New Mexico Chiropractic Association Journal Serving the Profession since 1947 Inside This Issue… President’s Report............1 NMCA Board of Directors 2008–2009...... 2 NMCA Committee Chairmen 2008–2009...... 2 From the Executive Director........... 4 Advanced Practice Second Round of Modules Scheduled........................ 4 What has the NMCA done for me lately?........... 6 Congratulations to Dr. Brian Hesser.............. 6 Legislative Update & PAC Report................... 8 Chiropractic Trigger Point Injection Therapy............. 9 Report from the NCLC ~ Washington DC ~ February 27, 2009........... 11 Get Paid on Your Medpay Claims................14 Convention & Membership.................... 15 2009/2010 Calendar Of Events.........16

First Quarter 2009, Volume 10, Issue 1

President’s Report

Dear Colleagues, Here we are again, the NMCA annual convention is once again upon us. Over the past several months many doctors have called and e-mailed me concerning the new regulation and licensing requirement for CE hours in documentation. Since we all have read about how the insurance industry, as well as the federal government, has listed the chiropractic profession as one of the worst for “correct documentation of care,” it has led me to think about continuing education. What is continuing education? As a profession, why do we need continuing education? Did we not get all the education we need, to do what we do best, to take care of our patients? What is continuing education? Random House defines continuing education as: “an instructional program that brings participants up to date in a particular area of knowledge or skills.” Webster’s Dictionary says: “education provided for adults after they have left the formal education system, consisting typically of short or part-time courses.” Dictionary. com states: “a program of noncredit courses for adults regardless of previous education, offered typically by a university extension or institute.” I think that all three definitions, although touching on different aspects of continuing education, hit the nail on the head, especially for the chiropractic profession. Each and every DC needs to be on the cutting edge of knowledge when it comes to the evaluations and treatments we offer to our patients for the correction of the cause of their disease. Even though we received the best education that the college or university that you graduated from had to offer, we as an individual doctor need to be on the cutting edge of the learning cusp to provide the best and most up-to-date services for our patients. Regardless of our own personal philosophies or techniques used to correct the dis-ease in our patients, we all need the willingness to keep learning about how and why we, as a profession, can make a difference in our patients’ overall health. Yours in Chiropractic Health, Dr. M. E. Brown, BS, DC President, NMCA

Classifieds....................... 17

New Mexico Chiropractic Association P.O. Box 21100 Albuquerque, NM 87154 Phone: 505-280-0689 www.nmchiro.org

Remember to Support and Thank the Professional Associate Members of the NMCA. You can get all contact information on our web site at www.nmchiro.org on the Start Shopping page and in the left hand column under Shop Here, Help NMCA!! Brican Systems Corporation Doctor Greens/Wellness Watchers Guna, Inc. Heel, Inc. HESSCO

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First Quarter 2009

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NMCA Journal

NMCA Board of Directors 2008–2009 Executive Committee

North Central District Directors

Dr. Michael E. Brown, President Las Cruces

Dr. Nancy Savoia, Los Alamos Dr. Lise Wall, Santa Fe

Dr. Robert Jones, Vice President Albuquerque

West Central District Director

Dr. Susan Hilliker, Treasurer Taos

South Central District Director

Dr. Edward Altman, Secretary Albuquerque

East Central District Director

Dr. Susan M. Bright, Past President Santa Fe

Southeast District Director

Jaeni Aarden, Executive Director Albuquerque

Northeast District Director

Central District Directors

Southwest District Director

Dr. Michael Pendleton, Albuquerque Dr. David Peer, Albuquerque Dr. George Simmons, Albuquerque

Dr. John Rogers, Silver City

Dr. Dennis Kirsten, Gallup Dr. Douglas Patrick, Alamogordo Dr. Bill Smith, Portales Dr. Misty Smith, Hobbs Dr. Alan Dunaway, Clayton

Northwest District Director

NMCA Committee Chairmen 2008–2009 ACA Liaison/National Legislative Affairs

Legislative Committee

Dr. Bill Doggett, Albuquerque

Dr. Robert Jones, Albuquerque Dr. Sherry Gaber, Santa Fe

COCSA Committee Dr. John A. Rogers, Silver City

Convention Committee Dr. Michael Pendleton, Albuquerque

Education Committee Dr. Ben Markham, Albuquerque

Ethics/Bylaws Committee Dr. Elaine Adams, Albuquerque

Insurance Relations

Medicare Committee Membership/Public Relations Committee Peer Review Committee Dr. David Peer, Albuquerque

Scholarship Committee Dr. Derek Atchley, Albuquerque

Worker’s Compensation Committee Dr. George Simmons, Albuquerque

To contact any of the Board Members or Committee Chairmen, go to our website at www.nmchiro.org or contact: NMCA P.O. Box 21100 • Albuquerque, NM 87154 [email protected], 505-280-0689 or fax 505-828-1128

VERY IMPORTANT!

Be sure to check our website

www.nmchiro.org

on a regular basis for the most up-to-date information from many different sources!

Editorial Policy This Journal is the official publication of the New Mexico Chiropractic Association. The NMCA assumes no responsibility for material contained in articles, letters or advertisements published and publication does not necessarily constitute endorsement of them. The deadline for submission of articles and advertisements is three weeks prior to publication. Advertising rates can be obtained by contacting the NMCA at 505-280-0689.

