At the August 2018 meeting, the MAC Board of Directors voted to recommend OneGratefulPatient.org, a patient-centered project giving the online community a chance to learn about common sense health care that works – chiropractic. A project created by OneChiropractic, OneGratefulPatient.org gathers patient testimonials that share the truth about the power of chiropractic care. Patient endorsements are seperated into numerous categories, which include such topics as: 

The MAC Board hopes that OneGratefulPatient.org will become a one-stop depository for patient testimonials about chiropractic and its many health benefits. Check it out at www.onegratefulpatient.org and read the incredible stories that have already been compiled. 

And, if you have a patient whose life has been changed by chiropractic and whose story could change the lives of countless others for the better, ask them to submit their story to OneGratefulPatient.  

Last Thursday, at their final meeting of 2018, the MAC Board of Directors voted unanimously to sign on to a letter to Congress from the ACA and other chiropractic organizations regarding HR 7157, the “Chiropractic Patients’ Freedom of Choice Act of 2018.” Other signatories of the letter include the ChiroCongress (formerly COCSA), the Clinical Compass, the Association of Chiropractic Colleges, and (as of this writing) more than 30 other state chiropractic associations.

The text of the letter can be accessed online here.

HR 7157 would allow chiropractors to practice within their state’s scope of practice. Currently, the only chiropractic service covered by Medicare is manual manipulation of the spine to correct subluxation. In the vast majority of states, however, chiropractors are empowered by their scopes of practice to provide a wide range of safe, effective, non-drug approaches to managing pain and promoting health. The bill would add no new services, but rather allow patients to access benefits through Medicare that chiropractors are licensed and able to provide.

The MAC and ACA are making HR 7157 the primary focus of next year’s “Advocacy Day” on Capitol Hill during the 2019 National Chiropractic Leadership Conference (NCLC). NCLC is the profession’s premier grassroots effort, offering excellent opportunities for chiropractors nationwide to meet with their national lawmakers and high level health care policymakers to discuss issues important to the chiropractic profession.

How You Can Get Involved

• If you have questions, go to acatoday.org/medicarefaq.
• If you have a relationship with a U.S. congressman or senator, let the MAC know.
• Promote the Medicare Equality Petition to your family, friends and patients: https://www.acatoday.org/Advocacy/Engage-with-ACA/National-Medicare-Equality-Petition/Sign-the-National-Medicare-Equality-Petition

The MAC is closely monitoring the progress of HR 7157 as it moves its way through the “lame duck” session. It is unlikely Congress will have time to act on HR 7157 before this legislative session is over (December 31), but the introduction of the bill this session paves the way for future reintroduction and the beginning of the education process, of which NCLC will be a huge component. Stay tuned!

Sale of CBD Must Be Done in Compliance with the Michigan Medical Marihuana Act, and the Medical Marihuana Facilities Licensing Act.

On May 10, the Michigan Department of Licensing and Regulatory Affairs (LARA) and the Michigan Bureau of Medical Marihuana Regulation (BMMR) released an advisory bulletin clarifying the use and sale of cannabidiol (CBD) and industrial hemp in the state of Michigan. The advisory states: “The possession, purchase, or sale of marihuana or any marihuana product – including CBD – must be done in compliance with the MMMA [Michigan Medical Marihuana Act] and MMFLA [Medical Marihuana Facilities Licensing Act].”

Products Derived from Hemp

The advisory bulletin goes on to clarify the “transfer” of products derived from hemp: “Any possession or transfer of industrial hemp – or any product claimed to be ‘hemp’-related – must be done in compliance with Michigan’s Industrial Hemp Research Act.” The Industrial Hemp Research Act (IHRA) authorizes the growing and cultivating of industrial hemp for research purposes only. Passed in 2014, the IHRA authorizes the Department of Agriculture and Rural Development or colleges/universities in Michigan to grow and/or cultivate industrial hemp for purposes of research. The research must be conducted under an agricultural pilot program or other agricultural or academic research project.

The full text of the advisory bulletin can be found online HERE

What About Products Derived from Mature Stalks?

Under Michigan law, the definition of marihuana does not include the mature stalks of the plant. Whether a product made from said stalks would be exempt from this prohibition is not clear at this time.

