Fall 2012 Logan Speaks

LOGAN SPEAKSFALL 2012 | Logan Speaks is produced by the offices of Institutional Advancement and Public Relations

Examining the Factors thatFuel PerformancePage 2

4 Faculty Research Published in Preventive Medicineand Brain

6 The Educational Value of Evidence-Based Research

8 Marketing Motivation:The Science of Social Media

9 Did You Know?

10 Doctor to Doctor

12 Postgraduate Seminars

SCIENCE AND NATURE ALIGNED IN BALANCE

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LOGAN UNIVERSITYLogan University is a diverse andengaging community committed to excellence in health sciences,education and service, guided byintegrity, commitment and passion.

LOGAN COLLEGE OF CHIROPRACTICLogan College of Chiropractic prepares students to become doctors of chiropractic who are superblyeducated and clinically competent, practicing portal-of-entry chiropractic physicians. This mission isaccomplished through our dedicated faculty, recognized for student-centered excellence; comprehensivescience-driven, knowledge-based and information-facilitated curriculum; enhanced by community andpublic service. The institution is committed to the conduct of research and other scholarly activities.M

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2 SCIENCE AND NATURE ALIGNED IN BALANCE

Behind many of theserunners, jumpers andthrowers competingacross Missouri standmembers of Logan’sBIOFREEZE® Sports& RehabilitationCenter led by DirectorLaney Nelson, DC,DACBSP, and

Assistant Director Connie Hayes, DC.Dr. Nelson’s team dedicates its summersto track and field athletes, impartingprotocols from Logan’s Master of Sciencein Sports Science and Rehabilitation. But, Dr. Nelson says he and his colleagueshave also learned lessons from theseathletes as well.

“We have learned that track athletes havea tremendous amount of physical demandplaced on them, which is complicated bysmall allocations of time to rest and healbetween training and competitive events,”said Dr. Nelson, whose team has treatedapproximately 2,500 track and fieldathletes this summer. “When you’re onthe sidelines working with these athletes,you’re a part of another kind of speedevent—working to quickly and safelyreturn these athletes back to the field.

Consistency is critical if you are to treatthe 100 to 200 athletes who compete at a weekend meet.”

According to Dr. Nelson, track and fieldathletes have no shortage of techniquesthey employ to enhance performance. He says the Logan team is focused ondeveloping strategies to help theseathletes and their training staffs leveragetheir skill sets and achieve morepredictable outcomes.

“When every second counts, we rely on these strategies to ensure we are thorough, efficient and effective,” Dr. Nelson added.

Dr. Nelson’s team uses acronyms tooutline their strategies’ evaluation andtreatment measures so they’re easilyrecalled when on the sidelines. Theemergency acronym, referred to asABPCDE, instructs the health team toassess the athlete’s airway, blood pressure,conscious level, disfigurement and thenevaluate the diagnosis.

His second strategy, focuses on treatment of the athlete, and accounts for the students’ educational and personal variations.

The acronym BSMFNOPQR=S helpsstudents develop their clinical thinkingand management. The letters remind thestudent to check:

• Blood stabilization: Does treatmentneed to bring new blood into the areafor chronic injuries or restrict blood ifan acute condition?

•Muscle: What strategy will be used totreat the injured muscle sector?

• Fascial: What strategy or technique willmanage fascial plane restrictions?

• Neurologic: What neurological levelneeds to be addressed from amanipulative standpoint?

• Orthopedic: What tests or signs areneeded to validate the treatment andthe outcome?

• Plan: How are we going to implementthe strategy given our time constraints?

• Quietly Report: The heightenedemotions associated with competitiveevents do not negate the need forcorrect documentation. When it isquiet, make sure you chart to thestandard of care.

• Success: If you follow the strategy, thenyou can expect a successful outcome.

Examining the Factors that Fuel Performance

Dr. Laney Nelson

Dr. Laney Nelson IntroducesStrategies for Treating theSummer Track and Field Athlete

For some athletes, overcoming hurdles is all part of the game. These young men and women calculate every

stride and leap, vying to set a new record of achievement; and, in doing so, they transform a track and field

into a testing site for human performance. When plagued by injury, they rely on a team of coaches, trainers

and physicians to return them to the field before the brief season passes them by.

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3LOGAN SPEAKS FALL 2012

Whether treating an injury or enhancing performance, Dr. Nelsonadvises his students and colleagues toapply a proven strategy to better manage patient outcomes.

Running the Risk of OvertrainingUnlike contact sports where athletes mustadapt and maneuver based on theiropponents’ strategies, the track and fieldathletes perform on a linear plane.

“These athletes move in one repetitivedirection, needing to rapidly reach theirtop speeds and angular velocity and thenmaintain it throughout the competition,as opposed to basketball or football playerswho change their directions and rates of speed throughout the game,” said Dr. Nelson. For example, the averagefootball play or basketball exertion lasts10-15 seconds; whereas, track events lastfrom 12 seconds to minutes. “Thecombination of the dynamics of a trackand field athlete and the condensedseason often lead to overtraining.”