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First Quarter 2009

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From the Executive Director… Dear Doctors of Chiropractic: 2008 was a very busy year for the NMCA. Not only did we have the traditional happenings of each year such as the Convention, membership drive, Journal publication, Legislature, etc., we had eight additional seminars for the Advanced Practice Certification. And, we are doing it all again this year! 2009 promises to be as busy, and even more exciting, because, in addition to all of the above, the NMCA Board of Directors has voted to establish an Independent Physicians Association for the Doctors of Chiropractic in our state. Dr. Marc Girod has been the “man behind the scenes” in the formation of a NMCA IPA and has provided an article in this Journal to inform you of what is occurring. I think you will be excited to hear about this newest venture! As of this writing, we have approximately 175 new or renewed members in the NMCA. There are still about 80 members from 2008 that have not yet renewed; so, we are hoping for a record membership this year…at least a record for the six years I have been working with the association! If you have not already done so, please get your membership renewal and convention registration to me so that I know you will remain active with the NMCA and be joining us in May. One of the speakers that we booked for this coming Convention had to cancel a few weeks ago. We were able to replace him with another GREAT speaker, Dr. Kevin Wong, who will be teaching Practical Spinal & Extremity Adjusting. We know you will enjoy his presentation! The second round of the Advanced Practice education has been set. Dr. Taylor had his first and second modules in February and March. Number three will be held in May here in New Mexico on the 30th and 31st of the month. The six NUHS modules will begin in August and run once a month through January of 2010. Information, including registration forms, for membership, the Convention, Dr. Taylor’s Module #3 and the six NUHS modules can be obtained by going to our web site at www.nmchiro.org and clicking on the appropriate event in the center of the Home Page. If you have questions, please feel free to contact me at 505-280-0689 or by e-mail at [email protected]. I will be happy to provide any information that I can. By the time you receive this Journal, the 2009 Legislative Session will have come to a close and we will know if either of our Bills, HB 14 Chiropractic Formulary and HB 561 Insurance Equity, have passed through the system. If you are not on the NMCA list serve, you will be able to check our web site on the Legislative Page for information on this outcome. Dr. Steve Perlstein, NMCA PAC Chair, has provided a report of the 2009 Session in this Journal for your information. Thank you to all the Doctors of Chiropractic in NM that support the NMCA and the efforts the Board of Directors and Committee Chairmen. These doctors are dedicated advocates of chiropractic and do their very best for each and every one of you. I know they would love to have your comments and suggestions for ways that the NMCA can continue to serve this great profession. I look forward to seeing you all in May at the Convention! In the meantime, live every day to its fullest and enjoy life and enjoy this Journal!! With warm regard, Jaeni Aarden Executive Director

NMCA Journal

Advanced Practice Second Round of Modules Scheduled Dr. Michael Taylor Module #3 & NUHS Modules #1 through #6 I now have the dates for the above courses that will be held here in New Mexico and have confirmed with the Marriott Pyramid that we can have them there, as we did for the first round of classes. I have sent the registration forms over to our web master and they can be obtained on the Home Page of our web site…www.nmchiro.org… by clicking on either Dr. Taylor’s Module #3 or NUHS Modules 1–6 in the center of the Home Page. The dates are as follows so that you can save them on your calendars, if you plan to attend: Dr. Taylor Module # 3 will be held on May 30 & 31, 2009. NUHS Modules # 1 through 6 will be on the following dates: August 22 & 23, 2009 September 19 & 20, 2009 October 17 & 18, 2009 November 14 & 15, 2009 December 12 & 13, 2009 January 16 & 17, 2009 I would ask you to get your registration forms to me, as soon as possible. I do not need payment at this time but would like to have an accurate count of attendees, as that could make a difference in the size of room we obtain.

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NMCA Journal

What has the NMCA done for me lately? Marc Girod, BA/BS, DC, NMCA IPA Chair If we were members of the Nebraska Chiropractic Physician’s Association (NCPA), all 430 of us would belong to two Independent Physicians Associations (IPAs). As doctors, we would have state and national Political Action Committees (PACs) to protect chiropractic and drive the legislative process. We would also have a charity (Healing Hands) and an advertising program to get our message to the consumer. Lou Andersen, the Executive Director of the NCPA and the CEO of Pinnalce Physicians Network, Inc. and SecureCare, Inc. IPAs, has directly lobbied for full funding of the entire breadth of the chiropractic scope of practice. And guess what? The entire scope is funded. So, chiropractors in Nebraska can offer their patients a full range of primary care services (if they choose to do so) and be properly reimbursed for it! Because of Mr. Andersen’s efforts, only chiropractors can legally do level 5 adjusting in their state. As NCPA doctors, we would also have access to a health plan. The list goes on… You see, we do a pretty good job in New Mexico, but wouldn’t we love a little more parity and a little more influence? What could our PAC do with more funds and more backing? What has the NMCA done for me lately? The answer is: the New Mexico Chiropractic Association has decided to create an IPA after the Nebraska Model. In fact, Lou Andersen will be consulting on the formation of the NMCA IPA. Mr. Andersen is the Chief Executive Officer of Managed Care Operations and Executive Director of the Nebraska state association. He brings 23 years of leadership in the health care arena to his current assignment. Most recently, Mr. Andersen served as CEO of Coventry Health

Care of Nebraska. Previously, he served in numerous executive roles, including President of Health Data Management Company and Senior VP for Mergers and Acquisitions for United Health Group. Mr. Andersen received his MBA from New York’s Columbia Universit y Graduate School of Business and received his undergraduate degree in accounting Louis M. Andersen from the University of Nebraska. This means that we will have an organization fully capable of representing our collective interests and those of New Mexico healthcare consumers. Though this is truly a long-term project, we hope to have a running IPA by year’s end and to be seeking contracts for our members shortly thereafter. Once everything is set up, you will be informed as to how you can become a part of the NMCA IPA. The NMCA is growing, vibrant and alive. Through the efforts of the PAC, we are not as vulnerable to the whims of the CODEX. And, through the PAC, I’m sure we will get an equal pay bill passed. Now with the IPA, we will be able to fund the PAC and increase the message of preventive care to New Mexicans. It is a bright new beginning and through the bold and decisive actions of your board, the future looks even brighter. If you would like additional information, please feel free to contact me at 505-822-0306, ext. 203, or by e-mail at drgirod@ lifetimechiropractic.com. Thank you NMCA!

Congratulations to Dr. Brian Hesser for His Nomination to the NM Board of Chiropractic Examiners!! Dr. Brian R. Hesser obtained a Bachelor of Science in Biology at New Mexico State University after serving in the US Marine Corp. Dr. Hesser then attended and graduated from Parker College of Chiropractic with honors in April 1998. Dr. Hesser has been a part of the Las Cruces business community since October of 1998 when he opened Millennium Chiropractic and Rehab, DBA Millennium Health & Wellness. His innovative facility combines chiropractic care, physical therapy, nutritional and lifestyle changes, massage therapy, digitally enhanced x-rays, after-care programs and wellness preventive care. He became a certified clinical nutritionist in 2006 and has been providing the Las Cruces community with nutritional counseling and weight loss programs ever since. Most recently, Dr. Hesser has combined his passion for fitness and nutrition by opening Club Fitness. Dr. Hesser has been appointed to the New Mexico Board of Chiropractic Examiners (NMBCE). His service on the NMBCE will begin this year and he will serve until July 1, 2013. We know Dr. Hesser will proudly serve the board with the same integrity and dedication that he has provided to Las Cruces and the surrounding communities over the past 10 years!

