As part of its ongoing effort to provide a diversity of clinical education experiences for its students, New York Chiropractic College (NYCC) recently signed an internship agreement with Stony Brook University, New York’s second largest university. The agreement will enable NYCC’s chiropractic students to experience hands-on clinical training at the Stony Brook University student health centers as Stony Brook’s students get to discover chiropractic’s many benefits. NYCC currently affiliates with SUNY Farmingdale, and with New York’s largest university, the University of Buffalo. Stony Brook University is a member of the prestigious Association of American Universities, the invitation-only organization of the best research universities in the country, and Kiplinger’s Personal Finance magazine lists it as one of the “100 Best Values in Higher Education” among public universities. NYCC continues to pursue similar arrangements with private colleges and universities throughout the United States.

Seneca Falls: On July 28 and 29, New York Chiropractic College held commencement exercises, conferring upon candidates the Doctor of Chiropractic, and Master of Science in Acupuncture, or Master of Science in Acupuncture and Oriental Medicine degree. On Saturday, July 28, at 10 AM, 27 candidates for the degree of Doctor of Chiropractic were awarded their diplomas in a ceremony held in the campus’s Delavan Theater. The commencement address was delivered by Serge Nerli, D.C., a 1983 NYCC alumnus. Nerli earned a Master of Science in Nutrition from the University of Bridgeport in 1999, has a private practice in Fresh Meadows, N.Y., and currently serves on the NYCC Board of Trustees. Valedictorian Rachel A. Streit had the honor of addressing her classmates and the assembled audience. Christa Marie Whiteman was named Salutatorian for the Spring 2007 graduating class. On Sunday, July 29, at 10 AM, the NYCC School of Acupuncture and Oriental Medicine (AOM) graduated 31 master’s candidates. The commencement address was delivered by Dainel Seitz, chair of the Accreditation Commission for Acupuncture and Oriental Medicine and executive director of the Council on Naturopathic Medical Education. Former president of New England School of AOM and former chief of the Acupuncture Unit for the Massachusetts Board of Registration in Medicine, Seitz earned his Bachelor of Arts and Master of Arts for Teachers from the University of Chicago and holds a law degree from Boston University Law School. He served as founding dean of the AOM master’s degree programs at NYCC and currently serves on NYCC’s Oriental Medicine Advisory Committee. For further information about New York Chiropractic College’s degree programs in chiropractic, acupuncture and Oriental medicine, and applied clinical nutrition, please visit our Web site at:

In a letter dated July 27, 2007, Dr. Frank J. Nicchi, President of New York Chiropractic College (NYCC), received official notification from the Commission on Accreditation of the Council on Chiropractic Education (CCE) reaffirming accreditation for the College’s doctor of chiropractic program. The reaffirmation marks the beginning of the next eight (8) year accreditation cycle for the college’s chiropractic program. Expressing delight at the good news, President Nicchi remarked, “I’m thrilled with the report and extremely proud of the valuable contributions by faculty, staff and students to this significant achievement.”

Company refused fair reimbursement for covered services, Department alleges TRENTON – On Monday the Department of Banking and Insurance (DOBI) filed an administrative order levying $9,475,000 in fines against Aetna Health Inc. for refusing to appropriately cover certain services provided by out-of-network health care providers – including emergency treatment – in violation of New Jersey rules and regulations. In June, DOBI received numerous complaints after Aetna issued a letter to health care providers stating that the company had determined what was “fair payment” for services rendered by non-participating physicians and health care facilities and that “additional reimbursement would not be considered.” This included services by non-participating providers that were required under New Jersey law, such as emergency care, services provided by non-participating providers during an admission to a network hospital, and services rendered as the result of a referral or authorization by Aetna. The letter stated that Aetna determined that 125 percent of the Medicare allowable amount was fair payment, and 75 percent for lab fees and durable medical equipment. As a result, many patients were subject to receiving bills for the amount Aetna would not pay, creating significant financial exposure. Under such circumstances, New Jersey regulations state that members of a health maintenance organization (HMO) have the right to “be free from balance billing by providers for medically necessary services…” DOBI Commissioner Steven M. Goldman signed the order requiring Aetna to cease its limited reimbursement practice, to reprocess all claims for services rendered by non-participating providers adversely affected by Aetna’s unfair practices, and make payment to those providers based on the billed amount plus 12 percent interest from the date the claim was initially paid, in addition to the monetary penalty. Aetna has 30 days to request an administrative hearing objecting to the order. If no hearing is requested, the order will then become final.

