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The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy
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Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk
Nov 600:14:47Tap to summarizeCF 380: Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk Today we’re going to talk about Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com Things you should do. Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #380 Now if you missed last week’s episode, we talked about Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. It’s been a bit cray cray around here. We’re on the hamster wheel again with regards to the nurse practitioner. Our nurse that’s been in NP school and we’ve been waiting to graduate got an offer for full time from the clinic she’s been doing her clinicals with and, just from a pure financial standpoint, she had to take it. I can only offer part time until the schedule fills up. So….down the road we go. Looking for a new staff member to help us grow the clinic medically and service-wise. She/He is out there. We just gotta find ‘em. Next, you’ve heard me speak about selling part of the clinic several times over the last several years. We were going to have a final discussion after going back and forth on the contract. What changes could they live with and what could we live with in a final contract. That sort of thing. Well, unfortunately and tragically, the CEO of the company was heading to one of their clinics in a small airplane that unbelievably crashed with no survivors. Absolutey unbelievable. His name was Dr. Justin Ramsey and he was a great guy. Not only was a lot of this a business thing but, I got to know Justin fairly well and we were friends. It’s been very hard to process on lots of different levels. Losing a friend and who knows where that puts us with selling a portion of the clinic? We don’t know. But I do know this; I’m getting up every morning and going to work and making patients feel better. It will all fall into place as soon as it is supposed to fall into place. That’s enough, let’s hop in. Item #1 The first one is called, “Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial” by Gevers-Montaro et al and published in the Journal Of Pain in August 2024. Remember, the citations can be found at chiropracticforward.com under this episode. Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial Gevers-Montoro, Carlos et al. The Journal of Pain, Volume 25, Issue 8, 104500 Why They Did It Chronic primary low back pain (CPLBP) refers to low back pain that persists over 3 months, that cannot be explained by another chronic condition, and that is associated with emotional distress and disability. Previous studies have shown that spinal manipulative therapy (SMT) is effective in relieving CPLBP, but the underlying mechanisms remain elusive. How They Did It This randomized placebo-controlled dual-blind mixed experimental trial aimed to investigate the efficacy of SMT to improve CPLBP and its underlying mechanisms. Ninety-eight individuals with CPLBP and 49 controls were recruited. Individuals with CPLBP received SMT or a control intervention, 12 times over 4 weeks. The primary outcomes were CPLBP intensity and disability (Oswestry Disability Index). Secondary outcomes included pressure pain thresholds in 4 body regions, pain catastrophizing, Central Sensitization Inventory, depressive symptoms, and anxiety scores. What They Found Individuals with CPLBP showed widespread mechanical hyperalgesia and higher scores for all questionnaires. SMT reduced pain intensity compared with the control intervention, but not disability. Similar mild to moderate adverse events were reported in both groups. Mechanical hyperalgesia at the manipulated segment was reduced after SMT compared with the ...