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NMCA Journal

Legislative Update & Pac Report Steve Perlstein, DC Chair, NMCA PAC As of this writing, the legislative session is half way through and will finish on Saturday, March 21. Your PAC and lobbyist, Linda Siegle, have been working diligently as always to further our agenda, as well as watch bills that may impact us one way or the other. The following is a list of the bills we have been actively working on and/or following: HB 14 HB 41 HB 56 HB 61 HB 110 HB 111 HB 129 HB 179 HB 203 HB 267 HB 286 HB 303 HB 492 HB 509 HB 561 HB 585 HB 655 HB 664 HB 736 HB 779 HB 789

Tabled Tabled Tabled

Tabled Tabled Tabled

Tabled Tabled Tabled

SB 58 SB 104 SB 174 SB 278 SB 236 SB636 SJM 6 This list has been provided for you without any explanation of each bill (with the exception of the two below) because it is the hope of the NMCA leadership and the PAC that you will familiarize yourself with the NM legislative website and look up these bills. This is a very simple process. Go to legis.state.nm.us and look on the left side of the screen where you can click on the word legislation, then click on bill finder, then fill in the number of the bill you want to see.

That bill will come up in a PDF version for your perusal. On this website, you can also look up your legislators, which will show the districts that they represent, as well as how to contact them by email and/or by phone. The following information is highly relevant and for your immediate consideration: HB 14 is our Advanced Practice Formulary bill that has cleared the House and is awaiting scheduling in Senate Public Affairs. This bill will allow our board to create the formulary of natural medicine, if you will, while leaving the dangerous drugs and controlled substances, should we request any, to the Medical and Pharmacy Boards. HB 561 is our Insurance Parity bill, which would require non-profit insurance companies to pay us equally for procedure codes shared by other health care practitioners. This bill is currently awaiting its next committee assignment following a do pass by House Health and Government Affairs. We have introduced this bill in order to generate dialogue between the insurance companies and us. We have succeeded in doing just that, with more to come. Tabled means that any further discussion on the bill in committee has been put on hold, which is a fancy way of saying that the bill is dead without having been voted on as a do not pass. A bill that has been tabled can be put back on the table for further discussion, but that remains highly unlikely. It is decidedly important to all of us that the PAC continue to do the excellent work that it does monitoring legislative activity and introducing legislation that furthers our profession. We will not be able to do this for much longer if those who are not contributing financially to the PAC continue. We will run out of money and will no longer be able to afford our lobbyist. Without a lobbyist, we will essentially become impotent in the legislative world and any credibility that we have achieved will be lost. Perhaps this does not register as something that impacts being a chiropractor personally, but it will. We are a significant political entity in this state because of those who have chosen to contribute. We need everyone’s contribution to continue to strengthen our position. More gets done that way. If you are one of those who do not contribute, please reconsider.

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First Quarter 2009

Chiropractic Trigger Point Injection Therapy Michael Taylor, DC, DABCI, FICC, NMD Adjunct Post-Graduate Professor, TCC Instructor Injectable Nutrients Course ~ 18 Years This article must, in no way, be construed as containing all the information necessary for the chiropractic physician to safely administer injectable, trigger point therapy. It is the intent of the author to provide a fairly good explanation and description of what is involved in administering trigger point injection therapy by an appropriately trained chiropractic physician. Myofascial pain syndrome is a common painful muscle disorder caused by myofascial trigger points. This condition must be differentiated from fibromyalgia syndrome, which also involves multiple tender spots or tender points. Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. These spots are painful on compression and can produce referred pain, referred tenderness, motor dysfunction, and autonomic phenomena. Trigger points are classified as being either latent or active, depending on their clinical characteristics. An “active” trigger point causes pain at rest. It is tender to palpation with a referred pain pattern that is similar to the patient’s pain complaint. The pain will radiate from the trigger point and is often described as spreading or radiating. A latent trigger point does not cause spontaneous pain, but may restrict movement or cause muscle weakness. The patient who enters your clinic presenting with muscle restrictions or weakness may become aware of pain originating from a latent trigger point only when pressure is applied directly over the point. When firm pressure is applied over the trigger point in a snapping fashion perpendicular to the muscle, a “local twitch response” is often elicited.

Pathogenesis: Scientific evidence is somewhat lacking regarding the development of trigger points and their associated pain patterns. Yet, many researchers agree that acute trauma or repetitive micro trauma may lead to the development of a trigger point. Lack of exercise, prolonged poor posture, vitamin deficiencies, sleep disturbances, and yes…subluxations may all predispose to the development of the trigger point.

Commonly Involved Muscles: Those muscles that are commonly involved include the muscles of the cervical and thoracic spine and shoulders including the upper, mid, and lower trapezius, scalene,

sternocleidomastoid, levator scapulae and the erector spinae and quadratus lumborum of the lower back region. Trigger points can, and commonly occur on the extremities as well.

Evaluation: No laboratory test or imaging technique has been established for diagnosing trigger points. Palpation of the hypersensitive bundle or nodule of muscle fiber of “harder than normal” consistency is the physical finding most often associated with a trigger point.

Pre-Treatment Considerations: Although many trigger points respond very well to standard chiropractic therapy, some of the more resistant ones don’t. Therefore, these points deserve consideration of trigger point injection therapy. The chiropractic physician must fully inform the patient regarding indications, possible complications and have the patient sign a “consent to treat” form or note it in his daily notes. Contraindications to trigger point injections would include anticoagulation or bleeding disorders, the presence of local or systemic infection, an allergy to the agents used in the injection, and aspirin ingestion within 3 days of the injection. The complications that “could” (but virtually would never, ever occur with proper technique) include skin infection, pneumothorax (never aim the needle perpendicular to the intercostal space - for that matter, always review and re-review the patient’s anatomy to avoid any possible complications from accidental artery puncture, abdominal or chest cavity puncture), needle breakage, hematoma formation, and vasovagal syncope. To prepare, the doctor must gather: Rubber gloves, gauze pads or cotton balls, alcohol pads, 3 or 5cc syringes, lidocaine (1%) without epinephrine or procaine with prescriptive authority along with a “trace” of 8.4% sodium bicarb to take away the sting, and/or B12, magnesium, traumeel, and spascupreel (from HEEL) or Guna Muscle and Guna Nerve along with the Guna “regional” remedy being treated, 25 gauge needles by 1 inch in length and adhesive bandage. Multiple trigger points may be injected during any one session. Some trigger points may need to be re-injected weekly or monthly. If the therapeutic effect is achieved, the scientific literature supports that no more than four (4) sets

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(or sessions) of injections should be performed in any “one” trigger point during one year. The CPT code is 20552 which qualifies for single or multiple trigger point injection(s) of 1 or 2 muscles. CPT code 20553 would be used for single or multiple trigger point injections of 3 or more muscles. Be sure to bill the agent(s) being administered in the trigger point injection by using an appropriate J-code.