Dr. Nelson and his team instruct theirathletes and respective coaching staffs totrain at 80 percent of the athlete’sperceived capabilities. “By working withand helping to educate the coaching andtraining staffs, we’ve seen a sharp declinein stress fractures alone,” added Dr. Nelson.

When working with a track and fieldathlete, Dr. Nelson recommendspractitioners:

• Consider the lower extremity’s internalrotational speeds, as it relates to groundreaction forces.

• Assess the internal hip, tibia and talar speeds in regards to the pronationsequence.

• Test for abductor strength and speed by using a timed challenge.

• Perform Feiss’ line and measure talar drift, talar and navicular drops and glides.

Fueling PerformanceEven with the propertraining and exerciseregimens, track andfield athletes mustexamine their diets if they are to reachtheir maximumperformance levels.Robert Davidson, MS,PhD, assistant

professor with Logan’s Master of Sciencein Nutrition and Human Performance,dedicates several trimesters of studycovering the subject of nutrition andperformance. He says athletes needstrategies for maintaining their bloodglucose levels and hydration.

“I was a track and field athlete who found my calling in nutrition when Ilearned that my college coaching staff atthe time couldn’t answer my diet-relatedquestions,” said Dr. Davidson. “Since mycollege track days, I’ve dedicated mycareer to educating others on the linkagebetween nutrition and performance,which is undeniable.”

Among the current literature, Dr. Davidson says, it’s been reported that when physical activity is conductedfor less than 90 minutes, consider acarbohydrate source unnecessary.However, physical endurance for longerthan 90 minutes requires carbohydrates,which some athletes will consume viasports drinks or gels to maintain theirblood glucose levels during competition.

“This is why you’ll often find triathletes,for example, packing baked potatoes onrace day,” said Dr. Davidson. “It’s beenreported that by maintaining bloodglucose levels, athletes can lengthen theirpeak performance periods by one hourbefore they’ll hit fatigue.”

Dr. Davidson also emphasized hydrationlevels for track and field athletes, giventhey often spend two days out in the heatand sun competing. “For high schooltrack athletes, I recommend mixing up

their water intake with an electrolyte-replacement drink,” he says. “They could safely consume two sports drinks for every water bottle, so long as they are replacing electrolytes—needed torehydrate quickly—and other keycompounds and elements required tomaintain thermal regulation, like sodiumchloride, magnesium, calcium and zinc.Be mindful that many sports drinkscontain carbs, which are only needed ifcompeting or training for periods longerthan 90 minutes.”

When it comes to athletes’ home plates,Dr. Davidson advocates for consumingwell-balanced meals with variation;complete protein sources to supportmuscle growth and regeneration; andiron-rich foods, such as red meat, formaking blood cells with hemoglobin.

“Eating pasta before a game is great forcarb-loading,” he said. “But, athletesshould never cut out entire food groupsfrom their everyday diet. The biggestdifference between athletes’ dietscompared to non-athletes’ is they areconsuming more calories.”

We invite Logan alumni to

contact Drs. Nelson and Hayes to

make appointments on the Logan

campus for assistance in setting

up school site visits and learning

more about assessment.

To learn more about Logan’s

Master of Science in Nutrition

and Human Performance,

call 800-533-9210 or

visit Logan online at

www.logan.edu/future-students.

Dr. Robert Davidson

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Dr. Norman Kettner’sGreatest Research Honor … Thus Far

Nearly seven years ago,Norman W. Kettner,DC, DACBR,chairperson of Logan’sRadiology Department,and his collaborativeresearch team at theMassachusetts GeneralHospital’s Athinoula

A. Martinos Center for Biomedical Imaginginitiated a series of studies. The studiesrepresent part of the team’s long-termresearch trajectory: to map the functionaland structural cortical neuroplasticreorganization related to the peripheralneuropathy of carpal tunnel syndrome(CTS). They have employed multiple

powerful neuroimaging methods, withrobust analytical imaging paradigms, to render valuable insights into theabnormal cortical and subcortical processing arising from CTS and itsaccompanying chronic pain.

Recently, they completed another CTS study using magnetoencephalography(MEG) as the neuroimaging technique. Itsfindings included median nerve conductiondeficit was associated with a delayedresponse time in the primary somatosensorycortex, altered cortical rhythms andmaladaptive cortical neuroplasticity. Theteam then worked to publish its paper.

What happened next Dr. Kettner woulddescribe as “the preeminent honor of myresearch career”—Brain, which boasts animpact factor of 9.4 and is considered one of the top neurology journals, accepted thepaper titled “Spatiotemporal Mapping

Cortical Neuroplasticity in Carpal TunnelSyndrome.”

