Abstract:
BACKGROUND:Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician "work" is defined. OBJECTIVE:Results of work and time inputs from chiropractic physicians are compared with those reported by osteopathic and medical specialties. Last, implications for reimbursement of chiropractic fee services are discussed. METHODS:Total work, intraservice work, and time inputs for clinical vignettes reported by chiropractic, osteopathic, and medical physicians are compared. Data for chiropractic work and time reports were drawn from a national random sample of chiropractors conducted as part of a 1997 workers' compensation chiropractic fee schedule development project. Medical and osteopathic inputs were drawn from RBRVS research conducted at Harvard University under a federal contract reported in 1990. Both data sets used the same or similar clinical vignettes and similar methods. Comparisons of work and time inputs are made for clinical vignettes to assess whether work reported by chiropractors is of similar magnitude and variability as work reported by other specialties. RESULTS:Chiropractic inputs for vignettes related to evaluation and management services are similar to those reported by medical specialists and osteopathic physicians. The range of variation between chiropractic work input and other specialties is of similar magnitude to that within other specialties. Chiropractors report greater work input for radiologic interpretation and lower work input for manipulation services. CONCLUSIONS:Chiropractors seem to perform similar total "work" for evaluation and management services as other specialties. No basis exists for excluding chiropractors from using evaluation and management codes for reimbursement purposes on grounds of dissimilar physician time or work estimates. Greater work input by chiropractors in radiology interpretation may be related to a greater importance placed on findings in care planning. Consistently higher reports for osteopathic work input on manipulation are likely attributable to differences in reference vignettes used in the respective populations. Research with a common reference vignette used for manipulation providers is recommended, as is development of a single generic approach to coding for manipulation services.
journal_name
J Manipulative Physiol Therjournal_title
Journal of manipulative and physiological therapeuticsauthors
Hess JA,Mootz RDdoi
10.1016/s0161-4754(99)70060-6subject
Has Abstractpub_date
1999-06-01 00:00:00pages
280-91issue
5eissn
0161-4754issn
1532-6586pii
S0161-4754(99)70060-6journal_volume
22pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to correlate the heart rate variability (HRV) indices with variables of pain that were experienced by individuals with chronic neck pain. METHODS:This was a blinded cross-sectional study. Individuals with chronic neck pain (n = 15) and healthy participants (n = 15), both sedenta...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2018.11.010
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:This article evaluates reliability and diagnostic validity of the cervical flexion-rotation test (FRT) to discriminate subjects with headache because of C1/2 dysfunction. In addition, this study evaluates agreement between experienced and inexperienced examiners. METHODS:These were 2 single blind comparative...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmpt.2008.03.012
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To present the diagnosis and differential diagnosis of diabetic polyneuropathy and report a case in which a patient with this disorder was successfully managed utilizing chiropractic procedures. CLINICAL FEATURES:An 80-year-old man with a history of diabetes mellitus complained of low back pain along with bu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:The aim of this preliminary study was to investigate the immediate effects on pain and pressure pain threshold (PPT) of a scapular repositioning technique in patients with acute spasmodic torticollis. METHODS:A randomized, single blind pilot study was conducted. The subjects were 23 individuals (age 20-40 y...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmpt.2013.05.020
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To investigate (1) whether thoracolumbar posteroanterior (PA) stiffness differs between 2 conditions of ribcage movement: unconstrained and constrained, and (2) whether the effect of ribcage constraint on PA stiffness varies according to where the PA force is applied. DESIGN:Two-factor within-subjects design...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/S0161-4754(02)54131-2
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To determine whether a newly developed disability scale for patients with neck pain demonstrated acceptable reliability and validity. METHODS:Testing was conducted using three different samples of patients with neck pain (n = 162). Test-retest reliability of the scale was carried out on the same day with one...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the feasibility of collecting valid and widely used health outcomes, including information concerning cost of care, using a Web-based patient-driven patient-reported outcome measure (PROM) collection process within a cohort of UK chiropractic practices. METHODS:A Web-bas...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmpt.2015.12.001
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to propose questions that may be helpful to educate patients considering treatment approaches to manage low back pain (LBP) and to determine if the information currently presented in informed consent (IC) documents at chiropractic colleges is sufficient to help a patient consider...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmpt.2012.01.004
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:To quantify the projection errors caused by the combining of selected x-axis translations with selected y-axis rotations as seen on plain film anteroposterior (AP) radiographs. STUDY DESIGN:A computer was used to model the projection of the lamina junction and points on the lateral body margins of a 2-dimen...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1067/mmt.2001.118206
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the reliability of the Goutallier classification system (GCS) for grading muscle fatty degeneration in the lumbar multifidus (LM) using magnetic resonance imaging (MRI) examinations. METHODS:Lumbar spine MRI scans were obtained retrospectively from the radiology d...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2013.12.010
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Reports of complications after chiropractic adjustments were administered to the lumbar spine and/or pelvis are rare. This case report provides the events associated with a sacral fracture that was not identified before a side-posture sacroiliac adjustment. CLINICAL FEATURES:The patient suffered from blunt, ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract:Objective:The purpose of this study was to measure the acute (1 session) and chronic effects (6 sessions) and the follow-up (2 weeks) of anteroposterior articular mobilization of the talus, grade III of Maitland, on the dorsiflexion range of motion (ROM), pain, and functional capacity of individuals with subacute and c...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2017.02.003
