The Danish Institute for Health Technology Assessment (DIHTA) has published low back pain guidelines "to manifest today's knowledge on the problem and the most rational way to handle it." The Danish National Board of Health is not only dedicated to establishing guidelines, but serious about seeing them applied, as indicated by this published statement:
Denmark will ensure that international HTA (health technology assessment) initiatives are monitored and the results applied to the Danish National Health Services."
Chiropractic, which received it authorization in Denmark in 1992, is flourishing. According to Henrik Laugesen,DC, president of the DCA, the chiropractic profession in Denmark cannot meet the demand for chiropractic.
The guidelines are divided in two volumes. The first volume gives a thorough discussion of back pain, its risks and diagnosis. The second volume deals with the treatment parameters and identifies the health professions that treat patients with low back pain.
Under the section "The chiropractor in the primary health care sector," the scope of chiropractic practice is delineated: "diagnosis, treatment and prevention of biomechanical functional lesions for patients suffering from low back pain." The Danish guidelines stratify their recommendations into three areas:
Treatments recommended only for certain conditions include: injections; trigger point injections; facet joint injections; epidural injections; acupuncture; massage; heat/cold therapy; back surgery; bed rest; and transcutaneous nerve stimulation.
Under "treatments which can generally be recommended," manual therapy (which includes chiropractic) is the first listed. It is cited as having "moderate costs" with the following recommendations:
Denmark joins a growing list of countries that have examined the scientific literature and found sufficient evidence to recommend chiropractic for low back pain. While it is understood chiropractic is effective for more than just back pain, this is an important step in establishing chiropractic's value and place in each country's health care system.
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.
