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On the surface, it was just another typical moment in a chiropractic physician’s office. I was walking down the hall from one treatment room where I had just left a patient with an injured knee, to check on another patient who was receiving care for a painful shoulder.

But on that short walk down the hall, I was actually walking the long divide between two health care paradigms. While the patient with shoulder problems was receiving what would normally be considered “standard” treatment — heat, ultrasound and chiropractic manipulation — the patient with the bum knee had several acupuncture needles inserted around her knee and ankle.

In one room, the basics of applied physiology were being utilized: Heat was being used to perfuse the injured area with blood, bringing with it oxygen, nutrients, and other supplies for healing, and taking away the detritus of repair. Ultrasound was altering the permeability of the cell membranes, allowing the injured tissues to more readily imbibe the blood’s bounty. And joint manipulation was restoring normal physiological shape and function to the ligaments surrounding the joint.

But in the other room, a completely different process was apparently taking place: The normal flow of qi, a nebulous “life energy,” was being restored. Excess yang, represented by the heat of inflammation, was being quenched by employing the water principle of the body, as water is always used to put out a fire; meanwhile, meridians controlling the patient’s earth energy were used to nurture the damaged tissues.

How do I, as a doctor trained in both eastern and western medicine, reconcile these two utterly divergent approaches? One is so clearly logical and wrapped in the science of the west, while the other explodes with image and allegory, as if the needles tell a parable of health in their placement and actions.

And with increasing frequency, I find that I not only combine these disparate therapies in my practice, but in the treatment of singular patients. Some patients receive both chiropractic and acupuncture. Some are treated with eastern herbs and western physiotherapy. Others are treated with western nutrition and acupuncture.

“Do I contradict myself? Very well then I contradict myself,” said the poet Walt Whitman. “I am large, and contain multitudes.”

Perhaps the best way of uniting these two approaches to human health which do not speak the same language either literally or figuratively is to apply the principles of scientist and philosopher Alfred Korzybski which can be best summed up by this statement:

At the beginning of every physician’s career, there is a moment in which we commit ourselves irrevocably to the wellbeing of our fellow humans. At that moment, when a physician takes his oath of responsibility — whether it is the Hippocratic Oath of the medical physician or the Chiropractic Oath of the chiropractic physician — we become responsible to a good far broader than our petty, individual prejudices.

From the moment I took my oath to the present day, I have striven to uphold its tenets. Whether it is navigating the thickets of a patient’s privacy requirements to ensure that they receive the best care, or challenging health insurers whose policies would require me to commit malpractice, I have always held in mind the obligations of this oath.

So I am understandably sickened when I come across examples of other doctors who not only ignore their moral obligations, but actively violate them to the detriment of their patient. Of course, the Josef Mengele wannabees who conducted the Tuskegee Experiment immediately come to mind.

But not far behind is the as-yet unnamed doctor and his employer, Ball Memorial Hospital, who recently threw a critically ill woman out of their emergency room because she is a transsexual woman. But the expulsion only occurred after several hours during which hospital patient Erin Vaught, vomiting blood and suffering from intractable pain, was subjected to ridicule and derogation at the hands of other hospital employees, being referred to as a “he-she” and being entered into the hospital database as a male, even though her ID card clearly identified her as a female.

Here is part of what happened, in her own words:

They completed my regestration [sic] and I saw that had put “M” as my gender.
I pointed out that my ID says female. She looked annoyed and the lady
next to her snickered. She told this jock type triage person to take my
vitals; he glared at me for a second and turned his head and said,
“Remember payback sucks.”

You can read her full account here.

Those of you who read my blog regularly know that I have previously written extensively about how transgender people should be treated by doctors, and that I hold in low esteem those who discriminate against people with gender variations.

I fully understand that sometimes people do hurtful things to others out of ignorance. But in this day and age, there is no excuse for any health professional to be unaware of the needs of this demographic. In addition, and quite clearly, the activities of Ball Memorial Hospital and its employees went far beyond those which can be written off as ignorance.