Transcribe →Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection
Oct 1600:21:15Tap to summarizeCF 379: Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection Today we’re going to talk about Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com Things you should do. Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #379 Now if you missed last week’s episode, we talked about Differences In Whiplash And Normal Neck Pain & Spinal Manipulative Therapy And Scoliosis. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Now that the Fall is upon us, things are leveling out and getting mroe and more stable around here. Which means less travel and more living in my house like a regular normal person. Except, we stayed in my hometown last weekend for my 35th high school reunion. Which is weird as hell to say. But it is what it is. I have the gray hair to prove it. Got to see a lot of folks I haven’t seen in a while and that’s always good. Some never go back. They didn’t have a good experience in high school so they care nothing about it. I get that. That wasn’t me though. I had an incredible experience. I won state in the discus and was a two-way starter and football captain, honor grad, and had a great circle of friends that I absolutely still stay in touch with and still enjoy texting and seeing every now and then. High school was somethign else for me and I wouldn’t trade it for anything. So we go back when it’s time. Something I’ve been working on lately; through Facebook, a colleague reached out to me and said that with my ortho diplomate cert and my Forensics diplomate cert, that I should consider doing designated doctor work or medicolegal work out of state. She said she travels out of state once every 6-8 weeks and makes a gob of money doing so every year. Well hell, you don’t have to tell me twice. There absolutely SHOULD be more benfits to having Diplomates so, if I got ‘em, miight as well use them. So, I started down the path of getting licensed elsewhere and holy guacamole what a sincere time suck pain in the ass. Wow. Absolutely stupid the hoops you gotta jump through. I’ve been licensed in TX since 1998 but I have to do mental gymnastics to add a license somewhere else?? Insantiy. But, I’m getting there. Then, once licensed, I have to take a course that will prepare me for the Qualified Medical Examiner exam. Then I take that QME and pass it and Kablamo! I’m off to the races and adding an extra revenue source that can be maintained once I retire from actively treating patients every day. Which, psssst…..between me and you….if you don’t want to die in yoru practice or sell it someday desperately for pennies on teh dollar, is exactly what we should all be doing. We should be acting as if there is an end game. Because there is and none of us are getting out alive. Why do you think I have the VoiceOver thing going? The Airbnbs thing? You think I post my paintings and my sculptures on social media so often so that I can brag? Hell no. I want a portfolio and people to know, like, and eventually buy my art. If myy paintints annd sculptures are news to you, go to www.riverhorseart.com and check it out. The point is; I’m trying to plan for the end game. I’m trying to do what I can to maximize my end game. You should be too. Item #1 Our first one this week is called Association of Opioid use Disorder Diagnosis with Management of Acute Low Back Pain: A Medicare Retrspective Cohort Analysis by Moyo et al and published in Journal of General Internal Medicine in 2024. Remember, the citations can be found at chiropracticforward.com under this episode. Moyo, P., Merlin, J.S., Gairola, R. et al. Association of Opioid Use Disorder Diagnosis with Management of Acute Low Back Pain: A Medicare Retrospective Cohort Analysis. J GEN INTERN MED 39, 2097–2105 (2024). https://doi.org/10.1007/s11606-024-08799-3 Why They Did It They wanted to see if people with this opioid problem were treated differently for sudden back pain. How They Did It The main independent variable was OUD diagnosis measured prior to the first LBP claim (i.e., index date). Using multivariable logistic regressions, they assessed the following outcomes measured within 30 days of the index date: ...
Transcribe →Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness
Mar 6, 202500:18:20Tap to summarizeCF 360: Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness Today we’re going to talk about Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #360 Now if you missed last week’s episode, we talked about ‘Do physicians follow guidelines and updated chiropractic trends’. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. I just returned from a trip to Ft. Worth for a business thing. I mentioned last episode that I am potentially selling 60% interest in the clinic here to a private equity group out of Houston. You know, selling 60% of your blood sweat and tears over the course of 25 years or so….that’s a hard thing to come to terms with. But, when you consider some factors, it starts to shine up like a bright shiny penny. For example, I live in Amarillo, TX. While I love my city, there aren’t a ton of chiros busting down the gates to be established here. If I wanted to sell my practice on the market by myself, I’d be hard pressed to find a buyer. If I DID actually find a buyer, I don’t think I could get what I’d want for it at all. How many stories do I need to hear about chiros that are ready to retire not being able to sell their practices so they’re basically just SOL and have to shut the doors and get nothing for their years of work? How many of those do I have hear before I actually take them to heart and believe them? This group is offering more for 60% than I believe I could get for 100% on my own. Basically. Another thing is that I’m 52 and while I am young for retirement when we consider other professions, I am getting to an age that a full day take more of a toll on my body and my energy than I’d like to admit. When I see 45 