General Principals of Injection Technique: Use aseptic technique. Know your anatomy. Hitting the bone is NOT a bad thing. The plunger should depress easily. The injections will be applied in the center of the trigger point and “fanned” in at least 3 quadrants with a “retrograde” (injecting on the way out but the needle never leaves the original injection point until all the injection has been completed) manner. Each trigger point will need between .5cc to 1.5cc of your selected injection cocktail. The symptoms may be reproduced during the injection and rapidly dissipate following the injection. Mark the area where you will want to insert the needle with a large ear speculum. Insert the needle quickly (remember, know your underlying anatomy!), pull back on the plunger to make certain that you are not in a vessel, and

NMCA Journal inject in a retrograde manner. Inject at least 3 quadrants. Some doctors like to use a 27 gauge needle. I recommend against it. Some muscular types could develop a very quick reflex spasm and “shear” the 27 gauge needle. This won’t happen with a 25 gauge. Once the needle is removed and the injection of the trigger point is complete, massage the injection site for a few seconds to assist in dispersing the medication throughout the trigger point. Instruct the patient to avoid any exercise that would involve the area for 2 to 3 days following the injection. Simple range of motion movements is acceptable and advisable. Trigger point injections by the chiropractic physician are a natural adjunct to that part of our practices that are musculoskeletal. The patients will, generally, rapidly respond to treatment as it pertains to their chronic, pesky trigger points that otherwise don’t adequately respond to our other conservative therapies. If you have any questions, please feel free to contact me at 918-749-3797 or by e-mail at [email protected]. References: Cordone, D. Am Family Practice 2002;66 / Manual of Neural Therapy according to Huneke 11th Edition / Myofascial Pain and Dysfunction “The Trigger Point Manual” Travell and Simons

David A. Dengler, DC, DACBR Chiropractic Radiologist Consider consulting Dr. Dengler for: • Routine spine film reading service • Second opinions on X-ray, MRI or CT • Extremity, chest, or abdomen studies Other services available: • Consultation on film quality issues • Personalized x-ray technique charts • X-ray film duplication

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NMCA Journal

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First Quarter 2009

Report from the NCLC ~ Washington DC ~ February 27, 2009 Bill Doggett DC FACO FICC ACA Delegate from New Mexico The national assault on the physician status The ACA and the profession now face the specter of national health care reform proceeding without chiropractors being initially defined as “physicians.” The Blue Cross/ Blue Shield Federal Employee Health Benefit Plan, the largest health plan for federal workers, has been identified by President Obama as the template for coverage for any new broad ranging health care reform. In fact the BC/BS federal plan has already been specifically used in federal law as a “benchmark” for coverage. Specifically, under the SCHIP program, section 2109 “Coverage Requirements for Children’s Health Insurance” lists as a “Benchmark Benefit Package” the “Blue Cross/Blue Shield preferred provider option service benefit plan.” (42 U.S.C. 1397 cc(b) No other private health insurer is identified in that manner. In addition, the SCHIP law provides that “physician” services are included in “basic services” that must be covered. The services of other health care providers are considered “additional services” that are optional. 42 U.S. C. 1397cc(c)(2). Inclusion of chiropractic services under the BC/BS FEHBP was a direct result of a settlement with the Blue Cross/ Blue Shield Association in the Trigon litigation. However, recently the BC/BSA announced that, while coverage would not be affected, chiropractors were to be removed from the BC/BS FEHBP definition of “physician” effective January 1, 2009. The plans definition of “physician” has always tracked that of Medicare until now. The impact of this demotion, which is consistent with the recent pronouncements of the AMA that would limit the use of the term “physician,” cannot be understated given the importance of this plan in the future national health care reform. The ACA is beginning to receive reports of doctors being refused referral and ordering privileges as well as the denial of previously covered physical therapy benefits of this new BC/BS FEHBP policy.

United Health Care Policy The ACA and other major national chiropractic associations recently reacted with alarm to proposed changes to United Health Care policy on coverage of chiropractic services which, in our view, would effectively negate the role of a doctor of chiropractic as a physician. UHC’s coverage pronouncements are perhaps the most influential and widely utilized policy adopted by any health insurer. The proposals constitute an immediate threat to patient care in the view of all the organizations and would relegate chiropractic

care to a medical backwater. UHC has recently responded to ACA president Manceaux and has offered the ability for additional comment but no assurance of any change. ACA has responded by agreeing to meet with them and cooperate in their CPAC process but also requested a deferral of the policy given the overall serious adverse effects of the policy. UHC responded with an offer to meet but no offer of a deferral.

Obama Health Care plan The Obama plan has two key points; Accountability and evidence based effectiveness. The plan builds on the employer based system. Small employers will get a tax credit of up to 50% of premiums paid. It establishes an “employer plan” for those without employer coverage and the self employed. It establishes an “institute to guide reviews and research on comparative effectiveness” and it increases the focus on wellness and preventive care. Much of the detail remains missing and we all remember that the devil’s in the details. Providers will be subjected to a new range of reporting related to cost and effectiveness. What we don’t know is how chiropractic will be covered, or not. Some or most of the proposals to be introduced or discussed are likely to pre-empt state laws, meaning that DC’s availability may be limited or left to a referral position. If a federal plan is modeled after the current BC/BS FEHBP, the standard option limits chiropractic care to ten (10) visits. In the current H.E.L.P. committee, Sen. Bingaman has been tasked with writing the portion of the bill that deals with private insurance and COVERAGE. How do we assure that we will be included and that our patients will be allowed free access to the provider of their choice and that all procedures performed by their chiropractor will be a covered benefit eligible for reimbursement in parity with all other providers? One of the key ways that we can improve our chances is to encourage our patients and staff to sign up with www.Chirovoice.org . The time is short and the need is great. The administration will be putting together the details of the national healthcare program during the next 30 days and it is vital that we collect as many e-mail addresses as possible so that our patients will have the opportunity to ensure that they continue to be able to receive full chiropractic benefits under whatever national healthcare plan is developed. The collection of addresses and patients signing up is vital. What would you think if you were a legislator and were told that millions of chiropractic