They were words and actions intended to hurt. Intended to humiliate. Designed to violate the very core of the oath that those physicians had taken on the day they became doctors.

I am absolutely appalled, yet at the same time, relieved. I am appalled that the incident even occurred, and even more stunned at the hospital’s decidedly pusillanimous response. And I am at the same time relieved that I do not belong to a profession which indulges and condones such bigotry.

Regardless of what unethical behaviors that chiropractic physicians have been accused of over the years, none of it even approaches the level of disregard for patients and their rights which is a standard feature of mainstream medicine. From selling confidential patient data to pharmaceutical companies to denying medical care to black men to watch them die from untreated syphillis, my profession has never come close to the level of depravity demonstrated so often by mainstream medicine.

I hope Ms. Vaught and her family find the courage to sue Ball Memorial Hospital. Though such a suit will likely not touch the individuals who perpetrated the crime, it will be as close as anyone gets to a reprimand.

Otherwise, the same reprisal that was visited upon the Tuskegee doctors will also befall the Ball doctors.

That is, nothing. Nothing at all.

I’m kicking off this year’s fall/winter lecture series with what I think may be one of my best — and most important — lectures ever. It will be held at 7 p.m. at the Litchfield Community Center, on September 22.

The title of the lecture is What To Do When The Drugs Don’t Work, and will discuss the ways that alternative medicine can assist people suffering from chronic illness.

From diabetes to heart disease to osteoporosis, 45% of Americans suffer from one or more chronic diseases. Chronic diseases cause 7 out of every 10 deaths; they significantly impair your quality of life; and they account for 81% of all hospital admissions.

The bad news is that these diseases are poorly managed with drugs, and even when they are, the side effects can make the ‘cure’ almost as bad as the disease.

But the good news is that many chronic diseases can be prevented or controlled without drugs.

It will be a 90-minute lecture, and at the end, you will learn how to take control of your health and prevent or manage your chronic illness without becoming dependent on medicines. Using research and science-based strategies, Dr. Jenkins will demonstrate why non-drug therapies are more effective, less expensive, and better for your health.

All seminar attendees will receive a workbook which will help them develop a custom health plan that matches their needs.

Attendance is free of charge, but registration for the seminar is required. Call 860-567-5727 and ask Teresa to reserve your seat.

For most of the past 100 years, chiropractic physicians and their patients were the only torch-bearers for safe, patient-centered alternative medicine. During the anti-alternative purge of the 20th century, homeopathy was all but wiped out in this country, surviving only on the fringes in Europe for 60 years. Osteopaths, once allied with chiropractors in their unique approach to health, threw in the towel and were co-opted by mainstream medicine; today, the difference between an osteopathic doctor and a medical doctor is indistinguishable except for the initials after the name.

Providers of nutritional and herbal medicine such as the Thompsonians and Eclectics were all but exterminated, and by the 1950s, chiropractic was the only profession left that could provide patients with informed, educated, alternative medicine.

Even then, the level of harassment was formidable. The chiropractic doctor who treated me as a child was — unbeknownst to me — one of the leading forces in the fight for chiropractic equality. Dr. Reeve, of Dayton Ohio, was jailed no fewer than 6 times for “practicing medicine without a license,” during his struggle to obtain licensure for chiropractic doctors.

Slowly, the tide has turned. Chiropractors are the first and only alternative medicine doctors to obtain licensing in all 50 states. And although few people know this, it was at a chiropractic college that acupuncture first found a home in this country, as New York Chiropractic College was the first college in the U.S. to offer training in acupuncture for doctors.

We are, in a way, accepted by medical insurers. But on a very limited basis and at rates that are prejudiced against chiropractic doctors and their patients. So much of what I could offer patients is denied because their insurance companies refuse to pay for procedures which are medically necessary and part of my scope of practice. And even if they were to pay, the reimbursement offered to a chiropractic doctor runs from 10% to 40% of what a medical doctor is paid for the same procedure — despite our superior
skills and training in many procedures.

