July 18, 2021 - Chiropractic Economics, Issue 11

AUGUST 26-29, 2021 | HYATT REGENCY ORLANDO

PLENARY TOPICS: The Opioid Epidemic: The Greatest Crime of the CenturyAvoiding Medical Errors in Raising, Adjusting and Leading Our YouthEthical Practices & Communicating Effectively: the Subject of SEXBusiness Rules & Laws: Let us Protect YouHow Documentation Is Used To Retain Patients

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• Integrative Practices• Laser• Leadership• Menopause• Neurology• Nutrition• Patient Retention• Pediatric Acupuncture• Pediatric Wellness• Rehabilitation Strategies• Risk Management• Success• Technology

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FEATUREDCONTENT 16 Treating female patients holistically Chiropractic care through a woman’s physiological journeyBY KRISTINA PETROCCO-NAPULI, DC, MS, FICC, FACC

SPOTLIGHT

24 A chiropractic firstThe first female president of the ACA talks goals and the future of the fieldBY MICHELE MAIERS, DC, MPH, PHD

36 Women’s re-entry into chiropracticThe Women Chiropractors (WDC) ReEntry Program is filling the gap for women DCs

BY KAREN HUDES, DC

62 DCs in the newsRecognitions or best practices in marketing, promotions and community involvement among doctors of chiropracticBY CHIROPRACTIC ECONOMICS STAFF

72 Buyers Guide: Massage & Acupuncture

Chiropractic Economics (ISSN 1087-1985) (USPS 019-178) is published monthly except semi-monthly (twice a month) in January, February, April, June, July, August, September, and October; 20 issues annually. Address: Chiropractic Economics Inc., 8430 Enterprise Circle, Suite 200, Lakewood Ranch, FL 34202. Phone: 904-285-6020. Website: www.chiroeco.com. (A Florida Corporation) Postmaster: Please send form #3579 to Chiropractic Economics, PO Box 3521, Northbrook, IL 60065-9955. Periodicals class postage paid at Lakewood Ranch, Florida and at additional mailing offices. GST #131868416. Statement: While encouraging the free expression of opinion by contributors to this publication, Chiropractic Economics and members of its staff do not necessarily agree with or endorse the statements made in the advertisements or contributed articles. Chiropractic Economics is owned by Arthur J. Gallagher Risk Management Services, Inc., Nicholas Doyle, Area President. Authorization for the use of photographs and/or illustrations is the responsibility of the author(s). All materials submitted for publication shall remain the property of this magazine until published. Change of Address: Six to eight weeks prior to moving, please clip the mailing label from the most recent issue and send it along with your new address (including zip code) to the Chiropractic Economics Circulation Department, PO Box 3521, Northbrook, IL 60065-9955. For a faster change, go to www.ChiroEco.com and click on “Magazine.”

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PHOTO CREDITS: ALL IMAGES ARE FROM ADOBESTOCK.COM UNLESS OTHERWISE NOTED.

PERFECTPRACTICE PRACTICE CENTRAL

46 Taking care of the hands and feetWise words from a wise woman lead to happy patients and practice

BY REBECCA WILDER, DC

CLINICAL CONCERNS

30 The Hawthorne EffectUsing the famed study to achieve maximum benefits for your chiropractic office

BY STEWART GANDOLF, MBA

TECH TALK

42 My Olympic dreamSports medicine and ‘magical tape’ lead trainer to the Olympics

BY ERIN E. HASSLER, DAT, MS, ATC, LAT, PES

52 Decompression technologyModern table-driven vs. puller systems

BY DAVID BOHN, DC

64 ‘FemTech’ seeks a movement toward holistic women’s healthFor holistic caregivers, technology is filling the large gaps in female health care

BY RICK VACH

BACKLOG12 Health News, School News,

Awards & Practice Advice12 Don’t-Miss Events13 By The Numbers: Women’s Health14 Staff Product Pick14 Profitable Practice

EVERYISSUE 6 Letter from the Editor 8 ChiroEco.com Resources 70 Product Showcase 72 Buyers Guide 76 Datebook 78 Marketplace 80 Ad Index

“As we continue to super-duper specialize, we get very good

at one particular focused area, and there is a lack of

holistic care and so...people fall through the cracks”

— Sonya Borrero, director of the Center for Women’s Health Research and Innovation

at the University of Pittsburgh

4 CH IROPRAC TIC ECONOMICS • JULY 18 , 202 1 CHIROECO.COM

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LETTER FROM THE LETTER FROM THE EDITOR

BPA Worldwide Chiropractic Economics’ subscriptions are audited by BPA Worldwide, the most dominant global media auditing company for B2B publications in the world. BPA certifies that Chiropractic Economics has the highest number of requested readers in the profession. Chiropractic Economics is the only independently audited requested publication serving the chiropractic industry.

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Our 2021 Readership Survey found that women’s health was the top specialty topic of interest among doctors of chiropractic responding to the survey, so we’re pleased to present this robust issue including articles on women DCs as prima-ry-care holistic doctors for their female (and male) patients, the first woman president of the American Chiropractic Association outlining their new initiatives, how “FemTech” is disrupting women’s health care, a

profile of the Women Chiropractors (WDC) ReEntry Program, and more.

“As the majority of chiropractic patients are women, framing female chiropractors as primary care physicians can be beneficial to patients and to the chiropractic profession,” writes Kristina Petrocco-Napuli, DC, MS, FICC, FACC, in our feature story. “Treating the whole female patient, while keeping in mind her physiological journey and all that impacts it, will result in superior patient care.”

Readership surveyThank you to all the DCs who participated in our Readership Survey, which always provides us with excellent feedback and will shape our editorial approach entering 2022.

That feedback included requests for more clinical and technique articles, case studies and research; less COVID news (aren’t we all experiencing COVID fatigue?); and more in-depth info on techniques/modalities such as kinesiology taping, nutrition/supplements, and various forms of laser therapy.

Also, congratulations to our randomly-drawn Readership Survey prize winner, Alfredo Garcia, DC, of Sandy Springs, Ga., who will receive a gift certificate for the equivalent amount of a 40-inch smart TV for his reception area.

To your practice’s success,

Richard Vach EDITOR-IN-CHIEF

Letter to the EditorWith the strides made by the chiropractic industry over the years, why can’t any new colleges/universities open here in the states, whether as public or private? I know public is more daunting because others in health care put up road-blocks for many reasons (a topic all too familiar that could have its own plethora of debates), but why no expansion with more private universities?

A couple of programs such as Palmer College and National University of Health Sciences have three and two locations in several states. Is this something other programs should try to mimic? Think of the pockets of regional areas in the country that have no schools to choose from. An example, prospective students in Mississippi, Alabama, Louisiana, Arkansas, Tennessee and North Carolina that want to stay close to home have choices of Parker (Dallas), TCC (Pasadena, Texas), Life (Georgia), Sherman (SC), or Keiser (Florida), and as mentioned Palmer and National University have Florida locations as well. These six states have to go to either TX, FL or SC.

If the industry has a concern over the amount of student debt, perhaps having a few options a bit closer to home could offset some of that debt. Where I live in South Louisiana, one of the smaller states that typically is in the lower echelon of economic opportunity, we have three medical schools, four PA schools, multiple FNP programs, two DPT programs, five athletic training programs, dozens of nursing schools, and if you go over the state line into Mississippi less than an hour, there is a DO medical school program. This area would be a hotbed for prospective DC students.

I know one DC that is on the Louisiana board and he is also on the board for his alma mater and he has pushed for it in meetings but can’t get support.

Ken Jenkins, ATC, PTA

WOMEN’S HEALTH

“TREATING THE WHOLE FEMALE PATIENT, WHILE KEEPING IN MIND HER PHYSIOLOGICAL JOURNEY AND ALL THAT IMPACTS IT, WILL RESULT IN SUPERIOR PATIENT CARE.”

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President of Palmer West, William Meeker, retiresAfter nearly 40 years of service to Palmer College, William (Bill) Meeker, DC, MPH, president of Palmer’s West campus in San Jose, Calif., has retired as of June 30.

“I know the Palmer College community joins me in congratulating Bill on his nearly four decades of impactful service to Palmer and the chiropractic profession,” said Dennis Marchiori, DC, PhD, chancellor and CEO. Appointed president in 2007, Meeker received his Doctor of Chiropractic degree from Palmer West in 1982.

“I’m very proud to have been a member of Palmer’s academic community for my entire professional career,” said Meeker. “My association with Palmer has energized my passions and provided me many pathways to serve the chiropractic profession.” ChiroEco.com/pw-meeker

Partnerships guarantee admission to NCHS health care programsTo help more students become leaders in health care, Northeast College of Health Sciences (formerly New York Chiropractic College) has prioritized building articulation agreements with colleges across the country; these agreements allow students to secure admission to NCHS’s Doctor of Chiropractic and Master of Science in Applied Clinical Nutrition programs. As of Spring 2021, NCHS had nearly 40 partner institutions, with close to 60 articulated programs and more in the works.

The college offers two articulation tracks; both allow students in a variety of bachelor’s programs — including biochemistry, natural sciences and health sciences — to secure admission to the NCHS program of their choice.ChiroEco.com/nchs-partners

IRAPS 2022 call for abstracts for platform and poster presentationsSherman College of Chiropractic is now accepting abstracts for its 17th International Research and Philosophy Symposium (IRAPS), a peer-reviewed chiropractic conference. To be considered, abstracts must be submitted by Sept. 1. IRAPS will be held in conjunction with Lyceum 2022, April 28-30, on Sherman's campus in Spartanburg, S.C.

Topics may include case studies focusing on location, analysis and correction of vertebral subluxation (LACVS); philosophy of chiropractic as a component of LACVS-type care; or scholarly pursuits that will advance chiropractic education and practice.

View the detailed Call for Submissions at sherman.edu/iraps. ChiroEco.com/iraps-2021

TRENDING STORIES

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2021 Summer Product Showcase & Buyers GuideYour Premier Source for the Latest Industry Products and Services

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TWITTER DISCUSSION

RESOURCES @CHIROECO.COM

SOCIALMARKETING

What are the most critical nutritional supplements women need to take?

Tips for optimizing your digital marketingJason Deitch, DC, founder of AmpLIFEied.com and co-founder of TheSmartChiropractor.com, took time to answer some frequently-asked digital marketing questions for Chiropractic Economics readers.

What kind of contact should DCs be getting out on their digital platforms and how often? Focus on the two biggest challenges — content and consistency. All your digital marketing communications channels require a consistent stream of content in order to work. Content is like fuel. Consistency is a requirement for momentum and growth.

What kind of content should chiropractors be sharing?• Syndicated content — Chiropractors can subscribe to social media content services. There are

free options such as following AmpLIFEiedLiving on Facebook and sharing free daily posts. There are also services that automatically post chiropractic content to a chiropractor’s social channels.

• Local content — Chiropractors create and share messaging that is of most interest and value to their “locals.” Local content should not be thought of as advertisements. It’s not asking the question “What do I have to say to get them in the door?” It’s asking, “What can I share that would be most interesting and most valuable to my practice’s target audience?”

How often should chiropractors share? Too often chiropractors rely on a random “post and pray” strategy. Smart chiropractors delegate responsibilities to their team. The best practices create a cadence of monthly campaigns, weekly topics and daily posts. Creating a 12-month calendar is the smartest way to plan for optimal results. —Michele Wojciechowski

Each month we’ll ask a new question on our Facebook page. Join the conversation at facebook.com/ChiroEcoMag

FACEBOOKQUESTION

What are the most common health issues among your female patients?

17,350 followers

eBooksVisit our eBooks page to see the latest specialty publications on cutting-edge topics such as CBD, PEMF and clinical nutrition.ChiroEco.com/chiropractic-ebooks

Email CoursesTry one of our eCourses and get up to speed with lessons on business and chiropractic sent straight to your inbox.ChiroEco.com/chiropractic-ecourses

PodcastsWe’ve interviewed some of the best minds in chiropractic. Listen on the go. ChiroEco.com/podcast

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Nutrition Response TestingSeptember 18-19 • Boston, Mass.Learn the basics from Dr. Ulan himself, including the basis of Nutrition Response Testing, the fundamentals of the 13-step procedure, demonstration of the technique and drilling on finding the lock (one of the most important steps of Nutrition Response Testing), how to do a rudimentary body scan, how to test basic stressors to the body, and additional clinical pearls.

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The Aging Brain: Evidence-Based Interventions for Brain HealthOn DemandTakeaways include clarifying factors that contribute to neurodegeneration in midlife and advanced age with a focus on Alzheimer’s disease and dementia, discussing contributing nutritional deficiencies and more. chiroeco.com/webinar-listings.

Learn more at chiroeco.com/events.

BACKBACKLOG CATCHING UP ON THE LATEST NEWS, TRENDS AND INNOVATIONS FROM THE CHIROPRACTIC COMMUNITY

I N D U S T R Y N E W S

Minnesota Chiropractic Association hires ACA to manage operations

The American Chiropractic Association (ACA) has entered into an agreement with the Minnesota Chiropractic Association (MCA) to provide association management services. MCA will continue to function as an independent organization, with its own governance, while ACA manages its daily operations.

