The Florida Current: How can Florida doctors survive in an HMO world? Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week

Reprinted from The Florida Current
http://www.thefloridacurrent.com/

By Christine Jordan Sexton, 8/18/2011

Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week.

State Rep. Darren Soto is hosting a meeting at the Florida Hospital in Orlando on Aug. 25 to answer questions from doctors and hospitals about how to play in the new mandatory managed care environment, said Soto, a Democrat from Orlando. This isn’t the first meeting on the statewide Medicaid managed care project, but it may be the first one where the agenda is aimed at answering health care providers’ questions. Soto said providers need to understand how the changes impact their businesses if they want to stay in business.

"This won't be political," said Soto, who actually voted against the sweeping reforms along with the other Democrats in the House of Representatives. "It's an effort for me to help educate the doctors and administrators and others folks who are potentially dealing with Medicaid reform. …. This is geared toward providing information on what would be a huge reform affecting loss of doctors offices."

Agency for Health Care Administration spokesperson Michelle Dahnke confirmed that Dudek -- and not a proxy -- will be at the meeting.

This is not the first time that Soto has hosted meetings in Orlando with agency secretaries. He previously met with former Department of Health Secretary Ana Vimonte Ros and former Department of Community Affairs Secretary Tom Pelham, who addressed autism in the Hispanic community and the foreclosure crisis, respectively.

"If you ask the right way you can get a lot of secretaries to come down," said Soto.
Filed in: Health Care
Tags: Medicaid Reform

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Dervices include: consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties. Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors

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Broward Chiropractor Troy Lomasky Notes Consumer Reports Review of the Benefits of Chiropractor Visits, Chiropractic Treatment, Massage; "It's magical," Says Florida Patient

Consumer Reports noted in this 2011 review of chiropractic and other alternative treatments, which said that in one in four respondents undergoing chiropractic treatment for any condition said their chiropractor was more interested and insightful than their medical doctors.


Alternative therapies
Last reviewed: September 2011



This article appeared in September 2011 Consumer Reports Magazine.



Complementary care: Carola Hamann of San Francisco likes to play hockey despite hips that ache from arthritis and other ailments. She says that combining yoga, chiropractic care, and conventional physical therapy has helped keep her on the ice. (Photograph by Frank Morgenstein)


Done anything alternative lately? If so, you have a lot of company. When we surveyed 45,601 Consumer Reports subscribers online, we found that three out of four were using some form of alternative therapy for their general health. More than 38 million adults make in excess of 300 million visits to acupuncturists, chiropractors, massage therapists, and other complementary and alternative practitioners each year in the United States.

Despite the hoopla over alternative therapies, when we asked respondents how well the therapies they used worked for 12 common health problems, results showed that they were usually deemed far less helpful than prescription medicine for most of the conditions.

Even widely used dietary supplements ranked far below over-the-counter medications in many cases. But hands-on treatments such as chiropractic and deep-tissue massage, as well as the mind-body practice of yoga dominated the lists of helpful alternative treatments for discomfort from conditions such as back pain, neck pain, and osteoarthritis.

Carola Hamann, 42, of San Francisco said she has found that yoga, combined with monthly chiropractic adjustments and some exercises her physical therapist recommended, has helped a lot to relieve pain in her hips from osteoarthritis and other concerns. She keeps her medical doctor informed about therapies she has tried but notes that her chiropractor "sees how everything's connected."

Of alternative treatments used for general health, mainstream vitamins and minerals were the most widely used, with 73 percent of respondents taking them. But 57 percent said they used dietary supplements other than vitamins or minerals. And about one in five reported using mind-body therapies such as yoga or hands-on therapies such as massage.

A total of 30,332 survey respondents gave us their perceptions of the helpfulness of treatments for their most bothersome conditions over the past two years. The respondents were Consumer Reports subscribers, and our findings might not be representative of the general population. Respondents based their opinions on personal experience, so the results can't be compared with scientific clinical trials. And our results do not take into account the power of the placebo effect, the tendency of people to find even simulated or sham interventions helpful.