But that’s all about to change.

TheNational Association of Chiropractic Attorneys (NACA) has announced that it has issued a proclamation recognizing “the historic and profoundly positive legal ramifications for the chiropractic profession and the patient community it serves in Section 2706, ‘Non-Discrimination in Health Care,’ recently enacted as part of the federal ‘Patient Protection and Affordable Care Act.’”

The provider non-discrimination provision says that “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.”

Once in full effect, health insurance companies will no longer be able to deny my patients their right to receive coverage for their acupuncture treatment, their nutritional therapies or the many other medically necessary services which I provide but which insurers routinely reject.

The provision has long been championed by the American Chiropractic Association (ACA) and members of the Chiropractic Summit. It was achieved primarily due to collaboration with Sen. Tom Harkin (D-Iowa) and help from other key players such as Sen. Chris Dodd (D-Conn.). Although he did not support the final bill overall, Sen. Orrin Hatch (R-Utah) also lent his support for the advancement of the non-discrimination provision. ACA will continue to fight for proper implementation during the regulatory process.

“It is important to recognize this provision as a historic first for the chiropractic profession. We now have a federal law applicable to ERISA plans that makes it against the law for insurance companies to discriminate against doctors of chiropractic and other providers relative to their participation and coverage in health plans,” said NACA Vice President Mike Schroeder. “While there is still much work to be done in the regulatory process, we are encouraged by the fact that Congress has finally acted to end provider discrimination based on one’s license.”

It is also important to note that Section 2706, and its assurance of non-discrimination in terms of participation and coverage, effectively requires that doctors of chiropractic be allowed to provide any“essential benefit” that is within their scope of practice. This will prove to be a particularly significant victory as the essential benefitspackage under the health care reform law is defined over the next couple of years.

“As significant as Section 2706 is to the chiropractic profession, it is possible to lose ground during the regulatory drafting process,” said NACA President Paul Lambert.

Believe me, the opponents of chiropractic care will work long and hard to keep chiropractic patients out in the cold. In fact, the American Medical Association has already begun attacking the provision, once again fearing the economic competition that chiropractic physicians represent.

To support the work being done to ensure the proper implementation of the provider non-discrimination provision, please add your voice to the thousands demanding full and fair insurance coverage at www.chirovoice.org.

Even if you don’t follow health news closely, it would have been hard to miss the recent headlines as the diabetes drug Avandia went “on trial” before the FDA.

The problem was simple: Avandia tends to kill the people who take it by giving them strokes and heart attacks. So some intelligent people thought it should be taken off the market.

Before all was said and done, it was revealed Avandia’s maker GSK had manipulated  risk analysis data, one of the panel’s scientists was on the payroll of a GSK competitor, and in the end the FDA figured that killing off some people with diabetes wasn’t so bad after all and let Avandia stay on the market.

Missing from the whole discussion was the idea that you don’t need Avandia or any other drug to treat type II diabetes!

While on vacation last week, I had the opportunity (and the need) to do something I rarely do at home: Get a chiropractic adjustment.

The need was spurred by a headache subsequent to a 100-mile bike ride that saw me traverse Cape Cod from outermost Provincetown to downtown Hyannis, and back again. It was a pleasant trip, though exceedingly hot. And even though I ride a recumbent bicycle, which is far more comfortable for the neck over long distances than a standard upright, the recumbent in the extremely laid-back configuration can produce significant neck strain over time.

I was greeted on the morning following my ride, by a classic cervicogenic headache — that is, a headache caused by the vertebrea in the neck becoming fixed in position. This is the cause of most headaches, which in the popular literature are often referred to as “tension headaches.”

I had been needing an adjustment for some time, but like the average bad patient, I kept putting it off. In part, because most other chiropractic physicians work the same hours as myself, and in part because I’ve just been too busy. Sound familiar?