Among key benefits of the new arrangement, which began June 1, MCA will

have the opportunity not only to leverage ACA’s expertise in association management but also its deep understanding of chiropractic issues and its strong relationships across the industry.

“ACA is excited to work with MCA and help strengthen its operations, which support its important work on behalf of Minnesota doctors of chiropractic,” said ACA Executive Vice President Karen Silberman.

“MCA’s mission, governance and our dedication to our members remain the same. We are confident ACA’s expertise in association management will bring new membership growth and greater operational stability to our organization,” said MCA President Vincent Pankonin, DC.For more information, visit mnchiro.com or acatoday.org.

Building on its “We Take Care of Our Own” philosophy, NCMIC launched a fully-redesigned Starting Into Practice website in May, specifically with the needs of chiropractic students in mind. From business plans to social media marketing, the website offers resources to help prepare students for the transition from school to practice. The resources are also useful for new DCs or those transitioning to a new mode of practice.

“We know the shift from student to practicing DC can be a stressful one. That is why the Starting Into Practice website is such a great resource,” said Dan Zimmerman, director of corporate relations at NCMIC. “It is one of the most comprehensive guides I have seen available to students at no cost. We are frequently adding new resources to the site, and with the new design, it’s now easier to use than ever before.”

NCMIC’s Starting Into Practice® Program has held on-campus presentations for over 20 years, helping prepare students for life after graduation. The Starting Into

Practice website provides helpful resources for students whether they’re starting their own practice, joining an existing practice or becoming an independent contractor. From creating a financial plan, to building a professional team or marketing a practice, the website offers students research-based and real-life examples they can use to guide decisions regarding their practice.

“I’m proud of all the work that went into the relaunch,” said Zimmerman. “As a team, we all look forward to hearing feedback about the many ways students are using the website and its value in helping them start into practice.”For more information, visit startingintopractice.com.


“WOMEN IN THE TOP 1% OF THE INCOME DISTRIBUTION HAVE A LIFE EXPECTANCY THAT IS 10 YEARS LONGER THAN THAT OF WOMEN IN THE BOTTOM 1%, A DIFFERENCE THAT EQUATES TO THE HEALTH IMPACT OF A LIFETIME OF SMOKING.”— HEALTH, INCOME & POVERTY: WHERE WE ARE & WHAT COULD HELP, HEALTH POLICY BRIEF, HEALTH AFFAIRS

Carnegie Mellon University’s He Lab is focusing on noninvasive neuroengineering solutions that provide diagnostic techniques and innovative treatments. Their latest research demonstrates that noninvasive neuromodulation via low-intensity ultrasound can have cell-type selectivity in manipulating neurons.

“Deep brain stimulation, which is highly successful, but an invasive form of electric stimulation through implanted electrodes, is one example of how neuromodulation is being used in a clinical setting today,” explained Bin He, professor of biomedical engineering at Carnegie Mellon University. “Medical professionals have also used noninvasive transcranial magnetic stimulation and transcranial current stimulation, both of which lack the ability to specifically focus on the neuro-circuit level.”

Low-intensity transcranial focused ultrasound, or tFUS, is noninvasive, precise, and it does not require surgery. During tFUS neuromodulation, pulsed mechanical energy is transmitted through the skull, with high spatial resolution and selectivity, at highly-targeted brain regions, which can be steered to elicit activation or inhibition through parameter tuning.

In work recently published in Nature Communications, He’s group demonstrated that specific cell types can be targeted through tFUS neuromodulation. This finding is significant, because it demonstrates the capability for a noninvasive neuromodulation technique to modulate a selected cell subpopulation, using a technique that can be directly translated for human use.For more information, visit engineering.cmu.edu.Source: Science Daily, sciencedaily.com

H E A LT H N E W S

Focused ultrasound enables precise noninvasive therapy “Women in the U.S.

are three times more likely to die in child-birth than those in Sweden and Norway and are more emo-tionally distressed than women in Ger-many or France. It also found that nearly half of U.S. women report problems with their medical bills, com-pared with only 2% of women in the U.K.”

― Commonwealth Fund

1in5210,000Hip fractures that occur each year in the U.S., 80% of which occur in women. Source: Johns Hopkins Medicine

Women who die within a year after sustaining a hip fracture.Source: Johns Hopkins Medicine

Women in the U.S. who report skipping needed medical care because of costs.Source: Commonwealth Fund

41.8%

4x33%+

Osteoarthritis is four times more common in women than men.Source: Gender Disparities in Osteoporosis, Khaled A. Alswat, J Clin Med Res

Percentage of U.S. women aged 20 and over who are obese.Source: U.S. Centers for Disease Control

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CH IROEC O.C OM JULY 18 , 202 1 • CH IROPRACTIC ECONOMICS 13

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BACKBACKLOG

The World Federation of Chiropractic (WFC) has appointed its first African representative to its executive committee. Kendrah da Silva, DC, has served on the WFC Board of Directors since 2019 and represents the African region; the WFC Board of Directors is made up of 13 representatives, nominated or elected from each of the WFC’s seven world regions. She was unanimously elected on May 18 at a meeting of the WFC Board of Directors, replacing outgoing WFC Vice President Michele Maiers, DC, MPH, PhD.

Da Silva is a 1994 graduate of Technikon Natal (now Durban University of Technology). She runs a busy general chiropractic practice in Midrand, South Africa, balancing patient care with work in chiropractic politics and education.

She is currently serving her third term as

president of the Chiropractic Association of South Africa (CASA), the largest national chiropractic association on the continent. She volunteered there shortly after graduation and has been involved with CASA in some capacity for over a quarter of a century, including as a CASA Council Member since 2000.

Speaking on her appointment, Da Silva said, “I am overwhelmed by the confidence that my fellow board directors have placed in me. This is an awesome opportunity to serve the chiropractic profession in a new capacity. As vice-president, I’m looking forward to continuing to support WFC initiatives, including our #BeEPIC campaign and the WFC Principles, and further cement the progress the profession has made thus far.”For more information, visit wfc.org.

C H I R O P R A C T I C N E W S

WFC appoints first African representative to executive committee

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FEATURESTORY

T H E TA K E AWAY

Adolescent girls and young women require specific wellness and prevention treatment, despite middle-aged women making up the majority of chiropractic patients. Young girls and women are dealing with increased pain and injury due to bodies growing more quickly and technology usage causing musculoskeletal pain in the neck and low back, headaches and more.

TREATING FEMALE PATIENTS HOLISTICALLYChiropractic care through a woman’s physiological journeyBY K R I ST I N A P E T R O CCO - N A P U L I , D C , M S , F I CC , FACC

TIME TO READ: 11-13 MIN

THE PERCENTAGE OF WOMEN ENTERING THE CHIROPRACTIC PROFESSION has been steadily

increasing since the early 1990s, from about 13.3% to more than 31% in 2019. This growth in

practitioners has brought with it additional perspectives on patient populations and treatment,

ultimately helping chiropractors to better provide patient-centered, holistic care.


A female majority of patientsAccording to the National Board of Chiropractic Examiners (NBCE) 2020 practice analysis, 57% of chiropractic patients are female, and nearly 46% of those patients are between the ages of 30-64. As females comprise the majority of the population that chiropractors treat, framing female chiropractors as primary physicians can be beneficial to patients and to the chiropractic profession as a whole.

For example, chiropractors often treat a wide range of health issues and conditions — biomechanical issues, nutritional concerns, and disease prevention and risk factors, to name a few — in their female patients, who often seek chiropractic care because they want a practitioner who will treat their body in its entirety. It is imperative that chiropractic practitioners consider the whole patient when creating a treatment plan because there may be underlying factors that can impact their health and well-being.

It’s also important to conduct a thorough history of each patient, as a woman’s physiological journey can help tell where she has “been” and where she is “going.” Forgetting to look backward when talking to female patients can cause practitioners to miss important pieces related to the patient’s current state of health.

Treatment in adolescence Although middle-aged women make up the majority of patients chiropractors treat, adolescent girls are experiencing more musculoskeletal pain than ever before. Determining the cause of the pain is of utmost importance, as adolescents are more likely to carry it with them as they age if it is not resolved.

Pain that commonly affects young girls includes musculoskeletal pain in the neck and low back, headaches and abdominal pain, and is often attributed to the changes their bodies experience as they age. Additionally, in recent months, many chiropractors have seen increased pain in young girls due to the growing use of technology during the COVID-19 pandemic. It is suggested that adolescents use technology for no more than two hours per day; because of COVID-19, however, many schools transitioned online, so adolescents are using technology more than ever before. This contributes to increased musculoskeletal pain, as many students did not have a proper work area, causing text neck, poor posture and a lack of ergonomics.

In addition, the age at which a female has her first period can affect her health later in life. A young woman who experiences precocious puberty, or who menstruates before the age of 12, has a 50% increased likelihood of breast cancer and is more likely to be impacted by polycystic ovary syndrome (PCOS) and other

FEATURESTORY

13OBESITY IN CHILDREN UNDER

THE AGE OF 13 CAN CAUSE HEART DISEASE TO DEVELOP

AS EARLY AS AGE 25

For health care providers, it is imperative to ask the difficult or uncomfortable questions about a patient’s

health history in order to treat them properly.


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metabolic syndromes. Precocious puberty can affect the age of menopause and can be caused by childhood obesity, ingestion of animal proteins and exposure to endocrine-disrupting chemicals.

When it comes to treating young adults, specifically females, wellness and prevention are incredibly important. Identifying risk factors early can impact how they progress on their physiological journey. Chiropractors should educate parents on diet and exercise, as one in three American teens are overweight. Being overweight directly impacts cardiovascular health (obesity in children under the age of 13 can cause heart disease to develop as early as age 25), causing high cholesterol, diabetes, precocious puberty and asthma, so it is important to develop and encourage healthy diet and exercise habits from a young age.

Female risk factors As women age, they are at a greater risk for cardiovascular disease, so it is essential to educate patients on signs and symptoms of heart disease and on prevention and lifestyle interventions to avoid heart disease. When female chiropractors are framed as primary physicians, they can offer tips and advice to help patients live an overall healthy lifestyle.

For health care providers, it is imperative to ask the difficult

or uncomfortable questions about a patient’s health history in order to treat them properly. For example, pelvic floor dysfunction can happen to anyone, not just older women. In fact, women as young as 15 years old have experienced pelvic floor dysfunction, and, contrary to some misconceptions, a woman does not have to have had children or have been pregnant to experience it. Pelvic floor dysfunction can lead to urinary incontinence, which is one of the most embarrassing topics for women to discuss, even with their health care provider.

It is the responsibility of the health care provider to break the barrier of discomfort and create trust with a patient to have open and honest conversations, because that will inform and shape the treatment plan. Chiropractic care can significantly impact urinary incontinence, but if it is unknown that a patient is struggling with this issue, it may never be resolved.

Uniqueness of treating female patients There are many unique aspects to keep in mind when treating female patients, like social determinants of health, which are often missed by chiropractic providers. Social determinants include a patient’s ability to access quality health care — are providers available in their area? Do they have transportation to and from appointments? Are there financial barriers at play? Social determinants can also include the patient’s ability to make educated health care choices and decisions as well as the patient’s relationships with friends and family.

Where a patient lives, works, learns and plays can also impact their well-being. For example, do they live near green space where they are able to get out and walk? Do they work in a building that causes environmental exposure? These are questions that need to be asked to better inform patient care.

FEATURESTORY

A YOUNG WOMAN WHO MENSTRUATES BEFORE

THE AGE OF 12 HAS A 50% INCREASED LIKELIHOOD OF

BREAST CANCER

When female chiropractors are framed as primary physicians, they can offer tips and advice to help

patients live an overall healthy lifestyle.


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Additionally, as health care providers, it is necessary to not dismiss a patient’s pain. Regardless of age or background, women’s pain is often dismissed, especially when it comes to chronic pain. Women perceive pain differently than their male counterparts and are more likely to experience chronic pain than men. Chronic pain patients seek a provider who will listen and truly help them, and it is important to remember that the same issue doesn’t always create the same pain in two different patients. Investigate all aspects of a female’s pain, because it might not only be related to the musculoskeletal system but also to other contributing factors.

Educate and make patients part of their own careRemembering to keep patients at the center of care is so important, but especially when treating women. Let patients be part of their care by making choices about their health care treatment.

Chiropractors should also educate and empower their female patients, as they make the primary household health care decisions across the country. Chiropractors can play an important role in educating patients to make good choices for themselves and other members of their family and should empower their patients by helping them advocate for themselves and for the care they need, want and deserve.

Maintaining an evidence-informed practice is of the utmost importance. Base care in evidence and research by finding methods proven to work and referring to outside sources when needed. The ACA Council on Women’s Health is a great resource when looking for information or direction on treating female patients. The Women’s Health Council’s mission and vision is to support and help practitioners treat their female patients in the best way possible, and the council provides practitioners with the materials and knowledge they need to do just that. The purpose of the council is to increase education, care and awareness of conditions that specifically impact women’s health; identify and support research and evidence-based practice as it relates to women’s health; and determine relevant quality measures and standards for women’s health. This, among many other resources, can greatly benefit the care of female patients while improving the chiropractic profession as a whole.