Many manufacturers of CBD oil advertise that their product uses only mature stalks, sterile seeds, or other parts of the plant that fall outside the definition of marihuana. The U.S. Department of Justice’s Drug Enforcement Administration (DEA), however, seems dubious regarding such claims. In a Clarification of the New Drug Code (7350) for Marijuana Extract, DEA writes: “According to the scientific literature, cannabinoids are not found in the parts of the cannabis plant that are excluded from the CSA [Controlled Substances Act] definition of marijuana, except for trace amounts (typically, only parts per million) that may be found where small quantities of resin adhere to the surface of seeds and mature stalk. Thus, based on the scientific literature, it is not practical to produce extracts that contain more than trace amounts of cannabinoids using only the parts of the cannabis plant that are excluded from the CSA definition of marijuana, such as oil from the seeds. The industrial processes used to clean cannabis seeds and produce seed oil would likely further diminish any trace amounts of cannabinoids that end up in the finished product.”

DEA appears to be implying that CBD oil with any medicinal value cannot be manufactured from the parts of the marihuana plant that fall outside of the legal definition of marihuana. DEA does indicate in their “Clarification,” however, that: “[I]f a product, such as oil from cannabis seeds, consisted solely of parts of the cannabis plant excluded from the CSA definition of marijuana, such product would not be included in the new drug code (7350) or in the drug code for marijuana (7360), even if it contained trace amounts of cannabinoids.”

Conclusion

In closing, after this LARA clarification, we believe that selling CBD oil out of a chiropractic office carries a potentially large amount of legal risk. Look for more information in the June 2018 edition of the MAC eJournal.

This article is intended to be informational only and does not constitute legal advice regarding any specific matter or situation. Legal advice may be given only on the basis of specific facts relayed by a client to an attorney.

MAC Convinces Blue Cross to Delay eviCore Implementation Again!

As you know, Blue Cross Blue Shield of Michigan has contracted with eviCore, a medical benefit management company, to manage their beneficiaries’ chiropractic benefits. This agreement was set to begin on July 1, 2018.

After months of negotiations with the MAC, Blue Cross has decided to delay the July 1, 2018, scheduled date for the implementation of eviCore, until further notice. They have also agreed to consider possible alternatives recommended by MAC.

Our Legal Affairs team will continue to negotiate with Blue Cross and work to ensure that any utilization process they adopt will be in the best interest of our members and their patients. Stay tuned for more information on this critical issue as it develops!

MAC Testifies on Naturopathic Physician Bill

As Written, Bill Would Allow Naturopaths to Perform “Musculoskeletal Manipulation”

Earlier this week, MAC Government Relations Director Carl Alden testified before the Michigan Senate’s Regulatory Reform Committee on Senate Bill 826, legislation that would provide for the licensure of naturopathic physicians. Under Section 18165(C)(vii) of the bill as written, a naturopathic physician may, consistent with his or her naturopathic education and training, perform “musculoskeletal manipulation.” While the bill does provide that a naturopathic physician may not perform chiropractic adjustments unless also licensed as a chiropractor in Michigan, the reality is that this does not prohibit naturopaths from manipulation of the spine and/or extremities.

Carl’s testimony focused on the education and training a naturopathic physician receives in “musculoskeletal manipulation,” and whether that education and training is adequate to competently perform spinal manipulations.

While the bill did pass committee, the main sponsor of SB 826, state Senator Rick Jones of Grand Ledge, assured the MAC that he will work with us to develop a suitable amendment addressing our concerns and that the bill will not move without being amended. Stay tuned.

Dr. Monika Buerger will be speaking at the MAC Fall 2018 Convention & Exhibition, October 5-7, 2018, at the Renaissance Center in Detroit. Her presentation, “Balancing the Brain, Chiropractic Style,” will be on Saturday from 8a-12p, for 4hours of continuing education, including two hours in the performance and ordering of tests and one hour in pain and symptom management. She will also be presenting a class for CAs, “Raw and Real,” on Friday from 4-7p.

Currently in the United States, one in five children are said to have a mental disorder, and one in six a neurodevelopmental disorder. The rates of suicide have skyrocketed in the last fifteen years, and by 2025 it is estimated that Alzheimer’s Disease will increase by 40 percent.

The chiropractic profession is best positioned to be the leaders in the functional wellness movement and help turn the tide on these numbers. But in order to do so, understanding the “Chiropractic-Gut-Brain-Sensory Axis” is imperative.

The Impact of Sensory-Motor Function on Health

Stress and anxiety are pervasive in modern life. No matter what the cause, getting to the root of the problem is essential for making lasting change. One overlooked underlying cause of stress and anxiety is poor sensory-motor function. 