I was fortunate, however, to find that Dr. Donna Heitzman, in Provincetown, would have a few minutes to see me that afternoon. As Dr. Heitzman, a delightful woman with a puckish sense of humor, treated me, I was reminded of just how powerful the act of simply touching someone can be.

Arguments for the healing power of touch sends skeptics into paroxysms of denial, as healing touch is often so closely associated with fundamentalist religious practices, and the denial of the spiritual aspect of humanity is a fundamental tenet to the skeptic’s belief system.

Nonetheless, there is a significant body of research which demonstrates the power of touch. Most recently, researchers found that the quality of objects that people were touching — heavy vs. light, hard vs. soft, rough vs. smooth — caused people to form unconscious associations between what they were touching and unrelated experiences. For example, rough objects made social interactions more difficult and hard objects made people more rigid in negotiations.

Massage has been shown to prime the brain for release of oxytocin, commonly known as the “empathy” hormone, making people more capable of bonding with and trusting others.

But touching is even more powerful than that. Touch has been shown to reduce cardiac arrythmias in ER patients, and even have beneficial effects on the red blood cells of comatose patients. Touch also increases one’s overall sense of well-being and reduces blood pressure.

Of course, chiropractic adjustments are all about touch, and I am very conscious of the quality of my touch when I am treating patients. Not infrequently, patients will experience an overwhelming emotional response to a chiropractic adjustment. Crying, laughing and sudden relaxation are all common responses to a chiropractic adjustment. Part of it is due to the neurological and biochemical changes which adjustments create, and part of it is simply due to being touched.

Which brings us back to Dr. Heitzman’s office. Immediately after being adjusted, my headache disappeared, which is a common response to chiropractic treatment of tension headaches. But more surprising to me was the overwhelming sense of relief I felt. In addition to the emotional relaxation, I felt the muscles of my upper back and shoulders let go of tension that I didn’t know they held.

Dr. Heitzman and I spent a few more pleasant minutes talking shop, and then I proceeded to hop on my bike and ride an easy 7 miles back to the house where I was vacationing. A long nap that afternoon ensued, unusual for me.

It was good to be reminded in such a direct, clear way of the powerful treatment that I can offer to my patients. When the “Gee, thanks Doc, that feels a lot better” response becomes commonplace, it is all too easy to forget the powerful sensations lying behind those words, the power of a chiropractic adjustment and the power of a healing, caring touch.

As I do periodically, I reviewed the costs of the practice this spring, and was, frankly, appalled at how much I was spending for a second phone line — a line which was used primarily for faxes, incoming call rollover, and for me to return patient calls or to call the kids and remind them to clean their rooms.

I felt there was probably a better way to spend this money, particularly as there are easier and cheaper ways to provide the same services.

So, step 1 was to move to an internet fax service. For pennies per month, this service provides a dedicated fax number. Incoming faxes such as lab reports are mailed to us as a PDF file, which we can then immediately transfer to the patient’s electronic file. No paper, no printing, no muss, no fuss.

Outgoing faxes are simply PDF files emailed to the service which then sends them to the receiving party’s fax machine. So, for example, when I make a referral to another physician or to the local lab, I no longer have to print it out and have Teresa schlep it through the fax. Instead, I make the referral through the electronic medical records system, save it as a PDF file, and email it to the service. Takes maybe 15 seconds.

With the need for a fax line obviated, we dumped it. But then another problem became apparent, because I ended up using the single line for making outgoing calls, such as returning calls from patients and the periodic calls to home that are routine in any working parent’s day, to make sure the hermit crab got fed and that nobody was doing anything that would result in concussions or uncontrollable bleeding, and to say, yes, I will spend my lunchtime going to the school to drop off the homework you forgot.

