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Measuring the ROI of Your Practice’s Social Media

Thursday, March 23rd, 2017

Mark Sanna, DC, ACRB Level II, FICC

How do chiropractic marketers measure their return on investment (ROI) when it comes to social media? After all, follows, likes and repins are not the usual marketing metrics. At the same time, the standard performance indicators we typically use to gauge the success or failure of digital marketing don’t apply as easily to social media. Counting website hits and click-throughs are not a means of measuring ROI in this realm. Social media marketing is still in its early days for most chiropractors and monitoring a few key metrics can help you determine whether your efforts and initiatives in social are moving the needle for your practice.

As you look forward to the year ahead and begin allocating your marketing resources, take time to consider the following metrics and related critical questions.

Share of Voice

How does your practice’s social presence stack up against your competitors’ not only in terms of the size of your audience (number of followers, fans, pinners, etc.), but in terms of their level of engagement? How engaged are your patients and potential patients compared to those of your competitors? How many people are talking about your practice, how frequently and in what context?

Conversations 

Are you having conversations with your patients? If not, it’s time to re-examine the content you are posting. Conversations put the “social” in social media. Don’t speak at your audience, speak with them. Every post is an opportunity to stimulate a dialogue. Creating dialogues increases your patients’ affinity to your practice.

Advocates 

Do you have any patients who have become super followers or super fans of your practice’s social media? If the answer is yes, be sure that you leverage their passion for your practice. If the answer is no, you may be missing out on a huge opportunity to increase the number of potential patients who have been exposed to your practice in the past, but are now compelled to try it, thanks to a super fan’s glowing recommendation. Take the opportunity to activate your super fans by noticing them and engaging with them.

Product Guidance 

Are you asking your patients questions to learn what they like about your practice and the products and services you provide? Social media provides your practice with the access to a large, free, real-time focus group. You can leverage your social network to help guide you in which products and services you choose to offer. This can help save you from making timely and costly mistakes. Many times you don’t even have to ask—just simply listen and respond. As an example, a chiropractor added massage therapy to his practice. The comments of the long wait time caused by an out of touch massage therapist caused the chiropractor to change the flow in the office to decrease wasted time. Patients were thrilled with the changes and posted their overwhelmingly positive responses.

Critical Questions

These metrics don’t show the complete picture of how social media can affect your practice’s bottom line. Several follow-up questions can help you determine how effective you are at engaging your social media audience.

Do more people know about your practice than before?

How to learn it: Measure the number of mentions your practice receives and the number of positive reviews you generate and compare your results to the volume of traffic on the social sites of the other chiropractic practices in your community per reporting period.

Are more people hearing your message than before?

How to learn it: This is called your practice’s reach. Measure the growth in the number of your followers/fans per reporting period. You can enlist tools that measure Twitter reach and use tools such as LinkedIn analytics and Facebook Insights that report on number of impressions.

Are your posts generating traffic?

How to learn it: If you are being truly engaging, interesting and valuable in all of your social media interactions, then you are not simply sharing all of your content day after day. However, when you do link back to your own website’s content, measure the resulting traffic to your site via Google Analytics. Then you can drill down to determine which traffic was nurtured through social media.

Are people reacting to what you’re putting out there?

How to learn it: Measure the number of click-throughs your posts receive as well as the number of comments per post. The number of shares and retweets your posts receive is a great way to identify the number of super fans you are engaging per reporting period.

Social Media ROI is Complex

Social media ROI is clearly more complex than a simple cost vs. practice awareness equation. While social can certainly affect the journey of patients to your practice, it cannot be simply superimposed over it. There are just too many touchpoints in too many places to limit social to one fixed point along a patient’s path.

The ROI of social media for your practice is delayed ROI. This may be tough for many chiropractic marketers to swallow, but it goes back to your overall marketing strategy. Social is not just another marketing channel; it is a critical part of your practice’s overall communication platform. It touches many areas within your practice from patients’ retweets all the way up to the chiropractor’s blog posts.

When it comes to social, chiropractic marketers shouldn’t be hyper-focused on the immediate ROI, but instead get your practice team focused on another question: What have we learned today from our patients?