The chief regulator of all sensory information and processing is the vestibular system. It may seem like a strange connection, but the vestibular system has effects that reach far beyond balance. In fact, it is central to regulating our sensorimotor systems, which are at the core of how we take in information and respond to our environment. Mood, cognition, immune system function and overall health all rely on proper sensorimotor processing. When the sensory-motor systems are impaired, there’s a misfire between our experiences and how our brain interprets these experiences. The result is a chronic state of unease and a triggering of the fight-or-flight stress response. This response leads to chronic firing of the HPA axis and too much of the stress hormone cortisol. When cortisol production is ramped up for too long, it can lead not only to stress and anxiety, but also depression, thyroid dysfunction, immune dysfunction, and blood sugar elevation. Not only that, but a prolonged stress response also interferes with the function of frontal lobe of the brain, the area that governs executive functioning. 

Chronic stress and cortisol upregulation will also lead to irritation of the mucosal barrier and ultimately to a “leaky gut” and vagal tone dysfunction. Over the last decade, science has shown the important connection between gut health and brain health and nearly all modern day diseases.  Chronic upregulation of cortisol will also have a negative effect on our DNA methylation and cause “road blocks” in many key biochemical pathways. 

From “Tech Neck” to Trauma

Whether it be from “tech neck” or trauma, the cervical spine is a core component of vestibular and proprioceptive sensory input into the brain. Biomechanical dysfunction of the cervical spine will lead to poor neurological integrity of the sensory-motor systems. This is WHY chiropractic care is so essential to the fundamental health of every human being!

In conjunction with chiropractic adjustments, Precision NeuroIntegrative ™ and “gut rehab” protocols will help enhance neurological integrity, help regulate the HPA axis and lead to optimal physical and mental health. 

To learn more about Dr. Buerger and Intersect4Life visit: www.intersect4life.com

A 1991 Life Chiropractic College-West graduate, Dr. Monika Buerger is an author and national and international lecturer in the field of functional neurology and functional medicine. She is part of the International Chiropractic Pediatric Association’s seminar program, where she offers a course on Neurosensory Integration and Sensory Processing Disorder. Due to large demand, she now offers advanced courses on the topic for chiropractors interested in caring for children with neurodevelopmental disorders. She is a certified DAN! (Defeat Autism Now!) practitioner and is the founder of the Intersect4kids program, a Neurodevelopmental Certification Program for doctors. She has been in family wellness practice since 1992, first in Northern California and currently in a thriving practice in Southeastern Idaho, where she helps both children and adults regain their health through natural alternatives.

Fall 2018 Convention & Exhibition

Quick Links

• SPEAKERS & SESSIONS
• SCHEDULE
• EVENTS 
• EXHIBITOR INFORMATION 
• ACCOMMODATIONS
• REGISTRATION INFORMATION

The MAC returns to the Beautiful Marriott at the Renaissance Center in downtown Detroit for the 2018 Fall Convention & Exhibition. Located on Detroit’s world-famous RiverWalk, join your chiropractic colleagues, our dynamic lineup of speakers, and representatives from dozens of exhibitors for this incredible three-day showcase of the best that chiropractic has to offer. Don’t miss this amazing event!

Mr. Roberto Monaco will be speaking at the MAC Fall 2018 Convention & Exhibition, October 5-7, 2018, at the Renaissance Center in Detroit. His presentation, “How to Attract an Avalanche of New Patients with Group Communication,” will be on Saturday from 2-6p, for 4 hours of continuing education. He will also be speaking at the Opening Session” on Friday from 7-8:30p, for 1 hour of continuing education. For more information or to register, CLICK HERE.

I am going to guess something about you right now (I usually get it right 99% of the time): 

The last chiropractic talk that you gave, you spent most of your preparation time going over the slides instead of rehearsing your talk out loud, true? 

C’mon, admit it, you old sap. Don’t be embarrassed. You’re in good company. 

It went something like this: 

You spent most of your time reviewing the slides 

… adding a new study,

… changing the fonts,

… adding a cool picture,

… finding that perfect video to add to your deck,

… instead of physically rehearsing your talk, am I right? 

Then, after your slides were perfect, you were ready to present. 

During the presentation, you actually felt the urge to read the text on the slides out loud to your audience (just in case some of them could not read). Congratulations! You have become a slide presenter! (*cough* *cough*) 

Here is something I have learned during the last five years working with chiropractors all over the world: 

Doctors are addicted to PowerPoints. It is sad but is true. 

Look, it is not your fault, it is the culture of the chiropractic coaching industry. 