First Quarter 2009 patients desired to retain their benefit to secure chiropractic care without any restrictions or gatekeepers and then only a few hundred of those patients contacted your office confirming those contentions? If we want to be included in the plan as full scope physicians we must get a much larger patient base able to e-mail their legislators expressing those desires. We feel that the plan is on a fast track and that if we don’t have those patient addresses within the next 30 days then we may miss our window of opportunity. How vital is this? Well, the plan’s basic definitions will likely follow the Federal Employees Benefit Program. Currently, BCBS is the principle administrator of that program and they have proposed dropping chiropractors from the list of physician level providers. The potential implications are enormous! Instead of raising the Medicare reimbursement to full scope and parity reimbursement, this could lower the rest of the plans to manipulation only! I asked you all to sign up and get patients to sign up and I can only surmise that you do not want full covered, full parity of payment or entry level provider status in the coming national healthcare plan. Now the push is on! The plan will move forward with us or without us! If you do want to be included then you must get involved and get your patients involved, now. Are they alone in wanting to eliminate the physician status of chiropractors? No. United Healthcare is the largest insurer in the country and they have also proposed that chiropractors should be removed from the list of physician level providers. The ACA will continue to fight this battle, but what will you do if the federal program does not allow you to diagnose, does not allow you to order physiotherapies or x-rays? The ACA needs those of you who are not members to join. We will fight these battles until the last dog dies, but there are fewer and fewer dogs left. Yes the financial times are difficult, but we don’t have the luxury of letting personal emotions and agendas get in the way. There is likely to be an open door in the new healthcare plan for preventive and wellness services, but if we are not classified under the new plan as physicians then that opportunity goes away too. Go to www.acatoday.org and fill out the on-line application. When the national healthcare plan is passed, and it will be passed this year, we will either be included or excluded. Your membership is vital and your lack of membership is telling the story of inadequate involvement, insincere commitment and the shortcomings of professional commitment to your patients and profession.

Legislative visits Drs. Rob Jones, Yeon-Joo Lee-Jones, Bill Doggett and three students (SCUHS, Life and Palmer West) and Julie

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NMCA Journal Olson visited all five of our New Mexico congressional offices. We were warmly greeted and had an opportunity to discuss our concerns relative to national health care and the current VA bills that are in the House (1017 and 484). All of the offices were in support of the current legislation to allow Tricare enrollees and active duty military personnel full chiropractic benefits. One of the things that surprised us was the definition of preventive healthcare that most held. This was the early detection of disease. We then had the opportunity to discuss with them our concept of preventive health care being the creation of health life styles, diet, nutrition, exercise and injury prevention and how chiropractors focus on those aspects of our patients lives and why that puts us in the appropriate position to be primary care providers and participate in integrated health care delivery facilities. They also had a different understanding of what integrative health care is. They were under the impression that integrated care involves using PA’s and Nurse Practitioners. This allowed us to give them our opinion that integrative care would also involve non-traditional, complementary and alternative providers (chiropractors) using treatment methods that did not necessarily involve drugs and emphasized the basic healthy behaviors that are integral to preventive care. We have asked Sen. Udall to consider sponsoring a companion bill in the Senate to Filner’s Tricare bill and have asked all three representatives to co-sponsor both bills. The principle legislative aides responsible for health care legislation in each office are: Rep Lujan - [email protected] Rep. Heinrich - [email protected] Rep. Teague - [email protected] Sen Udall - [email protected] Sen. Bingaman - [email protected]

Electronic Health Records Chiropractors will be able to be eligible for EHR incentive payments that can be up to $60,000 over a 5 year period. There are some conditions, obviously, that must be met. You must bill more than $25,000 in Medicare services. You must attest that you are using the EHR software. You must demonstrate that you use the software that includes functional assessments as in the new PQRI denominators. I, the ACA and the NMCA will provide more information for you regarding EHR in the near future.

PQRI We have been asking for a level playing field for about 113 years. Well, PQRI is a part of that field. We have anecdotal evidence that what we do is provide quality care, generate high patient satisfaction and improve patients’ quality of

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life and functionality. But, this will not be recognized unless chiropractors participate in performance and quality reporting of functional outcomes. The new healthcare legislation will have a great deal of interplay with paying for procedures that have been proven to be of significant quality and proven effectiveness. Reporting on the appropriate performance measures that are tied to the work we perform as acknowledged in billing the code 9894x is vital to how chiropractic services and our effectiveness will be evaluated as it pertains to the healthcare legislation that the Obama administration will get passed this year.

Quality reporting G8539 is the code used for the new PQRI documentation of functional outcome. G8541 is the code for when you do not use a functional assessment tool and so when you start a patient on a treatment plan you would record the G8539 code following the manipulation code and at the end of the treatment plan you would again use the same type of functional assessment tool (Oswestry, McGill, Neck pain and disability, Rand 36, Rand 12) and the G8539 code following the 9894x code for that visit. Compliance with the procedures and use of the G codes properly will generate up to a 2% bonus at years end. The PQRI and G-codes will be explained in much greater detail in May at the NMCA convention as a part of your coding and documentation CE requirements. Lastly, let me share with you some words directly from one of our strongest chiropractic supporters in the Senate,

First Quarter 2009 Sen. Tom Harkin. He has committed to keep us in the national health plan with full scope coverage. He said that he will work hard for us “But, I can’t win this fight all by myself. I am going to count on your continued support. I’m going to count on the ACA to mobilize its members to communicate three simple messages to every member of Congress. 1. We need to replace the current sick care system with a genuine health system – one focused on wellness and prevention. 2. We need a health care system that integrates the very best scientific based practices and medicines, whether conventional or alternative. 3. And we need to end discrimination against chiropractic” Those are the words of the strongest chiropractic supporter that we have in the Senate and the one that has kept us in the programs (VA, DOD and Medicare Demo). He has been charged by Sen. Kennedy to formulate the part of the national health plan that includes coverage and procedures. Sign up for chirovoice and especially get your patients signed up. We have a small open window to get this done (30 days) so don’t wait and don’t procrastinate, do it now!! All I do that I’ve found effective is to take one of the sign up sheets (chirovoice) and fold it in half leaving the web site address on top and give the sheet to the patient asking them to go to the site and sign up so that they can stay abreast of the national health care plan and help me protect their right to come to the office for chiropractic care under any new national health care plan that is proposed.