Dr. Mark Sanna is a member of the Chiropractic Summit, the ACA Governor’s Advisory Board and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching (www.mybreakthrough.com 1-800-723-8423).

Energy, Not Time, Is Your Most Precious Resource

Monday, December 5th, 2016

Mark Sanna, DC, ACRB Level II, FICC

We live in a digital time. Our rhythms are rushed, rapid fire and relentless, our days carved up  into bits and bytes. We celebrate quick reaction more than considered reflection. We skim  across the surface, alighting for brief moments at dozens of destinations but rarely remaining  for long at any one. We race through our lives without pausing to consider who we really want  to be or where we really want to go. We’re wired up but we’re melting down.    Most of us are just tying to do the best that we can. We survive on too little sleep, wolf down  fast foods on the run, fuel up with coffee and cool down with alcohol and sleeping pills. Faced  with relentless demands at work, we become short‐tempered and easily distracted. We return  home from long days at work feeling exhausted and often experience our families not as a  source of joy and renewal, but as one more demand in an already overburdened life.

Consider these scenarios: 

 You attend an hour‐long Team Meeting in which not a single second is wasted – but  during the final half hour your energy level drops off and you struggle to stay focused.

 You race through a meticulously scheduled four‐hour shift but by midway your energy  has turned negative‐impatient, edgy and irritable.

 You set aside time to be with your children when you get home at the end of the day,  but you are so distracted by thoughts about work that you never really give them your  full attention.

 You remember your wedding anniversary – your computer alerts you and so does your  smart device– but by the evening, you are too tired to go out and celebrate.

Energy, not time is the fundamental currency of high performance.   

This insight revolutionized my thinking about what drives enduring high performance. It has  also prompted a dramatic transformation in the way I coach my clients to manage their lives,  personally and professionally. Everything they do – from interacting with patients and staff to  spending time with their families – requires energy. Obvious as this seems, we often fail to take  into account the importance of energy at work and in our personal lives.  Without the right  quantity, quality, focus and force of energy, we are compromised in any activity we undertake.

Performance, health and happiness are grounded in the skillful management of energy.

There are undeniably difficult patients, tough days, bad relationships and real life crises.  Nonetheless, we have far more control over our energy than we realize. The number of hours in  a day is fixed, but the quantity and quality of energy available to us is not. It is our most  precious resource. The more we take responsibility for the energy we bring to the world, the  more empowered and productive we become. The more we blame others or external  circumstances, the more negative and compromised our energy will be.
If you could wake up tomorrow with significantly more positive, focused energy to invest in  your practice and with your family, how significantly would that change your life for the better?  As a leader and a manager, how valuable would it be to bring more positive energy and passion  to your practice? If your practice team could call on more positive energy, how would it affect  their relationships with one another, and the quality of service that they deliver to your  patients?

To be fully engaged, we must be physically energized, emotionally connected, mentally focused  and spiritually aligned with a purpose beyond our immediate self‐interest. Full engagement  begins with feeling eager to get to the practice in the morning, equally happy to return home in  the evening and capable of setting clear boundaries between the two. It means being able to  immerse yourself in the mission you are on, whether it is grappling with a frustrating challenge  in the practice, managing your practice team on a project, spending time with loved ones or  simply having fun. Full engagement implies a fundamental shift in the way we live our lives.

You must become fully engaged. Four key energy management principles drive this process.

Principle 1: Full engagement requires drawing on four separate but related sources of energy:  physical, emotional, mental and spiritual.   

Human beings are complex energy systems, and full engagement is not simply one‐dimensional.  The energy that pulses through us is physical, emotional, mental, and spiritual. All four  dynamics are critical, none is sufficient by itself and each profoundly influences the others. To  perform at our best, we must skillfully manage each of these interconnected dimensions of  energy. Subtract any one from the equation and our capacity to fully ignite our talent and skill is  diminished, much the way an engine sputters when one of its cylinders’ misfires.    The more toxic and unpleasant the energy, the less effectively it serves performance; the more  positive and pleasant the energy, the more efficient it is. Imagine for a moment that you are  about to have a chiropractic adjustment. Which energy quadrant would you want your  chiropractor to be in? How would you feel if he entered the adjusting room feeling angry,  frustrated and anxious? What if he was disengaged, laid back and slightly spacey? Obviously,  you want your chiropractor energized, confident and upbeat.

