13]

Position Available

POSITION W/SALARY & BUY-

IN &/OR BUY-OUT OPPRTY in Yorktown for F-T DC. Extremity exp/proficiency, CCEP or other similar certification preferred. Upper Cervical & Thompson or similar technique used in a straight chiro estd practice of 15+ yrs. Currently seeing 35-45 patients on M/W/Th. T & F available to open also. MT on site. Front Desk/CA personnel in place. Practice mgmt software & electronic billing thru Health Fusion. Pls send cover ltr & CV or resume to dcinyorktown@yahoo.com.

ASSOCIATE WANTED: To

join growing team at Effective Chiropractic. Currently hiring for a F-T Assoc DC w/PT privileges to work in Millersville, MD location w/prospect of running your own EC location within a year. 401k, bonus pkg, malpractice & health insurance offered. Pls contact Dr Hardnett at 410-562-5858 for details & submit resume/CV to dochardnett@comcast.net. [7/30/12]

ASSOCIATE CHIROPRACTORS needed for busy multiplying chiro & rehab practice. Techniques/Tx: Diversifed, Palmer Pkg, Drop, F/D, N o n - Continued on page 17

17

Surgical Spinal Decompression. Looking for sev hungry DCs to see between 30-60 pts per day, also teaching rehab to patients. Compensation: Salary + bonus, Pd vacation, & ins benefits available. Contact us & send resumes to drerikawarner@gmail.com. [7/17/12]

SEEKING ASSOC DC for 28 yr old practice in South Hill. Located near Lake Gaston & Buggs Island Lake. Seeking highly motivated, philosophy based individual. Unique, small town practice focusing on wellness care, rehabilitation & corrective care. Good starting salary with bonus incentives. Four & a half day work wk, pd holidays. Malpractice benefits pd. VCA dues pd. Retirement plan participation when qualified. Contact us at 434-447-7860. [7/16/12]

LOOKING FOR a positive DC w/applied kinesiology training to join a growing practice in Annandale. Our practice is sports med based w/ART certified docs & MTs, nutritionist, & naturopathic dr. Lots of room for the 1 right person who wants to grow a wonderful, busy practice with my supportive, upbeat team. I have the perfect marketing platform to train you

to grow yourself a busy, rewarding practice. Willingness to work some Saturdays is required. Pls contact Dr Kathy Coutinho at drkathy@posichiro.com, www.posichiro.com, 703-642-8685.

IMMEDIATE OPENING for Chiropractic physician in rapidly expanding Clinic in NoVa just 30 minutes from Wash, DC. Excellent base salary, bonus system, health benefits, malpractice benefits, profit sharing pension plan. Come join our experienced prof Chiropractic family. Must have VA license, excellent adjusting skills & be willing to contribute to our winning team. E-mail resume to DrChiroMed@aol.com. [7/9/12]

PARTNERSHIP OR BUY-OUT opportunity. 16 yr old SOT practice in downtown Fredericksburg. Dr ready to retire or convert to nutrition practice. Great opportunity for an SOT dr to take over the chiropractic part of the practice. Contact Christine at cthompson@whole-health.net or 540-809-4223 for details. [7/5/12]

LOOKING FOR an energetic associate w/superior adjusting skills, can educate patients, w/high energy, & upholds to the highest

ethical standards. Woodridge clinic specializes in corrective care & rehab. We offer a competitive salary, bonus plan, health benefits. We are looking for the right associate who truly believes in the healing powers of chiropractic. Email your resume to chiro368@aol.com.

GREAT OPPORTUNITY for the right person. Looking for a honest, caring, self-motivated dr to practice in our Newport News office. Strong clinical & adjusting skills a must. Salary + incentive bonus. Pls email resume to dr.westby@gmail.com. [6/15/12]

POSITION AVAILABLE on our wellness team for an amazing manual adjuster. Right candidate has diversified, manual adj techniques, good communication skills, leads a healthy lifestyle by ex, wants to work in a wellness environment, has kids & infant adj exp, is a solid team player. No need to put attn towards hiring, firing, mktg, collections, any of the busy admin hassles. Position available immediately. To apply, submit cover ltr explaining why you would be a good fit, a recent photo if you like, as well as your current resume to spinalcorrectioncenter@yahoo.com. [6/11/12]

