Show Notes for February 1, 2013

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast, and Proud to be the #1 Search Result for Chiropractic Podcasts in the iTunes Podcast Directory.

In this week’s news:  We’ll Be Looking At –

  • Provider Responsibility to Disclose Threats to Health or Safety
  • Measuring Quality for Medicare Patients
  • And Finally a Story about Neural and Psychosocial contributions to sex differences in knee osteoarthritic pain

For HealthBeat, This is Dr. Todd Eglow!

Welcome to HealthBeat Podcast #395, recorded February 1, 2013.

HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

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And Now for some news ….



Provider Responsibility to Disclose Threats to Health or Safety

A recent ChiroCode email discussed Provider Responsibility to Disclose Threats to Health or Safety.

On January 15, 2013, HHS issued a letter reminding all health care providers of their ethical and legal responsibilities in situations where a patient presents a serious danger to himself or to others. They wish to promote awareness that HIPAA does not preclude a provider from taking appropriate actions by disclosing necessary information about a patient to law enforcement, family members of the patient, or other persons, in these situations.

In a related move, “As part of his recommendations to protect our communities from gun violence, President Obama today (January 16, 2013) rightly called for Mental Health First Aid training to help teachers and staff recognize the signs of mental health disorders in young people and find them appropriate care,” said Linda Rosenberg, President and CEO of the National Council for Behavioral Health.

“The youth version of Mental Health First Aid is an evidence-based training program to help citizens identify mental health problems in young people, connect youth with care, and safely deescalate crisis situations if needed. The program, focusing on youth ages 12 to 25, provides an ideal forum to engage communities in discussing the signs and symptoms of mental illness, the prevalence of mental health disorders, the effectiveness of treatment and how to engage troubled young people in services.”

Surf to our Show Notes for Links –

Go to  to read the HHS letter.

Go to  to learn more about the Mental Health First Aid Program.

Go to  to read the announcement from the White House.



Measuring Quality for Medicare Patients

The American Chiropractic Association, the ACA, recently sent out information about assuring Quality in providing care for Medicare patients.

The Patient Protection and Affordable Care Act made participation in Medicare’s Physician Quality Reporting System (PQRS), formerly referred to as PQRI, mandatory beginning in 2015.

However, PLEASE NOTE that the Centers for Medicare and Medicaid Services (CMS) recently ruled that providers who are not successfully/satisfactorily participating in PQRS by the 2013 reporting period (Jan. 1 – Dec. 31, 2013) and beyond, will have their Medicare reimbursement decreased by 1.5 percent beginning in 2015. In 2016, the payment decrease will be 2%.

If you have never participated in PQRS, you may not know where to begin. For those doctors of chiropractic who are continuing their participation in PQRS in 2013, please be advised that significant updates and revisions have been made to the PQRS Measures applicable to chiropractic practices.

“Quality” is an increasing concern for healthcare policymakers in Washington, DC. The word dovetails into various areas such as pay-for-performance and health IT.

Quality measures, generally, are rooted in evidence-based medicine. They can be “guideline” measures (e.g., you get 12 visits for acute low back pain), “process” measures (e.g., when a patient comes in with a cardiovascular episode and you gave them an aspirin), or “outcome” measures (e.g., “X” condition was resolved). There are also other types of measures.

Surf to our Show Notes for details of this ACA article –



Neural and psychosocial contributions to sex differences in knee osteoarthritic pain

People with osteoarthritis (OA) can have significant pain that interferes with function and quality of life.

Women with knee OA have greater pain and greater reductions in function and quality of life than men. In many cases, OA pain is directly related to sensitization and activation of nociceptors in the injured joint and correlates with the degree of joint effusion and synovial thickening.

In some patients, however, the pain does not match the degree of injury and continues after removal of the nociceptors with a total joint replacement.

Growth of new nociceptors, activation of nociceptors in the subchondral bone exposed after cartilage degradation, and nociceptors innervating synovium sensitized by inflammatory mediators could all augment the peripheral input to the central nervous system and result in pain.

Enhanced central excitability and reduced central inhibition could lead to prolonged and enhanced pain that does not directly match the degree of injury. Psychosocial variables can influence pain and contribute to pain variability.

A recent review in the journal Biology of Sex Differences, explores the neural and psychosocial factors that contribute to knee OA pain with an emphasis on differences between the sexes and gaps in knowledge.

Surf to our Show Notes for the full article –



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Finally, I leave you with the following quote:

Desire is the key to motivation, but it’s determination and commitment to an unrelenting pursuit of your goal – a commitment to excellence – that will enable you to attain the success you seek.”
– Mario Andretti

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.


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