As the majority of chiropractic patients are women, framing female chiropractors as primary care physicians can be beneficial to patients and to the chiropractic profession. Treating the whole female patient, while keeping in mind her physiological journey and all that impacts it, will result in superior patient care. Being attentive, asking questions and truly listening to patients will always lead to the best possible outcomes.

KRISTINA PETROCCO-NAPULI, DC, MS, FICC, FACC, is a strong advocate for women’s health and the assistant dean of the College of Chiropractic at Logan University and the president of the American Chiropractic Association’s Council on Women’s Health. She earned a bachelor’s degree in health sciences from the University of Arizona and a Doctor of Chiropractic from New York Chiropractic College. She then attended Syracuse University, where she graduated with a Master of Science from their Graduate School of Education with a concentration in instructional design, development and evaluation. An experienced speaker, she has presented at over 100 conferences, conventions, ceremonies and symposiums, and her work has been published more than a dozen times.

FEATURESTORY

15WOMEN AS YOUNG AS 15

YEARS OLD HAVE EXPERIENCED PELVIC FLOOR DYSFUNCTION

It is the responsibility of the health care provider to break the barrier of discomfort and create trust with a patient

to have open and honest conversations, because that will inform and shape the treatment plan.


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A CHIROPRACTIC FIRSTThe first female president of the ACA talks goals and the future of the fieldBY M I C H E L E M A I E R S , D C , M P H , P H D

TIME TO READ: 10-12 MIN.

THIS PAST FEBRUARY the American Chiropractic Association (ACA) elected me its first female president. Many will see this as an important milestone in ACA’s history. For me, this election is most important not in its quality of being a “first” but for the fact that it is part of a larger movement for increased diversity in the chiropractic field.

An all-female-led executive teamIn addition to my leadership as president, the ACA will benefit from the expertise and experience of Dr. Kathy Boulet, recently elected as vice president, and Karen Silberman, who continues in her role as executive vice president.

We are proud to be part of an all-female-led executive team, and we hope to set an example for other female practitioners and students, especially those aspiring to be in industry leadership roles. Together with our board, we hope to lead the ACA and guide the chiropractic field as a whole toward a more diverse, equitable and inclusive future.

This is no small task, and it will take more than my one-year term as president to achieve this goal. After my tenure as president, the work I’m leading today will necessarily continue so that the organization can continue to grow. I want to acknowledge, however, what a unique time this is for the chiropractic profession. A happy confluence of election schedules, shifting demographics and the hard work of female chiropractic practitioners has resulted in more female-led chiropractic organizations than ever before in our field’s history.

At present, women lead the ChiroCongress, the International Chiropractic Association, the Federation of Chiropractic Licensing Boards and the American Black Chiropractic Association. We believe this presents some interesting opportunities for increased coordination between the organizations, and as a group we are currently discussing how improved communication and coordination could transform how chiropractic is perceived within the broader health care system.

T H E TA K E AWAY

The ACA president stresses that the industry as a whole must focus on policies and initiatives that expand access to and utilization of chiropractic care services while continuing diversity efforts to serve a greater and more diverse part of the population.


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Strategic goals to drive broader awareness of chiropractic care benefitsMy work as president to coordinate with other organizations aligns with the ACA’s 2020-24 strategic plan and its mission to inspire and empower our members to elevate the health and well-being of their communities.

As an organization, we are embracing a collaborative, inclusive approach, both between our members and in partnership with other organizations, so that we can move our entire profession forward. To that end, the ACA’s strategic plan includes the following goals:

• Advance professional parity: At present, Medicare coverage for chiropractic care does not cover the full range of services that practitioners offer and are educated to provide. In April 2021, Rep. Brian Higgins of New York introduced the Chiropractic Medicare Coverage Modernization Act (H.R. 2654), which would enable patients to access care from their chiropractor for all Medicare-covered benefits allowable under the practitioner’s state license. Currently, passing H.R. 2654 is our top legislative priority at ACA.

• Implement initiatives to increase partnership with the broader health care system: To better position chiropractic physicians to deliver the patient-centered, evidence-informed care that our patients need, we are embarking on several initiatives and advocacy efforts. One part of this is serving as an educational resource and advocate via a new site, Hands Down Better (handsdownbetter.org), that provides information on a range of health topics, and connects the public with ACA doctor-members. Another important aspect of our work includes developing partnerships with key industry stakeholders to create business and clinical learning opportunities about best practices, ethics, professionalism and relevant issues, such as how patient-centered chiropractic care can help address the opioid abuse epidemic.

We believe that passage of H.R. 2654 will have a significant impact on the opioid abuse crisis ravaging the nation, which is due in large part to a drug-reliant approach to pain management. By utilizing other pain management

techniques, such as manual manipulation of the spine and the extremities, and leveraging chiropractic physicians at the top of their license, chiropractic care can help divert patients away from opioid treatment plans and assist those recovering from opioid dependence.

In recent years, chiropractic care has grown in recognition as an effective means of combating the opioid abuse epidemic. The modernization of chiropractic coverage within Medicare will expand treatment options for patients who might otherwise have to pay out of pocket for services not previously covered. This will also reduce care fragmentation, decrease costs, and increase access for some of our most vulnerable patients.

Fostering growth through mentorship and DEIMentorship and inclusion have long been part of my work at the ACA and in the chiropractic field. Prior to my election as ACA president, I had the privilege of helping establish NextGen (formerly known as the Millennial Think Tank), a program designed to provide support, professional development oppor-tunities and mentorship to early-career practitioners with less than five years of experience.

Since the program’s founding in 2016, I served as mentor to junior professionals, many of them young women seeking guidance and support as they built their careers in a predominantly white male field. Following my election, I stepped aside in this role to allow a new generation of practitioners to assume the role of mentor and help others, particularly those underrepresented in chiropractic.

H.R. 2654WOULD ENABLE PATIENTS

TO ACCESS CARE FROM THEIR CHIROPRACTOR FOR ALL MEDICARE-COVERED

STATE BENEFITS

Time and time again, we have seen the positive effect that increased diversity within chiropractic has on patients and students from various backgrounds.


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Time and time again, we have seen the positive effect that increased diversity within chiropractic has on patients and students from various backgrounds. For patients, having a provider of their same gender, race or ethnicity can make them feel more comfortable and increase the likelihood of receiving patient-centered, culturally competent care.

Given increasing accounts of women feeling unheard, disregarded or dismissed by male providers, it is all the more important that we increase gender diversity in the field and ensure women receive the care they need. Northwestern Health Sciences University reports that for the last two years, 51% of its chiropractic students have been female. While this represents significant progress in the field, there remains more to be done.

In 2018, the ACA Commission on Diversity established a road map for the ACA to increase diversity within chiropractic and improve the care provided to underserved and intersectional populations. To further this effort, my team and I are calling on primary care practitioners, hospitals and community clinics alike to form community-driven complementary and integrative health (CIH) programs, better serve diverse communities, increase cultural competence, elevate professionals of color and improve accessibility of chiropractic care. In my term as president of ACA, fostering diversity and inclusion within the organization and the profession is a high priority.

My hope is that by exemplifying the inclusiveness and forward-thinking our industry needs, I can inspire other women and practitioners from other

underrepresented groups to envision themselves as leaders. Electing women and people of color to leadership positions is an important step, but it is just one part of increasing diversity and inclusion in this sector and ushering in positive change in our health care system. I look forward to working with the ACA and other chiropractic organizations to facilitate that change.

The future of chiropractic careOn the heels of a famously unpredictable year, predicting the future in any field feels a little like folly. In place of that, I want to encourage my fellow practi-tioners to focus on what is possible and on the work we can do today to achieve those long-term goals.

Along with the leadership team at ACA, I will be moving the organization toward fulfilling its strategic goals in the next year. Beyond that, ACA and the industry as a whole must continue to focus on policies and initiatives that expand access to and utilization of chiropractic care services: passage of H.R. 2654, increased DEI efforts, creating more community-focused CIH programs, and working together for the common good. This will go a long way toward ensuring that one day everyone will have access to the patient-centered care they need.

MICHELE MAIERS, DC, MPH, PhD, has focused her career on bridging research and public health policy, empowering clinicians, patients and policymakers to make better decisions about conservative and integrative health care. She does so as ACA president and executive director of research and innovation at Northwestern Health Sciences University. To learn more, go to acatoday.org/SP-MicheleMaiers.

In my term as president of ACA, fostering diversity and inclusion within the organization and the

profession is a high priority.

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CLINICAL CONCERNS

THE HAWTHORNE EFFECTUsing the famed study to achieve maximum benefits for your chiropractic officeBY ST E WA R T G A N D O L F, M B A


T H E TA K E AWAY

Staff performance improves when work is being measured. Still applicable today is the famed study of worker productivity that instead made the study itself a revelation in performance and management.

NOT EVERYONE RECOGNIZES THE CLASSIC BUSINESS TERM The Hawthorne Effect. This label has been around for some time, and it comes to us with an enduring history in business.

But if you know the concept by name — if you call it something at all — it’s likely that this principle is already hard at work in some parts of your office. Frankly, this is a concept that can effectively define and improve nearly every facet of your practice. Here’s where and how every chiropractic office can score maximum and positive benefits.

Improvement principlesThis concept quantifies critical performance and organization improvement principles for:

• Documenting patient care, progress and outcomes• Patient satisfaction, compliance and follow-up• Marketing and advertising; return on investment• Individual and staff incentives, goal setting and personal growth• Tracking and achieving critical success factors and business objectives

First, the brief backstory. The now-famous industrial project began in 1924 when Harvard Business Professors

Mayo and Roethlisberger studied worker productivity at Western Electric’s Hawthorne facility. The electric company had commissioned research to determine if there was a relationship between productivity and work environments.

The original purpose of the Hawthorne studies was to examine how different aspects of the workspace, such as lighting, the timing of breaks, and the length of the workday, had on worker productivity. Additional studies continued over several years. But it turned out that the study itself — not the lighting or other work environment changes — was making the difference.1

“The Hawthorne Effect — a term coined in the 1950s — describes the phenomenon of test subjects changing their performance in response to being observed, as some Hawthorne employees did when they knew they were part of the study.”2

The power of observationAlthough thoughtful discussion about these studies continues, the broad concept suggests that it is human nature for people to change or improve their behavior due to their awareness of being observed or monitored. In some instances, people may simply work harder. But with specific and quantified goals and objectives, individuals can focus their efforts on achieving


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CLINICALCONCERNS

measurable and positive change for the benefit of the patient and the practice.

Subsequently, the social science world came to connect business progress and success with a modern, human-centered environment. And, to distill the concept, doctors, office managers and employees recognize that people’s performance improves when work is being measured. The contemporary quick notes (and variations) for every DC’s office are:

• What gets measured, gets done• What gets measured, gets improved• If you don’t measure it, you can’t manage it

Quantify and measureOne of the strongest and most widely applicable of the Hawthorne tenets is the concept that having a quantifiable measure is a means to gauge progress and success. What’s more, it guides changes — to correct misdirection and/or direct improvements. Some objectives can get stalled at a vague-and-lofty stage that lacks a quantifiable indicator of progress (or perhaps a lack of progress). Is there specific progress within the practice, and/or clear contribution to the business bottom line?

Being “busy” is not the same as being productive or effective. And, without specific numbers, there is no accurate picture. The individual responsible and accountable for the goal — as well as the supervisor — doesn’t know how they’re doing.

Nearly every chiropractic practice faces challenges: to support daily operations and meaningful goals through resource allocation and a balanced budget. Without specific measures for every facet of the practice, it’s nearly impossible to manage patient care, as well as staff performance and

business goals. To illustrate, one of our favorite business examples is a marketing fundamental. That is, advertising, or any promotional activity, needs to be performance-driven. In marketing, the “Hawthorne” name usually falls away in favor of “return on investment” (ROI). It is the critical measure of “dollars in” vs. “dollars out.” ROI defines the financial benefit from a specific marketing effort. It is the gold standard indicator of what’s working and/or what needs to change.

Testing, tracking and calculating ROI reveals if your marketing and advertising is successful or wasteful. In other words, it measures what you get back compared to what you put in. Plus, it’s an opportunity to do more of what’s working.

The Hawthorne Effect in the chiropractic officeThe Hawthorne Effect is versatile in its applications and useful-ness in most every chiropractic practice. Here are the critical management questions that guide the measure and direction of performance:

Goals — Precisely, what do you want to achieve? Objectives can be for the overall practice, for the team or department, or for an individual job function … but it must be expressed in specific and measurable values. Goals are sometimes defined in big chunks, perhaps annual or quarterly numbers, but smaller monthly, weekly or even daily goals can be more practical, and more achievable, slices.

Quantify — What are the units of measure? How do you quantify the goals, the process and/or the work? Is the unit of measure in number of patients, dollars or activity completed? For example, winning some number of patient appointments may not be as useful or specific as knowing the dollar value of the resulting case size. The meaningful business goal(s) should be expressed in units of measure that can be reasonably documented, recorded and reported.