patients in one day at 52 vs when I was 42….there’s just a damn difference. Here’s the most important factor; I’ve had COVID 5-6 times now and I’ve only missed 1 day of work. I know some of you are clutching pearls right now but I didn’t always know at that exact time that I actually had COVID and just to safe, I always wore a mask and was OCD about keeping my hands clean. The point is; that’s not fair to me, it’s not fair to my patients, it’s not fair to my family, and it’s not fair to my employees that LITERALLY EVERYTHING depends on my presence in the clinic. IF I’m out, everything suffers. I’m a fool and I’m irresponsible if I don’t do everything I can to make this clinic and the lives of my people more stable. If I get sick sick, if I need a surgery, if I break a bone…..everybody is wondering if they need to find a new job. We can’t have that and bringing in a partner is how we’re going to be bigger, stronger, and more stable. They’re going to help me bring in an associate, when the finances make sense, they’re going to help bring in a PT, and they’re going to help bring in pain management services. When you combine these with the fact that we already have a young and slowly building medical brand, acupuncture, massage, etc….these things should all contribute to a very well-rounded, comprehensive clinic that can run should I happen to be absent. And lastly, I want to travel while my hips and knees allow me to travel. I want to paint and sculpt and make music and do my voiceover and do more of the things that feed my soul. Instead of ONLY the things that feed my family. I need more of a mix. The longer I live, the less time I have to live. So it’s time to make a move and make it count. See? When you really start to break it down and put it into context, selling 60% doesn’t seem quite so awful now does it?? Plus, the clinic doesn’t change. We’re already successful. They don’t want to change what make my clinic what it is. They just want to add to it and optimize what we’re already doing so well. Yes please. And pay me while we’re at it and allow me to get off of the damn hamster wheel I’ve been on for 27 years.<span class="Apple-convert...
Transcribe →Do Physicians Follow Guidelines & Updated Chiropractic Trends
Feb 20, 202500:13:45Tap to summarizeCF 359: Do Physicians Follow Guidelines & Updated Chiropractic Trends Today we’re going to talk about Do Physicians Follow Guidelines & Updated Chiropractic Trends But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #359 Now if you missed last week’s episode, we talked about how the first provider chosen matters and then we talked about neural mobilization. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. We are in the quadremic around the Texas Panhandle and, from what I hear, around the USA. What’s the quadremic, you might ask. Well, it’s RSV, the Flu, COVID, and the regular norovirus. Evidently it’s hitting from all directions this month. I’ve had COVID. Just two weeks ago. But now it’s like I have something else on top of that. My head is all stopped up, trouble catching my breath, and just sort of messy all over. But I’m here, damnit! I’m Gen X-ing it, pushing through, and making things happen regardless. If you’re a regular around here, then you know last week I spoke about all of the random ays I’ve had off in the last month or so and how, for a practice that doesn’t scare people into a million visits, days off can be pretty detrimental. A true schedule killer. So, we’re not letting this little lingering illness keep me down and at the house. I mentioned some time back that I am entertaining the idea of selling 60% of the clinic to a private equity group out of Houston, TX. As I go through the process, I’ll share more and more about what’s going on, why it makes sense, and if you want to have a valuation done on your own clinic, you can just get hold of me and I’ll get you with the right people. But, I will walk you through it and talk about it as I go. We have a transition team Zoom call this afternoon so will know a bit more for next week’s podcast. But for now, let’s hop into the research. Item #1 Our first one this week is called, “Diagnostics and treatment of acute non-specific low back pain: do physicians follow the guidelines?” By Trachsel et al and published in Swiss Medical Weekly on January 24, 2025. Holy smokes it’s a hot one!! Remember, the citations can be found at chiropracticforward.com under this episode. Trachsel M, Trippolini MA, Jermini-Gianinazzi I, Tochtermann N, Rimensberger C, Hubacher VN, Blum MR, Wertli MM. Diagnostics and treatment of acute non-specific low back pain: do physicians follow the guidelines?. Swiss Med Wkly [Internet]. 2025 Jan. 24 [cited 2025 Feb. 17];155(1):3697. Available from: https://smw.ch/index.php/smw/article/view/3697 Why They Did It Clinical guidelines for acute non-specific low back pain recommend avoiding imaging studies, refraining from strong opioids and invasive treatments, and providing information to patients to stay active. Despite these recommendations, many patients undergo diagnostic and therapeutic assessments that are not in line with the current evidence. AIM: To assess the management of acute non-specific low back pain by Swiss general practitioners (GPs) and their adherence to guideline recommendations. How They Did It We performed a survey using two clinical case vignettes of patients with acute non-specific low back pain without red flags or neurological deficits. The main differences between the vignettes were sex, age, profession, pain duration and medical history. GPs were asked about their management of those patients. What They Found Of 1,253 GPs, 61% reported knowing current clinical guidelines and 76% being aware of “Choosing Wisely” recommendations. Diagnostic evaluations included X-ray and magnetic resonance imaging (MRI). For pain management, GPs recommended mostly non-steroidal anti-inflammatory drugs, paracetamol and metamizole. Treatments with potential harm ...