SEEKING ASSOCIATE w/buy in opportunity for busy 25 year estd practice in Fairfax. Please fax CV to 703-264-7988. [6/7/12]

SEEKING MASSSAGE THERAPIST for busy 25 year est practice in Fairfax. Please send CV to 703-264-7988. [6/7/12]

F-T OR P-T ASSOC position available in Woodbridge. Ideal candidate is ethical, hard-working & a team player. We utilize primarily diversified adjusting, myofascial release techniques (ART & Graston) & PT in treating our patients. Salary + malpractice & health ins benefits for F-T. Partnership opportunity for right candidate. Great opportunity for new doc to learn all aspects of running a successful practice & develop the necessary skills to diagnose & treat w/great results. Pls send all resume to drstevenhan@yahoo.com. [6/4/12]

SEEKING MOTIVATED assoc dr for growing Leesburg clinic. F-T, salary + bonus position for right dr. P-T hrs also possiblity. Pls email or fax resume to mistypauldc@aol.com or 703-777-8002. Call 703-777-2532 w/questions. [6/4/12]

Continued from page 16

Continued on page 18

18

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Office Name_________________________________________

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FAX THIS FORM TO 800-279-8229 orMAIL TO I.C. System, Assn. Relations,

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Another Unified VCA Member Benefit Program!

SEEKING MASSAGE THERAPIST: F-T indep contractor for busy chiropractic Wellness office in Fairfax City. Looking for outgoing, hard working, wellness oriented, caring, people-person to join our team. MT who wants to make a long term commitment and is willing to commit time & energy to building a strong stable practice. Please fax resume to Jo at 703-385-9693. [5/30/12]

SEEKING Chiropractic Physician w/strong ethics & chiro purpose to join growing practice. Successful candidate should have superior adjusting skills, clear comm skills, good sense of humor, ability to work w/a team of health professionals to improve patient outcomes. At the Advanced Wellness Centre, we offer chiropractic, licensed PT, massage, acupuncture, clinical hypnosis, exercise training, nutritional counseling w/a registered dietitian. Please email cover letter/resume to awc.resumes@gmail.com. Come join our team of professionals & make a difference! [5/24/12]

SHENANDOAH VALLEY: Looking for qualified assoc. Clinic specializes

in sports med, functional rehab. Adjunctive training or interest in myofascial release techniques, acupuncture, nutrition, dry needling, functional taping nice but not reqd. Patient base ranges from chronic disease to elite athletes. Salary commensurate w/exp + performance bonus. Ownership opps (buy in/buy out) encouraged & will be discussed, also benefits pkg. Email CV to jobposting00@gmail.com or fax to 540-635-4450. [5/14/12]

INDEPENDENT CONTRACTOR: NoVa, long standing practice. Female preferred. Will help you establish yourself if you are motivated! Contact drlisa22003@yahoo.com. [5/11/12]

CENTRAL Va: Assoc dr needed. Salary + % of services. Benefits included. Pls call 434-942-0765 for further info. [5/10/12]

NORFOLK practice specializing in improving health & wellness, enhancing athletic performance & the prevention, mgmt & rehab of sports-related injuries is looking for F-T associate. Reliable, outgoing, energetic dr who can engage & communicate w/people is a must.

Excellent adjusting skills reqd; exp in instrument adjusting, extremities, knowledge of rehab, & ART a +. Very competitive compensation pkg. Send CV to drclayton@ghentchiro.com. [4/24/12]

IMMED OPPTY in rapidly expanding, 1st class, rehab/sports med oriented practice in Williamsburg. Awesome oppty for right doc. Must be motivated, enthusiastic, team playing, people person w/excellent diversified adjusting skills. Rehab training/certif a plus. Phenomenal patient base & fantastic support staff incl mktg coordinator. Base salary + exc bonus system, health benefits, malpractice, CE allowance, etc. We want you to be a huge success – come join us! Fax or email resume to 757-220-0162/hr@pintochiro.com. [4/16/12]

SPORT & SPINE REHAB, a rapidly growing Chiro, PT & Rehab co is looking for highly skilled, ethical DCs w/exc clinical, interpersonal & comm skills. Competitive salary, bonus structure, benefits plan inclusive of health, dental, life, long term disability insurance as well as cont ed benefit, 401K match, ownership plan, more. For more info, pls contact Dr Jay Greenstein at drjay@ssrehab.com.