New York Attorney General sent a letter to the insurer’s UnitedHealthcare unit to cease the implementation of a program design to rank doctors according to quality and cost effectiveness. The attorney general is prepared to seek an injunction if UnitedHealthcare fails to comply with the request TO READ ATTORNEY GENERAL CUOMO'S LETTER TO UNITEDHEALTHCARE CLICK ON THE LINK BELOW

Any paper claims received by Medicare after June 29, 2007, must be submitted on the new version of the CMS 1500 form (08-05 version). If the old CMS form (version 12-90) is received by Medicare after June 29, 2007, the paper claim will be returned to the provider for resubmission on the new form. Medicare also requires the use of the National Provider Identifier (NPI) on paper claims as well as electronic claims. Be sure to denote your NPI on the new CMS 1500 forms on both electronic and paper claims.

New York Chiropractic College was presented with the “Gold” award during a ceremony held Friday, June 8, 2007. “Today we give quality its due,” said Nicchi, “as we join a small handful of institutions of higher education to receive Empire State Advantage’s ‘Excellence at Work Program’ Gold level of recognition.” NYCC is the only college of chiropractic or school of acupuncture and Oriental medicine ever to be so honored. Nicchi thanked all those who work at NYCC for their hard work and dedication: “This award belongs to all of you.” The Gold Level of recognition is reserved for those educational institutions who have demonstrated outstanding leadership and offer highly effective teaching and work practices. An onsite review team visited the NYCC campus to evaluate, among other qualities, the college’s management systems, work processes, employee satisfaction and customer service. Empire State Advantage (ESA) Executive Director George Hansen, in awarding the honor, said “This is the best kind of day that we have …when we can come out to present and award and celebrate!” ESA Board Chairman Ronald Knight said “We need to have more celebrations of this kind – celebrating our work.” He congratulated NYCC on its achievement and challenged those present to be proud of your accomplishment, continue the “improvement journey” aggressively and to reach out to other area organizations to share what has been learned and to ask for help. “This is how communities of excellence grow,” he said. New York State Senator Michael F. Nozzolio, who was on hand to share in the celebration, remarked “Congratulations on a job well done…this recognition is certainly well deserved.” ESA Executive Director George Hansen and Chairman of the ESA Board of Directors Ronald Knight presented NYCC President Frank J. Nicchi, D.C., M.S. and Chairman of the NYCC Board of Trustees, Lewis J. Bazakos, D.C., M.S. with the ESA “Excellence at Work” Program Gold level of recognition, thus making NYCC one of only eight organizations in New York State to be so honored. To learn more about ESA please visit their Web site at

The Sherman College of Straight Chiropractic Board of Trustees recently announced the appointment of Jon C. Schwartzbauer, D.C., as the college’s fourth president, effective August 13. A Sherman alumnus, Schwartzbauer brings a breadth of academic, leadership and administrative experience, as well as a passionate commitment to vertebral subluxation-centered chiropractic. Most recently he has served the college as vice president for academic affairs and director of the Leadership and Practice Management Institute. Schwartzbauer and his wife, Mitzi, a clinical sciences faculty member at Sherman, ran Schwartzbauer Straight Chiropractic Center in Mahtomedi, MN, for five years before he joined the Sherman College faculty in 2002. The couple also served as team chiropractors for the St. Paul Saints, a minor league baseball team in their home state of Minnesota. Schwartzbauer was selected in early 2006 to lead the launch and development of Sherman College’s Leadership and Practice Management Institute (LPMI). As LPMI director, he worked to create a culture of ever-improving leadership within the chiropractic profession. He instituted Sherman College’s Success Colloquia, a series of seminars designed to enhance leadership and practice management skills for members of the chiropractic profession as well as Sherman students and faculty. He also laid the groundwork for a student leadership program on campus. He was named vice president for academic affairs in December 2006. In addition to the doctor of chiropractic degree he earned in 1997, Schwartzbauer holds a B.S. from Excelsior College. His appointment as president follows a nationwide search and comprehensive selection process that provided the college with a broad array of talented candidates. “I am committed to being a faithful steward to the college’s history and working with the college community as we address the opportunities in chiropractic education today,” Schwartzbauer says. “I look forward to working with our talented and dedicated board, faculty, staff, students, alumni and supporters to strengthen Sherman College and the chiropractic profession.” Schwartzbauer says his priorities include increasing enrollment and fund-raising at the college. “I am grateful for the trust the Board has placed in me,” he says. "I intend to put my heart and soul into Sherman College.” Sherman Board Chair Cindy Pekofsky, D.C., says the trustees look forward to working with Schwartzbauer as he continues to lead and advance the college’s mission of being the leader in bringing straight chiropractic to the world. “We are excited to welcome Dr. Schwartzbauer as Sherman College’s fourth president, and we look forward to the great things we will accomplish for Sherman College and for the chiropractic profession under his leadership and guidance,” she says. Pekofsky adds that the continued service of Sherman College’s Interim President and founder, Thomas A. Gelardi, D.C., will be invaluable in the coming months as he helps provide a seamless transition to Dr. Schwartzbauer’s dynamic leadership. “The board is extremely grateful for Dr. Gelardi’s dedicated service to the college and for his many contributions to the college’s successes during his tenure as interim president for the past two years,” she says.