Transcribe →First Provider Matters & Neural Mobilization
Feb 13, 202500:13:37Tap to summarizeCF 358: First Provider Matters & Neural Mobilization Today we’re going to talk about First Provider Matters & Neural Mobilization But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #358 Now if you missed last week’s episode, we talked about Utilization and Expenditure of Chiropractic and we talked about Hormone Therapy in Females. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Well, if you’re a regular listener, then you know we have gone a couple of weeks without a podcast. Unfortunately, my mother went through a battle with her health and ultimately lost that battler on January 24, 2025. She had been in the hospital for several weeks prior and every minute before work, at lunch, and after work was spent at the hospital. Not writing podcasts, as I’m sure you all understand. Then, we’ve kind of been in recovery mode. Trying to get my thoughts together and honestly…..just taking a little time to breathe. So, here we are this week. Can I tell you what some time off will do to an evidence-based practice. Day-um…. One word….two syllables….Day-um. Christmas was on a Wednesday which is a week wrecker. Then NYE was on a Wednesday, yes…a week wrecker. Then we had the snow storms and over 11 inches of snow so a couple of days off there. Then my mom’s passing then my mom’s funeral so a couple more days off there. Next thing you know a good Monday for me was 45 patients and I was looking at 28 or so. Not a good thing so fortunately, I’m getting the train back on the track now with 38 this Monday and Wednesday is looking solid as well as Thursday and Friday so I think the ball is back in play. Which takes some stress off. Oh, and while my mom is in the hospital and we don’t know if she’s going to make it, I had to take a quick trip to support my daughter’s cheer team down in Fort Worth, TX. My damn sexy pick up truck died on the way home and has been in a mechanic shop 250 miles away for the last 3-4 weeks. Then, after the funeral, my wife and I got COVID. 2025 is hating on my but we’re winners around here and, like I said, I think we’re already back on track. If you’re a praying person, I’d ask you to include us today. Include us for mom, our clinic’s health, and for a better, stronger 2025. That would be amazing of you. Now, enough woe is me, let’s get to the research. Item #1 Our first one this week is called, “First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization” by Bise et al and published in Physical Therapy and Rehabilitation Journal in September 2023. Remember, the citations can be found at chiropracticforward.com under this episode. Christopher G Bise, Michael Schneider, Janet Freburger, G Kelley Fitzgerald, Galen Switzer, Garry Smyda, Pamela Peele, Anthony Delitto, First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization, Physical Therapy, Volume 103, Issue 9, September 2023, pzad067, https://doi.org/10.1093/ptj/pzad067 Why They Did It Costs associated with low back pain (LBP) continue to rise. Despite numerous clinical practice guidelines, the evaluation and treatments for LBP are variable and largely depend on the individual provider. As yet, little attention has been given to the first choice of provider. Early research indicates that the choice of first provider and the timing of interventions for LBP appear to influence utilization. We sought to examine the association between the first provider seen and health care utilization. How They Did It Using 2015–2018 data from a large insurer, this retrospective analysis focused on 29,806 patients seeking care for a new episode of LBP. The study identified the first provider chosen and examined the following year of medical utilization. Cox proportional hazards models were cal...