Principle 2: Because energy capacity diminishes both with overuse and with underuse, we  must balance energy expenditure with intermittent energy renewal.   

We rarely consider how much energy we are spending because we take it for granted that the  energy available to us is limitless. In fact, increased demand progressively depletes our energy  reserves – especially in the absence of any effort to reverse the progressive loss of capacity that  occurs with age. By training in all dimensions we can dramatically slow our decline physically  and mentally, and we can actually deepen our emotional and spiritual capacity until the very  end of our lives.

When we live highly linear lives – spending far more energy than we recover or recovering  more than we spend – the eventual consequence is that we break down, burn out, atrophy,  lose our passion and get sick.  Sadly, the need for recovery is often viewed as a sign of weakness  rather than as an integral aspect of sustained performance. The result is that we give almost no  attention to renewing and expanding our energy reserves, individually or for our practice.

To maintain a powerful pulse in our lives, we must learn how to rhythmically spend and  renew energy.   

The richest, happiest and most productive lives are characterized by the ability to fully engage  in the challenge at hand, but also to disengage periodically and seek renewal. Instead, many of  us live our lives as if we are running in an endless marathon, pushing ourselves far beyond  healthy levels of exertion. We become flat liners mentally and emotionally by relentlessly  spending energy without sufficient recovery. We become flat liners physically and spiritually by  not expending enough energy. Either way, we slowly but inexorably wear down.    Think for a moment about the look of many long‐distance runners: gaunt, sallow, slightly  sunken and emotionally flat. Now visualize a sprinter. Sprinters typically look powerful, bursting  with energy and eager to push themselves to their limits. The explanation is simple. No matter  how intense the demand they face, the finish line is clearly visible 100 or 200 meters down the  track. We too must learn to live our lives as a series of sprints – fully engaging for periods of  time and then fully disengaging and seeking renewal before jumping back into the fray to face  whatever challenges confront us.

Principle 3: To build capacity, we must push beyond our normal limits, training in the same  systematic way that elite athletes do.   

Stress is not the enemy in our lives. Paradoxically, it is the key to growth. In order to build  strength in a muscle, we must systematically stress it, expending energy beyond normal levels.  Doing so literally causes microscopic tears in the muscle fibers. At the end of a training session,  functional capacity is diminished. But give the muscle twenty‐four to forty‐eight hours to  recover, and it grows stronger and better able to handle the next stimulus.  While this training  phenomenon had been applied largely to building physical strength, it is just as relevant to  building “muscles” in every dimension of our lives – from empathy and patience to focus and  creativity to integrity and commitment. What applies to the body applies equally to the other  dimensions of our lives.

We build emotional, mental and spiritual capacity in precisely the same way that we build  physical capacity. 

We grow at all levels by expending energy beyond our ordinary limits and then recovering.  Expose a muscle to ordinary demand and it won’t grow. With age it will actually lose strength.  The limiting factor in building any muscle is that many of us back off at the slightest hint of  discomfort. To meet increased demand in our lives, we must learn to systematically build and
strengthen muscles wherever our capacity is insufficient. Any form of stress that prompts  discomfort has the potential to expand our capacity – physically, mentally, emotionally or  spiritually – so long as it is followed by adequate recovery.

Principle 4: Positive energy rituals – highly specific routines for managing energy – are the key  to full engagement and sustained high performance.

Change is difficult. We are creatures of habit. Most of what we do is automatic and  nonconscious. What we did yesterday is what we are likely to do today. The problem with most  efforts to change is that conscious effort can’t be sustained over the long haul. Will and  discipline are far more limited resources than most of us realize. If you have to think about  something each time you do it, the likelihood is that you won’t keep doing it for very long. The  status quo has a magnetic pull on us.

A positive ritual is a behavior that becomes automatic over time – fueled by some deeply  held value.   