ABSTRACT Background Widely used models for teaching and assessing communication skills highlight the importance of greeting patients appropriately, but there is little evidence regarding what constitutes an appropriate greeting. Methods To obtain data on patient expectations for greetings, we asked closed-ended questions about preferences for shaking hands, use of patient names, and use of physician names in a computer-assisted telephone survey of adults in the 48 contiguous United States. We also analyzed an existing sample of 123 videotaped new patient visits to characterize patterns of greeting behavior in everyday clinical practice. Results Most (78.1%) of the 415 survey respondents reported that they want the physician to shake their hand, 50.4% want their first name to be used when physicians greet them, and 56.4% want physicians to introduce themselves using their first and last names; these expectations vary somewhat with patient sex, age, and race. Videotapes revealed that physicians and patients shook hands in 82.9% of visits. In 50.4% of the initial encounters, physicians did not mention the patient's name at all. Physicians tended to use their first and last names when introducing themselves. Conclusions Physicians should be encouraged to shake hands with patients but remain sensitive to nonverbal cues that might indicate whether patients are open to this behavior. Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names. Arch Intern Med. 2007;167:1172-1176 Gregory Makoul, PhD; Amanda Zick, MA; Marianne Green, MD Author Affiliations: Center for Communication and Medicine (Dr Makoul and Ms Zick) and Division of General Internal Medicine (Drs Makoul and Green and Ms Zick), Northwestern University Feinberg School of Medicine, Chicago, Ill.

New York State Insurance Superintendent Eric Dinallo today issued a plan to reform the resolution of disputed workers’ compensation claims. The plan substantially speeds the resolution of disputed claims from over 6-months to 90-days and was submitted in a letter sent on June 1, the deadline set by the Governor. The Superintendent outlined the reforms and their benefits in the letter and submitted an accompanying set of regulations. Resolving disputes faster is one part of the historic agreement between business, labor and government to reduce system costs to employers while increasing benefits to injured workers and getting employees back to work faster. "We are delivering on our promise to reform workers’ compensation in ways that both reduce costs to employers and increase benefits. This reform is an essential part of reviving the State’s economy and encouraging businesses to create more jobs here," Governor Eliot Spitzer said. "These reforms will significantly increase the efficiency and fairness of the system and accelerate the time it takes to get benefits to injured workers. Workers will be able to return to work earlier, system costs will fall and premiums will become more affordable for business owners. This is truly a win-win for employees and employers," Insurance Superintendent Dinallo said. "I would like to thank my staff and our advisors for their excellent and speedy work. We trust that we will be able to continue to find ways to improve the workers’ comp system thanks to the highly collegial and productive dialogue and process that we have with our advisors." On March 13, Governor Spitzer announced legislation to reduce the State’s high workers’ compensation costs for business, while increasing the State’s weekly payments to injured workers. By 2010 maximum benefits will rise to nearly $700 per week from only $400 today. The Governor asked Superintendent Dinallo to lead several reform efforts that further the legislative goals. The first task was reforming the adjudication process with a goal of reducing the time it takes to resolve disputed claims to 90 days. Currently, it takes more than 200 days. During this period, the injured worker may be receiving no cash payments or medical benefits. Delays in cash payments can cause serious financial hardship. Delays in receiving medical benefits and treatment can affect workers’ long-term medical prognosis and the ability to return to work. Under the current system, it is often not until the pre-hearing conference – an average of 75 days from the start of the claim – that the parties have sufficient information to evaluate their claims and defenses. It takes almost three more hearings for a typical claimant to establish a disputed claim and start the flow of benefits. In the 20 percent of cases that take more than three hearings, the average number of hearings is five. It can take up to 90 days to schedule each additional hearing. The newly proposed process will significantly accelerate resolution of disputed cases to within 90 days or less of the dispute. This will cut the time by more than half for the resolution of disputed claims. The reformed process was developed by the Workers’ Compensation Task Force led by Executive Director Bruce Topman after consultation with advisors designated by the Governor drawn from business labor, the legislature and executive departments. It sets specific time benchmarks for each stage of the proceedings, accelerates the time when evidence must be submitted and testimony taken, and requires professional representatives and medical providers to meet their responsibilities in a timely fashion, with consequences for not doing so. A major improvement will require employers, claimants and doctors to submit complete information up front. Early information substantially increases the opportunities for settling cases at an accelerated mediation session and at the pre-hearing conference. It also makes the trial-ready claim quicker and the initial evidentiary hearing follows within minutes of the pre-hearing conference. The proposed regulations accelerate claim resolution through earlier factual disclosure and assist injured workers in filing claims with all necessary information.