Transcribe →Utilization and Expenditure of Chiropractic & Hormone Therapy In Females
Jan 22, 202500:17:10Tap to summarizeCF 357: Utilization and Expenditure of Chiropractic & Hormone Therapy In Females Today we’re going to talk about Utilization and Expenditure of Chiropractic & Hormone Therapy In Females But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #357 Now if you missed last week’s episode, we talked about Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Alright, the first week of getting back to a normal schedule. As I mentioned, I don’t love January as a healthcare provider. Especially one that accepts insurance. Insurance re-sets for most in January and people are broke from Christmas in January. We start getting a little more back to normal in late February to mid March. So…we’re starting with 42 on the Monday I’m typing here. That’s not a terrible start and I’ll tell you why. I came up with the perfect schedule. Here’s how that would look if I could have the ideal set up. Monday – 43 patients (6 new patients, 3 morning and 3 in the afternoon) Tuesday – 28 patients (2-3 new patients) Wednesday – 43 Patients (6 new patients, 3 morning and 3 in the afternoon) Thursday – 43 patients (6 new patients, 3 morning and 3 in the afternoon) Friday – 28 patients (2-3 new patients) 185 Patients Per Week 22-24 New Patients Per Week These are just general ideas. Do not undershoot them trying to stay below them!!! Now that’s not ideal for the provider that thinks they have to be hands on with every single patient from start to finish and spend an hour with each of them. It would actually be impossible. But, for me, I do all exams and re-exams and I do all adjustments. I do this with an assistant standing in the doorway doing the chart notes as they’re happening. Then the patients are handed to the CA and, when appropriate, taken for therapy and rehab exercises. It’s not a cookie cutter thing and not all patients have the same things goign on. Some get just rehab, some get just therapy, some come in for decompression and/or laser alone without being adjusted. We have massage patients I’ve never met in my life. Same with acupunture and the medical end of the business. That is the whole point with mutilple directions and streams. Some patients utilize it all. Some utilize only what they are really interested in. We always have the opportunity to cross market internally with our existing and past patients to help float the whole boat rather than just one service. Hell yes that’s challenging to promote so many diifferent revenue streams. I knew your question before you even verbalized it. That’s why you use AI to come up with a monthly marketing plan to evenly support and promote all streams of business throughout the year. This month, for example, is January so AI say’s let’s do a “New Year, New You” campaign and concentrate on Weight loss meds, hormone pellets and balanceing, IV therapy, and chiropractic to start 2025 with more function, feeling better, and looking better. Not a bad idea. We’ll promote PRP and other services through February and on and on. Anyway, a little peek into the inner workings here at Ol Uncle Jeffro command and control. Take what you like, leave what you hate. Onto the research! Item #1 Our first one this week is called, “Hormone Therapy and Biological Aging in Postmenopausal Women” by Liu et al and published in JAMA Netowrk Open in August of 2024, hot potato, look out! Remember, the citations can be found at chiropracticforward.com under this episode. Liu Y, Li C. Hormone Therapy and Biological Aging in Postmenopausal Women. JAMA Netw Open. 2024;7(8):e2430839. doi:10.1001/jamanetworkopen.2024.30839 Why They Did It Menopause is associated with biological aging, and hormone therapy is associated with health outcomes in postmenopausal women. Objective<...
