The first meeting of the Agency for Health Care Policy and Research (AHCPR) sponsored Panel on Low Back Disorders was held on November 9 and 10, 1991. The panel is comprised of 21 members from a wide spectrum of health care disciplines. The chiropractic profession was represented by Scott Haldeman, D.C., M.D., Ph.D. and John Triano, M.A., D.C.
The AHCPR is a federal agency charged by the U.S. Congress to accomplish many tasks within the health care arena. One of those tasks is to "facilitate the development of practice guidelines and measurements of quality care (please see "Chiropractic Cost Comparisons Presented at AHCPR Conference" in the March 1, 1991 issue of "DC"). This is just one of the many panels that the AHCPR is planning to sponsor.
The chairman of the panel is Stanley J. Bigos, M.D., a professor in the Department of Orthopedics at the University of Washington School of Medicine. Dr. Bigos made very clear the need for the panel: "Everyone has interest in dealing with patient needs and provider responsibilities to the patient." When asked about the inclusion of two members of the chiropractic profession he stated: "Chiropractors are represented along with all other specialties and providers that deal with back problems."
When the convening of the AHCPR panel was originally reported in the October 11, 1991 issue of Dynamic Chiropractic, the panel expected to complete its work _before _the Mercy Center Conference would convene in January, 1992. Now that the panel has had its first formal meeting, it appears that the panel will not complete the process until sometime in the fall of 1992. According to Dr. Bigos, the goal of the expert panel process will be to produce federally mandated expert guidelines for the treatment of low back pain.
The fact that the AHCPR panel will continue its process beyond the expected publication date for the Mercy Center Conference proceedings allows for the conference results to be included in the literature interpretation portion of the AHCPR project. It is also important to note that Dr. Haldeman is the chairman of the Mercy Center Conference and Dr. Triano is on the steering committee and is a committee captain.
The efforts of the chiropractic profession in the areas of chiropractic research, the Utah study (please see the October 25, 1991 issue of "DC"), the RAND Study (please see the October 11, 1991 issue of "DC"), and the Mercy Center Conference (please see the December 20, 1991 issue of "DC") are giving chiropractic greater access and credibility in the health care industry. The AHCPR Panel on Low Back Disorders will be yet another opportunity for chiropractic to prove itself and move forward toward greater recognition.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