The American Chiropractic Association is urging doctors of chiropractic nationwide to take immediate action to provide documentation pertaining to the discriminatory practices of chiropractic networks. The investigation of these matters is becoming of national interest and we want to be ready to supply regulatory authorities with the information they need. Your assistance is needed by June 15, 2007. "Doctors across the country have the information that regulatory authorities need to address the serious problems posed by managed care organizations," announced ACA President Dr. Richard Brassard. "Many doctors have assisted us over the past two years in this long battle, but now more than ever, it is time for all doctors of chiropractic to take a stand to protect our patients and our profession. We have a real opportunity, one that we may not have again, to address the problems of these networks – and we cannot do it without help." ACA has been in communication with several state Departments of Insurance and Attorneys General regarding tactics by managed care networks that, in ACA’s view, limit reasonable and necessary treatment, placing effective patient care at risk. Our preliminary evidence gathered was used to petition these state regulatory agencies to investigate these practices. Recent indications received by ACA lead us to believe that state agencies are prepared to take a closer look in connection with these managed care networks. "The only way that state authorities will act is if they have the ‘ammunition’ to take on the powerful and wealthy managed care companies," added Dr. Brassard. "That ammunition is your patients’ records, which contain hard evidence on how managed care decisions have limited access to medically necessary chiropractic care that is provided for under plan descriptions and/or state law." To do your part and assist ACA and regulatory authorities with this historic investigation, we request that you take the following steps by June 15. (Documentation will continue to be collected after that date, but will be most useful before the deadline.) Read and sign the Business Associate Agreement (found here) creating an arrangement between you and the ACA, so that you do not need to sanitize records for this project or in the future. The purpose will always be for the Insurance Relations Department to investigate issues that impede patients obtaining the care they need. Note that all unsanitized patient records will be kept in a locked room in locked cabinets. Identify patients whose care or benefits have been compromised by coverage decisions made by managed care networks and speak with them to ascertain if they are interested in allowing their medical file to be shared with the ACA and regulatory authorities. A patient information sheet is provided (here) for your convenience. Only the ACA, State Departments of Insurance and State Attorneys General offices will be privy to the information in the patient records. No information regarding patients or their doctors will be shared with managed care companies. Obtain HIPAA Authorization: Explain HIPAA rights to the patient – (a brochure can be found (here) just in case you are unsure if your office documentation is up to date.) Once you are sure the patient clearly understands the reason for this initiative, and they indicate they would like to participate, have them sign the HIPAA Authorization (found here) which has been pre-completed for your convenience. Mail the following to the ACA: copies of your five complete unsanitized patient files with the associated HIPAA Authorization and your signed Business Associate Agreement to the following address: American Chiropractic Association Attention: Insurance Relations/Records 1701 Clarendon Blvd Arlington, VA 22209 If you are having trouble accessing the links above, all the referenced documents can be found on the ACA Web site at www.acatoday.org/datacollection For questions about this initiative, please e-mail [email protected] or call (703)276-8800 and ask to speak with someone in the Insurance Relations Department. Your assistance with this unprecedented data collection is appreciated. Together we can bring managed care abuses to light and with one voice share this information with those who have the power to bring change.