ARE YOUR PATIENTS SUFFERING FROM INDIGESTION, HEARTBURN, REFLUX, DIGESTIVE GAS, BLOATING, ETC AND DON’T WANT THE MANY POSSIBLE SIDE-EFFECTS OF HYPOCHLORHYDRIA FROM H2 BLOCKERS AND PROTON PUMP INHIBITORS? CONSIDER USING HYPO-D FROM NUTRI-WEST, A 2-PHASE PRODUCT SUPPLYING HCL, PEPSIN & PAPAIN FOR STOMACH SUPPORT AND PANCREATIN, PANCRELIPASE, AMYLASE, BROMELAIN AND BILE SALTS FOR PANCREATIC AND GALL BLADDER SUPPORT. TAKE 1-3 TABLETS WITH MEAL, WORKING DOSE UP GRADUALLY. WHAT ABOUT REFLUX SYMPTOMS??? CONSIDER USING NUTRI-WEST’S TOTAL UPPER G-I. IT SOOTHES AND HEALS AN IRRITATED ESOPHAGEAL LINING. CHEW TWO TABLETS ONE HOUR BEFORE OR AFTER MEALS, WITH MINIMAL WATER. (It contains l-glutamine, okra, stomach, folic acid, vitamin A, aloe vera, N-Acetyl-glucosamine, bromelaine, duodenum, DGL, cabigen extract, slippery elm and magnesium chelate.)

For Questions or Ordering: call 800-255-3292 or 505-237-9680

First Quarter 2009

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NMCA Journal

Get Paid on Your Medpay Claims David Peer, DC For the past year, I have been reviewing Medpay cases for an independent review company. I took the job because the Croft Whiplash Treatment Guidelines were number one on the company’s reference list. The NMCA has officially endorsed the Croft Guidelines and I personally feel that they are fair, but there is more to Croft than just the familiar chart. Please familiarize yourself with the Croft Chart (available at the NCMA website) but realize that Croft is also about performing an examination that supports your diagnoses, outlining a treatment plan, performing re-evaluation examinations that show objective improvement and moving your patient to active care when appropriate (read exercise rehabilitation). After completing the training with the review company and my first year of reviewing chiropractic cases, I would like to offer this inside view. In order to make your Medpay cases bulletproof you must: 1. Establish a causal relationship between the accident and the symptomatolgy of the patient. This is done in your chief complaint interview and has to get into your notes. Be sure to mention the patient’s position in the vehicle (i.e. seatbelt restrained driver) the nature of the collision (rear impact), timing of the onset of pain, loss of consciousness, and transport to E.R. Continue with the nature of the complaints, palliative and provocative factors etc. 2. Perform physical exam, orthopedic exam, neurological exam, and chiropractic exams. Spinal listings are not enough to establish that your patient was injured in the accident. You have got to perform an examination that supports your diagnoses. If you are going to make sprain/ strain diagnoses, you have got to perform range of motion testing. 3. You have got to state your treatment plan and perform periodic re-evaluation examinations that show objective improvement. This is an essential part of Croft and a common cause of claim denials. After every ten visits, re-test your positive or abnormal findings. Resolve diagnoses that are healed and update your treatment plan. 4. Keep an eye on the Croft Guidelines treatment number and duration. If you are obviously going to go way beyond the numbers for the patient’s grading, you’ve missed something. Go back and re-examine to identify missed issues or uncover the complicating factors that explain the persistent nature of the patient’s problems. 5. You cannot treat a patient forever. Not all patients return to pre-accident status. Assign an impairment rating and

discharge the patient. This is one of the most common complaints about our profession from insurance adjusters, we don’t know how and when to end a case. If you don’t feel confident doing this, refer your patient to Dr. Pendleton, Dr. Bonnie, Dr. Schnapp or Dr. Peer. These doctors do this type of work regularly. Most frequent claim denials result from the doctor’s lack of establishing a causal relationship between the accident and the condition of the patient. This is done by talking to the patient and putting the relevant information into your notes. Second place goes to “the doctor’s examination does not support his diagnoses.” In my experience, this is commonly a straight chiropractor performing a spinal screen, noting the appropriate spinal listings and then making segmental dysfunction or closed spinal dislocation diagnoses. Please don’t stand on principle here, my colleagues. And, don’t misunderstand me here. I will stand side by side with any of you and argue the subluxation complex until the cows come home. I understand sympathetic facilitation and autonomic imbalance, as well as anybody. I am with you all in my understanding of, and my extreme compulsion to, the importance of the spinal adjustment in restoring homeostasis. What I’m asking of you all is this. If you are going to get involved in the auto insurance game, then learn to play by the rules. If you don’t want to play by their rules, that’s fine. I completely understand. But don’t you dare be the cause of Medpay claim denials and then turn around and charge the patient because you didn’t get paid. Our patients pay their Medpay insurance premiums and they deserve to get the benefit of that insurance if they get injured in an accident. If you take a Medpay case and don’t follow the rules, it will result in the claims getting denied. If you then make the patient pay you, you are in violation of your chiropractic oath. I know that this is a strong statement. I stood like all of you and took that oath. I know that you all swore to do everything in your power to help every patient at every opportunity that you got. If you take a Medpay case and don’t play by the rules, you are hurting your patient. It’s ok not to take these cases, if you don’t want them. Go ahead and refer your Medpay cases to Dr. Rob Jones, Dr. Robert Byrd, Dr. Herb Beatty or Dr. Marc Girod, the doctors that do this type of work all the time. As always I am available to discuss this matter further with any or all doctors. As your NMCA Central District Director, I want to hear your thoughts and concerns. I can be reached at 505-888-9616 or [email protected].