I use the word ritual purposefully to emphasize the notion of a carefully defined, highly  structured behavior. In contrast to will and discipline, which requires pushing yourself to a  particular behavior, a ritual pulls at you. Think of something as simple as brushing your teeth. It  is not something that you ordinarily have to remind yourself to do. Brushing your teeth is  something to which you feel consistently drawn, compelled by its clear health value. You do it  largely on automatic pilot, without much conscious effort or intention. The power of rituals is  that they insure that we use as little conscious energy as possible where it is not absolutely  necessary, leaving us free to strategically focus the energy available to us in creative, enriching  ways.

Look at any part of your life in which you are consistently effective and you will find that certain  habits help make that possible. If you eat in a healthy way, it is probably because you have built  routines around the food you buy and what you are willing to order at restaurants. If you are  fit, it is probably because you have regular days and times for working out. If you manage your  practice team well, you likely have a style of giving feedback that leaves people feeling  challenged rather than threatened. If you are closely connected to your spouse and your  children, you probably have rituals around spending time together with them.  Creating positive  rituals is the most powerful and effective way to manage energy in the service of full  engagement.

Dr. Mark Sanna is a member of the Chiropractic Summit and a board member of the  Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching.  (www.mybreakthrough.com 1‐800‐723‐8423).

 

At Scrip Hessco, chiropractors can find the products that they require, easily, conveniently, and affordably. Scrip Hessco’s massive inventory allows chiropractors to search for specific items, or browse for new and exciting options. The most successful chiropractors are the ones that are constantly evolving and taking necessary steps to keep business fresh and interesting for the patients, as well as for themselves.

For more than 40 years, ScripHessco has been the leading full-service distributor of chiropractic supplies such as Biofreeze and equipment to the chiropractic industry. Rely on ScripHessco to help you serve your patients and grow your business with popular resale items.

How to Make Your Chiropractic Practice Grow

Monday, May 16th, 2016

Mark Sanna, DC, ACRB Level II, FICC

CEO, Breakthrough Coaching

Breakthrough Coaching Logo

Building a successful chiropractic practice can be a competitive business. You must continually advance your practice by attracting new patients, maintaining the ones you already have and incorporating new technologies and techniques. This is something you must do continually or your practice will stagnate rather than expand.

 

Win on the Web

There is a high likelihood that your next new patient will search for you on the web even if they have been referred by one of your current patients. Make sure that their first impression of your practice is excellent by hiring a professional web designer to build a website for your practice. Make sure that the content is written with search engine optimization in mind, so prospective patients will find you when searching the web. If you don’t already have a catchy phrase or brilliant logo for your practice, now would be the time to create one. Include well produced, short video clips so that patients can get to know something about you before coming to your practice. Patients come to your practice assuming you know how to do chiropractic, but what they really want is to get to know you and your staff. They want to be welcomed and feel that they have made a good decision on how to spend their hard earned dollars on their health. If they like how they are treated and feel you have their best interests at heart, then they will trust you.

 

Review Your Software

If you are serious about expanding your chiropractic practice, you must be sure the software system you have in place will accommodate the growth and the requirements of electronic records management. If you’re unsure if you have the right software, you will need to review several different systems to determine which will best suit your needs. Practice can become a nightmare if you don’t have the proper software to track appointments, insurance claims, patient records, and payments. The right software should allow you to file insurance claims electronically to save you time and paperwork. A good piece of software will allow you to track your practice, spot trends in services and reimbursement, and help you grow into a profitable practice all at the same time.

 

Market Internally

Internal marketing and word-of-mouth advertising are the best two ways to attract new patients. They are also the least expensive methods of advertising. Word-of-mouth is spread mostly by people who come to you for chiropractic services and are pleased with your work. Patients who are pleased with their chiropractor, typically recommend them to their friends and family members. You can encourage former patients who no longer visit you by reaching out to them with reminder postcards for a check-up or for other services. If you don’t get an immediate response, continue to mail on a quarterly basis. It often takes several contacts before a reminder will spur someone into action. In addition to postcards, write and send a monthly newsletter to all of your patients via e-mail. Include useful information that educates your patients while subtly promoting your practice.