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To establish the mechanism of the thoracolumbar spine during trunk rotation and its restriction. DESIGN:Patients with one-sided rotation restriction were examined seated on a chair with the pelvis fixed in neutral position, at maximum right and left trunk rotations, before and after mobilization of movement ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:A managed care organization (MCO) examined differences in allowed cost for managing low back pain by medical providers vs chiropractors in an integrated care environment. The purpose of this study is to provide a retrospective cost analysis of administrative data of chiropractic vs medical management of low b...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2009.10.001
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The reliability of a test depends on its standardization. Instrumental measurement of the reproducibility of the test is an effective way to evaluate the level of standardization obtained. Improved standardization is believed to yield greater reliability. OBJECTIVE:The objectives of this study were to measu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1067/mmt.2002.126472
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate differences in muscle activity in participants with and without low back pain during a side-lying lumbar diversified spinal manipulation. METHODS:Surface and indwelling electromyography at eight muscle locations were recorded during lumbar side-lying manipulations in...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2016.02.011
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Measurement of cervical motion (CM) is probably the most commonly applied functional outcome measure in assessing the status of patients with cervical pathology. In general terms, CM refers to motion of the head relative to the trunk as well as conjunct motions within the cervical spine. SPECIAL FEATURES:Mu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.jmpt.2008.08.004
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:Nonspecific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms, such as fear-avoidance behaviors. This study aimed to evaluate the effect of cognitive behavioral therapy (CBT) associated with stabilization exercise (SE) on thickness of transverse ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2019.03.015
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate outcomes of chronic patients unresponsive to previous spinal manipulative therapy subsequently treated with manipulation under anesthesia (MUA). METHODS:A prospective outcome cohort study was performed on 30 patients who had not improved with previous treatment a...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2014.05.002
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To determine if chiropractic manipulation could relieve carpal tunnel syndrome (CTS). CLINICAL FEATURES:A 42-yr-old female suffered from pain, tingling and numbness in the right wrist. Paresthesia along the C6 dermatome, a positive Phalen's test and Tinel's sign was present. EMG testing confirmed the clinica...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Most of the studies of physical examinations of the cervical spine have shown poor reliability. PURPOSE:To assess the interexaminer reliability in physical examinations of the cervical spine. SUBJECTS:Forty-eight subjects, age range 18 to 63 years. METHODS:Two physiotherapists independently evaluated a nu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/s0161-4754(99)70002-3
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:The viscoelastic mechanical compliance properties of the human arterial system were examined in 100 subjects with A-mode Doppler ultrasound diastolic flow analysis. This technique of diastolic flow analysis is utilized to identify early atherogenic peripheral arterial disease. The sensitivity of the commonly ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate musculoskeletal injury rate and physical fitness before and 6 months after an endurance, strength, and motor control exercise program in preprofessional dancers. METHODS:This uncontrolled trial was completed at a college offering a professional bachelor degree in dan...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmpt.2012.04.014
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:Our aim was to report changes in neck pain at rest, active cervical range of motion, and neck pain at end-range of cervical motion after a single thoracic spine manipulation in a case series of patients with mechanical neck pain. METHODS:Seven patients with mechanical neck pain (2 men, 5 women), 20 to 33 yea...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2007.03.007
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to investigate the effect of chiropractic care in a multiclinic setting on sympathetic and parasympathetic nervous system activities using heart rate variability (HRV) analysis. METHODS:Physicians of chiropractic in private practice were provided with an HRV device to perform ana...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmpt.2006.03.010
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:Although some surveyed groups of chiropractors consider themselves qualified as primary care providers, consumer attitudes of such may affect practice success. The purpose of this study is to determine chiropractic patients' perception of chiropractors as primary care providers and to determine what disorders...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2006.11.007
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to investigate the possible prognostic value of disk-related magnetic resonance imaging (MRI) findings in relation to recovery at 14 months in patients with severe sciatica, and whether improvement of disk herniation and/or nerve root compromise is concurrent with recovery. METHOD...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2006.12.004
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of positive chiropractic test results in relation to low back pain status and to determine the sensitivity, specificity, and predictive (positive and negative) values of these tests. DESIGN:Study subjects were examined by a chiropractor who was unaware of their low back pain statu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/s0161-4754(00)90245-8
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to systematically review the literature evaluating the reliability and validity of all available methods for measuring active and passive cervical range of motion (CROM). METHODS:Electronic databases (PubMed, MEDLINE, CINAHL, EMBASE, and AMED) were searched through OVID from the...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.jmpt.2009.12.009
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:Back pain has consistently ranked among the top general health complaints among college students, but few studies have examined risk factors for back pain in this age group. This cross-sectional survey evaluated the association between the self-reported annual low back pain with the estimated usual backpack w...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2010.06.003
更新日期:2010-07-01 00:00:00