According to Dr. Kettner, the publishedresearch has translational impact as itcontributes to the understanding of theneurological mechanisms underlying centralsensitization, a maladaptive neuroplastic statewith enhanced nociceptive responsivenessand excitability. Central sensitization isfundamental in the conversion to andmaintenance of chronic pain.

“In CTS, as with many chronic disorders, an underlying mind-body interaction isoperational, which becomes associated with a state of maladaptive corticalreorganization,” said Dr. Kettner. “Themaladaptive neuroplastic responses in CTSare biopsychosocial and evolve from theabnormal afferent processing associated withmedian nerve injury (paresthesia, persistentnociception, referred pain), along withdisturbances in cognition (fear memory,hypervigilance) and affect (pathologicalanxiety, catastrophization).”

One of the most unexpected findings fromthe research, according to Dr. Kettner, was


Spatiotemporal Mapping Cortical Neuroplasticity in Carpal Tunnel SyndromeRupali P. Dhond1*, Emily Ruzich1, Thomas Witzel1, YumiMaeda1,4, Cristina Malatesta2, Leslie R. Morse3, Joseph Audette5,Matti Hamalainen1, Norman Kettner4, Vitaly Napadow1,4

1 Martinos Center for Biomedical Imaging, Dept. of Radiology,Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.

2 Dept of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital, Medford, MA, USA

3 Dept of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA

4 Dept of Radiology, Logan College of Chiropractic/University Programs,Chesterfield, MO,

5 Dept of Pain Medicine, Harvard Vanguard Medical Associates, Atrius Health, Boston, MA, USA

SUMMARY Neuroimaging data demonstrate that carpal tunnel syndrome(CTS), a peripheral neuropathy, is accompanied by maladaptivecentral neuroplasticity. To further investigate this phenomenon, we collected magnetoencephalography data from 12 CTS patients and 12 healthy volunteers undergoing somatosensory stimulationof median nerve innervated digit 2, digit 3, and ulnar nerveinnervated digit 5. Nerve conduction velocity and psychophysicaldata were acquired to determine if standard clinical measurescorrelated with brain response.

In carpal tunnel subjects, but not healthy volunteers, sensory nerveconduction velocity for digit 2 and digit 3 was slower than digit 5.However, somatosensory M20 latencies for digits 2 and 3 weresignificantly longer than those of digit 5. The extent of the M20delay for median innervated digit 2 was positively correlated withdecreasing nerve conduction velocity and increasing pain severity.Thus, slower peripheral nerve conduction in carpal tunnel syndromecorresponds to greater delays in the first somatosensory corticalresponse. Furthermore, spectral analysis demonstrated weaker post-stimulus beta event related desynchronization and earlier andshorter event related synchronization in carpal tunnel subjects. Theextent of the decreased event related synchronization for medianinnervated digits was positively correlated with paresthesia severity.We propose that ongoing paresthesias in median nerve innervateddigits render their corresponding sensorimotor cortical areas “busy”thus reducing their capacity to process external stimulation. Finally,carpal tunnel subjects demonstrated a smaller cortical sourceseparation for digit 2 and digit 3 in comparison with healthyvolunteers. This supports our hypothesis that ongoing paresthesiaspromote blurring of median nerve innervated digit representationsvia Hebbian plasticity mechanisms.

In summary, this study reveals significant correlation between theclinical severity of carpal tunnel syndrome (CTS) and the latencyof the early M20 as well as the strength of long-latency betaoscillations. These temporal MEG measures are novel markers ofneuroplasticity in carpal tunnel syndrome and could be used tostudy central changes that may occur following clinicalintervention.

Dr. Norman Kettner

Logan Faculty’s Research Published in Preventive Medicine and Brain

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the slower peripheral nerve conductionvelocity in CTS, correlated with decreasingresponse time in the primary somatosensorycortex. “The delayed peripheral nervetransmission resulted in delayed response inthe primary somatosensory cortex,” addedDr. Kettner. “This cortical delay suggeststhat more complex cortical processing maybe required in CTS compared to healthycontrols. In addition, the delay in corticalresponse correlated with the intensity of theCTS metrics for pain and paresthesiasuggesting this increased afferent traffic wasslowing the cortical somatosensory responseto external inputs.”

Dr. Kettner says another focus of the team’songoing research is to characterize thecentral neural correlates of CTS patients inresponse to acupuncture stimuli. This workhas revealed clinical and neuroimagingevidence for beneficial neuroplasticreorganization that stems from theintervention of acupuncture in CTS patients.

“Our work has added to the growingrecognition that diverse mechanisms maydrive beneficial neuroplastic reorganizationin the brain, including neural stimulation,physical activity, cognitive and motorlearning and environmental enrichment,”said Dr. Kettner. “This therapeutic approachconstitutes a new, safe and effectivearmamentarium for clinicians who employneurorehabilitation in patient care.”