Why these treatments?
For most conditions we asked about, the No. 1 reason respondents gave for choosing an alternative treatment was simply that they were "a proponent" of it.

"Some people use these therapies because it's just the way they were raised," says Richard Nahin, Ph.D., M.P.H., senior adviser for scientific coordination and outreach at the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Some say they have gone through a transformational process, such as a major illness that has caused them to look at their life in a different way, Nahin says. Others believe dietary supplements are safer than prescription medication because they're natural, even though that's not necessarily the case, he says.

And for some conditions, people choose alternative treatments to avoid the side effects of conventional medications. That was true for about two out of five respondents suffering from insomnia.


Adjustment



Michael Shannon of Ocala, Fla., gets treatment from chiropractor Dennis Seese, D.C., of Belleview, Fla.
Photograph by Steve Williams

When Michael Shannon, 63, of Ocala, Fla., reinjured his back in 2008 he immediately found the closest chiropractor. After the initial 90-minute session, he walked out feeling that it had helped a lot. "It was amazing," Shannon says. After four more chiropractic sessions of about 15 minutes each, along with occasional sessions of massage therapy, he was largely symptom-free. When he feels his back tightening up again, he schedules another adjustment. "It's magical," he says.

One in four respondents undergoing chiropractic treatment for any condition said their chiropractor was more interested and insightful than their medical doctors. More than 30 percent of respondents who had acupuncture felt the same way.

The role of doctors
Our survey found that the wall between conventional doctors and alternative medicine isn't as high as you might assume. Our readers said doctors were generally aware of their use of alternative therapies for their medical conditions.

For instance, 57 percent of people who got Shiatsu massage, usually for back or neck pain, said their doctors knew about it, and so did 81 percent of those who sought chiropractic care.

Sixty-five percent of those who practiced progressive relaxation said their medical caregivers knew about it, as did 68 percent of readers who meditated. A majority of those taking dietary supplements, vitamins, and minerals said their doctors were aware of it.

But doctors were selective in their endorsement of dietary supplements, our survey showed. They tended to point patients toward products with some clinical evidence behind them, such as fish oil for cardiovascular problems, and glucosamine and chondroitin for osteoarthritis.


Integrative healing:  Avis Brown of Morgan Hill, Calif., says that deep-tissue massage, meditation, and dietary changes have helped free her from the painful symptoms of fibromyalgia. (Photograph by Robert Houser)


"We have to be responsible captains of our own health ship," says Avis Brown, 65, of Morgan Hill, Calif., a reader who participated in our survey. "And doctors are our navigators." She said that she received a diagnosis of fibromyalgia about 18 years ago but that massage, meditation, and a sugar-free diet have helped her remain free of symptoms for more than 10 years.

In many cases, a substantial minority of respondents using a particular treatment said their doctors were the ones who had pointed them to it in the first place. Twenty-eight percent of readers who used deep-tissue massage, usually for back or neck pain, said their doctors had recommended it. So did 26 percent of people who used deep-breathing exercises and 21 percent who went to a chiropractor.

Though it's still a rarity, some doctors are adding alternative treatments to their own therapeutic tool kit. Brenda Bourassa, 65, of Winslow, Maine, gets regular acupuncture treatments for her neck pain from Rick Hobbs, M.D., a family physician in nearby Waterville. She says that she was skeptical at first but that the treatments have helped. "I believe that eventually it will eliminate the pain, not just relieve it on a temporary basis," she says.

Hobbs said he became interested in acupuncture in 2004. He now limits his practice mainly to acupuncture and integrative medicine and is president of the American Academy of Medical Acupuncture. "People still think of me as a family doctor as well as an acupuncturist," he says. "My patients stuck with me."



Copyright © 2004-2011 Consumers Union of U.S., Inc.

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida, near Ft. Lauderdale.  A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.