Practices

PARTNERSHIP OR BUY-OUT opportunity. 16 yr old SOT practice in downtown Fredericksburg. Dr ready to retire or convert to nutrition practice. Great opportunity for an SOT dr to take over the chiropractic part of the practice. Contact Christine at

Continued from page 17

Continued on page 19

19

NEED CEUs?Want to save time, travel costs, and

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GO ONLINE!

Unified VCA Members saveon top-quality, convenient creditsfrom industry leaders EON! and

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Another Unified VCA Member Benefit Program!

cthompson@whole-health.net or 540-809-4223 for details. [7/5/12]

ALEXANDRIA practice for sale: automatic Cox F/D, therapy tables, state of the art e-stim units, handless ultrasound, Lloyd elevated hi-lo tables w/ drop, rehab, 2000 sq. feet, in medical building, networked computer & phone system. medical software, steady patient flow, etc. Doc looking to retire. The price is 50K. Send email inquiries to: drrick974@gmail.com. [6/13/12]

11-YEAR PRACTICE in historic waterfront town. Town growing quickly as resort area. Great beaches, fishing, hunting, golf & lifestyle. Well-equipped office w/certified EMR (4 yrs incentives), Impluse IQ, Hill flexion tables, therapies. Great staff w/massage/myofascial therapist. Collecting $180,000 on 2 ½ days/wk. Much more potential at 4-5 days/wk. $109,000. Call 757-442-1158. [6/4/12]

TAKE OVER 15 yr old practice 10 minutes from VA line in NC. 1600 sq ft fully furnished with xray, hundreds of files, signage, no start up costs! $2400/mo. Call Tom 757-404-7643. [5/3/12]

FAIRFAX CTY: 36 yr family practice. Same location since inception. Lg active patient base, tenured staff. 1100 sq ft fully equipped attractively apptd office condo. Call or email Paragon Group 800-582-1812; info@eparagongroup.com. [4/27/12]

Products & Services

JAXSEN’S ALL NATURAL 9 herbal ingredients not only provide anti-inflammatory & analgesic properties but slows the progression of joint degeneration - which ultimately leads to arthritis. Our patented carrying agents help to deliver the herbs deep into the tissue & joints. Visit www.Jaxsens.com. [6/22/12]

ANNOUNCING NECK COR-RECT, a patented neck support designed for use in car seats, strollers & child carriers. Pls go to www.Indiegogo.com/projects/89785?a=529834&i=mail & support my project. This can be a new income stream for your practices, help kids from head drooping related neck pain, & create jobs in the USA.

Thanks for your support, Chris Connolly, DC. [6/15/12]

SRA DIAGNOSTICS: One system can control pain & dysfunction in as little as 30 seconds! Powerful outcomes, referrals & income building + evidence based & easy to use! For info & CEC courses near you; visit SRAChiro.com. [4/21/12]

TRUSTED VOICETM on-hold system turns your hold button into an effective, efficient practice-building system. Radio/TV voiceovers, chiropractic radio, patient ed CDs also available. VCA endorsed. 10% VCA MEMBER discount! Call 877-55VOICE or visit www.trustedvoice.com.

DISABILITY INSURANCE: Unified VCA members are eligible for discounts on disability insurance. Let us shop all the top carriers & bring you the best rate. VCA-endorsed. Call Dana at 804-897-9040 or email dharrison@mail.com.

Space Available

SEEKING PRACTITIONER to share office space. Charlottesville, 2300 sq ft, available T, Th, Sat. Prefer integrative minded practitioner (DC, MT, acupuncturist, medical/pain mgmt dr). Contact Suzanne Coffey, DC APCM, 434-825-4362, drcoffeydc@gmail.com. [7/17/12]

Equipment

4 PCS PROGRESSIVE RESIS-TANCE equipment: white metal w/teal naugahyde; neck, LB, torso rotation, back ext; $2,000 ea, practically brand new. Pediatric Ponee table $1,000. Pics available. Call Suzanne Coffey, DC APCM 434-825-4360. [7/17/12]

INSIGHT SUBLUXATION STATION: Purchased in 2008, minimal usage. Includes Thermal Scanner, Algometer, SEMs, Pulse Wave Profiler, Wireless Inclinometer, computer & small printer. Purchased for ~$17,000 & selling for $6000 obo. Please email mjackson@connections4children.com for pictures & more info. [7/5/12]

VORTEX FITNESS Pro-Trainer System II & 4-Way Selectorized Neck Machine: (1) Pro-Trainer System: Functional & core strength training systems featuring the Vortex™ “Grab-and-Go.” Accommodates benches, core boards, training balls & is 100% wheelchair accessible.