As Dr. Kettner looks toward the future, hesays the new MEG data used in the Brainstudy may serve as primary outcomemeasures in future interventions for CTS orother chronic pain syndromes.

Dr. Cheryl Hawk’sResearch Lands inPreventive MedicineAccording to Harvard Medical Schoolfaculty and Harvard Health Publications,good health means more than treatingillnesses when they occur—it meansachieving and maintaining a healthyweight, getting optimal nutrition, exercising and staying fit, and takingsteps to prevent disease.

If Cheryl Hawk, DC,could add one more tothat list, there’s no doubtshe would includecomplementary andalternative health care.

For more than 35 years,Dr. Hawk, director

of clinical research at Logan College ofChiropractic/University Programs, has beendeeply involved in wellness promotion anddisease prevention and its role in today’schiropractic model. At Logan, her researchhas centered on developing ways to integratemainstream prevention and healthpromotion practices into chiropractic.

Earlier this year, Dr. Hawk earned the honor of being published in Preventive Medicine—one of the highest ranking medicaljournals—for her research on the potentialrole of complementary and alternative healthcare providers in chronic disease preventionand health promotion. Dr. Hawk said thepublished research is significant for manyreasons, but perhaps one of the morenoteworthy reasons is that it reachesthousands of readers outside of thechiropractic industry.

“Complementary and alternative health careis almost always viewed as a treatment forconditions, and very seldom in the context of wellness, disease prevention and healthpromotion,” she said. “We wanted to use theNational Health Interview Survey (NHIS)data to explore the idea that people do usecomplementary and alternative health carefor wellness, not just for treating conditions.”

Dr. Hawk collaborated with Dr. HarrisonNdetan from the Parker Research Institute in Dallas, Texas, and Dr. Marion WillardEvans Jr. from Texas Chiropractic College inPasadena, Texas. Dr. Hawk said while manyothers in the past had used the NHISdata set, she and her co-authors were thefirst to conduct their particular analysis.

Their findings showed that manyrespondents do not use complementary and alternative health care to treat specificconditions; rather, a substantial number of complementary and alternative healthcare users take advantage of it forwellness, improved energy and improved immune function.

“For us, these findings reinforce the theoretical basis of chiropractic, as well as other complementary and alternative health care practices,” she said. “However, itcould come as a surprise to those not familiarwith complementary and alternative healthcare practices as well as mainstream health care providers.”

AbstractPotential role of complementary andalternative health care providers inchronic disease prevention and healthpromotion: An analysis of National Health Interview Survey

SURVEY DATAObjective: To make a preliminaryassessment of the potential role of the mostfrequently used licensed or certified UnitedStates complementary and alternativemedicine (CAM) providers in chronicdisease prevention and health promotion.

Method: This was a secondary analysis ofthe 2007 United States National HealthInterview Survey (NHIS), the most recentto include CAM use. The Adult CoreSample, Person and Adult Complementaryand Alternative Medicine data files wereincluded. NHIS complete survey designstructure (strata, cluster and survey weights)was applied in generating nationalpopulation estimates for CAM usage.

Results: Chiropractic or osteopathicmanipulation (8.4%) and massage (8.1%)were most commonly used; acupuncture wasused by 1.4% and naturopathy by 0.3% ofrespondents. Substantial proportions ofrespondents reported using CAM forwellness and disease prevention, andinformed their medical physician of use.Fifty-four percent were overweight or obese,22.0% physically inactive, and 17.4%smokers; 18.0% reported hypertension,19.6% high cholesterol, and 9.1%prediabetes or diabetes.

Conclusion: CAM users present with riskfactors, which are priority public healthissues. This implies a need to train CAMproviders in evidence-based healthpromotion counseling. CAM encountersmay provide opportunities to coordinatehealth promotion and prevention messageswith patients’ primary care providers.

Dr. Cheryl Hawk

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When Jonathan Emlet and John

Ellis graduate from Logan College

of Chiropractic/University Programs,

they’ll have something that most

of their peers don’t—published

research as well as an award from

the Association of Chiropractic

Colleges and Research Agenda

Conference (ACC-RAC).

“There’s something very gratifying aboutknowing firsthand what I’m doing iseffective,” said Ellis. “When I graduate, I can adjust with confidence knowing thetechnique works because I helped tovalidate its benefits through research.”

Along with Dr. KevinWard, who graduatedfrom Logan in August2011, Emlet and Ellisvolunteered their timeto continue an ongoingline of research into the effects of spinalmanipulation therapy onFitts’ Law Performance.

Building on research that Dean of Logan’sResearch Division Dr. Rodger Tepeconducted in 2010, their objective was todetermine whether or not chiropracticadjustments had any effect on reactiontimes of participants both with and withoutneck pain.

