Santa Clause # 2706

obamacare1As Obamacare becomes a reality (and BTW, his administration calls it that so no need to always refer to it by it's proper name – "The Affordable Care Act" ) anyhoo... no one is exactly sure how this is all going to play out, though lower premiums for New York residents in 2014 is already one positive side effect. Clause 2706 should be of specific interest as Ankita Rao says: " ... it requires that insurance companies "shall not discriminate" against any health provider with a state-recognized license. That means a licensed chiropractor treating a patient for back pain, for instance, must be reimbursed the same as medical doctors. In addition, nods to alternative medicine are threaded through other parts of the law in sections on wellness, prevention and research."

It should also be noted that as provider's become Accountable Care Organizations (or ACOs) this could be very good for us integrative medicine practitioners.

The ACO model works something like the old HMO model but is also tied to performance. Let's use as an example a patient with low back pain due to a degenerative disc(s) and stenosis.  Said ACO would get a flat amount of money to deal with the problem.

So in this model they might be more willing to send this patient to me and my yoga therapist buddy before opting for the expensive surgical option because if we get results the ACO will save money/profit on that patient.  Some surgeons might be grumbling right now, but there will still be plenty of folks who need surgery just as there are plenty of folks who need myofascial specialties. And plenty who can profit from both. I've worked with plenty of them.

Which leads me to an aside – the article I excerpted from (tip of the hat to  Libby Eason) highlights the very fine Bastyr Center for Natural Health and as I look over their services/treatment options I see no structural integrators/myofascial specialists.

This is, IMHO, all too common missing element among integrative medicine centers and – informed speculation alert!  is not fascia the tissue that integrates the rest of the body?

I'm thinking about this because of a medical intern from George Washington University who was shadowing me, meaning that she sat in on sessions with patients, attended a lecture and engaged me in conversation as much as time would allow.  We're a teaching hospital, so this is quite commonplace for us.

By the end of her mini-residency she was of the opinion that structural integration & fascial work should be an essential component to all integrative medicine centers as it has the potential to help the greatest number of patients. No argument from me on that on, but it does beg the question why this is not so.

Is it that IM doesn't understand SI?  Or that SI practitioners aren't interested in crossing over?  Or something else? I welcome your thoughts.

And Rachel. big tip of the hat to you!  You're a spectacular person and are going to be a mighty fine MD.  I know your patients will love you as much as we all do at the center. Best of success to you!