 

Maintain Current Patients

Although it is normal to lose some patients, you can advance your chiropractic practice by maintaining as many as possible. According to expert practice builders, twenty five percent of your marketing efforts should be focused on attracting new patients to your practice. Your main focus should be on retaining your current patients. Make sure that your current patients are satisfied with your service so they won’t think about finding another chiropractor. Build strong relationships with your patients. Chiropractors who focus on their patients and establish strong relationships increase their revenues, even during financially hard times. Make an effort to remember each patient’s personal information and family members’ names to show that you value their business and see them as an important part of your practice. Solicit your patients’ feedback about their experience with your practice and use the information to realize your strengths and fix your weaknesses.

 

Attract New Patients

Even if you have a large patient base, over time some patients will stop coming in for various reasons. They may move, lose or change their insurance or simply decide to try another chiropractor. Play an active role in your community. Performing community outreach by volunteering to speak at schools, service organizations, local employers and other groups is a highly effective way to attract new patients. Give presentations on topics consistent with your philosophy on health and wellness to bring visibility to your practice and promote your expertise.

 

Most organizations won’t mind if you pass out business cards after your talk. Even if you don’t, people who are looking for a chiropractor will remember your presentation and will locate you via your website. Where state laws allow, you can make yourself especially attractive to new patients by giving them a special offer. Offer a complementary consultation or other service and let people know that you will extend the offer to their family members, friends and co-workers. Reward people who refer new patients to your practice. Give them a small item, such as a gift card, for each family member or friend they refer to you.

 

Expand Your Services

One way to grow your practice is by offering new products services. There are many services that are compatible with chiropractic care. Nutritional supplements, orthotics and supports are natural compliments to chiropractic care. Massage therapy, acupuncture and exercise therapy are high demand procedures that fit well in a chiropractic setting.  Research the services that are in demand and determine whether they will be profitable for your practice to offer them.  Be aware of the services that other health care providers are offering in your community to be sure that your practice remains competitive. Review the pages of this and other chiropractic publications on a regular basis to keep up to date on current practice trends.

 

Add New Technologies

One important way to advance your chiropractic practice is to keep your technology up-to-date. This is especially important when a new technique or piece of equipment can help differentiate your practice by making your procedures easier and more comfortable for your patients. For example, you can switch to digital x-rays that can be read immediately and deliver less exposure to radiation. The new generations of hand-held instrument adjusting devices come equipped with auditory feedback signals that indicate to both doctor and patients that a desired level of movement has been achieved. Many chiropractors are finding that laser therapy is an excellent high-tech adjunct to the traditional modalities they offer. The results are well documented and providing laser therapy can create the cutting-edge buzz that helps to grow a practice. Feature your use of technology prominently in your ads and on your website. Send postcards to patients notifying them when you incorporate something new and beneficial into your practice.

 

Focus on Your Patients

Make the choice to establish, build, and retain solid relationships with your patients. Listen to what they want and treat them well. Give them the intrinsic value they seek from choosing your practice. Deliver quality care above and beyond what they expect. The payback for you will be increased patient referrals, more satisfied patients, and greater profitability. It is then that your practice can continue to grow and truly flourish.

 

Dr. Mark Sanna is a member of the Chiropractic Summit, the ACA Governor’s Advisory Board and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching

 

At Scriphessco.com, chiropractors can find the products that they require, easily, conveniently, and affordably. Scrip Hessco’s massive inventory allows chiropractors to search for specific items, or browse for new and exciting options. The most successful chiropractors are the ones that are constantly evolving and taking necessary steps to keep business fresh and interesting for the patients, as well as for themselves.

For more than 40 years, Scrip Hessco has been the leading full-service distributor of chiropractic supplies such asBiofreeze and equipment to the chiropractic industry. Rely on Scrip Hessco to help you serve your patients and grow your business with popular resale items.

 

Aging Americans Find New Avenues for Pain Relief with Complementary and Alternative Medicine

Tuesday, November 11th, 2014

Authored by:
KRAY KIBLER, Chief Operating Officer and Chief Financial Officer, Scrip Companies
CRAIG HOOD, Executive Vice President, Allegro Medical

The growth in the number and proportion of older adults in the United States has reached unprecedented levels, creating a number of issues for Baby Boomers, including a rise in chronic conditions, greater demand for pain relief, overuse of pharmaceuticals and high prescription expenditures. Combined with the looming physician shortage, the U.S. healthcare system faces the potential for longer waiting times and lower quality of medical care.