While the team discovered improvedmovement times in participants with neckpain who received spinal manipulationtherapy, their research also revealedsomething else.

“Going into the study, I had an idea that wewould find the chiropractic adjustment tohave a significant effect on movement timesin symptomatic participants, but we alsofound a significant change in movementtimes with non-symptomatic participants,”said Emlet. “I enjoyed working on a topicthat is relatively untouched in thechiropractic research realm and knowingour study’s findings could have a positiveimpact on the profession.”

The abstract, “A Single Blind RandomizedControlled Trial of the Effects of SpinalManipulative Therapy on Fitts’ LawPerformance in Participants With andWithout Neck Pain,” was published in theJournal of Chiropractic Education. The fullresearch manuscript has been submitted tothe Journal of Manipulative and PhysiologicalTherapeutics for peer review.

Student Research at LoganWhile the hard work and determination of Emlet, Ellis and Dr. Ward is reflected intheir abstract’s publication and recognitionat ACC-RAC, they offer accolades to Dr. Tepe for his mentorship and for creatingan inviting and collaborative environmentfor student research to occur.

“One of the reasons why I chose Logan wasthe institution’s emphasis on research,”Emlet said. “As soon as I began thedoctorate program, I got in contact with Dr. Tepe and let him know that I wasinterested in conducting research, and that I was willing to begin as soon as possible.”

Dr. Kevin Ward

The Educational Value of Evidence-Based Research

John Ellis (left) and Jonathan Emlet

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Ellis agreed.

“We came prepared to research andpresented ourselves as people who wantedto do this study to further chiropractic,”he said. “I think Logan’s faculty is pleased tosee the outstanding research projectsperformed by Logan students.”

For years, Logan has offered educationalcurricula designed to teach students aboutresearch in both the classroom setting and intheir senior research projects. At any giventime, there can be as many as 80 differentstudent research projects taking place atLogan on topics ranging from the effectsof chiropractic care on head and neckconditions to balance and fall prevention totreatment and prevention of sports injuries.The institution boasts one of the highestnumbers of required student research hoursand is one of the few chiropractic collegeswith an Evidence-Based Journal Club,created to teach students how to beconsumers of research and criticallyevaluate scientific journal articles.

“What students learnhands-on by doing theirown literature reviewsand their ownexperimental projects,like a clinical trial,is invaluable,” saidDr. Tepe. “The biginitiative here at Loganis to do an outstanding

job of educating students so theybecome lifelong learners.”

Research in PracticeDr. Ward, who practices at TaschlerSpine and Rehab in Fairfax, Va., saidknowing that he’s providing evidence-basedcare, as supported by the latest literature,has increased his confidence with

patients and validated his care to otherhealth providers.

“Last month, I met with a neurologist,and I was telling him how chiropractic carecan be beneficial for some patients withcervicogenic vertigo,” Dr. Ward said.“He was skeptical, so I told him about ourstudy at Logan. He said it was the firsttime chiropractic care had ever beenexplained scientifically.”

Dr. Tepe was not surprised by theneurologist’s response:

“We’re in the business of changing

the perception of chiropractic through

research on several levels. We

want our students to be information-

literate, evidence-informed, evidence-

based practitioners. The mission of

the research division at Logan is to

design, conduct, present and publish

studies that investigate the efficacy,

safety and our cost-effectiveness

of chiropractic intervention on

musculoskeletal conditions in

diverse populations.”

The Fitts’ Law research study demonstratesthat a single cervical manipulation resultedin dramatic improvement in sensory motorcoordination, speed and accuracy inparticipants with and without neck pain.

Ellis said the most valuable learningexperience he gained was understanding theprocess of creating a research project andseeing it through from start to finish. “I’ve

never had anything published, and I’m nowat an institution where that is reallyencouraged,” he said. “I enjoy being ableto crunch the numbers to see if we’regetting the results we need. That’s funfor me, and the results were amazing—better than we expected.”

For Emlet, learning the importance ofconducting meaningful research that buildson previous studies and supports futureinvestigations has been most beneficial.

“The information that has been derivedfrom this study can be used in futureresearch on the effects of chiropracticadjustments,” he said. “It can also giveus a better understanding of howchiropractic aids the body in maintaininghomeostasis.”

Dr. Ward plans to apply his researchskills in generating case studies from hisown patient experiences, leveraging thesestudies as a basis for more extensiveresearch, such as clinical trials. Aschiropractors strive to return their patientsto full function as rapidly as possible,Dr. Ward maintains that research is keyto this mission and can guide the mosteffective clinical practices.

Emlet and Ellis are continuing Fitts’ Lawresearch and the effect of chiropracticadjustments under Dr. Tepe’s mentorship.Building on the most recent award-winningstudy, this Logan faculty and student researchteam is conducting a new investigation thatwill examine the effects of multipleadjustments in a repeated measures design.