Prof Xiaobin Wang, Xianhui Qin, Hakan Demirtas PhD, Jianping Li MD, Guangyun Mao MD, Prof Yong Huo MD, Prof Ningling Sun MD, Prof Lisheng Liu MD and Prof Xiping Xu MD ABSTRACT Background The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. Our aim was to do a meta-analysis of relevant randomised trials to assess the efficacy of folic acid supplementation in the prevention of stroke. Methods We collected data from eight randomised trials of folic acid that had stroke reported as one of the endpoints. Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risk of stroke with a random effect model. The analysis was further stratified by factors that could affect the treatment effects. Findings Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0•82, 95% CI 0•68–1•00; p=0•045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0•71, 0•57–0•87; p=0•001), a decrease in the concentration of homocysteine of more than 20% (0•77, 0•63–0•94; p=0•012), no fortification or partly fortified grain (0•75, 0•62–0•91; p=0•003), and no history of stroke (0•75, 0•62–0•90; p=0•002). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant. Interpretation Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention. The Lancet 2007; 369:1876-1882

ABSTRACT Objective To test the reproducibility of the finding that early intensive care for whiplash injuries is associated with delayed recovery. Methods We analyzed data from a cohort study of 1,693 Saskatchewan adults who sustained whiplash injuries between July 1, 1994 and December 31, 1994. We investigated 8 initial patterns of care that integrated type of provider (general practitioners, chiropractors, and specialists) and number of visits (low versus high utilization). Cox models were used to estimate the association between patterns of care and time to recovery while controlling for injury severity and other confounders. Results Patients in the low-utilization general practitioner group and those in the general medical group had the fastest recovery even after controlling for important prognostic factors. Compared with the low-utilization general practitioner group, the 1-year rate of recovery in the high-utilization chiropractic group was 25% slower (adjusted hazard rate ratio [HRR] 0.75, 95% confidence interval [95% CI] 0.54-1.04), in the low-utilization general practitioner plus chiropractic group the rate was 26% slower (HRR 0.74, 95% CI 0.60-0.93), and in the high-utilization general practitioner plus chiropractic combined group the rate was 36% slower (HRR 0.64, 95% CI 0.50-0.83). Conclusion The observation that intensive health care utilization early after a whiplash injury is associated with slower recovery was reproduced in an independent cohort of patients. The results add to the body of evidence suggesting that early aggressive treatment of whiplash injuries does not promote faster recovery. In particular, the combination of chiropractic and general practitioner care significantly reduces the rate of recovery. Pierre Côté 1, Sheilah Hogg-Johnson 2, J. David Cassidy 3, Linda Carroll 4, John W. Frank 5, Claire Bombardier 6 1Institute for Work & Health, the University of Toronto, and the Toronto Western Research Institute and Rehabilitations Solutions, Toronto, Ontario, Canada 2Institute for Work & Health, the University of Toronto, and Mt. Sinai Hospital, Toronto, Ontario, Canada 3University of Toronto, and the Toronto Western Research Institute and Rehabilitations Solutions, Toronto, Ontario, Canada 4Alberta Centre for Injury Control and Research, Edmonton, Canada 5Institute for Work & Health, the University of Toronto, and the Institute of Population and Public Health, Toronto, Ontario, Canada 6Institute for Work & Health, the University of Toronto, the Toronto General Hospital Research Institute, and Mt. Sinai Hospital, Toronto, Ontario, Canada Arthritis Care & Research Volume 57, Issue 5, Pages 861 - 868