Limitless exercise possibilities in a very small space. See http://www.vortexfitness.com/Equipment.aspx - Pro-Trainer System II. (2) Neck Machine: Starting resistance as low as 1 lb, compared to min of 10-15 lbs of other neck machines on market today. Perfect for neck rehab. See http://www.rehabequipment.com/ewc.htm. For detailed info & pics for both/either, email drstevenhorwitz@gmail.com. [6/22/12]

TONS of equipment: Pettibon wobble chairs; Spinal Curve Solutions cervical traction chairs; Lloyd Table Co. upper cervical adjusting bench; Pope Counter Stressing Traction units; x-ray view boxes, processor, Bucky/stand, cassettes, ID printer, other accessories; Lazy Boy reception chairs; Pro-Adjuster. Call 434-385-1110. [6/11/12]

FULL FUNCTIONING X-ray system & processor. Processor in mint condition along w/the X-ray system & track. For detailed info & pics send request to bodyin8@yahoo.com. [5/23/12]

4-DRAWER, heavy-duty, metal HON 500 series cabinet, putty color, great cond, 36x53 in, 3-part telescoping slide suspension. Mechanical interlock allows only 1 drawer to open

at a time to inhibit tipping. Adjustable hang rails for side-to-side letter/legal filing. Usually $500-$600, selling for $250. Will need to be re-keyed. Call 804-304-6214 for more info. [4/16/12]

CHIROPRACTIC TABLES, ELECTRO THERAPY, ULTRA-SOUND, X-RAY, IST: New, used & reconditioned. HF Hill & Assoc, visit www.UsedChiroEquip.com, call 800-434-4551.

Unified VCA DC Members may place a classified ad in The Virginia Voice and on the association’s website free of charge. Fee is $85 for non-member DCs and all Suppliers. Listing will remain on website for 3 months, plus appear in at least one issue of VCA’s newsletter and at least one broadcast email/fax to member and non-member DCs throughout Virginia. Limit of 35 words may be imposed. For deadlines, display ad information and/or to submit your listing, e-mail vcacentral@hughes.net.

Continued from page 18

20

Program at 7/25/2012 (Subject to Change)

Friday, October 12(Recommendation: Arrive Thursday and enjoy the resort at unbeatable rates!)

When Session For Speaker Sponsor

Morning Optional Golf, Spa Events

10:00am-2:00pm Blitz Review of Decompression Therapy DCs Chris Proulx, DC Free Separate Seminar from HF Hill & Assoc.2:00pm Registration Opens

2:30-6:00pm - The Lumbar Spine from an Orthopedist’s Perspective DCs Corey Wallach, MD Inova Spine Institute - Miracles in Our Midst DCs, CAs Dean DePice, DC TLC Superteams - Chiropractic & Oncology – Managing Pre- Existing Conditions & Side Effects of Conventional Treatment DCs & CAs Jeffrey Sklar, DC Cancer Treatment Centers of America3:15-5:50pm EHR & Eclipse on an iPad DCs & CAs Matthew Schrier, DC

6:00-6:30pm IPN & Insurance Updates All Jay Greenstein, DC, CCSP Bibhu Misra, MSc, DC, ACRB-1 FIAMA

6:30-7:15pm Welcome Reception with Exhibitors All New American Folk by Narissa Bond

Rest of Evening On Own

Saturday, October 13 When Session For Speaker Sponsor

7:30-8:00am Continental Breakfast with Exhibitors All

8:00-10:00am - Cox Technic Flexion Distraction: Research Leads the Way for Care of Low Back Pain, Neck Pain & Radiculopathy DCs James Cox, DC - Three Paradigms of Chiropractic Care DCs & CAs David Lee, DC NutriWest MidAtlantic - Practicing Without Fear: An Introduction to Developing a Compliance Program for Your Office DCs & CAs Becky Walter, MCS-P