At Logan’s 2012 Homecoming, theLogan College Alumni Associationpresented the Logan Senior ResearchProject Award to students John Ellis,Jonathan Emlet and (now Dr.) KevinWard. The three honorees shareda $2,000 award.

Dr. Rodger TepeDr. Rodger Tepe, Dean of Logan’s Research Division

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Excerpts The American Chiropractic Association

ACA Pledges to Continue Patient Access Fight as HealthReform Law Upheld

When the U.S. SupremeCourt ruled the PatientProtection andAffordable Care Act as

constitutional, it preserved Section 2706.The ACA advocated for the inclusion ofthis provision in the legislation, whichestablishes a “provider non-discriminationprovision” applicable to all EmployeeRetirement Income Security Act (ERISA)health care plans, including self-insured,multi-state plans that are not subject toprovider-friendly state laws.

“Regardless of how you feel about thislegislation in general, Section 2706 has tobe recognized as an historic first for thechiropractic profession. We now have afederal law applicable to ERISA plans thatmakes it illegal for insurance companiesto discriminate against doctors ofchiropractic and other providers basedon the provider’s license or scope ofpractice,” said ACA President KeithOverland, DC. “While the fight to fullylevel the playing field for doctors ofchiropractic in our health care system goeson, the non-discrimination provision,when it is fully implemented, will extendthe availability of chiropractic services toseveral million employees at large, nationalfirms that operate in multiple states.

The majority of the law’s key provisions,including the provider non-discriminationprovision and the individual mandate, are scheduled to take effect no later than 2014.

The Court’s ruling also confirms all 50states must establish “state insuranceexchanges” where eligible consumers can shop some insurance plans’ prices and benefits, as specified by federalgovernment guidelines. According to the ACA’s news release, “safeguardingsignificant ‘state flexibility’ is seen as oneway to ensure that consumers have accessto the services provided by doctors ofchiropractic and that state laws favoringconsumer choice of provider remainapplicable, for the most part, in the state exchange environment.”

Chiropractic Economics

Research Supports Chiropractic’s Effectiveness

Including evidence-based health careapproaches, like chiropractic, in value-based health plans may advance cost andclinical effectiveness, according to findingsfrom recent research titled “A Hospital-Based Standardized Spine Care Pathway:Report of a Multidisciplinary, Evidence-Based Process.”

In the study, the 402 low-back painpatients treated exclusively by doctors of chiropractic at Jordan Hospital inPlymouth, Mass., achieved successful clinical outcomes in an average of 5.2visits at the low cost of $302 per case,while maintaining satisfaction rates above95 percent. In addition, self-reported painand disability scores were reduced byabout 70 percent over the course of just a few weeks.

“As employers expand their approach to implementing value-based plans, these additional findings increasinglydemonstrate the potential value thatinclusion of chiropractic services mayprovide,” said Bruce Sherman, MD, FCCP, FACOEM, former medical director,Whirlpool Corporation and contributingauthor of Outcomes-Based Contracting™:The Value-Based Approach for OptimalHealth with Chiropractic Services.

HealthCare Medicine Institute

A collaborative investigation betweenresearchers from the University ofMaryland School of Medicine and theShanghai University of TraditionalChinese Medicine concluded: “Recentclinical trial and systematic review resultsclearly show acupuncture to be morebeneficial than conventional standardcare for many pain conditions….” Aspublished in Medical Acupuncture, thereview notes that “basic science researchhas identified several mechanisms bywhich acupuncture exerts its effectivenessin the treatment of pathologicalconditions.”

Did YouKnow? In an effort to keep you informed about recent news and industry changes that may

affect the profession and your practice, we’ve collected the following news briefs from

various trade publications and news articles. We hope you find this synopsis beneficial.

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Doctor DoctorTO

Logan College of Chiropractic/University Programsand the Logan Alumni Associationhave partnered tosponsor Doctor toDoctor, a practice tips section featuring

effective practice management methodsfrom successful DCs. Doctor to Doctor is spearheaded by Dr. Ralph Barrale,vice president of chiropractic affairsand dean of postgraduate education. If you would like to submit a practicetip to Doctor to Doctor, please contactDr. Barrale at 800-782-3344, or e-mail your tip to [email protected].

Dr. Ralph Barrale

This installment of Doctor toDoctor features informationfrom Dr. David Heitmann, a December 2007 Logan DC graduate and an April2008 graduate of Logan’sMaster of Science in SportsScience and Rehabilitation. Dr. Heitmann owns IntegratedSport and Spine Clinic of Madison, Wis.

Dr. Heitmann shared this article with LoganCollege of Chiropractic/University Programsfor publication in Logan Speaks. Logan claimsno copyright interest in Dr. Heitmann’s work.


How toGrow YourPractice …On a LowBudgetDavid Heitmann, DC, MSIntegrated Sport and SpineClinic of Madison, Wis.

I started small … really small.

When I graduated from Logan, I purchased abuilding with duplex space. I rented theduplex space I didn’t need and allocated theupstairs real estate to my practice and home,dedicating 700 square feet to my practice and150 square feet to living space. This is not atypo, I said 150 square feet for living.

At the time, the space well suited my life.When I first opened my practice, there wereno official ends to the work day. If I didn’thave a patient, I would leave. With littlemoney to spend on a marketing campaign, Irelied on myself to connect with people one-on-one. Going to networking- or business-related events and meeting with businessowners became my job when I wasn’t treating patients.

I later refined my “pounding the pavement”approach and developed what I call a key-person marketing strategy. My goal: Connectwith every business owner in town. I knew if Icould personally meet with our town’s businessleadership and educate them on the value ofreferring their employees and friends to mypractice, I would increase my new patientreach exponentially while managing myinvestment of time and dollars.

For complementary businesses such as massage therapy providers and shoe stores, I would visit their businesses, spend timebuilding personal relationships with theowners and representatives, and shareinformation about how my services could help to grow their businesses. I never made the conversation about me.

To Communicate, You Must DifferentiateIn my town, there are more than 100chiropractors. For me to spend any time or money on advertising and othercommunication tactics, I had to differentiatemyself as a doctor, or I’d find myself lost in the crowd.

Lucky for me, I had a competitiveadvantage—my Master of Science Degree in Sports Science and Rehabilitation fromLogan. When I communicated withprospective patients and referral sources, I leveraged my expertise and practice focus on sports medicine.

I also submitted to the recommendations of author Chuck Mefford in his book“Brandformation,” which advises readers toaudit how your competitors are advertisingand positioning themselves and do something

Dr. David Heitmann (at left) with a patient.

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FPO

LOGAN SPEAKS FALL 2012

A Publication of Logan College ofChiropractic/University Programs forAlumni, Students, Employees andFriends of the College

LOGAN SPEAKSFall 2012Logan Speaks is published three timesa year: Winter, Summer and Fall.

Logan Board of TrusteesSteven C. Roberts, JD, LLMChair of the BoardDebra L. Hoffman, DCVice Chair of the Board

Logan Board MembersRachel Storch Akrongold, JDCynthia L. BaudendistelAnthony C. Bilott, DCRichard M. Bruns, DCChristophe Dean, DCPaul Henry, DCCarmen Jacoby Hutchcraft, DCCharles G. Kim, MBARick A. McMichael, DCMark O. Reeve, DCRobert J. StearleyRodney Williams, DC

Logan AdministrationGeorge A. Goodman, DC, FICCPresidentLaura McLaughlin, MA, JDGeneral CounselBoyd Bradshaw, EdDVice President of Enrollment ManagementCarl W. Saubert, IV, PhDVice President of Academic AffairsSharon Kehrer, MBAVice President, Administrative AffairsPatricia Marcella, MBAChief Financial OfficerRalph Barrale, DCVice President of Chiropractic AffairsPatricia C. JonesVice President, Institutional AdvancementElizabeth A. Goodman, DC, PhDDean of University ProgramsJames Paine, MEdDean of Student Services

Logan Speaks is produced by theoffices of Institutional Advancementand Public Relations. Readercomments can be sent to theeditor via e-mail at [email protected].

Thomas F. KellerAssociate Vice PresidentOffice of Public RelationsLogan Speaks Editor

LOGAN SPEAKSLogan College of Chiropractic/University Programs1851 Schoettler Road, PO Box 1065Chesterfield, MO [email protected] www.logan.edu1-800-782-3344, Ext. 2401

completely different. For example, manyof the doctors in my town advertise thetechniques they use. I take a differentapproach, even if I employ the sametechnique, because I question how thisinformation persuades a patient to seekmy care.

Yet, in my four years nowpracticing chiropractic andsports medicine, I’ve found thecheapest form of advertising issimply talking with people. Ialso use my new 6,000-square-foot clinic, which is a bit largerthan my first office space—by5,300 square feet exactly—tocommunicate my sportsscience and rehab focus. Inmy waiting room, you’ll seejerseys, helmets and othersports paraphernalia on mywalls. If I’m involved in acharitable endeavor, theevent’s marketing materialsare also prominently displayed.

Game Plan: Market SaturationMy master’s degree allows me to treatathletes on the field. What better way toreach athletes, their coaches and trainersthan by stepping out of my office and gettingon the field, which is exactly what I did.

It took four years, but my willingness to showup for practice and provide support for ourcommunity’s athletes has now led to my roleas the official medical provider for eight localteams. For these teams, my staff and I designtheir warm-up and cool-down routines,provide on-site support at competitions totriage injuries, and manage concussionscreenings and post-concussion care.