Cornerstone metrics — These are critical, and most often it is the basic numbers that define the path to success. As a starting point, these likely include the number of new patients, patient visits, collections and referrals. What’s more, these fundamentals are easy to track.

1950sTHE TERM “THE HAWTHORNE EFFECT”

ORIGINATED IN THE 1950S TO DESCRIBE EMPLOYEES WHO CHANGED THEIR PERFORMANCE WHEN THEY KNEW

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Performance ratio — Compare goals with actual performance. Make this comparison often and early. It’s of little help to check actual performance at the end of the month only to discover that a course adjustment in week two would have made the difference between hitting or missing the mark.

Synergy and teamwork — In a tight-knit business environment — as many chiropractic offices are — collective efforts and mutual support among the staff can magnify positive results. What’s more, individuals are responsive when there is attention and interest in what they do. Individuals who are accountable tend to perform better than unsupervised individuals.

Roadblocks and fixes — What obstacles are present and/or what adjustments are needed? It’s just as useful to discover what’s not working as expected. The numbers can reveal problems to be resolved for an activity and/or for system improvement.

There may be dozens of “Hawthorne Effect” pulse points in any chiropractic office. But begin with the critical-difference indicators that are most important to near- and long-term success. These may be measures of patient care as well as the business and financial well-being of the practice.

The Hawthorne Effect in businessWithout monitoring and testing, productivity, performance and goal achievement are only wishful thinking. Otherwise, there is no precise means to know if a department, a team or an indi-vidual is contributing to defined goals. There’s a certain pride — and improved performance — in the recognition of work effort and achievement, both individually and as a group.

Regardless of the label, “Hawthorne” may be one of the most versatile and valuable management tools for the success of any chiropractic office.

STEWART GANDOLF, MBA, is chief executive officer of Healthcare Success, one of the nation’s leading health care and digital marketing agencies. Over the past 20 years he has marketed and consulted for more than 1,000 health care clients, ranging from practices and hospitals to multibillion-dollar corporations. A frequent speaker, he has shared his expertise at more than 200 venues nationwide. To learn more, go to healthcaresuccess.com.

CLINICALCONCERNS

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SPOTLIGHT

WOMEN’S RE-ENTRY INTO CHIROPRACTICThe Women Chiropractors (WDC) ReEntry Program is filling the gap for women DCsBY KA R E N H U D E S , D C


DO YOU REMEMBER WHEN YOU FIRST GRADUATED from chiropractic college? Did you think, “OK, now what?” If not, you were lucky.

Many of us lack a clear idea of what to do next in order to get started. If we were smart and lucky, we found a mentor or a group of like-minded people to help us begin in practice in whatever form that took. With a combination of hard work, luck, blood, sweat and tears, many of us went on to build successful careers. But what about the ones who did not have that same combination of grit and good fortune, or for other reasons in life, ended up needing to start over?

Help starting overSometimes this “life stuff” comes at a time long removed from that first blush of post-graduation excitement and confidence. Divorce, kids, practice failure, death of a spouse or family member, change in the economic landscape, moving, and so many other reasons, just to name a few.

Life happens and sometimes it knocks you around a bit.

Getting back into practice after being out for five, 10 or more years can be daunting. Asking for help is scary. Resources for this type of situation are few, especially if you are on a tight budget or without a budget altogether.

Women in chiropractic, as in many other traditionally male-dominated professions, have fought a long uphill battle to begin to near equality. Slowly, women have begun to even the scales in numbers of students enrolled in chiropractic colleges, but this number still lags in practicing chiropractors.

In general, more women leave practice proportionally than do men post-graduation. The balance of home, practice, kids, family, aging parents and a host of other factors are the most common reasons for this and are not unusual or unique to chiropractic. This exodus of women from the workforce has never been so acute and noticeable as during the COVID-19 pandemic.

I suspect now that more women have left chiropractic than ever before. This article is a spotlight on one thing that can be done about it: The Women Chiropractors (WDC) ReEntry Program.

T H E TA K E AWAY

A ReEntry program is helping women chiropractors return to the workplace after the “life stuff” women face with family issues, personal economic changes and more.


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The WDC ReEntry ProgramWDC is a nonprofit organization whose mission is to support and empower all women chiropractors in technique, business, philos-ophy and life skills, as well as to help women find their purpose, find balance, and create a sisterhood that supports one another during school/graduation and throughout their careers. The ReEntry program is one of the ways in which WDC helps to lift up all women by giving a hand to those who may need it. ReEntry is the brainchild and passion project of Cyndy Shaft-Toll, DC.

The ReEntry Program was designed by Shaft-Toll for women starting over and returning to practice after “life happens” — a significant life event that took them out of practice for a period of time. She has personal experience in this; she started over after a divorce from her husband, who was also a chiropractor. Alone with seven children and in a practice that was struggling, she turned to fellow women chiropractors to mentor, coach and assist her in finding success. She comes from a chiropractic family and realized how fortunate she was to have others to turn to, and that many other women do not. She co-founded WDC with ReEntry as a core program, knowing firsthand the struggles women face in chiropractic.

Offering a foundation to start againThe program is offered free of charge to applicants who have left the profession and are looking to re-enter, start fresh, or

are just struggling in practice or life and need help. The goal is to help give women the building blocks and confidence to re-enter practice.

Classes take place weekly via Zoom, beginning every January with graduation set yearly on International Women Chiropractors Day, June 5. As of 2021, four cohorts have graduated, and the program has grown and helped more than 50 women re-enter practice.

A 2020 graduate of the program and now a WDC board member, Cristina Padilla, DC, writes this about her experience in ReEntry: “I joined ReEntry at the beginning of 2020. I had been looking to connect with women chiropractors in practice to share ideas and mastermind, since I’m a solo practitioner. When the program began, I was having some of the best months in practice but was struggling with systems and managing it all. Two months into the ReEntry program, the pandemic forced businesses to shut down and I lost about 60% of my business in less than a month. This was not only unexpected, but also concerning because I wasn’t sure if my practice would survive months of loss and stay-at-home orders.

“Fortunately, having the guidance, accountability, support, and mentorship of the Women Chiropractors group and the mentors in the ReEntry program, I was able to shift my focus and mindset and better plan for the future. Our motto in the group became ‘pivot, don’t panic,’ and having the weekly check-ins with the group helped us all to continue to grow through a pandemic. I am happy to say I was able to double my business revenue in 2020 and hire my first employee. I was also the recipient of the Linda Atkinson award, a grant offered by WDC to a woman in practice. This award allowed me to continue my personal development to complete some education and certifications that would help me grow my business even further. I cannot thank Women Chiropractors enough for their mission and dedication to create opportunities for women to get back into the profession, but also to advocate and connect new female doctors with other females in practice.”

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When life suddenly shiftsWe all have a story. For me, well, I was in the first class. After 17 years and some career success, after graduation I found my situation suddenly shifting. While I had a part-time practice, I had never placed all of my focus on patient care, instead doing third-party medical examinations primarily with insurance companies and lawyers. I was never fully satisfied by this work and suddenly I saw a shift coming on the horizon.

The landscape was changing, and I feared I would suddenly have no work. This is a terrifying prospect for anyone, and for years I had been the main breadwinner for my family. I knew it was finally time to shift to patient care full-time. This is what I had always wanted anyway, and yet … I was terrified. Not about the care, as I knew I was able to provide for patients, but at the time I was seeing four patients per week.

That is not a typo: four.

I had tried in the past to make a practice viable, and I had failed. I was suffering from anxiety and depression, and some days I had so much fear that it seemed to me that was all I was. I didn’t know where to start. I didn’t know what to do. I didn’t know what I didn’t know.

Fortunately, I was smart enough to know I needed help, and through a crazy combination of good fortune and the universe intervening, I found the help I needed.

At the time, WDC was just getting ready to launch the first ReEntry program, and my old roommate, friend and co-founder

of WDC, Rosemary Batanjski, DC, suggested I contact Dr. Shaft-Toll immediately and apply to the ReEntry program. I applied and was accepted, and it changed my life. These women changed my life. I think they may have saved my life.

Weekly programming and mentorshipThe weekly program in ReEntry offers topics that are broad and varied, as are the doctors enrolled. There is camaraderie and kinship and a sense of helping lift one another up. The mentor-ship provided is invaluable and exactly what I had been looking for since graduation.

Four years later I am in practice full-time, during a pandemic that has been difficult to navigate with rolling closures in my area. Many of the patients and doctors I know have fallen into states of anxiety and depression, and yet for me, for the first time in my career, I feel better overall than I ever have. I am not saying I don’t have days — we all have our days — but finally, 20 years into practice I got the help I needed to find and keep success.

Women Chiropractors and ReEntry made such a difference in my life personally that I am now honored to serve on their board. We are a nonprofit organization aimed at supporting and empowering women chiropractors and changing the landscape of our great profession. We continue to offer the ReEntry program yearly, as well as free regional one-day pop-up seminars, speaking opportunities for women chiropractors, support of female-led research, a scholarship program and a bi-annual convention.

Our Facebook group is the largest and most active in the profession, and offers non-judgmental clinical, practice-related and personal support. While the board members are volunteers, there are always costs to supporting these programs. If you want to support women taking their rightful place toward equality in chiropractic, then I encourage you to join our journey.

KAREN HUDES, DC, is a Canadian chiropractor, WDC board member and past ReEntry candidate. For more information or to support the WDC ReEntry program, go to womenchiropractors.org.

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Dissecting athletic movementI began to study how people moved as early as second grade. “It is rude to stare” was something I heard often. The problem was trying to turn off my analytical brain, as I worked so hard to dissect every part of any movement that caught my attention.

As a biology major and student athlete at Clark Atlanta University, I had the opportunity to observe the city of Atlanta

prepare for the 1996 Olympic Games. The entire city was like an Olympic showcase — the logos were everywhere, contests were on every radio and TV station, and people were even more friendly than usual. My friends and I swapped money with tourists from all over the world. The most exciting part was the front-row finish line seats that I got to the track and field events. I got to see some of my favorite athletes in the world.

Sports medicine inspirationInspired by a feature story on the jobs that were behind the Olympic team, I decided on my future career in sports medi-cine. Two years later I found myself as a graduate student at Life University, one of the biggest chiropractic schools in the country. As an athlete I always dreamed I would be competing in the Olympics, but my dream found new life as an athletic trainer.

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A medical provider with Team USA recalls her journey as an athlete then serving athletes on the road to the Olympics.


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and Division I athletics levels, and the WNBA and as a business owner, I found myself at the Olympic Training Center in Colorado Springs, Colo. During my internship, I got the chance to work with several sports teams, including Paralympic swimming and the Modern Pentathlon. It was during this trip that I was introduced to the art of kinesiology tape.

‘If I can tape it, I will!’The staff clinicians applied what seemed like magical tape to knees, ankles, shoulders and so many other places. I spent

every day studying the purpose and technique of the applica-tion of the special tape.

It wasn’t the first time I had seen it, but it was one of those things that was used in clinics and not on the field. My motto over the years has been, “If I can tape it, I will!” I could not wait to use it on my athletes back home. Anytime I got a roll of kinesiology tape or even a sample I would find some way to use it.

It is now 2021; I find myself as a medical provider with Team USA. I have worked with USATF youth, recreational and professional runners for the last 10 years. Kinesiology tape has been with me the entire time. The ease of use and self-application enables athletes to use it even when I am not with them. The adhesive is much stronger and more reliable when they need it most.

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TAKING CARE OF THE HANDS AND FEETWise words from a wise woman lead to happy patients and practiceBY R E B E CC A W I L D E R , D C


PRACTICE CENTRAL

T H E TA K E AWAY

Not unlike a misaligned tire on your car or the unsteady foundation of a building, negative adaptation from the foundation of the feet upward, gone unrepaired, can counter your best chiropractic methods.

ONE OF THE BEST PIECES OF ADVICE my great-grandmother passed down to my mother was to “take care of your feet and your hands.”

I never met this great-grandmother my mom lovingly called “Nanny,” but she sure knew what she was talking about! As a young girl I took these lessons from my mother to mean “moisturize and take care in the trimming of nails and cuticles and hope you never have to worry about the dreaded bunion.” I wasn’t one to don polish or have a mani-pedi on the regular as some of my girlfriends did, and, as I was a competitive youth soccer player and eventual college athlete, I focused my foot care on performance and some basic aesthetics and hygiene.

Fighting repetitive strainHaving suffered through unilateral Osgood-Schlatter disease, severe shin splints, stress fractures and plantar fasciitis off and on as a youth athlete, long-term relief finally came from a chiropractor who recommended custom orthotics.


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I was 15 years old and burning out physically and mentally from five years of reoccurring and repetitive strain injuries. Once I found custom orthotics, it changed my life both on and off the field, for they had an orthotic that fit in my cleats! I still play soccer and am still wearing custom orthotics 25 years later. They made me appreciate my feet, and now as a chiropractor, the value of my hands is unquestionable. Like I said, Nanny sure knew what she was talking about.