If you are (or were) in a coaching relationship, I bet your coaching group gave you a PowerPoint template and told you, “Here you go, the presentation is ready for you.” 

And because doctors trust their coaches, they do exactly that. They present the slides and become a slide presenter (instead of influencer). 

Unfortunately, they became what I call “Milli Vanilli” presenters. They ended up singing someone else’s song and get in trouble. 

Later, these doctors wonder: 

… “Why aren’t my closing ratios that high?”

… “Why am I not enjoying this talk as much?”

… “Why am I not connecting to the way I should?” 

Here is something for you to think about?

• Why, during presidential elections, do candidates that speak to crowds, trying to get their votes, not use PowerPoint?
• Why, as a Tony Robbins speaker, doing 400 talks per year, was I not allowed to use PowerPoints?
• Why does Jeff Bezos, the richest man in the world, prohibit using PowerPoint presentations at Amazon? 

Because when you do not know how to use slides, you become less effective. 

Listen, I am not bashing PowerPoint. I actually use them for my long-format training. 

But it is critical that you understand this: The PowerPoint presentation does not convert your audience into patients. YOU do. 

One of our coaching clients, Dr. Zaino, who built up one of the largest chiropractic practices in the world (at one point the office was seeing over 2,400 patients a week), built his business primarily doing dinner with the doctor talks without PowerPoint. 

I get the point that if you are doing other talks, like nutrition, detox, weight loss, etc., it takes lot of work for you to research your topic, etc. 

Obviously, having someone to do the research for you and build a slide presentation saves you a lot of time (I really believe that and I think it is a great service). 

However, you have to make sure that you make that presentation your own and you spend most of your time rehearsing your talk out loud instead of “going over the slides.” 

Look, if you want to have the confidence that your presentations and your ability to present your ideas are superb, then rehearse your talk, at least seven times!

Remember this: “Amateurs spend most of their time designing the slides so they can educate the room. Professionals spend most of their time practicing the talk so they can influence the room.” 

Roberto Monaco is the co-founder, chief presentation officer, and content developer of InfluenceOlogy, a company that seeks to help clients make more money, expand their mission and create a bigger impact in the world through public speaking, presentations, and influence. He has been a full-time speaker, coach and trainer since 2002, and has conducted more than 4,500 presentations in the United States, Canada, Mexico, England, Brazil and Puerto Rico. He has advised and consulted with Fortune 500 companies, executives, managers and sales professionals in the areas of peak performance, leadership, psychology of achievement, presentation skills and sales. 

He worked for the Anthony Robbins Companies for six years, and in 2004, 2005, 2006 and 2007 he was the top producer and revenue generator in the country. From 2005-2008, he also coached and trained all the other Peak Performance Strategists at The Anthony Robbins Companies. For the past several years, he has served chiropractors, showing them how to convert more patients. He has quickly become the “go-to” speaking coach for the top chiropractic advocates in the industry. He is the founder of The Chiro Speaking Club, an online community to teach doctors to attract and retain new patients through public speaking and group communication. He has also developed the premiere Public Speaking Seminar for Chiropractors, “Influencing From the Front for Chiropractors.”

Fall 2018 Convention & Exhibition

Quick Links

• SPEAKERS & SESSIONS
• SCHEDULE
• EVENTS 
• EXHIBITOR INFORMATION 
• ACCOMMODATIONS
• REGISTRATION INFORMATION

The MAC returns to the Beautiful Marriott at the Renaissance Center in downtown Detroit for the 2018 Fall Convention & Exhibition. Located on Detroit’s world-famous RiverWalk, join your chiropractic colleagues, our dynamic lineup of speakers, and representatives from dozens of exhibitors for this incredible three-day showcase of the best that chiropractic has to offer. Don’t miss this amazing event!

Speaker Notes

• F18 Illes Notes
• F18 Nerve Compression Lower
• F18 Nerve Compression Upper
• F18 Mussman MRI Notes
• F18 Buerger - Balancing the Brain
• F18 Koren Notes Magic
• F18 Koren Notes eReport
• F18 Koren Notes Vaccine Report
• F18 Meyn Notes
• F18 Human Trafficking Notes
• F18 Payne Episodic
• F18 Buerger - Raw and Real
• F18 Monaco Psychology Notes
• F18 Payne CA Notes
• F18 Mussman CA Notes
• F18 Insurance Panel - Treating Veterans
• F18 Insurance Panel - Modifier
• F18 Insurance Panel - Auto No-Fault