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First Quarter 2009

Convention & Membership Get everything you need to join us in May on our web site Home Page at www.nmchiro.org! As you know, the NM Board of Chiropractic Examiners has mandated that 12 of the 16 continuing education units for the 2009/2010 re-licensing year be done in Coding and Documentation. This mandate is a result of the OIG report that noted documentation problems within the chiropractic profession and Medicare’s “suggestion” that chiropractors must improve in their documentation, in particular. Because of this, the NMCA will be providing those 12 CEUs in Coding and Documentation presented by Dr. Mario Fucinari, DC, CCSP. Foot Levelers, Inc. is providing the sponsorship for Dr. Fucinari and we are very appreciative of their efforts on our behalf. Make sure you visit their booth at the convention to thank them!! We will also be having Ms. Susan McClelland, BA, CCA, LRT. Ms. McClelland is probably familiar to many of you as she has been a tremendous help to many of our doctors throughout the Medicare Demonstration Project and by coming to New Mexico several times to help with the coding and documentation during the Demonstration. In addition, for all of you that will have already obtained the required CEUs in documentation and coding, we will be presenting Dr. Kevin Wong, DC, speaking on Practical Spinal & Extremity Adjusting. Dr. Wong is being sponsored by NCMIC and we are greatly appreciative of their efforts on our behalf. Again, make sure you visit their booth at the convention to thank them!! Dr. Wong will be replacing Dr. John Hyland, who had to cancel for our convention weekend. At lunch on Saturday, we will have one of our very own DCs, Dr. Jeffrey P. Schnapp, present his unique perspective on bridging the gap between provider and insurance adjuster. I imagine all of you are interested in that topic and will enjoy his presentation! We will have a Hospitality Suite this year and everyone is invited to that room for relaxation and conversation! Check with the registration desk for the room number so that you do not miss this chance to spend time with your colleagues in a relaxed atmosphere. As of this writing, we have the following exhibitors that have registered to join us and we look forward to seeing them and having them with us for the weekend!! Doctors Greens/Wellness Watchers Nutri-West 4-Life National Orthopedic & X-Ray Supply Metagenics, Inc. Z-Coil Pain Relief Footwear Biogenesis Nutraceuticals, Inc. Foot Levelers, Inc. NCMIC Heel, Inc. Guna, Inc. TrailBlazer Take Shape for Life Brican Corporation Medical Specialists

Erchonia Laser Standard Process SW Sombra Ideal Protein SOH Productions Webster University Pre-Paid Legal & Identity Theft Shield Texas Chiropractic Xocai Chocolate Biopharma Cal NutraSciences Mediconsult New Balance Cutting Edge Catalog

All in all, we plan to have another wonderful event over the weekend of May 1 through 3, 2009, and hope to see you there! As a member benefit of NMCA, your registration and attendance at the 2009 Annual Convention is FREE!! Our membership year is from January 1 through December 31 and we hope you will renew your membership or join us for the first time ever or after being away for awhile!! We look forward to serving you and the chiropractic profession in NM for another great year of education and adventure!! You can obtain our Convention Flyer and Registration form for 2009, as well as a Membership Application and EZPay form, for your convenience in signing up and registering, on our web site at www.nmchiro.org by clicking on the Convention link on the Home Page. We look forward to seeing you all in May and having you with us as members for another year!!

First Quarter 2009

VISION STATEMENT of the NEW MEXICO CHIROPRACTIC ASSOCIATION The Vision of the New Mexico Chiropractic Association is to have every Chiropractor in the State of New Mexico as a member, working together to expand and protect the rights of the chiropractic profession. The NMCA needs every chiropractor in the state involved and united in order to combat any loss of chiropractic rights as they now stand, to stop any infringement by other professions into areas that are traditionally chiropractic in nature, to provide pathways for chiropractors to expand their areas of expertise in order to service their patient population to the fullest, to educate the public as to the value and benefit of chiropractic care, and to provide easy access to chiropractors within the health care industry. The NMCA is the only organization in the state that can accomplish the above work. This work cannot, however, be accomplished without the required funds and without the necessary people to follow through. Therefore, the NMCA needs a large and actively involved membership. No matter what part of the state you call home, if the Practice Act for Chiropractors changes, you will be affected—for better or for worse, depending on whose changes are adopted. Help us make the changes that occur, changes that you want to see occur, changes that will enhance your profession. In summary, the NMCA Vision is to have the total participation and backing of the entire chiropractic community in New Mexico toward the enhancement of the chiropractic profession while protecting the rights of chiropractors to treat patients within the expertise of their training and licensure. Please help us make this Vision a reality!!

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NMCA Journal

2009/2010 Calendar Of Events 2009 March • New Mexico Legislative Session ends March 21 at 12 Noon April • NM Board of Chiropractic Examiners Regular Meeting, April 11, 2009, 9 a.m. at the Regulation & Licensing Department, 2550 Cerrillos Road, Santa Fe May • NMCA Annual Convention, May 1 – 3, 2009, Marriott Pyramid North, Albuquerque • Dr. Michael Taylor Module # 3, May 30 & 31, 2009, Marriott Pyramid North, Albuquerque August • NUHS Module # 1, August 22 & 23, 2009, Marriott Pyramid North, Albuquerque September • NUHS Module # 2, September 19 & 20, 2009, Marriott Pyramid North, Albuquerque October • NUHS Module # 3, October 17 & 18, 2009, Marriott Pyramid North, Albuquerque November • NUHS Module # 4, November 14 & 15, 2009, Marriott Pyramid North, Albuquerque December • NUHS Module # 5, December 12 & 13, 2009, Marriott Pyramid North, Albuquerque

2010 January • NUHS Module # 6, January 16 & 17, 2010, Marriott Pyramid North, Albuquerque

NMCA Journal

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First Quarter 2009

Classifieds Looking for Employment TRANSCRIPTIONIST AVAILABLE ~~ Are you looking for a transcriptionist? Reasonable prices! Call 505-299-2613. Job Opportunities LOOK ING FOR A DC ~~ Millennium Health & Wellness is looking for a highly motivated and energetic DC to cover a few days each month at our new “state of the art” facility located in Las Cruces, New Mexico. This would include approximately 3 days a month and possible future coverage for scheduled vacations as well. Coverage will continue at least thru July with the possibility of permanent employment in the future. Millennium provides both chiropractic and physical therapy services and has been in business for ten years. Please contact us if you are interested in this unique opportunity. mark@ millenniumlc.com or call 575-521-0793. LOOKING FOR THE RIGHT DOCTOR ~~ Awesome opportunity for the right doctor. A new doctor just getting started, semi-retired doctor, part-time doctor a doctor looking to expand and/or an associate doctor. Active practice available in Mountainair, NM, come on down. Make 2,000 to 3,000 a month or more one day a week. Office is completely ready for the doctor to walk in and start treating patients. Large drawing area; marketing can increase patient volume; patient files and equipment included. I will assist the right doctor in transition. Call Dr. William L. Walker for information (505) 891-3345. WANTED ~~ A Chiropractor interested in relocating to sunny Alamogordo, NM. I am planning to retire 2-5 years from now. I am seeking a Dr. interested in working in my office with the intentions of buying me out when or before I retire. This Doctor would share office space but would work independently of me until such time as he, or she, purchased the office. This office grossed $227,500.00  in 2008. The Doctor could work in my office for three months using my equipment at no charge. At that time, terms would be negotiated. Contact Dr. Will May, 405 24th Street, Alamogordo, NM 88310. I may be reached Monday thru Friday at 575 437-4888 from 8 AM-1 PM and 2-6 PM. ASSOCIATE CHIROPRACTOR WANTED ~~ Clinic treats myofascial as well as internal discorders.  Lab on premises.  Call 575-622-8873 or 575-626-2388.  Small town, expanding with lots of opportunities. LOOKING FOR AN OPPORTUNITY ~~ I am a chiropractor in Albuquerque and I would love to work with another chiropractor to share expenses and be able to cover each other so we can travel and take time off.    Anyone need a little vacation?   If anyone is interested in chatting about possibilities, e-mail me at [email protected].  ASSOCIATE POSITION AVAILABLE WITH POTENTIAL BUYOUT OPTION ~~ Established Window Rock chiropractor seeks an associate for 17+ years established practice. Must be Arizona licensed with PT certification. Send resume and/or contact Dr. Dennis Kirsten, P.O.