Changing patients’ livesFor me it is impossible not to consider custom orthotics for my patients. It has proven to be a missing link to chronic and reoccurring issues, and as I said earlier, can be person-ally life-changing.

I urge you to remind yourself and your patients that our feet do a lot of work. Just getting out of bed and putting our feet on the floor can be the best or worst part of a person’s day. What I find most comforting about addressing one’s feet is that whether the patient is a senior, an athlete, a child or an adult, the importance of the proprioceptive input being received is vital for all of us. The feet have the highest density of proprioceptors in the body, second only to the spine.

Mechanoreceptors in the joints along with the muscle spindles of the foot muscles play a huge role in positive support reflexes and a variety of automatic reflexive reactions. These include the flexor/extensor reflex, which forces the leg to comply as a stabilizer. Weight-bearing activity compresses the joints and muscles, evoking reflexive activity in the extensor muscles, and inhibition of the flexor muscles. The common denominator for all of us bipedal folk is exactly what Nanny said — we need to take care of our feet (and our hands), and I would add, so they can take care of us.

The role of a stable foundationBesides the proprioceptive input communicating to your brain and body where you are on the planet, our feet are also responsible for holding up our entire skeleton. If the feet have altered functionality, the entire chain upward is going to pay a toll eventually.

If the pillar of a building is shaky, or in our case, the lower limb has proprioceptive imbalances, specific supports are needed to help achieve balance and proprioceptive symmetry. Adaptation both positive and negative play a role, of course, but as one worn-out tire on a car will cause the car to veer in one direction, or cause wear and tear on a compensating tire, your knees, hips, pelvis and low back will take on that stress and could overload in a negative way, potentially causing injury.

We are not truly symmetrical beings. Growing up in earthquake land in the San Francisco Bay Area, I know a thing or two about steady foundations not being rigid and always symmetrical to achieve stability. Buildings that will likely sway, like our bodies will move, need to adapt to stabilize in a balancing act because if we don’t, the rigidity will fatigue, and when overloaded will fall.

The importance of custom stabilizationIn my professional experience, 90% of people pronate, and many over-the-counter orthotic brands are available to assist with this condition. What I love about custom orthotics is the way they identify the difference that can occur foot to foot.

With leading manufacturers, the height differences of the arches of each foot are compared on their report after using one of their scanners or kiosks, and this factor specifically can illustrate to a patient their need for a more custom orthotic and one that addresses more than the singular medial arch and issue of overpronation.

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manufacturers have a custom orthotic specifically for that. There are custom orthotics for tight-fitting flats, athletics, and for those of us trekking through the back country, along a river or training for a triathlon, there are waterproof options.

Are you doing all you can to support your patients young and old? Are you counting on the built-in support from their footwear? As a previous footwear department manager from my days in retail before chiropractic school, I know shoe companies are not building a supportive shoe. Almost all of them count on a customer purchasing a supportive insole of some kind, especially the more active person. Are you addressing and adjusting the feet of everyone in your office?

As chiropractors we know that joint adjustment (especially the spinal joints) has a direct and immediate effect in normalizing receptor responses. Given the magnitude of sensory input, it’s no surprise the feet are to be included with the spine as containing the most receptors and have distinctive nerve circuits that demand our attention. Again, I am reminded of the wise words of Nanny, “Take care of your feet….”

Happy patients make happy practicesSo how do you do this, and how often? Can your senior patients stand and walk with confidence? How about after a fall?

My heartstrings were strummed with an elderly female patient early in my practice. She was very active, more

so than the average 20- and 30-year-olds whom I see regularly. One day, she tripped while shopping with her daughter and granddaughter. She did a course of physical therapy which was focused on strength and balance and she had improved, but she still wasn’t hiking as she used to, and she couldn’t paddleboard the way she could before her fall.

Less bothersome to her was some residual pain in her SI joint. She was frustrated and started to believe she would never get back on the water with confidence. I scanned her feet as I did with all my new patients, and when we saw that one foot had significantly less of an arch than the other, I convinced her to try a pair of custom orthotics in her water shoes specifically, but also suggested she wear a pair in other shoes. I adjusted her and her feet and she slowly broke in the custom orthotics. Within two weeks of wearing them she was back up on her feet on her board and loving life again. Happy patients make happy practices, and if we all followed Nanny’s advice, I think we’d all have happier practices.

REBECCA WILDER, DC, is a graduate of Ripon College in Ripon, Wisc., and attended Life Chiropractic College West in the San Francisco Bay Area of California where she grew up. She currently practices at Balanced Chiropractic & Physical Therapy in Charlottesville, Va., and is a member of the International Chiropractic Pediatric Association (ICPA).

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TECHTALK

NON-SURGICAL SPINAL DECOMPRESSION was originally developed and pioneered by Allan Dyer, PhD, MD, in 1985, and the first non-surgical spinal decompression table, the Vax-D, was introduced by him in 1991. As I graduated from the National College of Chiropractic (now National University of Health Sciences) in 1988, we called a very similar modality traction. Over the past 30 years many other doctors, scientists and corporations have developed other “non-surgical spinal decompression tables,” each with features believed to mimic or enhance the effectiveness of the original concept.

Debatable methods of forceOne thing decompression tables share worldwide is the use of a pelvic harness or belt that is placed above the pelvic brim so that a traction motor can caudally pull on the pelvis to place a traction or decompressive force on the spine.

The thing that brings debate among chiropractors is that there are tables that provide a distractive force by two other methods:

• The “pushing” type of table where an actuator or worm-gear elongates the lower half of the table and inversion-tables • And most of these “inversion” tables do not utilize belting, have no motor, rely solely on gravity, and as such, do not push or pull the patient

The first generation of decompression tables were “pushing” tables or “table driven” and are still being marketed today by several manufactures. There is little clear evidence or research as to why a manufacturer would choose a “pushing” over a “pulling” type of traction system for their table but it is interesting that nearly 100% of physical therapists use traction or decompression units utilizing a pulling motor.1

Since FDA approval is more stringent for traction motors and they are more expensive to produce, it would seem the selection is based more on cost and manufacturing convenience. There are currently only five traction motors available in the United States for use in decompression or traction tables.2

Variable patient positioningAfter 30 years of observation, personal use and teaching in the decompression market, it is my opinion manufacturing a pushing table would have lower production costs and would allow a company to over-simplify the patient setup and treat-ment for the doctor. The pusher-type systems seem to be inexplicably limited to just one patient position even though 30-plus years of research point to the necessity of variable patient positioning.3

It remains uncertain why the “table-driven or pushers” typically market at prices that are two to three times more

DECOMPRESSION TECHNOLOGYModern table-driven vs. puller systemsBY DAV I D B O H N , D C


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Table section articulation to accommodate various relief or positional preference postures is a clinical necessity. Use a table and belt system that also allows for the application of laser, ultrasound, EMS, heat/ice or diathermy during decompression to enhance patient flow as well as results.


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TECHTALK

than motor-mounted units when there is no research to imply superior clinical efficacy.

All decompression/traction units require some method of capturing or securing the pelvic-crest while restraining the thorax by way of a wing vest, axilla posts, Slip Stops or a hand-type grab. Belting can’t be eliminated based on the table type. Pelvic belting in pusher-type units is generally a Velcro wrap-over or a cinching strap incorporated into the tabletop, similar to a seatbelt.

Potential slip-through issues become evident at higher pulling forces and require a much greater reliance on some form of thoracic restraint. Tight thoracic belting or strapping can trigger breathing difficulties and trigger muscle spasm or guarding for some patients.4

The most frequent mechanical issue with pelvic strapping is usually effectively “pre-seating” the pelvic belt over the pelvic brim prior to the tabletop reaching its full traction pull weight. The belt should slip or pre-seat into its proper position simultaneously with the table’s caudal motion.

A pre-seatbelt failure allows the table to be excessively open under the patient’s lower back and sacrum, reducing treatment

efficacy and creating discomfort in some.5 Separating the actual “table separation” from the patient’s perception of the “application of tension” just makes more sense mechanically and clinically.6 Some manufacturers of “pull” traction tables utilize a table lock and a variable spring resistance feature so patients will “feel” more traction without excessively increasing their actual pull weight.

Manufacturer harness optionsBecause patients are not as relaxed and comfortable wearing a thorax harness, some manufacturers have abandoned using them and simply have the patient hold onto a bar or handles. The patient is advised to “release your grip if you feel pain.” This simplistic approach has been recognized by the FDA as a significantly effective and safe means of restraint.7

This hold-on advice is only a feasible option with a prone patient. I recommend my patients hold on to restrain their upper body in prone applications by placing their elbows down in the patient position of an adjusting table to assure their maximum comfort and compliance during decompression.

Flexion-distraction table manufacturers mostly abandoned

Positional preference is most important in the extension range-of-motion, since at least 80% of herniations demonstrate some relief with patient extension.


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direct pelvic capture and moved to the combination of the doctor hand contact on the spine along with ankle strapping. As flexion-distraction begins, the tension on the lower back is immediately felt. Supposedly this type of “traction” can produce adverse effects in some discs and many strain/sprain conditions as the unavoidable flexion stress is not uniformly applied. This form of traction is also very hard on the practitioner, as standing in slight flexion over patients day after day causes significant stress on their own lumbar spine, wrists and shoulders.

Excess flexion and position guidingDisc damage is not easily demonstrated or diagnosed.8 Some discs are receptive to flexion but in my opinion, and disc research, excess flexion or extension stress, whether upright or recumbent, can have dire consequences for many.

Practically all compression-disc issues will either tolerate and/or benefit from axial traction/decompression, but the patient posture on the table should be based on their comfort, or positional preference, pre-traction and shouldn’t be forced via the table’s resultant traction “pull.” This means that if flexion, extension or lateralization is required it should be a pre-traction event and never be further imposed during the table’s “pull.” The traction pull force should preferably remain axial so it doesn’t further aggravate sensitized tissue. Using pre-traction pain relief as your positioning guide assures the least irritating and most effective decompressive treatment.

Adding flexion or extension will provide no additional long-term benefit to the decompression effect from table distraction, but it can help provide centralization in many cases. Actually, distraction predictably reduces intradiscal pressure with the effect being dependent on the stage of degeneration of the affected disc. Research shows nearly 50% of moderately-degenerative discs achieved negative intradiscal pressure gradients with traction/decompression; however, only one in seven severely degenerative discs achieved the same reduction.9

100 YEARSFLEXION DISTRACTION HAS

BEEN USED FOR MORE THAN 100 YEARS TO TREAT HERNIATED

NUCLEUS PULPOSUS WITH THE PATIENT PRONE.

Belting should be quick, easy and reproduceable time after

time, ideally requiring one minute or less of setup time.


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Never underestimate the difference between pre-traction positioning and “flexed”-traction. I suggest pre-positioning patients into various enhanced flexion/extension or lateral postures while always remembering this important rule — keep the pull force axial. When the pull is coming from a pulling motor distant to the patient, the table’s

articulations are utilized as a means to reduce neural and/or mechanical compression or irritation that remains — with a recumbent patient the pull vector must remain parallel to the spine.

A “pulling” motor is perfectly suited for this use and will most ideally replicate what a clinician would do if manually stretching a spine.10 For example, my

puller tables allow for multi-vector pull options which provide a very precise, controllable pull that drives the decompression force direct to the spine with little to no patient slippage or movement. A certain puller table has a variable compression spring which allows the clinician to control the table movement or the patient’s “perception of the pull” safely without increasing pull force, which all others do.

As reported by Maitland, Saunders, Cyriax and others, mechanical traction is used because manual means are unsustainable and reproducibility is necessary. Mechanical devices were born out of the limitations of manual traction. It is rare for a clinician to lay a patient on a sliding table and “push” the table section — they grab and hold the body-region and pull it toward them using skillful and progressive distractions.

Rotation riskLaterality and rotation are two addi-tional considerations of patient positioning. Laterality or lateral bending is clinically needed in about 15-20% of clinical presentations but rotation, in my opinion, is never suggested due to the construction of the spinal disc, the prev-alence of rotation-induced disc injuries, and the real risk of re-injury when rota-tion is combined with distraction.

I have not treated conditions which require more than 25 degrees of lateral bending that can easily be achieved by pulling the patient’s hips 3-6 inches toward the edge of the decompression table prior to applying traction. All modern traction units will allow the pull motor to be offset at least 6 inches. This will allow ample treatment of any lateral disc condition. If a larger laterality exists as in a medial disc/nerve compression, a side-lying traction may be a viable option if the table allows this setup.10

This is why table section articulation to accommodate various relief or positional preference postures is a clinical necessity

TECHTALK

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“ They showed me that I was a great chiropractor, even though I had closed my first private practice,”

“I started working at The Joint Chiropractic in a part-time capacity, that ended up developing me as a professional and chiropractor. I was passionate about my patients’ positive outcomes, which definitely affected the clinics’ growth.”