America’s veterans are one step closer to gaining expanded access to chiropractic services after the U.S. House of Representatives passed legislation on May 23 that includes a provision to expedite expansion of the chiropractic benefit through the Department of Veterans Affairs (VA) health care system. The bill was approved 421:1. The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) lobbied successfully for passage of the bill, HR 1470, which requires the VA to have a chiropractor on staff at no fewer than 75 major VA medical centers before the end of 2009 and for all major VA medical centers to have a chiropractor on staff before the end of 2011. “I am proud that ACA and ACC spearheaded the advocacy efforts in support of HR 1470,” said ACA President Dr. Richard Brassard. “The health and well-being of our nation’s veterans is one of America's most important obligations. This legislation builds and expands on ACA’s previous work with Congress and will greatly improve the availability of chiropractic care to veterans young and old.” Congressman Bob Filner (D-Calif.), a strong supporter of extending chiropractic care benefits to military retirees as well as active-duty personnel, worked closely with the ACA in securing support for the legislation. As Chairman of the House Veterans Affairs Committee, Rep. Filner’s leadership was essential to securing House passage of the bill. According to remarks contained in the March 12, 2007, Congressional Record, Rep. Filner said that when writing the legislation he worked closely with “chiropractic patients, particularly our veterans, who know the benefits of chiropractic care and bear witness to the positive outcomes and preventative health benefits of chiropractic.” “I also was pleased to work with the American Chiropractic Association (ACA), the nation’s largest chiropractic organization and the national voice of doctors of chiropractic and their patients,” Rep. Filner said. Through previous congressional action, chiropractic care is now available at 30 VA facilities across the country; however, in the more than 120 facilities without a chiropractor on staff, the chiropractic care benefit that Congress authorized for America’s veterans remains virtually non-existent. Detroit, Denver, and Chicago are a few examples of major metropolitan areas without a doctor of chiropractic available at the local VA facility. ACA leaders believe that integrating chiropractic treatment into the VA health care system would not only be cost-effective, it would also speed the recovery of many of the veterans returning from current operations in Iraq and Afghanistan. A 2006 report from the Veterans Health Administration indicates that nearly 42 percent of veterans returning from the Middle East and Southwest Asia who have sought VA health care were treated for symptoms associated with musculoskeletal ailments – the top malady of those tracked for the report. HR 1470 is now headed to the Senate for consideration.

The New York State Chiropractic Association provides this information to you upon the request of, and as a courtesy to, the NYS Insurance Fund In its continuing effort to use technology to benefit policyholders, claimants and medical providers, New York State Insurance Fund CEO/Executive Director David P. Wehner announced that NYSIF has developed a state-of-the-art process for the electronic receipt of medical bills and accompanying reports. “I’m proud to announce medical bills are now being received without paper. This will definitely speed the bill-paying process while at the same time increasing accuracy. It’s a win for everyone. I congratulate our claims and information technology departments for their excellent work,” CEO Wehner said. NYSIF has selected two vendors, the Atlantic Imaging Group and P2P Link, to process bills and reports from providers and transmit them electronically to NYSIF where they will be logged-in and evaluated in an automated bill payment process. The new service is presently limited to bills submitted by providers using form CMS-1500, formerly known as HCFA-1500, or on a New York State Workers’ Compensation Board form C-4. NYSIF pays approximately 1.5 million bills per year. CEO Wehner says electronic receipt will ensure expedited and timely payments to medical providers and eliminate the need for them to place phone calls inquiring about the status of bills. “This represents a major improvement in customer service and provides more productive time for NYSIF’s claims professionals. CEO Wehner noted that NYSIF has been in the vanguard of insurance carriers finding innovative ways to integrate technology with the insurance business and the payoff has been remarkable for both the fund and its business partners. “Electronic receipt of bills is another major step forward.” The number of bills received electronically is expected to increase steadily as medical providers become familiar with the process and recognize its benefits. For additional information, contact Mr. Bob Lawson at 518 -437-3504