Transcribe →Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain
Jan 2, 202500:13:52Tap to summarizeCF 356: Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain Today we’re going to talk about Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #356 Now if you missed last week’s episode, we talked about Daily Water Intake & Curcumin Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Christmas is over now and this week we contend with New Year’s Day. What a pain in the butt, right? I enjoy a day off here and there just like anyone else but right in the middle of the week two weeks in a row starts to mess with business. So, last week I worked Monday, 1/2 of Tuesday, and 1/2 of Friday so basically two full days if you combine it all. We ended up with about 75 chiro patients for the Christmas week. That’s not great buut it’s better than nothing. Especially when you total the profit on 75 patients vs the total profit on zero patients had I chosen to take the full week off. Then, this week, we have New Years Day off and we’re slow becauuse it’s the damn holidays and, of course, insurance people renew on January 1st, so it’s looking bleak this week, folks. Typing out on a Monday, I have 78 or so for the whole damn week. Of course that will grow because Monday will re-book and then re-book again on Friday but that’s still bleak. What I’ve discovered over my career that you may or may not agree with is that the last 2 weeks in December and December as a whole really…it starts to slow up. People are getting ready for Christmas, xmas parties, buying gifts, and things like that. Then the insurance plans re-set in January and it just takes some time to re-engage in healthcare for these folks. So we start to see February as a growth month and start to hit our full stride again in March. That’s my experience anyway. I have 2 Airbnbs and I can attest that I’ve been booked at almost 100% capacity for months now but January and on are almost empty at the moment. It’s just that time of the year so, if you’ve slowed up like I have, you didn’t do anything wrong. It is what it is. Take this break to plan for 2025. Don’t have a plan? Get one. Use AI to give you ideas for growing your practice in 2025. At this point, its almost a crime to not be taking advantage of AI for purposes like these. OK, on to the research… Item #1 Our first one this week is called, “Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis” by Moyo et al and published in The Journal of Pain in 2024….and it’s muy en Fuego! Remember, the citations can be found at chiropracticforward.com under this episode. Patience Moyo, Jessica S. Merlin, Miriam George, Theresa I. Shireman, Brandon D.L. Marshall, Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis, The Journal of Pain, Volume 25, Issue 3, 2024, Pages 742-754, ISSN 1526-5900, https://doi.org/10.1016/j.jpain.2023.10.003. Why They Did It Nonpharmacologic approaches are recommended as first-line treatment for chronic pain, and their importance is heightened among individuals with co-occurring opioid use disorder (OUD), in whom opioid therapies may be particularly detrimental. Our objectives were to assess the receipt and trajectories of nonpharmacologic pain treatment and determine the association of opioid use disorder diagnosis with these trajectories. How They Did It This retrospective cohort study used Medicare claims data from 2016 to 2018 and applied group-based trajectory models to identify distinct patterns of physical therapy (PT) or chiropractic care treatment...
Transcribe →Daily Water Intake & Curcumin
Dec 19, 202400:04:06Tap to summarizeCF 355: Daily Water Intake & Curcumin Today we’re going to talk about Daily Water Intake & Curcumin But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #355 Now if you missed last episode, we talked about Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Hello, and it’s nice to be back in the saddle here at Uncle Jeffro studios. I don’t know if you’ve noticed or not but it’s a been a few weeks and I haven’t had a break from the podcast since I started it over 7 years ago. So, what’s that all about you might ask? Well, lemme tell you. As mentioned in more recent episodes, I’ve made some significant moves and important signings in the VoiceOver industry in the last month or two and I had to start acting like I’m important. Some projects come in with a Rushed audition request. Well, if I’m at the clinic all day every day, how the hell am I supposed to do that? I can’t just run home between patients, knock out an important audition, then run back to the office for patients. That’s a good way to lose voice over jobs and lose patients so, in an effort to find a way to balance it all a bit and make it all work together, I’ve spent the time and money to make my personal office space more hospitable to being able to perform auditions at the clinic when absolutely necessary. I actually just knocked one out today and I just got everything working last night. Good timing! Anyway, I had to hang sound absorption panels on the walls, sound absorbing curtains on the windows, get an audio interface up and running with all the right software and audio plug-ins, a new microphone, and on and on. People think you can just buy a mic, plug it in, and start making money. Of course, it’s more difficult than that and drowning out the sound of a bustling and busy clinic is a challenge. So that’s what’s been up. I don’t have it all dialed in perfectly yet but it will be and I’ll hopefully sound like gem when it’s all set up and tuned in! On other fronts, it’s about Christmas and it lands on a Wednesday this year. Which as a business person, sucks a lot. Now some of you I know just take the