10:00-10:15am Break with Exhibitors

10:15 -11:45am - Flexion Distraction Continues DCs James Cox, DC - Conclusion of Three Paradigms of Chiropractic DCs David Lee, DC NutriWest MidAtlantic - Conclusion of Intro to Compliance Programs DCs & CAs Becky Walter, MCS-P

11:45am-1:00pm Profession Updates, General Membership Meeting, District Director Elections (All)

1:00- 2:00pm Lunch with Exhibitors All OR New Member Lunch New Members, All Categories; Board of Directors

2:00-4:00pm - Flexion Distraction Continues DCs James Cox, DC - Neuromechanical Mechanisms of Chiropractic Adjustments: The State-of-the-Art Begins DCs Christopher J. Colloca, DC Neuromechanical Innovations - Patients, Procedures & Performance CAs Paul Lentini, DC Breakthrough Coaching

PROGRAMUnified VCA Fall ConventionOctober 12-14Kingsmill Golf Resort & Spa, Williamsburg, VATake Me to to the River... Again

21

4:00-4:15pm Dessert with Exhibitors All

4:15-6:15pm - Flexion Distraction Continues DCs James Cox, DC - Completion of Neuromechanical Mechanisms DCs Christopher J. Colloca, DC Neuromechanical Innovations - Patients, Procedures & Performance Continues CAs Paul Lentini, DC Breakthrough Coaching

6:15-6:45pm Private President’s Reception Invitees

7:15-10:00pm Awards Dinner Party Included in DC Registrations; Additional Tickets Available for Purchase

Sunday, October 14When Session For Speaker Sponsor

7:30-8:00am Continental Breakfast with Exhibitors All

8:00-10:00am - Flexion Distraction Continues DCs James Cox, DC - Medicare Made Simple Begins DCs & CAs Susan McClelland, FICC ChiroHealth USA - Patients, Procedures & Performance Continues CAs Paul Lentini, DC Breakthrough Coaching - 8-9:30: Epigenetic & Environmental Influence on Pediatric Health Begins DCs Laura Hanson, DC Life University Plus 9:30-10: Advancing Chiropractic DCs Greg Harris Life University

10:00-10:30am Extended Break with Exhibitors All

10:30am-12:00pm - Conclusion of Patients, Procedures, & Performance CAs Paul Lentini, DC Breakthrough Coaching10:30am-12:30pm - Medicare Made Simple Continues DCs & CAs Susan McClelland, FICC ChiroHealth USA10:30am-1:00pm - Conclusion of Flexion Distraction DCs James Cox, DC10:30am-1:00pm - Conclusion of Pediatrics DCs Laura Hanson, DC Life University

12:30-1:00pm Convention Adjourns for All Except Medicare Made Simple Attendees

12:30-1:30pm Lunch Break for Medicare Seminar Attendees, On Own

1:30-5:30pm Conclusion of Medicare Made Simple DCs & CAs Susan McClelland, FICC ChiroHealth USA

(If you weren’t able to arrive early, stay an extra day or two and enjoy the resort!) SpeakersSpeakers Include: Sponsored by:

Corey Wallach, MD

Dean DePice, DC

Jeffrey Sklar, DC

James Cox, DC Christopher J. Colloca, DC

Paul Lentini, DC Susan McClelland, FICC

Laura Hanson, DC

Breakthrough Coaching

Cancer Treatment Centers of America

ChiroHealth USA

Inova Spine Institute

Life University

Neuromechanical Innovations

NutriWest MidAtlantic

TLC Superteams

22

Want our 2 Cents?Speed up insurance payments while donating to the VCA!

MDOL is offering special pricing for Unified Virginia Chiropractic Association Members, and for every participating insurance claim you send electronically through MDOL, 2 cents will be contributed to the VCA. 2 Pennies Adds Up!

Submit your insurance claims electronically to any insurance company simply by entering data into an electronic HCFA form or batch uploading a file from a practice management system.

Call MDoL today (888) 499-5465 to start submitting claims, and mention this ad to start donating to the VCa.

Another Unified VCA Member Benefit Program!