Insurance committee recently submitted a letter to Aetna which we hoped would persuade Aetna to re-assess their new 2007 PPO In-Network fee schedule. In the letter, we raised the five issues noted below: 1. Notification of Fee Schedule Changes: Fees were reduced without proper notification to your chiropractic panel members. Should participating doctors have advance notice to their fee schedule? If Aetna’s profitability falters, are Aetna’s salaried employees given notice prior to their reduction in salary or benefits? Even if there is found to be no legal obligation, is there no moral compulsion to treat in-network providers fairly? 2. Parasitic vs. a Symbiotic Relationship with Aetna Providers: Are In-network providers considered as members of the Aetna team? According to an Aetna press release (Feb. 8, 2007; found on the web at http://www.aetna.com/news/2007/pr_4thquarter2006_earnings.htm), there was a 29% increase in net operating income in 2006 vs. 2005. Why penalize members of your team, who in part, were responsible for this success? Philosophically, the survival of any provider contract should be predicated on a symbiotic relationship. If provider fees become predatory, then the relationship becomes parasitic and is doomed to failure. The desire to obtain short term financial gains may have dire long-term consequences, and the fall off may be precipitous rather than gradual. 3. Disproportionate Cutbacks in Chiropractic Reimbursement: Why were Aetna’s In-Network chiropractic codes reduced by 28%, while therapies and modalities were only lowered by 8 to 10%? Was this meant to be a direct assault on chiropractic? Is this in line with a pay-for-performance concept? Is this backed by the current literature or just performed at the whim of an anti-chiropractic stand by Aetna? If on the other hand, it is Aetna’s long-term goal to eliminate the chiropractic panel, then I see nothing wrong with your present tactics. Is Aetna’s long-term goal to eliminate the chiropractic panel? 4. Maintaining quality of care and subscriber enrollment: Being that there is no change in reimbursements to out-of-network providers (who receive ‘Reasonable & Customary”), are there any concerns as to attracting and keeping a high quality of provider within the Aetna network? I would think that a higher quality of provider leads to a higher patient satisfaction and more enrollees. A loss of good chiropractors from the panel can result in an attrition of Aetna enrollment (a reversal from the current trend). 5. Foster Team Spirit or Animosity & Resentment: In light of the fact that Aetna’s recent trend is toward greater (rather than lesser) profitability, In-network providers feel discouraged and betrayed by a lowering of their fee schedule. Both Aetna and Aetna’s providers are faced with increasing costs of operation; but whereas Aetna appears to be doing better, the same can not be said for their providers. The reduction just adds insult to injury, and fuels resentment as we care for your Aetna subscribers. Are In-Network providers considered part of Aetna’s team, or are we to be Aetna’s adversaries? The NYSCA has recently brought similar issues to another major carrier in the New York region, and they have agreed to return the fee schedule to the 2006 schedule. We sent a broadcast fax to all the chiropractors in NYS applauding the responsiveness of this Insurance Carrier. We will anxiously await your responses (or lack there of) so we can inform NYS chiropractors as to where Aetna stands on these issues discussed. Unfortunately, we just got word that Aetna will not change the new fee schedule, and Aetna has made a conscious decision not to respond to our letter as it can only lead to dissension. Many members are concerned that NYSCA is not fighting for our survival. Can members please send constructive suggestions as to how we might deal with situations such as this?

ABSTRACT Objective. To determine if conservative treatments (manual therapies, physical medicine methods, medication, and patient education) relieved pain or improved function/disability, patient satisfaction, and global perceived effect in adults with acute, subacute, and chronic mechanical neck disorders (MND) by updating 11 systematic reviews of randomized controlled trials (RCT).

We would like to congratulate Gerald Stevens D.C, M.S., M.P.H., a member of NYSCA District 17, on his recent second research award at the ACC-RAC conference in Phoenix, March 2007. His research paper is entitled “Demographic and Referral Analysis of a Free Chiropractic Clinic Servicing Ethnic Minorities”. The paper analyzed the population characteristics of people attending a free ethnic minority clinic and how these individuals were referred into our facility. It is his hope that others can use this information to build similar clinics in the future. The paper is currently under review for publication in the Journal of Manipulative Physiology and Therapeutics (JMPT). Dr. Stevens is a clinician at the Depew Health Center, New York Chiropractic College and at SUNY Buffalo. He has two masters degrees in public health and pathology. Dr. Stevens is active in the chiropractic section of the American Public Health Association (APHA). Additionally, he active in the community forming collaborations with the American Heart Association, American Diabetes Association and American Cancer Society. On top of all this he is an avid traveler, hiker and camper.