Seniors represent 13.7 percent of the United States population, about one in seven Americans.2 Almost 92 percent of older adults have at least one chronic condition, and 77 percent have at least two. Some type of disability, such as difficulty in hearing, vision, cognition and ambulation, was reported by 36 percent of adults aged 65 and over.

In the midst of these trends, Complementary and Alternative Medicine (CAM), the wide array of healthcare practices, products and therapies that are distinct from those used in conventional medicine, is expected to experience unprecedented popularity. CAM practices are diverse and include chiropractic, massage therapy, acupuncture, nutritional medicine, naturopathy, herbalism, Ayurveda, Reiki, laser therapy and electrotherapy.
CAM also includes a large and diverse group of orally or topically administered products such as herbal medicines, botanicals and probiotics that are widely marketed and readily available, often sold as dietary supplements.

CAM therapies emphasize the natural healing ability of the body and prevention versus the conventional approach of treating disease and its symptoms. A growing number of traditional healthcare professionals have begun to integrate CAM into their treatment programs for its proven benefits, including pain and injury prevention, post-surgical treatment and non-invasive pain relief. For instance, the Mayo Clinic has incorporated massage therapy into post-surgical treatment.
The Mayo Clinic has incorporated massage therapy into post-surgical treatment, and California now allows chiropractic services for reimbursement when they are provided in federally qualified health centers (FQHC) and rural health clinics (RHC) — further demonstrating the mainstream acceptance of chiropractic.

The purpose of CAM is to move patients toward complete wellness, helping them to discover and understand the hidden causes of health challenges, creating a customized and comprehensive treatment plan, and investing in healthy aging to achieve lower disability rates down the road.

PAIN MANAGEMENT IN AMERICA
Pain is the most frequent reason patients visit the emergency department (ED) — over 70 percent. A number of studies show that fewer than half of post-operative patients receive adequate pain relief, despite the fact that poor pain management puts patients at risk, creates needless suffering, and increases costs of care.

It is also well documented that certain populations, including seniors, bear the burden of chronic pain disproportionately. Given the high cost of pain in human lives, dollars, and social consequences, CAM presents an avenue for relieving pain across the healthcare continuum.

The goal of pain management is to improve a patient’s quality of life. Paradoxically, advances in medicine that have led to greater survival rates among patients with cancer, heart disease, HIV/AIDS, stroke, traumatic brain injury and many other diseases have increased the number of people living with chronic pain.

The physician shortage will aggravate the issue of pain management. Currently, there is a shortage of more than 13,000 physicians, with the expected shortfall to grow 10-fold within 12 years.

HOW CAM ADDRESSES ACCESS ISSUES
Licensed chiropractors, massage therapists, acupuncturists and naturopathic physicians continue to be sought after as accessible and cost-effective healthcare solutions. CAM providers are held to the same strict standards of quality as conventional providers including advanced education, licensure, credentialing, the delivery of evidence-based care, and accountability for outcomes.

CAM providers, especially chiropractors and naturopathic physicians, represent first-contact providers and maintain referral relationships with conventional medical providers when services beyond the CAM practice become necessary. Overall, the practice of CAM has risen dramatically in recent years. According to the National Institutes of Health, an estimated 18 million Americans receive massage therapy each year, while chiropractors treat more than 30 million people annually.

A National Institutes of Health study found that among insured patients with back pain, fibromyalgia, and menopause symptoms, those who use CAM have lower insurance expenditures than those who do not use CAM. The study noted that CAM therapies avoid high technology and offer inexpensive remedies. CAM providers in this study included chiropractors, licensed massage therapists, acupuncturists, and naturopathic physicians.

The results suggested that, because individuals with high disease burden typically drive the majority of claims expense, the potential for savings is much greater for CAM users. What’s more, the trend toward the integration of CAM into standard care will improve access to care for many Baby Boomers.

PAIN MANAGEMENT OPTIONS
Chiropractic: Chiropractic treatment of neck and back pain, which is common among aging Americans, provides more relief than over-the-counter drugs like aspirin and ibuprofen. In one
study, after 12 weeks of treatment more than half treated reported at least 75 percent reduction in pain compared with one-third in the drug group. A year later more than 50 percent of those treated with chiropractic reported significant decrease in pain. In contrast, the patients taking pain killers had upped their dosage during the same period.

Massage Therapy: Studies show that massage therapy increases endorphins and serotonin, chemicals that act as natural painkillers and mood regulators. Massage therapy also reduces levels of the stress hormone cortisol, and turns off genes associated with inflammation and its associated pain, which in turn relieves muscle soreness. Moderate to deep pressure massage can activate the vagus nerve which regulates heartbeat, helping seniors experience pain relief for a number of conditions. Studies also show that massage helps reduce anxiety, pain and nausea in cancer patients by 44 percent, and also raises the level of cancer-fighting white blood cells.

Acupuncture: Acupuncture has been shown to relieve a wide range of pain conditions that impact seniors, such as carpal tunnel syndrome, fibromyalgia, headache, low back pain, myofascial pain and osteoarthritis. One study found that during acupuncture trials for patients with chronic low back pain, only 15 percent of subjects who received genuine acupuncture treatment needed extra pain medication, compared with 34 percent who were receiving placebo treatments, and 59 percent receiving conventional therapy. Furthermore, long-term pain reduction was achieved more effectively in subjects who received either real or placebo acupuncture versus those who received conventional therapy.

KEY ISSUES IN ADDRESSING PAIN MANAGEMENT FOR AGING AMERICANS
Population Boom
The population of Americans aged 65 years or older during the next 25 years is expected to reach about 72 million. By 2030, older adults will account for roughly 20 percent of the U.S. population.

During the past century, a major shift occurred in the leading causes of death for all age groups, including older adults, from infectious
diseases and acute illnesses to chronic diseases and degenerative illnesses. More than a quarter of all Americans and two out of every three older Americans have multiple chronic conditions, and treatment for this population accounts for 66 percent of the country’s healthcare budget.

The cost of providing healthcare for one person aged 65 or older is three to five times higher than the cost for someone younger than 65. Although the risk of developing chronic diseases increases as a person ages, the root causes of many of these diseases often begin early in life. Practicing healthy behaviors from an early age and getting recommended screenings can substantially reduce a person’s risk of developing chronic diseases and associated disabilities.

Overuse and abuse of pharmaceuticals
For decades, the most important tool in a health toolkit was the prescription pad, with an emphasis placed on treating an illness rather than focusing on prevention and treating the whole body. Hundreds of thousands of the nation’s seniors misuse prescription drugs, including painkillers, anxiety medications and other pharmaceuticals for treating a number of conditions from joint pain to depression.

Doctors are prescribing highly addictive drugs to older patients at record levels, according to a USA TODAY examination of government data. The impact,as measured in overdose deaths, ED visits and admissions to treatment programs, is considerable. Studies project that the number of seniors misusing pharmaceuticals will keep growing, fueled by the aging Baby Boomer population. Among the most common prescriptions given to older patients are opioid pain relievers and benzodiazepines, the psychoactive medications, such as Xanax and Valium, often used for anxiety. According to data from IMS Health, which tracks drug dispensing for the government, the 55 million opioid prescriptions written in 2013 for people 65 and over marked a 20 percent increase over five years — nearly double the growth rate of the senior population.

The average number of seniors dependent on prescription pain relievers in the past year reached an estimated 336,000, up from 132,000 a decade earlier, according to data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Annual ED visits by people 65 and over for pharmaceutical complications climbed more than 50 percent during that time, and the rate of overdose deaths among people 55 and older, regardless of drug type,
nearly tripled from 1999 to 2010, to 9.4 fatalities per 100,000 people, according to the Centers for Disease Control and Prevention.

The economic impact of medication-related problems in persons over the age of 65 is as much of an issue as Alzheimer’s disease, cancer, cardiovascular disease and diabetes. Medication-related problems are estimated to be one of the top five causes of death in that age group, and a major cause of confusion, depression, falls, disability and loss of independence.