In addition to being a chiropractor in-clinic, Tran has served as a Director of Chiropractic and in the capacity of a Professional Corporation (PC) in Florida. His extensive professional development at The Joint continues to fuel his career today - Tran is currently the Director of Chiropractic Operations for three successful clinics in Orlando.

“The Joint is the largest chiropractic network in the world, and I’m convinced that any doctor who understands the model can move up within the organization,” added Tran. “Every new graduate should work at The Joint if they have a desire to serve and deliver chiropractic to the populace.”

Expanding the Market for Chiropractic The Joint Chiropractic revolutionized access to chiropractic care when it introduced its retail healthcare business model in 2010. Today, the company is making quality care convenient and affordable, while eliminating the need for insurance, for millions of patients seeking pain relief and ongoing wellness. Every year The Joint attracts hundreds of thousands of patients into trying chiropractic care for the very first time, contributing to a growing profession nationally.

Multiple Career Paths for DoctorsWith over 600 clinics across the country, The Joint is the largest employer of chiropractors in the United States and provides a variety of opportunities for chiropractors.

Whether that be offering valuable adjusting experience or real-world business skills, to becoming a shareholder of a chiropractic professional corporation (PC), a regional developer, franchise owner or investor with a diversified portfolio, these are just some of the many paths to success in the profession with The Joint.

Grow Your Practice: Consider FranchisingBy investing in a chiropractic franchise, chiropractors can focus on delivering quality care while gaining expertise in the day-to-day operations and marketing of a business.

A franchise model provides a well-established path for solidifying new practice launches and driving sustainable growth. Additionally, the scalable nature and reliable support it offers are the most attractive aspects of franchising.

At The Joint Chiropractic, developing a winning recipe to franchise the business has centered on empowering chiropractors, as well as others who are entrepreneurially minded and passionate about the business, to bring exceptional and affordable chiropractic care to their communities.

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To Find SuccessFor David Tran, D.C., The Joint Chiropractic was an opportunity to hone his chiropractic communication, patient care, business acumen and professional development. In 2018, he closed his private practice and sought to stay busy. This life shift led him to The Joint Chiropractic where, according to Tran, the franchisees he worked for and the regional developer at The Joint provided him with a whole new lease on his chiropractic career.

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and must be considered when selecting a decompression table. Positional preference is most important in the extension range of motion, since at least 80% of herniations demonstrate some relief with patient extension.11

Consequently, it’s very important the table’s superior or cephalad section bends at the L5-S1 level and not at the mid-sternal region. Having the ability for full-torso extension is perhaps the most important of all pre-traction positional preference positioning options. If your decompression table is a “supine-only” model, I’d highly recommend safely trying to modify it to accommodate prone treatment or considering trading it for one that will. Flexion distraction has been used for more than 100 years to treat herniated nucleus pulposus with the patient prone. Mackenzie research has more than 300 published trials; McGill, Saunders, Fritz and many others all focus on treating herniated disc patients with prone treatment.

“Gravitational bias” now refers to the tendency of the nuclear material to migrate back to the anterior/central region of the disc and is a phenomenon difficult to visualize in a supine patient, especially with a patient supine for 15-30 minutes as the disc is isotropic.12

Disregarding patient testimonials, science, biomechanics and published research all point to the effectiveness and short treatment plans of prone disc treatment. To argue against it seems a bit irresponsible.

Expedite patient encountersIn today’s chiropractic clinics the use of a decompression/traction belt is either hated or revered. If your assis-tants break their fingernails, spend five minutes re-tightening belts or your

patients routinely have their pants pulled down and their breasts pushed up, you probably need a quick tuto-rial. Belting should be quick, easy and reproduceable time after time, ideally requiring one minute or less of setup time. I would also suggest saving staff and patient time by utilizing a pelvic belt that works for all treatment positions.

With some manufacturers offering drop table option and “open” harnesses, clinicians now have the ability to apply modalities and simultaneously adjust the spine with the patient on the decompression table providing specific and directed segmental contact when warranted during the axial distraction very similar to F/D but without the flexion component or wear-and-tear on the doctor.

Don’t let your patient results, clinic flow or capacity suffer because of inefficient belts or belting issues. Learn to expedite patient encounters by doing two or more things at once. Use a belting system that allows the application of laser, ultrasound, EMS, heat/ice or diathermy during decompression. A synergy of several safe, effective and efficient treatments with decompression enhances patient flow as well as your patient results.

DAVID BOHN, DC, graduated from National University of Health Sciences (formerly National College of Chiropractic) in 1988 and has since been in continuous practice. Since 2004 he has pursued development of both documentation and X-ray analysis software. He has extensive experience with developing, marketing and maintaining a successful practice, and is an instructor for KDT Decompression Therapy Seminars. For more information, go to kdttechnique.com/upcoming-seminars.

TECHTALK

References can be found online at chiroeco.com

It’s very important the table’s superior or cephalad section bends at the L5-S1 level and not at the mid-sternal region.

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The Ohio State Chiropractic Association (OSCA) marketed chiropractic to the running community in early June when it sponsored the “Chiropractic Keeps Me Moving Virtual 5K” along with the Johnston Chiropractic Clinic at the Darke County Fairgrounds in Greenville, Ohio. The race seeks to raise awareness for the effectiveness of chiropractic care in leading a healthy lifestyle, and a portion of the proceeds benefit the Ohio Chiropractic Foundation which provides scholarships to chiropractic students.

Food trucks and “fur babies” provided a fun time for future patients of Riggs Chiropractic when the clinic teamed with the local Southeast Kansas Humane Society in Pittsburg, Kan., and local food truck vendors for a food and animal adoption

event that featured free spinal screenings. “We wanted a way to benefit, especially during COVID, some of the other kind of local businesses that were needing help, and we have a soft spot in our hearts for animals and were like, what’s better than dogs and good food, so how cute would that be,” said Shelbi Heikes of Riggs Chiropractic, speaking to KOAM News. The Humane Society said the event was a great way to gain awareness and a great day for new adoptions, while the clinic announced that all proceeds from their new patient appointments would go toward the Humane Society.

April was Child Abuse Prevention Month, and Back to Health Chiropractic in Rossville, Ga., marked the month by donating 100% of all its proceeds from new patient registrations during the month to the local Children’s Advocacy Center. “Like most nonprofits they’ve had trouble raising funds this last year, but they are still providing services,” said Robert Moore, DC, speaking to WDEF. “They provide forensic interview and therapy for victims of child abuse. We just wanted to help them out and help them raise some money.” WDEF says the Children’s Advocacy Center provides a comprehensive path to healing for children who have experienced child sexual abuse or severe physical abuse.

DCs IN THE NEWSRecognitions or best practices in marketing, promotions and community involvement among doctors of chiropracticBY R I C K VAC H

NEWS


NEWS

DC Laurie Meinholz of Decorah, Iowa, of Nordic Chiropractic made good on her promise to give away the quarterly profits of her business to a local charity this spring, presenting a check for $800 to Helping Services for Youth & Families. “At the start of 2021 I pledged to donate all of my profits from my chiropractic office to local charities/non-profits,” she wrote in social media. “[During] all of first quarter, my patients have been voting between four different charities to decide which organization should receive the donation. I’ve tallied the votes! The winner won by only one vote! And the winner is: Helping Services for Youth & Families!!” Four more charities

or nonprofits were scheduled to be announced for her next quarter of donations. The decision to give away her profits began during the COVID-19 pandemic when her office stayed open with chiropractic an essential service, but she watched as fellow businesses and charities suffered. “By making this public, I’m hoping people will reevaluate where and how they spend their own money,” she told the Decorah News. “I want to inspire and motivate others to be generous. Sometimes people just need an example to follow.”

Mayor Sandy Roberson presented a plaque acknowledging 20 years in practice to Rocky Mount, N.C., chiropractor Dale Martini, who focuses on the musculoskeletal system and spine, also offering acupuncture, laser therapy and muscle rehabilitation services. “When I first opened, most of my patients came here because they had been in an accident,” Martini told the Rocky Mount Telegram. “Now, people realize that all of the services I offer support a healthy and happy lifestyle. I’ve never been busier.” Martini chose Rocky Mount with an eye on community growth in regard to its proximity to I-95 and U.S. 64. “Rocky Mount has been the perfect location,” he said. “I expect to be here for another 20 years.” The plaque was presented during an open house held at the office for business partners and vendors.

Laurie Meinholz, DC, donated her 2021 first-quarter profits to a local charity.

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DIGITALLY-DRIVEN WOMEN’S HEALTH, dubbed “FemTech,” encompasses companies focusing on gynecological and maternal care, female reproductive cancers, fertility solutions, general well-ness and more. It’s “big data” analytics, artificial intelligence and a spotlight on a traditionally male-centered health care system that, given the evidence, has left women behind.

Through data curation and driven by female founders in many cases, FemTech companies seek to give women control over their health, and health options that have been difficult to access to unavailable in the past.

Current Femtech products in the field, launching or in development include:

A secure digital communication tool that brings health care professionals, patients and family caregivers together on one platform; fertility-tracking mobile apps including pre- to post-partum care; digital blood tests to detect pregnancy complications; a cooling bracelet and app to help combat hot flashes; birth control delivery and education apps for underserved women and Medicaid populations; hormone health and tracking apps; and mental health apps to help combat anxiety (which women are twice as likely to experience).

Ida Tin, the Danish-born founder of a period and ovulation tracking app, is credited with the term “FemTech.” The idea for her app came from holding a cellphone in one hand and a digital temperature device in the other while wishing she could combine the two to track her fertility days rather than manually taking notes.

Failing women’s health — childbirthThe U.S. health care system, by many metrics, is failing women’s health.

The most developed nation in the world sees three times the deaths during childbirth of Norway and Sweden, and half of U.S. women report problems with their medical bills as compared to 2% in the U.K., according to research by the Commonwealth Fund. As recently as 2010, before the Affordable Care Act (ACA), also known as “Obamacare,” health plans were not required to include maternity coverage, and out-of-pocket spending for women was not limited. Preventive care, including cancer screenings, became free of charge, and women could no longer be denied insurance because of a preexisting condition — which at the time included pregnancy.

‘FEMTECH’ SEEKS A MOVEMENT TOWARD HOLISTIC WOMEN’S HEALTHFor holistic caregivers, technology is filling the large gaps in female health careBY R I C K VAC H


T H E TA K E AWAY

Why the need for “FemTech”? Holistic health care providers are seeing a technology push toward a whole-patient-centered approach to fill health care gaps rather than dividing up women’s health care.


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“Living in the U.S. was the first time I experienced being uninsured,” said Roosa Tikkanen, a researcher at the Commonwealth Fund who has lived in a number of countries around the world and is coauthor of a 2019 study on women’s health. “Right after I had graduated from Harvard. To me, that was the biggest irony of all — a fresh master’s in public health graduate, having just spent nine months learning how unfair the American health care system can be — experiencing it myself. In so many of the other places I’ve lived, I was assigned a national health insurance patient number automatically, like when I moved to England, I was sent the name and address for my primary care doctor and my National Health Service number in the mail.”

Munira Gunja was also an author on the study.“I have lived in the U.S. my whole life and work in this field

and still find it confusing to navigate our health care system,” said the researcher, who was pregnant at the time. “I am pretty terrified of receiving a surprise medical bill, despite the generous insurance coverage offered through my employer and despite the many calls to my physician’s office and the hospital billing department to ensure everything is covered.”

Driving FemTech developmentFemTech has years under its belt, developing behind the scenes before the poorly-understood term even came to the mainstream. The early days of FemTech were focused on reproductive health, fertility and periods, but it has since expanded to holistic health, including hormonal awareness, mental health, fitness and other drivers of women’s health and happiness.

The opportunity? Lowering the much-higher cost of health care for women, for individuals and for insurance companies.

The U.S. Department of Labor in 2015 reported that women between ages 19-44 had health care expenses that were 80% higher than those for men of the same age group, largely due to the cost of and need for reproductive services. For U.S. employers, untreated menopause symptoms cost $770 per patient per year, and COVID-19 exacerbated many health care costs for women.

Medical and alternative health care specialization has at the same time been a boon and a detractor for women, unintentionally moving away from holistic care and disconnecting various health care service providers.

“As we continue to super-duper specialize, we get very good at one particular focused area, and there is a lack of holistic care and so...people fall through the cracks,” said Sonya Borrero, director of the Center for Women’s Health Research and Innovation at the University of Pittsburgh, speaking to S&P Global.

Failing women’s health — U.S. support systemsResearchers found that emotional stress for U.S. women is a large barrier to achieving good health, leading to various health issues.

Research found that 1 in 3 women in the U.S. report emotional distress, much higher than women in most other countries, with only 1 in 10 reporting regular emotional distress in Germany and France.

Social determinants are a large source of stress for U.S. women — finding child care, job security, schools and education, diet and exercise, and meal prep and access to affordable, healthy food for families.

“We know that other countries spend a lot more on these ‘social’ factors than the U.S. does, providing job and income protection, and guaranteeing the right to low-cost or free education — not to mention paid maternity and sick leave,” Gunja says.

American women in the Commonwealth Fund report rated the quality of their health care the lowest out of the 11 developed countries.