whole damn week off. Because y’all either make more money they you deserve or because you’re just young and you think you should have the whole week off no matter how much you lose for that week. I know…..they wouldn’t be comign in anyway. That’s a lie. They absolutely still come to the chiropractor the week of Christmas. What we’ll be doing this year is working all of Monday, half of Tuesday, off Wednesday and off Thursday and then working half of Friday. It’s a compromise. In an half day, we can fit in about 30-40 if we have to. I don’t llke to bust my hump that hard but I will if needed and I like having more than enough in the bank when it comes time for pay day. So that’s waht we’re doing. New Years is the same but it’s not as big of a deal as Christmas so we’re just taking off New Years day and that’s it. And then Yay!!! Life gets back to normal again. That’ll be refreshing. OK, enough personal stuff, let’s hop into the research Item #1 Our first one this week is called, “”Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake A Systematic Review” by Hakam et al and published in JAMA Network Open on November 25, 2024 and thassa hot un’ honey!! Remember, the citations can be found at chiropracticforward.com under this episode. Hakam N, Guzman Fuentes JL, Nabavizadeh B, et al. Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake: A Systematic Review. JAMA Netw Open. 2024;7(11):e2447621. doi:10.1001/jamanetworkopen.2024.47621 Why They Did It Several public recommendations exist regarding the amount of daily water intake, yet the supporting evidence is not clear, and benefits of increasing water consumption are not well-established. Objective To summarize evidence from randomized clinical trials (RCTs) pertaining to the health-related outco...
Transcribe →Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach
Nov 21, 202400:24:45Tap to summarizeCF 354: Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach Today we’re going to talk about Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #354 Now if you missed last week’s episode, we talked about Head And Neck Cancer & Degenerative Cervical Myelopathy Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Nothing crazy this week. Just in the grind. I think we’re looking at a great week numbers-wise. We’re looking at about 165 or so this week. Maybe more. Hopefully more. Still doing the whack-a-mole thing with our billing and collections company. I don’t know exactly what’s going on with them but we just aren’t collecting much in the last month or so. It’s stressing me. After some time in business, you’ll start to feel a bit like a hamster on a wheel that never ever ends and it’s frustrating and stressful and somewhat maddening. If you describe yourself as a weak-minded person, start working for someone else. Just listen to your ol Uncle Jeffro on this folks. It ain’t for the faint of heart sometimes. It’s whack-a-mole but with potentially serious implications. Maybe I need to learn some meditation or something like that. Because you know what I’ve found? At the end of the day, it’s all going to be fine. It all works out. Hell, I lost $750k over a three year period because I had a girl who wasn’t doing her job but was convincing when asked if she was doing her job. Sometimes stats don’t tell the whole story when you’re doing PI work and reducing balances and all that. Anyway, if I can get over a loss like that, you can get over most things in life wouldn’t you agree? Remember, keep smacking each and every mole as they pop up, take a long weekend trip somewhere at least once per quarter, smile even when you’re sick, tired, don’t feel good, or are just in a bad mood, treat your staff and your family right, give you patients the best evidence-based, patient-centered care, make sure you are always marketing and keeping your eyes out for new treatment techniques and modalities and you should be good to go. Some big news on the VoiceOver side of my life. I recently made two really big moves. I signed with DPN Talent which is a group out of Beverly Hills and is one of the big five national talent agencies in the US. It’s the major leagues and it’s huge. This week, I signed with ACM which is a big national management group. So we have agents and management. DPN agent, ACM is management. When you hear someone’s voice on a Super Bowl commercial or some big campaign or movie trailer or something of that size and stature, you’re probably hearing someone that is with a large national agent or with a large management group like these two I’ve signed with. The point is: things just got really real on the VoiceOver front and Ol Jeffro needs to figure out how to be more available from day to day if needed. Which bring up one more thing I’ve was talking with our intern, Austin, about recently. Don’t wait until you’re my age to start considering an associate. I could have hired one years ago but my wife was resistant and, honestly……it’s kind of scary. We looked at what it would cost us instead of what it would give us. Having the right associate would give us security should something happen to me and it would give us clinical growth. I’ve said it before but, for better or worse, I have a big machine that I’ve built with about 11 or 12 employees currently. That’s a lot of mouths to feed every day. I’ve had COVID four and maybe five times and I only missed one day of work. Yes, blast me for going to work sick if you like. I wore my mask and kept my hands washed and all that good stuff but yeah……I know. Anyway, the point is that that is not fair to me, it’s not fair to patients, it’s not fair to my family, and it’s not fair to my staff for me to not have better systems in place f...