Abstract BACKGROUND Disclosing errors to patients is an important part of patient care, but the prevalence of disclosure, and factors affecting it, are poorly understood. OBJECTIVE To survey physicians and trainees about their practices and attitudes regarding error disclosure to patients. DESIGN AND PARTICIPANTS Survey of faculty physicians, resident physicians, and medical students in Midwest, Mid-Atlantic, and Northeast regions of the United States. MEASUREMENTS Actual error disclosure; hypothetical error disclosure; attitudes toward disclosure; demographic factors. RESULTS Responses were received from 538 participants (response rate = 77%). Almost all faculty and residents responded that they would disclose a hypothetical error resulting in minor (97%) or major (93%) harm to a patient. However, only 41% of faculty and residents had disclosed an actual minor error (resulting in prolonged treatment or discomfort), and only 5% had disclosed an actual major error (resulting in disability or death). Moreover, 19% acknowledged not disclosing an actual minor error and 4% acknowledged not disclosing an actual major error. Experience with malpractice litigation was not associated with less actual or hypothetical error disclosure. Faculty were more likely than residents and students to disclose a hypothetical error and less concerned about possible negative consequences of disclosure. Several attitudes were associated with greater likelihood of hypothetical disclosure, including the belief that disclosure is right even if it comes at a significant personal cost. CONCLUSIONS There appears to be a gap between physicians’ attitudes and practices regarding error disclosure. Willingness to disclose errors was associated with higher training level and a variety of patient-centered attitudes, and it was not lessened by previous exposure to malpractice litigation. Lauris C. Kaldjian1, 2 , Elizabeth W. Jones1, 3, Barry J. Wu4, Valerie L. Forman-Hoffman1, 3, Benjamin H. Levi5 and Gary E. Rosenthal1, 3 (1) Division of General Internal Medicine, Department of Internal Medicine, 1-106 MEB, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA (2) Program in Biomedical Ethics and Medical Humanities, University of Iowa Carver College of Medicine, Iowa City, IA, USA (3) Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, IA, USA (4) Department of Internal Medicine, Hospital of St. Raphael, New Haven, CT, and Yale University School of Medicine, New Haven, CT, USA (5) Departments of Humanities and Pediatrics, Penn State College of Medicine and Hershey Medical Center, Hershey, PA, USA

Seneca Falls, NY: New York Chiropractic College conferred the Doctor of Chiropractic degree upon 49 graduates Saturday, March 31, 2007, during its commencement ceremony held in the college’s Athletic Center. Dr. Frank J. Nicchi, president of NYCC, commented on the new graduates: "I’ve come to know a number of students in this graduating class. And while they will be missed, I anticipate great things from them!" Richard G. Brassard, D.C., a leader and innovator in the field of chiropractic, delivered the commencement address. A graduate of Palmer College of Chiropractic, Dr. Brassard currently serves as the President of Texas Chiropractic College and President of the American Chiropractic Association (ACA). Dr. Brassard was one of four individuals inducted as Fellows into the American College of Chiropractors (ACC). NYCC Board of Trustees member, Robert E. Daley, Ph.D., past U.S. Olympic Team Head Athletic Director, Edward J. Ryan, III, M.S. and Lee C. Van Dusen, D.C., D.A.B.C.O, Assistant Vice President of Institutional Quality and Assessment at NYCC were also inducted in a ceremony presided over by Thomas R. Ventimiglia, D.C., F.A.C.C., President of the ACC. The ACC was chartered under an Act of Congress in 1924 and is composed of chiropractors, educators and scientific investigators throughout the United States whose field endeavor lies within the domain of chiropractic. Its primary purpose is to encourage research and advance the philosophy, science and art of chiropractic. Additionally, Michael A. Mestan, D.C., D.A.C.B.R., Interim Vice President of Academic Affairs at NYCC, was selected as a Fellow of the International College of Chiropractors, an organization that promotes the philosophy, science and art of chiropractic and includes among its members, individuals who have shown themselves to be significant contributors to the development of the science of chiropractic. Brent Lindsay Moyer, class valedictorian, had the honor of addressing the assembled audience. Andrew Haynes Hancock was the class salutatorian. Awards were presented to select members of the graduating class. Class President Eoin Christopher Gregory received the Alumni Class President Award, the Lloyd E. Henby Distinguished Service Award and a Distinguished Service Award. Lance Jarrod Loomis, Class Treasurer, was presented with the D.D. Palmer Award and the Distinguished Service in Basic Sciences Award. The Diagnostic Imaging Award went to Sybil Ann Coburn, who also received a Distinguished Service Award. Distinguished Service Awards were also presented to Christopher John Arma and Laurissa Constance-Swaine Simms. The Ernest G. Napolitano Memorial Award was presented to Sarah Anne Harkins. Irum Hussain received the Frank E. Dean Memorial Award. Eric A. Steffen received the Frank P. DeGiacomo Technique Award. The recipient of the Libero A. Violini Distinguished Service Award was Michael V. Rockefeller. The Lorraine Welch Memorial Award went to Kimberly M. Carozzi and the Heath Center Award winners were Nathan A. Bukuts (Depew), Susan Leigh Szot (Levittown) and Jennifer Kelly Bollinger (Seneca Falls). For further information about New York Chiropractic College’s degree programs in chiropractic, acupuncture and Oriental medicine, and applied clinical nutrition, visit the college’s Web site at: