Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 By the way, have we forgotten that the Department of Consumer Affairs already provided a legal opinion that LAcs are authorized to diagnose disease? Why then so many people on this list are willing and eager to accept a much more restrictive interpretation? Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 Alon, I think if I remember this correctly, the LHC stated that this interpretation was not a correct legal interpretation. I do not know how they came to that conclusion nor if they were authorized to make legal arguements as well as evaluate the profession. We should know better by now that we cannot trust any of these politicians as they might change their minds on the way to the office. Keep up the fight. Mike W. Bowser, L Ac > " " <alonmarcus > > >Re: DX >Thu, 12 May 2005 10:22:57 -0700 > >By the way, have we forgotten that the Department of Consumer Affairs >already provided a legal opinion that LAcs are authorized to diagnose >disease? Why then so many people on this list are willing and eager to >accept a much more restrictive interpretation? > > > > > >Oakland, CA 94609 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 learning the ICD disease classification system (whether or not you want to also fit into >>>>Lets not forget that HIPPA now demands higher level ICD codes and the idea of just coding headache for example may not work.I have had claim rejected just for that reason. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 One can work with and accept new theories and applications without rejecting or downplaying the classical approaches to channel theory. I don't think the 'evolution' of Chinese medicine is into biomedical approaches, otherwise the tradition will be completely lost. We will end up just practicing Western medicine as therapists, with a little 'flavor' or sprinkling of Chinese medicine. On May 12, 2005, at 5:28 PM, jreidomd wrote: > Practitioners with exposure to > and open-minded acceptance of the evidence of some modern development > tend to lessen reliance on tendino-muscle channel, bi theory and > certain > modalities as we've learned clinical application of modern > neurology, Travell/ > Simmons and McKenzie protocols, dynamic-resistance and assisted > exercise, > modern soft-tissue manipulation, and appropriate use of nutritional > supplements that weren't around a few generations ago. All of > which is > completely in line with evolution of prior traditions, as well as > the established > statutory and legal interpretations for the State of California. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 the LHC stated that this interpretation was not a correct legal interpretation. >>>Remember the LHC has no legal standing and is only another opinion at this point. The strongest argument is simple president. We have been doing this for 20 years, period. Only if we decide to commit suicide, as some of the people on this list seem to do, by voicing support for these narrow interpretations, are these recommendation will become the rule.We need a voice from practicing professionals to counter these schools and their surrogates. While some of the schools supposedly have positions that reflect more of what is believe are the majority beliefs of CA practitioners, they choose to remain silent. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2005 Report Share Posted May 12, 2005 I beg to differ. There is more than one way to skin a cat. Look, I have no problem with people who want to practice musculoskeletal approaches to acupuncture, or who want to do a very 'westernized' approach to Chinese medicine. But please don't tell the rest of us that this is the only possible future for our profession. On May 12, 2005, at 5:28 PM, jreidomd wrote: > The ICD code that you designate is > nothing other than the level of specificity that you are confidant > that you can > justify. Maybe all you can justify is a Patient's complaint as > stated, in which > case that is the classification used, and Tx would probably be > considered > palliative. If you cannot justify anything according to the > international > standards, then the only thing you are affirming is incapacity to make > decision, and that obviously fails to meet minimum standards > necessary for > public safety and record keeping, which as I understand it is > really the only > thing government regulation is supposed to ensure. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 >>> By the way, have we forgotten that the Department of Consumer Affairs already provided a legal opinion that LAcs are authorized to diagnose disease? Why then so many people on this list are willing and eager to accept a much more restrictive interpretation? <<< [skip to bottom if you have any doubt or question about how to do an ICD defensible Dx - Joe] Well, the only reason I can guess is that they are treating cases that are way over their heads. I'm sure some here understand endocrinology, immunology etc far more than I could ever hope to, but the best they can do with direct correlation to ancient theory is some poetic nonsense about the san jiao, the six evils or whatever. Don't take that in the wrong way, - I'll sometimes use that theory, and anyone in practice a few years has some wonderful and surprising cures to confirm value in either the system or themselves as facilitators of healing. That doesn't change the fact that the understanding of what really is happening is relatively mickeymouse, and variable in Tx in comparison to what MD specialists are doing. In terms of validation by the mainstream biomed world, I see serious tactical error in pursuing narrow-focus RCTs and chemical-constituent herbal studies (which are only useful to us as pointers to formula modification). You really have to be stupid to think that all that research in China is going to further alternative practitioner status here; it either tells big-pharma what to co-opt next, or tells the FDA what to jump on next. I don't want to keep pushing this here if people don't want to try to get it, but I believe that the answer to becoming integrative as opposed to being squashed, lies in 1) – really learning the ICD disease classification system (whether or not you want to also fit into CPT procedure guidelines), and 2) – appreciating that _ functional _evaluation is the essence of evidence-based criteria, and _ functional _ evaluation is what you need to be developing and matching to the ICD (see example below at bottom). Oh, and 3) – backing off from knee-jerk prejudiced support of efforts to de-authorize and de-legislate what we already have. - and that includes backing off support for abolishing the broadly inclusive term oriental medicine under the guise of affirming that you love simple classical approaches. Current politics regarding our future are threatening far wider effect than the Work Comp overhaul of '93 that put independent evaluators like me out of a then very good business. This time it is really about first, marginalizing us all, and giving all 3rd party payers reason to deny. But more important to the cave dwellers who boast of cash only practice (which by any stats can reach less than 5% of a population that either pays mega rates for insurance or doesn't have any money for healthcare), this current legislation is a part of a back-door effort to limit use of modalities including herbs to only a few conditions that they plan to decide you have authority to diagnose. Our profession is full of people who don't have English legal language savvy, apathetic sheep who don't understand that politics is a dreadful long-drawn- out affair that requires oversight and input throughout, and snakes whose agenda is really the triumph of institutions, insurance, or other licensed professions over the sustainability of acupuncture and oriental medicine. The reason you should believe me is I'm a frightfully correct visionary (including some of TV's first 3D motion graphics and predictive imagery), and because I've grown up with and around a lot of legal minds. And also because I tell it like it is and am protected enough to have nothing to lose. I've long backed away from certain cases that I deemed to be more appropriately handled by one or more of the modern western medical specialties. It is not difficult to conclude from Harrison's Principles (the " bible of internal medicine " ) that biomedicine is far more scientifically advanced than any other traditional or derivative methodology, which in contrast are " deceptively simple to learn, yet complex to practice " as many teachers acknowledge. Non-biomedical approaches nevertheless have significant value in 1) refractory cases. 2) for persons ethically opposed, or unable or otherwise adverse to meeting the financial, environmental, and other costs endemic to allopathic standards, and 3) as complementary and integrative adjuncts to mainstream care, perhaps filling in substantive gaps in the biomed model by virtue of holistic viewpoint and humanistic elements. In my case it only took being approached by a few inoperable cancer patients to scare back some sense and humility, because in those instances I was called on with an underlying hope that I was a miracle worker, rather than as a specialty consult to provide an alternative opinion or coordinate care with the primary involved physicians. As numerous individuals and groups strive to formulate this new integrative healthcare, the first realm that many have been able to come up to par with standards, as far as matching terminology of evaluation while retaining application of the uniquely holistic qualities of oriental medicine, is physical medicine or orthopedics. Practitioners with exposure to and open-minded acceptance of the evidence of some modern development tend to lessen reliance on tendino-muscle channel, bi theory and certain modalities as we've learned clinical application of modern neurology, Travell/ Simmons and McKenzie protocols, dynamic-resistance and assisted exercise, modern soft-tissue manipulation, and appropriate use of nutritional supplements that weren't around a few generations ago. All of which is completely in line with evolution of prior traditions, as well as the established statutory and legal interpretations for the State of California. If you are seeing patients who already come in with one or more Dx, either conflicting or for different disorders, there are only three possibilities. Either they have left that doctor out of frustration, in which case you either start from scratch or send for the record to review, or they still see that doctor. If that doctor approves the patient seeing you, you either get a referral, or a request for you to do a consult. If you are seeing a patient surreptitiously, that is a clear ethical violation, and you are asking for trouble even if you never bill or write a reciept. As I have outlined in my first substantial papers, (see my website) : http://www.jreidomd.blogspot.com -when you learn how to properly do triage, you evaluate to whatever degree you are capable of, and then refer or treat accordingly. Understanding of this is so poor among so many, that they imagine that there is such a thing as an absolute and correct Dx. A diagnosis is nothing other than a working model for rationale and decision-making. The ICD code that you designate is nothing other than the level of specificity that you are confidant that you can justify. Maybe all you can justify is a Patient's complaint as stated, in which case that is the classification used, and Tx would probably be considered palliative. If you cannot justify anything according to the international standards, then the only thing you are affirming is incapacity to make decision, and that obviously fails to meet minimum standards necessary for public safety and record keeping, which as I understand it is really the only thing government regulation is supposed to ensure. Joe Reid, LAc, OMD 2005 Reproduction only with prior permission http://www.jreidomd.blogspot.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Talk with them. Mike W. Bowser, L Ac > " " <alonmarcus > > >Re: DX >Thu, 12 May 2005 19:07:59 -0700 > >the LHC stated that this >interpretation was not a correct legal interpretation. > >>>Remember the LHC has no legal standing and is only another opinion at >this point. The strongest argument is simple president. We have been doing >this for 20 years, period. Only if we decide to commit suicide, as some of >the people on this list seem to do, by voicing support for these narrow >interpretations, are these recommendation will become the rule.We need a >voice from practicing professionals to counter these schools and their >surrogates. While some of the schools supposedly have positions that >reflect more of what is believe are the majority beliefs of CA >practitioners, they choose to remain silent. > > > > > >Oakland, CA 94609 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2005 Report Share Posted May 15, 2005 In our formula for our profession. I urge that we lower the present emperor herb (political lobbyist) to the ministerial position and promote Public Opinion (New York Ad Agency) as the new emperor herb. With assistants WHO and NIH and Tradition. Only thing we'd be lacking is Gan Cao (harmonizing) and maybe some Ginger (anti-toxins) Of course there remains the question of liquid, tablet, granules and always patient compliance. Ed Kasper LAc. Licensed Acupuncturist & Herbalist Acupuncture is a jab well done www.HappyHerbalist.com Santa Cruz, CA. Quote Link to comment Share on other sites More sharing options...
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