Prior to the ACA in 2010, Gunja compared being a woman to be a “preexisting condition” unto itself. Most states’ insurers in the individual market were able to charge women higher premiums than men, and Medicaid was only available to women with very low incomes, who were pregnant or who had disabilities.

+80%WOMEN’S HEALTH

CARE EXPENSES IN 2015 COMPARED TO MEN IN THE SAME 19-44 AGE GROUP

Ida Tin, the Danish-born founder of a period and ovulation tracking app, is credited with the term “FemTech.”


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TECHTALK

Overcoming a history of exclusionMuch of U.S health care research has been male-centered, dating to 1977 when the U.S. Food and Drug Administration excluded women of childbearing age, the majority of women, from taking part in drug trials.

Race has also played a part in exclusion of health care opportunities, as opposed to other developed countries. In the U.S., three Black mothers die giving birth for every white mother, according to research from the Commonwealth Fund. U.S. women of all races have traditionally suffered from few workplace protections and usually must choose between work and family. Maternity leave is usually unpaid, unlike other developed countries, and child care, which is subsidized in many countries, in the U.S. is out of pocket, usually at great expense.

FemTech impactsThe end goal for FemTech is providing all women, regardless of status, access to health care they can afford, and learning from other efforts to apply best practices from around the world, as FemTech is far from simply a U.S. venture.

“I think patient-centered care is a big [goal],” Gunja says. “That is, ensuring patients feel empowered about their health care, and are educated by their physicians to make informed decisions on their health. It’s also about coordinating and integrating clinical care with other support services and forming a relationship with not just their primary care physician, but with a social worker, and therapist, and nurse, and the whole community of people that are involved with care.”

RICK VACH is editor-in-chief of Chiropractic Economics.

11TH PLACEU.S. WOMEN RATE THE QUALITY

OF THEIR HEALTH CARE THE LOWEST OF 11 DEVELOPED

COUNTRIES STUDIED.

The U.S. health care system, by many metrics, is failing women’s health.

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DEAR DOCTOR OF CHIROPRACTIC,You are essential to the health care of America. Your patients count on you to help them through this difficult time, as do your family and friends. If you’re a business owner your employees are counting on you also. In “normal” times you could escape the pressure by seeing friends socially, going to a restaurant, or maybe going to a movie theater. Now we’re trying to find that new normal as a society, trying to make it look as close to the old normal we can.

WE’RE IN IT TOGETHERLast year we told the story of the two young chiropractors who 30 years ago attained their DC degrees, both near the top of the same graduating class and full of enthusiasm to enter chiropractic care. When they returned for their 30-year reunion, both were married with family and had stayed in touch over the years. But while one worked in a multi-doctor practice, the other had founded his own multi-location practice and as CEO was contemplating an early retirement.

THE DIFFERENCE?How and why did the two DC’s paths diverge? Both sought success. Both were near the top of their class in school. Both entered the field with enthusiasm. The difference-maker was the business of chiropractic – learning the economics of the industry. The eventual CEO subscribed to Chiropractic Economics and gained the knowledge to take his practice to the next level.

LET OUR KNOWLEDGE BE YOUR POWERChiropractic Economics is the only BPA Audited publication requested by over 20,000 Doctors of Chiropractic. That’s why annually we’re voted by DCs as the No. 1 most-trusted and most-used publication. Whether you are new in the field or have 30 years under your belt, subscribe or add two years to your current subscription, for free, at chiroeco.com/subscribe today. We cannot guarantee your success in the industry, but as a reader of Chiropractic Economics you are essential, you’ll be best equipped for success.

Sincerely,

Richard VachEditor-in-Chief SUBSCRIBE NOW AT

chiroeco.com/subscribe.

YOUR PRACTICE PARTNERIssue 7: May 5, 2020 chiroeco.com

Government Passes Relief Bill

How DCs are Dealing How DCs are Dealing

with COVID-19with COVID-19

The Latest on The Latest on

Assistance for DCsAssistance for DCs

CBD and Improving CBD and Improving

Virus ImmunityVirus Immunity

COVID-19:HELP IS ON THE WAY

YOUR PRACTICE PARTNERIssue 8: May 22, 2020 chiroeco.com

THE 23RD SALARY & EXPENSE SURVEY

The Chiropractic Industry BenchmarkTrends & Tech

Into 2021IoT to Consider for Your Office

COVID-19 COVID-19 Update for DCsUpdate for DCs

YOUR PRACTICE PARTNERIssue 10: June 26, 2020 chiroeco.com

YOUR PREMIER SOURCE FOR THE LATEST INDUSTRY PRODUCTS AND SERVICES

2020 SUMMER

PRODUCTSHOWCASEBUYERS GUIDEÃ Anti-Aging ......................................................... 11 Ã CBD, Herbs & Homeopathy .......................23Ã Colleges ............................................................ 30Ã Consultants .......................................................31 Ã Continuing Education ..................................39Ã Diagnostics.......................................................47Ã Electro & Laser Therapy .............................55Ã Finance & Insurance .....................................59ÃMarketing ..........................................................67

ÃMassage & Acupuncture .............................75Ã Nutrition ............................................................83Ã Orthotics ......................................................... 99Ã Patient Education ....................................... 104Ã Rehab ...............................................................107Ã Retail.................................................................122Ã Software ...........................................................131Ã Supplies ...........................................................138Ã Tables ...............................................................147

8_24_2020_CE_FullPage_Requestor_CEi15_v2.indd 18_24_2020_CE_FullPage_Requestor_CEi15_v2.indd 1 8/26/20 10:23 AM8/26/20 10:23 AM

https://www.chiroeco.com/subscribe

PRODUCTPRODUCTSHOWCASE

To search for more products, or to submit a product, go to ChiroEco.com and click on “Products and Services.”*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

LED THERAPYNerve Beam LED wraps are high-powered LED red light and infrared therapy devices that deliver low-level but intense light energy into the body. LED therapy uses a broad spectrum of red light and infrared therapy to drive pain-relieving therapy results. Red light (660nm) LED diodes treat topically and have an analgesic effect and create an anti-inflammatory response, while infrared light (830nm and 850nm) LED diodes go deep into the tissue to deliver therapeutic pain relief and regeneration of the nerves.800-239-7880 • nervespa.com

FRANCHISE OPPORTUNITYThe Joint was originally founded in 1999 by a doctor of chiropractic with a vision to transform the traditional, often misunderstood concept of routine chiropractic care by making it more convenient, friendly and affordable. Today it has grown to a nationwide network of 500+ offices — and counting — and performs more than 4 million spinal adjustments every year. Its membership plans and packages eliminate the need for insurance, and its no-appointment policy, convenient hours and locations make care more accessible.866-395-7586 • thejointfranchise.com

IMAGING SOFTWAREChiroSight Software enables you to clearly annotate your X-rays, using tools for cervical curves, George’s Line, Gonstead and more. The annotation takes place right in front of the patient. Then, with advanced messaging, ChiroSight enables them to take the annotated images home. It also includes a fully customizable radiology report, plus a new AOMSI PI function that enables you to take a full flexion, extension exam in which the software will determine the impairment and build a radiology report with all relevant references.888-707-7010 • biokinemetrics.com

CBD SLEEP AIDMake sleep the best part of your night when you get fast and effective CBD results. Eventide 25mg CBD Softgels with Melatonin are specially formulated to support sleep and relaxation and give you anticipated results in an easy-to-swallow form. Softgels are made using water-soluble nanoemulsion technology and combined with melatonin. Each bottle contains 30 softgels.*844-349-6348 • eventidecbd.com


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JOINT SUPPLEMENTThrough the centuries, the indigenous peoples of the Amazon have relied on the rainforests for all their needs; the knowledge of its native flora and, in some cases, the closely-guarded secrets of the use of special plants, are now being unveiled as demand and interest in natural healing increases. Joint Formula is Energique’s exclusively blended rainforest botanical formula, featuring manaca, tayuya and Alchornea castaneifolia to help promote freedom of motion and joint health.*800-869-8078 • energiquepro.com

LASER TREATMENT SYSTEMThe KDT Laser Class IV System is available in a Tri-Wave 45 Watt or Dual Wave 30 Watt System; both are high-quality German diode systems backed by an industry-leading five-year warranty. This versatile treatment platform features an effective trio of 980/810/1064 wavelengths. It is affordable, powerful and portable — it weighs just 8 pounds — with more treatment options than ever before, and offers massage ball roller and adjustable zoom handpiece options. Full training and marketing are included.814-754-1081 • kdtneuralflex.com

DIGITAL REVENUE PLATFORMCombining clinical, communication, telehealth, marketing, lead generation and content creation tools, as well as digital revenue generation tools, Fiizio promises to create new cash revenue streams which will go directly to your bank account. It also offers a client payment platform, appointment requests, client review functionality and more. Grow your revenue, better communicate with and engage clients, generate new leads and extend your services digitally — all from a single platform.fiizio.com

TAX SAVINGSDid you know that most small business owners and near or retired individuals are the largest segment of people in the U.S. who overpay in taxes? Quartermaster Tax Management specializes in reducing tax liability up to 50% for chiropractors, all without changing CPAs. Over the past five years, Quartermaster’s clients have averaged up to 50% in annual tax savings, with no reduction to their standard of living; in one year, Quartermaster helped chiropractors find over $2 million in tax savings opportunities.704-490-5111 • quartermastertax.com/chiropractors


24/7 RELIEF & RECOVERY866-663-6567247rnr.com

3B SCIENTIFIC888-326-6335a3bs.com

4JOINTZ844-456-46894jointz.com

A2Z HEALTH MASSAGE THERAPY SCHOOLS888-303-3131a2zhealth.net

ACCESS EQUIPMENT CORP.256-245-8390chirocity.com

ACE MASSAGE CUPPING828-232-1622massagecupping.com

ACTIVATOR METHODS INT’L800-598-0224activator.com

ACUINTERNATIONAL SUPPLIES INC.888-322-8468acuinternational.com

ACUSAGE ACADEMY508-987-0178acusageacademy.com

ALLMAN PRODUCTS INC.800-223-6889allmanproducts.com

AMREX310-527-6868amrex-zetron.com

ANESTHALL TOPICAL ANALGESIC800-994-3776purplecream.com

ASSISTANTS FOR CHIROPRACTIC EXCELLENCE (A.C.E.)734-320-5058chiropracticassistants.com

AUBREY ORGANICS INC.800-237-4270aubrey-organics.com

B&B MARKETING LLC800-737-9295sacrowedgy.com

BALL DYNAMICS INT’L LLC800-752-2255fitball.com

BANNER THERAPY PRODUCTS INC.888-277-1188bannertherapy.com

BELLECORE LLC800-867-7414bellecore.com

BERMAN PARTNERS LLC860-707-4220bermanpartners.com

BIG KAHUNA NATIVE NATURALS435-527-0949bigkahunanative.com

BIOSOUND HEALING THERAPY888-495-1946biosoundhealing.com

BIOTONE800-445-6457biotone.com

BLUEBIRD BOTANICALS720-726-5132bluebird-botanicals.com

BML BASIC800-643-4751bmlbasic.com

BODY LOGIC214-378-6100ebodylogic.com

BODYZONE.COM770-922-0700bodyzone.com

BONVITAL INC.239-481-1002bonvital.com

BRYANNE ENTERPRISES INC.877-279-2663bryanne.com

CALIFORNIA COLLEGE OF NATURAL MEDICINE800-421-5027cconm.com

CAO GROUP801-495-5545caogroup.com

CBD CLINIC855-790-8169cbdclinic.co

CBD FOR LIFE732-939-4620cbdforlife.us

CHATTANOOGA800-592-7329chattgroup.com

CHI INSTITUTE800-743-5608soundvitality.com

CHINA-GEL INC.800-898-4435chinagel.com

CHIROPRACTICOUTFITTERS.COM952-270-0258chiropracticoutfitters.com

CLEAR MY HEAD LTD.937-847-2222clearmyhead.com

CLINICAL HEALTH SERVICES INC.888-249-4346clinicalhealthservices.com

COMFORT CRAFT800-858-2838comfortcraft.com

CORE PRODUCTS INT’L INC.800-365-3047coreproducts.com

CORFLEX INC.800-426-7353corflex.com

MASSAGE & ACUPUNCTUREChiropractic Economics is pleased to present the profession’s most comprehensive Massage & Acupuncture list. The information below was obtained from questionnaires completed by the listed companies. Companies highlighted in RED have an advertisement in this issue.

BUYERSBUYERSGUIDE


http://rnr.com

http://a3bs.com

http://jointz.com

http://chirocity.com

http://massagecupping.com

http://activator.com

http://acuinternational.com

http://acusageacademy.com

http://allmanproducts.com

http://amrex-zetron.com

http://purplecream.com

http://chiropracticassistants.com

http://aubrey-organics.com

http://sacrowedgy.com

http://fitball.com

http://bannertherapy.com

http://bellecore.com

http://bermanpartners.com

http://bigkahunanative.com

http://biosoundhealing.com

http://biotone.com

http://bluebird-botanicals.com

http://bmlbasic.com

http://ebodylogic.com

http://BodyZone.com

http://bodyzone.com

http://nutribonvital.com

http://bryanne.com

http://cconm.com

http://caogroup.com

http://cbdclinic.co

http://cbdforlife.us

http://chattgroup.com

http://soundvitality.com

http://chinagel.com

http://ChiropracticOutfitters.com

http://chiropracticoutfitters.com

http://clearmyhead.com

http://clinicalhealthservices.com

http://comfortcraft.com

http://coreproducts.com

http://corflex.com

http://ChiroEco.com

CORGANICS866-939-9541reliefcream.com

CRYODERM800-344-9926cryoderm.com

CURAMEDIX877-699-8399curamedix.com

DELMAR HEALTH CARE 800-347-7707delmarhealthcare.com

DESERET BIOLOGICALS800-827-9529desbio.com

DISCOUNT CHIROPRACTIC SUPPLIES888-444-6741discountchiropracticsupplies.com

DOCTOR HOY’S 480-357-4300drhoys.com

DRBARBARAEATON.COM907-444-9043drbarbaraeaton.com

DYNATRONICS800-874-6251dynatronics.com

EARTHLITE760-599-1112earthlite.com

ENERGIA MEDICAL860-707-4220energiamedical.com

ENLIVEN ESSENTIALS516-306-6589call us

ERCHONIA888-242-0571erchonia.com

EXERCISE TO HEAL LLC866-432-5356exercisetoheal.com

GEBAUER CO.800-321-9348gebauerco.com

GELLIFLEX SYSTEMS LLC833-435-4359gelliflex.com

GENERAL PHYSIOTHERAPY INC.800-237-1832g5.com

GOLDEN SUNSHINE USA INC.800-798-3977pain-terminator.com

GOLIFE787-648-9868golifepr.com

GOODMARK MEDICAL LLC866-214-5880goodmarkmedical.com

GOT YOUR BACK610-834-3992gotyourback.com

GRACE MEDICAL EQUIPMENT866-446-0234gracemedicalequipment.com

GREEN ROADS WORLD833-462-8922greenroadsworld.com

HANDS ON SUPPLY800-842-9874handsonsupply.com

HAUSMANN INDUSTRIES INC.888-428-7626hausmann.com

HEALTHLIGHT860-707-4220healthlightllc.com

HEALTHWAYS800-327-3822healthways.com

HEALTHY YOU800-826-9946healthyyouweb.com

HELIX PROFESSIONAL PRODUCTS800-631-8888helix4pain.com

HILL LABORATORIES CO.877-445-5020hilllabs.com

HIMALAYA HERBAL HEALTHCARE800-869-4640himalayausa.com

HOCKERT SALES800-451-5739hockertsales.com

HUMAN TOUCH LLC866-369-9426humantouch.com

HYDROMASSAGE800-796-7493hydromassage.com/eco

IHEALTH PRODUCTS INC.800-930-6493ihealthproducts.com

INADA888-769-0555inada-massagechair.com

INFINITY MASSAGE CHAIRS603-347-6006infinitymassagechairs.com

INNERSENSE ORGANIC BEAUTY877-254-7385innersensebeauty.com

INTERNATIONAL ACADEMY OF MEDICAL ACUPUNCTURE 800-327-1113iama.edu

JORDAN HEALTH CLINIC & DAY SPA386-736-0465jordanhealthclinic.com

KINAS MEDICAL — THE MIRACLE WAVE770-612-8245themiraclewave.com

KING BIO 800-543-3245drkings.com

KINIAN844-422-6633kinian.net

KOOL FIT AMERICA INC.800-852-5665koolnfit.com

LED TECHNOLOGIES LLC800-337-9565revivelighttherapy.com

LHASA OMS INC.800-323-1839lhasaoms.com


http://reliefcream.com

http://cryoderm.com

http://curamedix.com

http://delmarhealthcare.com

http://desbio.com

http://discountchiropracticsupplies.com

http://drhoys.com

http://DrBarbaraEaton.com

http://drbarbaraeaton.com

http://dynatronics.com

http://earthlite.com

http://energiamedical.com

http://erchonia.com

http://exercisetoheal.com

http://gebauerco.com

http://gelliflex.com

http://g5.com

http://pain-terminator.com

http://golifepr.com

http://goodmarkmedical.com

http://gotyourback.com

http://gracemedicalequipment.com

http://greenroadsworld.com

http://handsonsupply.com

http://hausmann.com

http://healthlightllc.com

http://healthways.com

http://healthyyouweb.com

http://helix4pain.com

http://hilllabs.com

http://himalayausa.com

http://hockertsales.com

http://humantouch.com

http://hydromassage.com/eco

http://ihealthproducts.com

http://inadausa.com

http://infinitymassagechairs.com

http://innersensebeauty.com

http://iama.edu

http://jordanhealthclinic.com

http://themiraclewave.com

http://drkings.com

http://kinian.net

http://koolnfit.com

http://lhasaoms.com

http://ChiroEco.com

BUYERSBUYERSGUIDELIFETEC INC.800-822-5911lifetecinc.com

LIGHTFORCE THERAPY LASERS877-627-3858litecure.com/medical

LSI INT’L800-832-0053lsiinternational.com

LYPOSSAGE877-346-1156lypossage.net

LZR7888-333-7511lzr7.com

MASSAGE MAGAZINE INSURANCE PLUS833-518-7520massagemagins.com

MASSAGE U INC.310-433-6234rollyourpainaway.com

MASSAGE WAREHOUSE800-910-9955massagewarehouse.com

MASSAGEBLOCKS.COM800-326-1972massageblocks.com

MEDI-STIM INC.800-363-7846medi-stim.com

MEDINATURA844-633-4628medinatura.com

MEDZONE CORP. — PAINZONE866-633-9663medzonecorp.com

MEYER DC800-472-4221meyerdc.com

MICROLIGHT CORPORATION OF AMERICA281-433-4648ml830.com

MIRIDIA TECHNOLOGY INC.888-647-4342miridiatech.com

MOTHER EARTH PILLOWS800-344-2072motherearthpillows.com

MULTI RADIANCE MEDICAL800-373-0955multiradiance.com

MYO-BREATHE LLC800-803-1535myo-breathe.com

MYONATURAL866-276-6058myonatural.com

NATURAL TOUCH MARKETING800-754-9790naturaltouchmarketing.com

NATURE’S RITE888-465-4404mynaturesrite.com

NEOTICA CREME910-686-4545neoticacreme.com

NEUROMECHANICAL INNOVATIONS888-294-4750neuromechanical.com

NORTH COAST MEDICAL800-821-9319ncmedical.com

NUTRACEUTICS CORP.877-664-6684nutraceutics.com

OAKWORKS800-916-4603oakworks.com

OMNI MASSAGE432-334-4900omnimassage.com

OPTP800-367-7393optp.com

OXYRUB PRO 888-349-0397meyerdc.com

PADO 866-528-1010padousa.com

PAIN MANAGEMENT TECHNOLOGIES800-239-7880itens.com

PARKER LABORATORIES INC.800-631-8888parkerlabs.com

PERFECTA PRODUCTS INC.330-549-1900maxfreezepro.com

PERFORMANCE HEALTH/BIOFREEZE800-246-3733biofreeze.com

PERFORMANCE HEALTH/BON VITAL’262-367-2711bonvital.com

PERSPECTIS INC.866-586-2278ajuvia.com

PILLOW OF HEALTH630-338-1327pillowofhealth.com

PIVOTAL HEALTH SOLUTIONS800-743-7738phschiropractic.com

PLATINUM MEDICAL800-201-6719platinummedicalllc.com

POINT OF LIGHT RECORDS949-436-2718peterkater.com

POLAR PRODUCTS INC.330-253-9973polarsoftice.com

POSTURE PERFECT SOLUTIONS LTD.604-985-0634evolutionchair.com

PRINCE OF PEACE ENTERPRISES INC.510-723-2428popus.com

PROMASSAGERS.COM702-334-0454promassagers.com


http://lifetecinc.com

http://litecure.com/medical

http://lsiinternational.com

http://lypossage.net

http://lzr7.com

http://massagemagins.com

http://rollyourpainaway.com

http://massagewarehouse.com

http://MassageBlocks.com

http://massageblocks.com

http://medi-stim.com

http://medinatura.com

http://medzonecorp.com

http://meyerdc.com

http://ml830.com

http://miridiatech.com

http://motherearthpillows.com

http://multiradiance.com

http://myo-breathe.com

http://myonatural.com

http://naturaltouchmarketing.com

http://mynaturesrite.com

http://neoticacreme.com

http://neuromechanical.com

http://ncmedical.com

http://nutraceutics.com

http://oakworks.com

http://omnimassage.com

http://optp.com

http://meyerdc.com

http://padousa.com

http://itens.com

http://parkerlabs.com

http://maxfreezepro.com

http://biofreeze.com

http://bonvital.com

http://ajuvia.com

http://pillowofhealth.com

http://phschiropractic.com

http://platinummedicalllc.com

http://peterkater.com

http://polarsoftice.com

http://evolutionchair.com

http://popus.com

http://ProMassagers.com

http://promassagers.com

http://ChiroEco.com

PROPER PILLOW800-961-7527properpillow.com

RAPID RELEASE TECHNOLOGY949-415-4778rapidreleasetech.com

REAL BODYWORK888-505-5511realbodywork.com

RICHMAR888-549-4945richmarweb.com

ROCKTAPE408-912-7625rocktape.com

ROSCOE MEDICAL800-871-7858roscoemedical.com

SCRIPHESSCO800-747-3488scriphessco.com

SIDMAR800-330-7260sidmar.com

SIGMA INSTRUMENTS724-776-9500sigma-instruments.com

SILHOUET-TONE USA800-552-0418silhouettone.com

SOMATHERAPY INSTITUTE760-328-8009somatherapy.com

SOMBRA MASSAGE LINE800-225-3963sombrausa.com

SOMBRA NATURAL PAIN RELIEVING GELS800-225-3963sombrausa.com

SOOTHING TOUCH505-820-1054soothingtouch.com

STARWEST BOTANICALS INC.800-800-4372starwest-botanicals.com

STOPNECKPAIN.COM800-995-8865stopneckpain.com

STRAIGHT ARROW PRODUCTS INC.800-827-9815straightarrowinc.com

STRONGLITE 800-289-5487stronglite.com

SUNSET PARK MASSAGE SUPPLIES813-835-7900massagesupplies.com

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ADVERTISERADVERTISERINDEXAccuflex Tables & Lasers ......................................................................................................................................................................................9, 29, 43Aspen Laser Systems ...........................................................................................................................................................................................................51Biotone ..................................................................................................................................................................................................................................... 25Cash Practice .......................................................................................................................................................................................................................... 37ChiroHealthUSA..............................................................................................................................................................................................................21, 55ChiroPlanet ..............................................................................................................................................................................................................................60Chiropractic Economics .....................................................................................................................................................................................69, 78, 79Concierge Coaches — The Chiro Event ........................................................................................................................................................................15Crossfields Chiropractic Design ......................................................................................................................................................................................78Dee Cee Labs .....................................................................................................................................................................................................................5, 34Designs for Health ...............................................................................................................................................................................................................45Eclipse Software ...................................................................................................................................................................................................................47ECS Therapeutics ..................................................................................................................................................................................................................78Emerson ................................................................................................................................................................................................................................... 57Ergo-Flex Technologies ..............................................................................................................................................................................................82-83Fenix Nutrition .......................................................................................................................................................................................................................39Florida Chiropractic Association ............................................................................................................................................................65, BellybandFoot Levelers ............................................................................................................................................................................................................ 7, 44, 84Foundation For Chiropractic Progress ..........................................................................................................................................................................41Fullscript ....................................................................................................................................................................................................................................31Functional Medicine University 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.................................................................................................................................................................................81Mineralgia ................................................................................................................................................................................................................................63Multi Radiance Medical ...................................................................................................................................................................................................... 35Performance Health ............................................................................................................................................................................................................56PineTales ..................................................................................................................................................................................................................................78Powerstep ..................................................................................................................................................................................................................33, InsertProfessional Co-Op ..............................................................................................................................................................................................................59Protocol ....................................................................................................................................................................................................................................50Science Based Nutrition .................................................................................................................................................................................................... 27Scorpion .....................................................................................................................................................................................................................................11Sombra Natural Wellness Products ..............................................................................................................................................................................49Standard Process .........................................................................................................................................................................................................2-3, 23Stopain Clinical .......................................................................................................................................................................................... 28, 61, CovertipSystemic Formulas ................................................................................................................................................................................................................19The Joint ........................................................................................................................................................................................................................... InsertThe Miracle Wave .................................................................................................................................................................................................................78Thomas Tables ....................................................................................................................................................................................................................... 77TruGen3 ....................................................................................................................................................................................................................................67Volume Practice ....................................................................................................................................................................................................................78World Federation of Chiropractic ..................................................................................................................................................................................54


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July 18, 2021 - Chiropractic Economics, Issue 11

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Transcript of July 18, 2021 - Chiropractic Economics, Issue 11