Rising cost of pharmaceuticals/drugs
Fifty percent of seniors take eight or more prescriptions on average. Top contributors to the cost trend among Baby Boomers include diabetes (28.3 percent), rheumatological (14.6 percent), and asthma and chronic obstructive pulmonary disease (COPD) drugs (14.3 percent), according to the 2010 Medco Drug Trend Report. Medco also found that as many as 75 percent of insured Americans in the Baby Boomer group are currently taking at least one medication for a chronic condition, and more than half are regularly taking three or more drugs. A 30-day supply of six of the 11 name-brand drugs that Medicare beneficiaries use the most cost more than $250 each.

CAM: EXPLORING ALTERNATIVES
CAM’s growing popularity highlights a path for improving conventional medicine and mitigating the three-pronged challenge of cost, access and quality. Fortunately,U.S.medical schools are developing CAM course work, and managed care organizations are providing some coverage for CAM therapies. A study by Harvard Medical School researchers, looking at trends over the past half-century, indicates that CAM will play a role in the U.S. healthcare system for the foreseeable future.

The study examined trends in the use of 20 different CAMs, covering everything from acupuncture to yoga, among representative socio-demographic groups across the continental U.S.
The findings show that:

  • Most of CAM therapies have steadily increased in popularity since the 1960s
  • Of those respondents who had tried an alternative therapy, almost 50 percent were still
    using it 11 to 20 years later
  • Most CAM therapies are used–at least in part–as preventative measures or as part of a regular fitness program
  • Demand for CAM is likely to grow.

HEALTHCARE WORKERS LEADING THE WAY IN THE CAM ADOPTION
Baby Boomers’ willingness to adopt innovative services is likely to hasten progress in patient- managed technology, such as mobile health, and reform in pain management approaches. The shift toward CAM will become exponential, especially given that many CAM approaches are no longer considered “alternative” for healthcare workers, the majority of whom use some form of CAM for themselves.

In fact, 76 percent of healthcare workers use CAM, compared to 63 percent of the general population. What’s more, healthcare providers, including doctors and nurses, were more than twice as likely to have used practitioner-based CAM, and nearly three times as likely to use self-treatment with CAM, during the prior year than support workers.

CONCLUSION
An increase in the number of chiropractors, massage therapists and acupuncturists has sparked an industry focused on providing high quality CAM equipment, supplies, life-enhancing products and the latest technology for consumers and businesses. Such medical developments and techniques are poised to change the face of healthcare.

At the same time, Baby Boomers are re-examining their priorities and taking better care of themselves, following basic health principles, such as exercising, eating whole foods, getting plenty of sleep, avoiding tobacco, sun exposure and stress, and increasingly turning to CAM as an important part of their overall healthcare. This fundamental behavioral shift will help to curb reliance on costly conventional medical care and improve overall pain management. To meet this coming upsurge in demand for real healthcare value, fully integrated CAM providers and CAM insurance benefits will play a critical role.

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Acupuncture May Change the Way the Brain Perceives Pain

Monday, December 6th, 2010

The idea of pricking your body with needles in order to relieve pain seems nothing if not counter intuitive, but thousands of acupuncture patients swear the treatments are effective in addressing pain of all kinds.

But how does it work? How much of the relief is due to the placebo effect — the mere perception that the needles are actually dulling pain — as opposed to a real biological change in the way nerves signal the brain to pain?

A new study lends support to the notion that acupuncture may actually modulate the brain’s perception of pain. In a study that used functional magnetic resonance imaging (fMRI) to track brain activity both before and during acupuncture, researchers led by Dr. Nina Theysohn at the University Hospital in Essen, Germany, and colleagues at University of Duisburg-Essen documented a specific pattern of brain activation during acupuncture that may represent an accessible pathway for addressing pain.

In the small trial, which involved 18 volunteers, each volunteer was placed in the fMRI scanner and then given a small electrical stimulus in the left ankle to generate pain. Acupuncture needles were then inserted at three places on the right side corresponding to regions known to modulate the ankle pain, and the fMRI was repeated. Comparing the brain scans before and after acupuncture, the scientists found that areas of the brain that were active during the pain stimulus were dampened during acupuncture, suggesting that the needles actually do cause a change in the way that the brain perceives and processes pain.

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