Transcribe →Head And Neck Cancer & Degenerative Cervical Myelopathy
Nov 14, 202400:21:36Tap to summarizeCF 353: Head And Neck Cancer & Degenerative Cervical Myelopathy Today we’re going to talk about Head And Neck Cancer & Degenerative Cervical Myelopathy But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast on wherever you listen to it Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #353 Now if you missed last week’s episode, we talked about PT In The ER & Back Pain And Mortality. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Well, let’s see, what’s up this week? I think we’re picking up a little. We had 155 chiro visits last week and being a Monday when I’m sitting down and thinking about all this, we have 47 today which includes 3 new patients and 4 re-exams so we’re looking pretty good. At the moment Monday morning, we have 134 set up for the whole week. Some will fall off and some will hop onto the schedule. That’s just the deal but Wednesday folks will re-book on Friday and Tuesday folks will re-book on Thursday or Friday so I’m betting we wind up back around the 150-155 mark if not more. We shall see. The story is that I’m still not where I was prior to COVID which is super frustrating. Back then I was around 180-200 per week. Which if I’m being honest, is too much for me. I’m too old for that. I’m actually pretty happy with 155-165. But, have you considered your future? I know two folks with two different stories I’ll share. One worked his whole life until he was diagnosed with cancer when he was in his 60s. He didn’t have an exit plan. He ended up passing away and his practice at that point was worthless and there was nothing to sell. Nothing. I don’t want that for you. The other died in his office working at about 75 or 80 years old. Now, this guy, I don’t believe in bad shape financially. I think he loved his job. But I also don’t want you forced into working into your 70s or 80s because you have failed to plan and you don’t have an exit plan. So, start at the end and work backward. What do you want your retirement to look like? What age would you like to retire? I’d recommend getting a wealth planner to help you plan it out, set goals, and keep you on track to reaching those goals. How much do you have to make and how much do you need to be investing monthly? What other talents and skills do you have that can hurry up your plans? I promise you have knowledge that nobody else has. Write books, become a speaker, release online courses, podcasts, etc. Become the expert and monetize it. Real estate is a good investment. Lots of things that can be done that give you better returns than just doing the stock market alone. These things can get you there quicker. One thing I’ll share is to make sure your clinic is sellable when you’re ready to sell one day. If you name the clinic ‘My Last Name Chiropractic’…..trust me if your last name is Williams, someone named Pavlochek doesn’t love the name ‘Williams Chiropractic’. If you’ve made the whole thing about you (and sometimes it’s really hard to not be about you), then when someone else comes in, trust fades. A lot of what we do in my clinic is ME centered but I advertise and promote our medical team a lot, acupuncture, massage, exercise/rehab and all that because I can’t have it being all about me. And when we find an associate that wants to make Amarillo and my clinic their home, you better believe we’re promoting the crap out of that associate. Before they even start. You won’t see my face on much if anything. These are things that make your clinic more sellable. That’s why mine is called Creek Stone Integrated Medical….because I don’t want to be the focus. As a result, we are in talks with a private equity investment group to sell 60% of our clinic which will pay me a salary plus my commission plus the buyout. Then, I can get an associate, and then once they’re busy and profitable, get another associate. That system sets up redundancy. If one leaves, the remaining associate can step up and train the next that we hire without me needing to be in the mix. Plus, we’ll be adding a PT soon so, with a nurse prac, a PT, an acupuncturis...
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