Box 666 Window Rock, AZ 86515. Cell: (928) 607-5414. Fax: (928) 871-3559. E-mail: dwkdc@ npgcable.com. ASSOCIATE POSITION AVAILABLE ~~CareMore Chiropractic Centers is looking for an associate doctor who has strong people skills and who appreciates a team approach to health care. We offer the best of solo practice without the headaches and a strong support team. Concentrate on doing what you love and know well--delivering chiropractic services-and let us do the rest. Please email Dr. Plaman at [email protected] call him on his cell at 505-681-9352 to explore your options. Practice for Sale/Office Space Available BEST OPPORTUNITY IN NEW MEXICO ~~ I have 1200 SQ FT of Office Space in a true adobe in New Mexico’s richest town that I’m looking to lease to someone willing to put in some sweat equity in developing a practice. The equipment is furnished, some of the advertising is done, and the phone is ready to go. All that’s missing is a doctor driven to succeed. Are you that doctor? Call me, Dr. David Grief at (505) 899-6600 to discuss this opportunity. Why is this the best opportunity in New Mexico? Because I’m not looking for an associate; I’m looking for a tenant. Call today. SPACE AVAILABLE ~~ Space available at 9601 Sierra Vista Court, NE, Albuquerque. Please contact Dr. Gretchen Peterson, DC, at 505-4808505 for details and information. GALLUP PRACTICE FOR SALE ~~ Ideal for starting or relocating doctor. Walk into an existing practice with a strong patient base. Present doctor is working part-time with very comfortable income. Definite room for expansion if you want full-time practice. Equipment and accounts receivable are negotiable. Truly a great investment for the right doctor. Grosses over 200k working 20 hrs/week! Call or e-mail for more details ~~ [email protected] or 505-879-4420. PR ACTICE FOR SALE ~ BUILDING & EQUIPMENT ~~ 30 + years, 6 years with current owner, established practice in Jal, New Mexico. 2600 sq. ft. building with more than enough space and rooms to accommodate adjustments, exams, therapies and x-rays. Equipment includes 2 adjusting tables, 1 combination traction/segmental distraction table, and more. Asking the fair market value of the building at $169,000. Contact Dr. Kendall Boyd at 505-5130319 or [email protected]. Services & Equipment Available EQUIPMENT FOR SALE ~~ Chattanooga Intelect Legend Ultrasound, $695, and Chattanogga Intelect 250 Ultrasound with 2 sound heads, $695. Both were tested April 13th, 2007 and both are in good working condition. Test results and pictures available upon request. Reconditioned Leander motorized flexion table, your choice of table top covers, $3200.00. Call Dr. Lyman or Dr. Derek Atchley at 505-265-5651 or email at [email protected]

EQUIPMENT FOR SALE ~~ Window Rock Chiropractic Equipment List (3) Rich Mar III G – Price - $850.00/per unit =$2550 (3) Rich Mar III - Price-$650.00/per unit =$1950 (1) Chattanooga Intelect Legend Stim – Price- $950.00 (2) Rich Mar IV Ultrasound – Price-$1000.00/ per unit=$2000 (1) Mettler Sonicator 706 Ultrasound – Price-$900.00 (4) Kaladar Medical Innovations-“The Stim” Price-$1000.00/ per unit=$4000 (1) Fisher Galvanic Unit-MD-1a – Price-$700.00 (1) Mettler 300 Auto Therm Shortwave Diathermy Price-$1,100.00 (1) X-ray: Universal 300/125 with Electric Locks, Konica QX 60 processor included with rare earth cassettes-$8,500.00 (1) X-ray: GE 300/125 included Konica QX 60 processor with rare earth cassettes -$6500.00 (1) Hill Anatomotor intersegmental traction table – Price- $1,100.00 (5) Spinalator intersegmental traction tables – Price- $700.00/ per unit=$3500 (2) Isotrack intersegmental traction tables – Price- $550.00/ per unit=$1100 (1) Barnes Flexion/Distraction Table – Price-$1500.00 (1) Richmar Shortwave Diathermy machine $1000.00 (4) G-5 machines bullet style -$575.00=$2300 (1) SAM unit - $1000.00 (1) Torque Specific Upper Cervical Adjusting Instrument -$8400.00 (1) Vax-D Spinal Decompression System – $20,000 (1) Torque Specific Adjusting Table – $7,400 Dr. Dennis W. Kirsten, D.C, 928-871-3556-office, 928-871-3559-fax, [email protected] EQUIPMENT FOR SALE ~~ Never been opened, HRV (Heart Rate Variability) Nerve Express unit. This unit tells the doctor if there is blocked regulation or switching of the autonomic nervous system, the patient’s level of fitness, and how they compare to healthy people in different age groups. This unit is made by Heart Rhythm Instruments, Inc. and was developed by the Russians for use in training their Olympic athletes and their military special-forces people. It prints out three pages of easy-to-read charts in color. I paid $3500 for this unit but am asking $3200 or best reasonable offer. The company has received full FDA approval on this unit. You have to have a computer to run it as it is mostly a software program. The test only takes about 7-8 minutes to run and the patient does not need to disrobe so it is easy to do. I will also give instruction on how to run and read it (which is really very easy). I use my other unit almost daily with my patients. If any doctors are interested, they can call me at my office. This is an excellent “high-tech” type of program that shows the patient if they are getting “healthier” which helps with compliance on the doctor’s treatment program. Contact Dr. Vernon Redd at 505-888-6138.

Classified ads are free to NMCA members, doctors and professional associates, and can be faxed to 505-828-1128 or e-mailed to [email protected]. Non-members please send ad and $50 to NMCA, P. O. Box 21100, Albuquerque, NM 87154. Please contact Jaeni Aarden, NMCA ED, at 505-280-0689 with questions.