How to Deal With Hyperglycemia

By David Seaman, DC

Reframing Hyperglycemia for the Patient

It is not uncommon for people to trivialize hyperglycemia; that is, fasting blood

glucose levels that exceed 100 mg/dL or a two-hour postprandial glucose level greater than 140 mg/dL, but less than 200 mg/dL, which reflects overt diabetes 1. This may be due to the fact that the potential clinical impact of hyperglycemia is not adequately emphasized. What if patients knew the following information?

A study that considered hyperglycemia and disease expression concluded that, ”the findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.” 2

Patients should specifically know which diseases are promoted by hyperglycemia, which is one component of the metabolic syndrome. Most patients will understand that there is a connection to diabetes and heart disease; however, the urgency of this problem is often not realized as a visceral experience for the patient that invokes behavioral changes. Perhaps this is because hyperglycemia is

not typically associated with pain or other symptoms and so, the insidious nature of diabetes and heart disease is commonly not felt until there is adequate end-organ damage. A clear problem is that, for the patient, diabetes and heart disease seem like distant problems from metabolic syndrome and so the importance of maintaining proper blood sugar levels needs to be reframed so patients embrace the dangers when its presence is identified. In addition to diabetes and heart disease, many other conditions are known to be promoted by hyperglycemia/metabolic syndrome including cancer, fatty liver disease and cirrhosis, gallstone disease, sleep apnea, and hypertension3. Women concerned about breast cancer and individuals with hypertension are rarely told that hyperglycemia is an underlying cause of these conditions. In the case of cancer, it is well documented that tumors thrive on glucose and so hyperglycemia must be avoided.4-6 With this knowledge about hyperglycemia and disease expression, it is possible to reframe hyperglycemia for the patient.

Reframing Hyperglycemia for the Chiropractor

As a chiropractor you may read the above information about reframing information for patients and think that these are not common conditions that you discuss with your patients; however, germane to the typical musculoskeletal chiropractic practice is the fact that hyperglycemia also promotes musculoskeletal aches and pains. For example, hyperglycemia/metabolic syndrome has been linked to what would otherwise be misinterpreted as “mechanical neck pain”7, and in general, local and widespread pain expression has been clearly linked to hyperglycemia8,9. Even tendinosis expression is associated with the metabolic syndrome in both sedentary individuals and elite athletes10,11. Osteoarthritis, another misunderstood so-called “mechanical condition” is also associated with hyperglycemia/metabolic syndrome12. While the precise details have yet to be unraveled, it is known that hyperglycemia leads to glycosylation of peripheral tissue components including musculoskeletal tissues12. Operationally, it can be described to patients that hyperglycemia chemically injures musculoskeletal tissues. Continued on page 23

23

The Virginia VoiceSummer, 2012

The Virginia Voice is the quarterly newsletter of the Unified Virginia Chiropractic Association, PO Box 15, Afton, VA 22920, www.virginiachiropractic.org.

Staff: Julie K. Connolly, Executive Director.

Editorial Committee: Thomas J. Wetzen, DC, President; Scott Banks, DC, MS; Sandy Elbaum, DC.

Advertising: Call 540-932-3100 or e-mail vcacentral@hughes.net.

Subscriptions: A subscription to The Virginia Voice is a benefit of membership. Back issues are archived for members only on association’s website.

Editorial Policy: Articles published in The Virginia Voice are screened by the Editorial Committee. However, neither the Unified VCA nor its officers or staff investigate, endorse, or approve any statements of fact or opinion, which are solely the responsibility of the authors/sources of information. They are published on the authority of the writer(s) over whose name they appear and are not to be regarded as expressing the views of the VCA. Articles accepted for publication are subject to editing.

Advertising Policy: Acceptance and publication of an ad in The Virginia Voice does not imply endorsement or approval of the company, product, or service. It is recommended that readers use due diligence and/or consult with their state chiropractic licensing board for further information on the use of advertised products or services.

Hyperglycemia is simultane-

ously associated with immune activation and the promotion of systemic inflammation, which increases in proportion to the level of postprandial hyperglycemia1. Because the American diet is rich in sugar and flour, researchers maintain that Americans spend most of their waking hours in a postprandial inflammatory state1, which likely adds to musculoskeletal pain expression.

