Two Surgeries, Two Outcomes & Cervical Artery Dissection and Spinal Manipulative Therapy

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 295: Two Surgeries, Two Outcomes & Cervical Artery Dissection and Spinal Manipulative Therapy

Today we’re going to talk about Two Surgeries, Two Outcomes & Cervical Artery Dissection and Spinal Manipulative Therapy

But first, here‘s that sweet sweet bumper music

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.

We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together.

Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [e-mail]

If you haven’t yet I have a few things you should do.

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
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You have found yourself smack dab in the middle of Episode 295

Now if you missed last week’s episode, we talked about Kids’ Screen Time & Physical Activity In Older Adults

Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Crazy week of trying to do too many things but one particular thought I will share with you all, there is a group that I have been in negotiations with for quite some time now. We are deciding whether or not we will sell a portion of our clinic to a larger conglomerate.

What if an established group came to you and offered to buy a certain portion of your practice and they were offering you more money for that portion than you think you could get for 100% on the private market?

What if? What would you do?? What would be your parameters? Your absolutely nots with regard to what you would accept and not accept for your salary, your staff, restrictions on your clinic’s spending and overhead?

It’s pretty interesting. There was a time when I was absolutely opposed to selling any portion of something I’ve built with blood, sweat, and tears over 20+ years.

When you’re 51 and getting more and more tired every year, things start to look a little differently don’t they? That’s what we’re doing right now and I can say……I think it’s going to happen but, as usual, you know I’ll be sharing the info with you as I go along the process. Once I know when I’ve made the right decision, if I think it would benefit my listeners, I’ll be happy to connect you with the group as well.

But I’ll be taking the hickey first before I ever share the info on the podcast. I have a good feeling about it so….down the road I go.

Item #1

The first on today is called “ Two Surgeries, Two Outcomes” by HBR Editors and published in Harvard Business Review and on March 18, 2019.

Why They Did It

Both Sean and Carla experienced back pain for years, leading them to seek medical intervention. They both had abnormal MRIs, prompting them to explore their respective healthcare options. Sean chose to go through a traditional route with his insurance, while Carla opted for Walmart’s Centers of Excellence (COE) program for spine surgeries. Their decisions were likely influenced by factors such as their previous experiences with healthcare, financial considerations, and recommendations from their healthcare providers.

How They Did It

Sean’s Path:

• Scheduled surgery with a local surgeon through traditional insurance.
• Utilized traditional insurance coverage for the procedure.

Carla’s Path:

• Contacted her traditional insurance carrier, which connected her with a third-party administrator (TPA).
• The TPA team handled her intake and gathered relevant health history.
• Selected a hospital affiliated with Walmart’s COE program based on her location.
• Hospital team reviewed her medical records and MRI images, connecting her with a nurse navigator.
• Flew to the hospital with her sister, received specialized care, and underwent surgery.

What They Found

Sean’s Experience:

• Followed a conventional healthcare path.
• Paid 50% of his spine surgery costs, which averaged around $15,000 for Walmart associates.
• Returned to work after 90 days.

Carla’s Experience (COE Program):

• Engaged with a streamlined process via Walmart’s COE program.
• Received comprehensive care package, including procedures, devices, tests, drugs, services, and travel expenses for both her and her caregiver.
• Stayed in the hospital for 2.5 days, which was the average for associates using the COE program.
• Transferred to a local hotel for recovery.
• Experienced a hassle-free postoperative journey, including postoperative visits and transportation.
• Returned to work after 75 days.
• Incurred no personal expenses for the surgery.

Wrap It Up

The COE program offered by Walmart provides a more streamlined and comprehensive healthcare experience for associates like Carla. It bypasses traditional insurance companies, negotiating bundled payments that cover all necessary costs associated with the procedure, including travel and lodging. This approach not only reduces financial burden on the patient but also ensures a smoother journey from diagnosis to recovery.

Comparatively, Sean’s experience with traditional insurance involved more fragmented steps and cost-sharing, ultimately leading to a longer recovery time and higher out-of-pocket expenses. While the COE program might have a higher upfront cost for Walmart, it proves to be a cost-effective solution in the long run, as it minimizes unnecessary surgeries and leads to better outcomes for the associates involved. This case study highlights the potential benefits of innovative healthcare programs in enhancing both patient experience and overall cost-effectiveness.

Before getting to the next one,

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.

When you decide you can‘t live without those products, send me an email and I‘ll give you the hookup. They will 100% differentiate your clinic from your competitors.

I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

Our last one this week is called, “ The association between cervical artery dissection and spinal manipulation among US adults” by James M Whedon, Curtis L Petersen, William J Schoellkopf, Scott Haldeman, Todd A MacKenzie, Jon D Lurie and published in PubMed on 09 July 2023. Hot potato!

Why They Did It

Cervical artery dissection (CeAD), which includes both vertebral artery dissection (VAD) and carotid artery dissection (CAD), is the most serious safety concern associated with cervical spinal manipulation (CSM). We evaluated the association between CSM and CeAD among US adults.

How They Did It

Through analysis of health claims data, we employed a case-control study with matched controls, a case-control design in which controls were diagnosed with ischemic stroke, and a case-crossover design in which recent exposures were compared to exposures in the same case that occurred 6-7 months earlier. We evaluated the association between CeAD and the 3-level exposure, CSM versus office visit for medical evaluation and management (E&M) versus neither, with E&M set as the referent group.

What They Found

• We identified 2337 VAD cases and 2916 CAD cases. Compared to population controls, VAD cases were 0.17 (95% CI 0.09 to 0.32) times as likely to have received CSM in the previous week as compared to E&M. In other words, E&M was about 5 times more likely than CSM in the previous week in cases, relative to controls.

• CSM was 2.53 (95% CI 1.71 to 3.68) times as likely as E&M in the previous week among individuals with VAD than among individuals experiencing a stroke without CeAD. In the case-crossover study, CSM was 0.38 (95% CI 0.15 to 0.91) times as likely as E&M in the week before a VAD, relative to 6 months earlier. In other words, E&M was approximately 3 times more likely than CSM in the previous week in cases, relative to controls. Results for the 14-day and 30-day timeframes were similar to those at one week.

Wrap It Up

Among privately insured US adults, the overall risk of CeAD is very low. Prior receipt of CSM was more likely than E&M among VAD patients as compared to stroke patients. However, for CAD patients as compared to stroke patients, as well as for both VAD and CAD patients in comparison with population controls and in case-crossover analysis, prior receipt of E&M was more likely than CSM.

Let’s get to the message. Same as it is every week.

Store

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can‘t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That‘s Chiropractic!

Contact

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Connect

We can‘t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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