Clearly I needed a second line, so I started using Skype for calls to landline and mobile phones. But I’ve never really been a big fan for several reasons, among them being that Skype uses proprietary protocols. Last year, I converted the entire office from Windows to the Ubuntu (Linux-based) operating system, which I found to be far more effective for our needs. With the most recent upgrade to the Ubuntu 10.04 operating system, my Skype broke completely, insofar as being able to call landlines and mobiles on it. I could  still make Skype-to-Skype calls with no problem, but forget calling the kids or returning patient calls. Skype’s tech support was only mildly interested in the problem, and eventually told me to purge the software and reinstall it, and if that didn’t work they were washing their hands of the problem.

Needless to say, it didn’t work. So I went in search of an alternative, and found Nomado. For a paltry 5 euros per month, I got my own incoming phone number, 500 minutes/month of talk time to almost any phone in the civilized world, automatic call forwarding to my cellphone and voicemail that is emailed to me as .wav files. And all at a price that is almost 50% less than what I had to pay Skype for same.

The voice quality is perfect, better than Skype, and far better coverage for calling Europe, the UK and South American countries. Plus, it uses the SIP protocol — an open source protocol — which means I have my choice of PC-based softphones as well as hardware phones to pick from, and I wasn’t stuck with the Skype non-functional software and hardware lineup.

I *highly* recommend this service over Skype. Better value, by far.

The Nomado website is a wee bit hinky, especially if you’re using Firefox on Linux — for the signup process, I had to boot up Chrome on a virtual XP machine to get the job done — but they have online chat tech support that is superb.

So I now have a direct incoming line, with all of the bells and whistles, for about $6 per month.

With the grossly inappropriate reimbursements the insurance companies are dishing out these days, it pays a doctor to stay on top of the technology curve. That way you can reduce costs while maintaining high levels of service.

More bicycling than doctoring, but this op-ed piece was recently published by the local newspaper.

Chalk it up to my public health efforts.

What would you say if health scientists had discovered a way to reduce your risk of chronic disease by almost 80 percent?

If it were a pill — one with no side effects — would you take it? How much would you pay for it? $50/month? $100/month?

In fact, health improvement of this magnitude was one of the goals of the billions of dollars spent on gene therapy research. Billions which were wasted, as I noted in a previous post. Even had genetic manipulation proved successful, you would still have paid through the nose to avail yourself of its solutions.

But because you are one of the five dedicated readers of this blog, I will tell you how to significantly reduce your risk of chronic disease for free.

A 2009 study involving over 23,000 Germans found that taking the following steps reduces your risk of diabetes by 93%, reduces your risk of heart attack by 81%, cuts stroke risk by 50%, and drops your chances of developing cancer by 36%.

Here’s how you do it:

• Don’t smoke.
• Keep your BMI under 30.
• Exercise 3.5 hours every week.
• Eat a diet rich in vegetables, fruit and grains, and low in meat.

That’s it. No gene-manipulating drugs, no daily aspirin, no useless statins, no anti-osteoporosis drugs, none of the other unscientific nonsense daily fostered  on an unsuspecting public as “prevention.”

Just “good, clean livin’,” as my Ohio ancestors would have described it.

Now, that doesn’t mean that even within those guidelines, additional nutritional or other resources might not be necessary, to combat the imbalances created by a frequently-toxic environment and food supply, or the vagaries of communicable diseases. Nor does it mean that you won’t need some assistance to put your lifestyle on that healthy path. But once you are there, and the longer you are there, it will get increasingly difficult to knock your health off balance or to knock your lifestyle out of whack. But adhering to those four principles is the foundation for all of the rest.

That, of course is where my profession comes in. If you can’t say yes to each of those four guidelines, I or one of my colleagues is likely to have the tools to help you get there. In fact, I can rather comfortably say that chiropractic physicians are the health care professionals best equipped for the prevention of chronic disease.

It was the great American inventor, Thomas Edison, who once said:

“The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease.”

I think I know which profession represents Edison’s ideal doctor. And we’re here right now.