Diet and Supplementation to Combat Hyperglycemia

Diet and supplementation can eliminate the hyperglycemia/metabolic syndrome. There is no need to complicate either intervention. I recently watched the new Chimpanzee movie and the chimps pretty much have metabolic syndrome under control. They exercise every day and they eat an anti-inflammatory diet that includes protein (monkeys and bugs), green vegetation, fruit, and nuts. We should consume our own version of lean protein and include tubers like sweet potatoes, and the diet part of the equation is covered; there is no need to make it any more complicated than this. Exercise and caloric intake should be tailored to get the body mass index below 25. Supplementation can be equally straightforward, and first, it is important to understand that no supplement cures the metabolic syndrome in the absence of dietary change, and the same holds true for medications such as metformin. The approach should be to eat anti-inflammatory and supplement the diet with key supplements. The key nutrients for supporting proper glucose metabolism from a physiological and economic perspective include vitamin D13,14, magnesium15,16, chromium17-19 and lipoic acid20-22. The recommend levels of supplemental nutrients are listed below. Vitamin D is the only nutrient that can be measured and supplemented based on the lab results, which means that vitamin D supplementation can vary substantially. Vitamin D should be taken with meals, as it is fat soluble, while magnesium, chromium, and lipoic acid should be taken on an empty stomach, at least 1 hour before meals. Table 1 is provided as an example of a supplementation regime.

Important to note is that there has never been a study wherein rigorous dietary changes were made and maintained, which were simultaneously complemented by the above-mentioned nutritional supplements. Consequently, monitoring of blood glucose levels is mandatory so as to avoid hypoglycemia.

References1. O’Keefe JH, Bell DS. Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a cardiovascular risk factor. Am J Cardiol. 2007;100:899-904.2. Barclay AW, Petocz P et al. Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. Am J Clin Nutr. 2008; 87(3): 627-37.3. Blaha M, Elasy TA. Clinical use of the metabolic syndrome: why the confusion? Clin Diabetes. 2006; 24(3):125-314. Klement RJ, Kammerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer? Nutr Metab. 2011; 8:75. http://www.nutritionandmetabolism.com/content/8/1/755. Seyfried TN, Shelton LM. Cancer as a metabolic disease. Nutr Metab. 2010;7:7.http://www.nutritionandmetabolism.com/content/7/1/76. 60 Minutes. Dr. Sanjay Gupta reporting the on the disease-driving nature of refined sugar. http://www.cbsnews.com/video/watch/?id=7403942n7. Mantyselka P et al. Prevalence of neck pain in subjects with metabolic syndrome – a cross-sectional population-based study. BMC Musculoskeletal Disorders. 2010;11:171.8. Mantyselka P et al. Glucose regulation and chronic pain at multiple sites. Rheumatology. 2008;47(8):1235-38.9. Mantyselka P et al. Chronic pain, impaired glucose tolerance and diabetes: a community-based study. Pain. 2008;137(1):34-40.10. Malliaras P, Cook JL, Kent PM. Anthropometric risk factors for patellar tendon injury among volleyball players. Brit J Sports Med. 2007;41:259-63.11. Gaida JE et al. Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance. Med Sci Sports Exerc. 2009;41(6):1194-97.12. Steenvoorden MM et al. Activation of receptor for advanced glycation end products in osteoarthritis leads to increased stimulation of chondrocytes and synoviocytes. Arth Rheum. 2006;54:253-63.13. Schwalfenberg G. Vitamin D and diabetes: improvement of glycemic control with vitamin D3 repletion. Can Fam Physician 2008;54:864-66.14. Cannell JJ, Hollis BW. Use of vitamin D in

clinical practice. Alt Med Rev. 2008;13(1):6-20.15. Guerrero-Romero F, Ta m e z - P e r e z HE, González-González G

et al. Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial. Diabetes Metab. 2004;30(3):253-8.For complete list of references, email vcacentral@hughes.net.

Dr David Seaman is Professor, Clinical Sciences at the National University of Health Sciences in Pinellas Park, FL.

Continued from page 22

Table 1. Supplemental Nutrients Supplement Amount Vitamin D3 (cholecalciferol) 4000-10,000 IU per day Magnesium 400-1000 mg in divided doses Chromium 200-300 mcg tid Lipoic acid 200 mg tid

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THIS ISSUE:• Fall Convention Preview• Hyperglycemia by Dr. D.

Seaman• Patient Privacy & Face-

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S. Weiniger• Pulling Together by Drs.

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