The following are informative minutes of the
Board of Directors
Minutes
The meeting was called to
order at
Motion: Moved by Bronston,
seconded by McMahon to approve the minutes of the
Discussion with Governor Doyle
The Board welcomed a visit by
Governor Doyle who expressed his complete satisfaction in the outcome of the
defeat of AB 814. In addition, the board and the Governor had the opportunity
to exchange views on the direction of health care reform.
Moved by Bronston, seconded
by
Guidelines Presentation
The Board participated in a
discussion with Gene Lewis, DC who is the Chair of the Council on Chiropractic
Guidelines and Practice Parameters (CCGPP). CCGPP is involved in a national
effort to draft “best practices” guidelines and would like the financial
support of state associations. In preparing for the presentation, the board
raised the following questions:
Best Practices Questions
Background Questions
What are the names of the
people who mandated CCGPP to develop these guidelines? What criteria did CCGPP
utilize to choose the participants?
Why are prominent
subluxation-centered teachers, authors, technique developers and researchers
absent?
Why are so many who were
involved in Mercy involved again?
Will you publish the names of
the individuals responsible for each chapter?
Will the clinical and/or
academic faculty of the colleges be asked to review or contribute?
There are guidelines for
vertebral subluxation, produced by CCP, which have been accepted for inclusion
in the National guidelines Clearinghouse. Will you invite the CCP people to
participate?
Will the document address the
issue of the severity of an injury?
Will the document give a
range of treatment that is dependent on the severity of an injury?
In the real world, chiropractors
are confronted with QA guidelines that require them to limit care in order to
stay on a managed care panel. The guidelines used in the QA process are often
set on an arbitrary basis. How will the document address this concern?
What colleges have expressed
support for this project? How will the document be viewed as credible if all
the colleges do not accept it?
Is this document aimed at the
practicing DC or the student? If it is aimed at the student, is CCGPP concerned
that it will take too long to have a meaningful impact in the field?
Who provided the initial
funding for the document?
How is COCSA involved in the
management of the document?
Is any one involved with this
project receiving compensation for his/her work? If so, please specify the amount.
Are individuals reimbursed
for anything other than out of pocket expenses for travel? If so, please
specify the item/s eligible for reimbursement.
What is the Monica Smith
survey?
What will occur if the
sufficient funds are not raised to support this project?
Your letter dated
Document Writing
Is there one Best Practices
document that you are using as a model?
The guidelines you gave us
for substance abuse are not guidelines at all but documentation of a workshop
on how to use guidelines on substance abuse.
The interferential guidelines
are obviously incomplete, and in draft form. There is no indication of who the
author is or how much additional information will be written. In addition,
there is a claim on page 82 that IFC is not indicated for LBP, based upon one
study, Werners, 1999. After reading Werners, I would disagree with the
guideline’s ultimate conclusion that Werner’s study represents Grade II
evidence that IFC in not indicated for LBP. Finally, there is extensive
literature about IFC and pain/LBP that was not included…why?
What topics will be
addressed?
Who will address subluxation
in this document? How will it be defined? Will they survey doctors about their
needs and attitudes?
Assuming the conclusions are
based upon evidence based practices, how can the committee focus on “all
conditions” seen in a chiropractic office? It seems that by making this “all
conditions” statement that any conditions not addressed will be considered not
to be within a chiropractor’s scope of practice.
Will the document address
chiropractic techniques? If so, what criteria will be used to establish the
credibility of a technique?
Will the document explicitly
state that chiropractors are ineffective at treating some conditions?
Document Review
What mechanism of evaluation
is to be utilized to format the final product?
Will the document attempt to
explain the philosophy of chiropractic?
Mercy was based on the
opinion of 35 or so people – how many will decide this time?
Will there be open forums
where any interested DC can present evidence?
Will any chiropractor who
wishes be permitted to participate in the review process?
What is the process to
approve a particular chapter?
We are concerned that
distributor has been selected so that the document can be rapidly disseminated.
How can we be sure that everyone will have an opportunity to comment before the
document is released?
Will the evidence based
information used in the document be available for field doctors to review
before the document is released?
Will the insurance industry
find the document credible if it does not have some sort of limitations on
care?
Practice Impact of the Document
Will state and national
associations be asked to endorse the document? If a majority of state/national
associations do not endorse the document, what effect will that have on its
distribution?
Will this document be
marketed? If so, what is the anticipated price? If not, how will it be
distributed and who will bear the cost?
What steps have been taken to
insure that this will not be construed as a “minimum Standard” or “maximum
practice guideline?
Will there be a standing
committee or board that will review the “best practices” literature on an
on-going basis, with new editions or supplements published as warranted by new
evidence?
Dr. Lewis will report on the
board’s questions to the full CCGPP.
Motion: Moved by
Animal “Chiropractic”
The board reviewed the
apology received by of a veterinarian who had advertised that he provided
“chiropractic” services to animal. He assured the WCA that, having been
informed that the use of the term “chiropractic” was reserved for chiropractors;
he would immediately change his advertising.
The board reviewed a proposal
by WTMJ to advertise on the Green Bay Packer Radio network. The board
determined that the cost of this type of advertising was beyond the means of
the WCA.
Blue Cross – High Cost Traction
The board reviewed the memo
sent to WCA members on billing and audit issues related to spinal decompression
technology.
Motion: Moved by Bronston,
seconded by Sleight to authorize the replacement of the WCA roof. Motion
carried.
The meeting adjourned at
approximately