As the teams’ medical director, thecommunity is reminded of my expertiseand practice focus, and I also enjoy cross-promotional opportunities with theathletic organizations.

Long-term GainsI don’t subscribe to short-term marketinginitiatives designed to get one person in thedoor. My focus is always on the long-termstrategy, which relies on personalrelationships.

Instead of spending a day atan off-site marketing event, Itake the time to get to knowmy patients while they’re inmy office. Our conversationsgo beyond their health needsand goals to what’s going on intheir personal lives. Whenpatients enjoy a positiveexperience, they will refertheir family and friends,which doesn’t cost me anyadvertising dollars.

In fact, because of my patientrelationships, I began earningreferrals from medical doctors

(MDs). As my patients returned to theirMDs excited about the progress we made,these doctors called a meeting with me tolearn more about my practice and itsofferings. Now, I co-treat patients with manyof our town’s local MDs. We open lines ofcommunication by reporting findings andtreatment plans, so our patients can benefitfrom coordinated care.

My support for patients regardless of theirinsurance status has also led to anotheropportunity—contracting with federallyassisted, qualified hospitals and managingrehabilitation for a community clinic andits 22,000 patients.

While I’ve enjoyed great success with thesemarketing strategies, I admit this approach isno silver bullet. It demands hard work,determination and a great investment of timeto execute. Looking back, I’ve spent verylittle in terms of money to establish such avaluable reputation in my community,allowing me to build a practice I no longerhave to call home.

My Master of ScienceDegree in SportsScience and

Rehabilitation fromLogan allows me totreat athletes on thefield. What better wayto reach athletes, theircoaches and trainersthan by stepping out ofmy office and gettingon the field, which isexactly what I did.

67021_SpeaksF12 8/15/12 9:47 AM Page 11


What’s a “tweet”? Do I need to be on LinkedIn?How do I start a blog?

While traditional marketing methods are still important, social media tacticsallow you to provide information onvarious platforms as a way to engage with customers, fans and, in many cases, patients.

Not every social media platform maymake sense for you or your practice.However, there are sites that can help youconnect with potential patients as well asmaintain communication with currentpatients. When used correctly andconsistently, social media can be avaluable marketing tool for your business.

In this issue of Logan Speaks, we explorethe objectives of several key (and free)social media platforms.

Facebook: a social networkingwebsite that allows you to create

a page and post information

Opportunity:Whether you have apersonal Facebook account or not,consider creating a separate Facebook pagefor your business. When you encourageyour patients and community supporters to“like” your page, the information that youpost on your Facebook page willautomatically appear in your fans’newsfeed. Facebook is a great way tointeract with your patients on a morepersonal level and demonstrate customerservice beyond the walls of your office. Useyour Facebook page to link to positivenews about the chiropractic industry; postinformation about your practice or photos(perhaps by introducing a new hire orpromoting an event); or share a dailyhealth or “Did You Know” tip.

Twitter: a social media site thatallows you to read, write or share

information in 140 characters or less,otherwise known as a “tweet”

Opportunity: Take advantage of this social media platform for time-sensitive announcements, updates orreminders for your patients and membersof the community. Like Facebook, Twittergives you a platform for conveying yourbrand and driving awareness of yourpractice. It’s also a great way to gather information about yourfollowers, their interests and the word onthe street. Here are some examples oftweets that can help market your practice:“Providing complimentary adjustmentstoday at the Maplewood CommunityCenter” or “Our office is open until 9tonight.” Additionally, Twitter’s use ofhashtags on subjects (for example,#carpaltunnelsyndrome) support specificcondition communications.

LinkedIn: a business-orientedsocial networking site that allows

you to post a professional profile ofyourself or your business

Opportunity: LinkedIn promotesnetworking with patients and professionalsin your community or industry. By creatinga profile (similar to an online resume) foryourself or your practice, you can networkwith people in your industry; promote newsor updates about your practice; createdialogue among a group; or recruitemployees. Ask your most trusted patientsto write a solid recommendation for you oryour practice on your LinkedIn profile.Testimonials are a great third-partyvalidation of your work.

YouTube: a video-hosting site thatallows registered users to upload

and share videos

Opportunity: If you don’t have thebudget to hire a professional productioncompany, one alternative solution isYouTube, which allows you to create andupload videos to its site as well as varioussocial networks and websites. WhileYouTube can be a catch-all for anyone andanything, it does have advantages forbusinesses. Consider making a compellingvideo that showcases your practice andstaff, demonstrates a chiropractictechnique, or highlights a patient successstory. A video can also offer a more visualdescription of your brand and values.

Blog: an online journal whereentries appear in a reverse

chronological order

Opportunity: Blogging provides anopportunity to communicate with yourpatients about common points of interest. You don’t necessarily need to be the world’sbest writer to maintain a blog. As achiropractor, keep your audience interestedin topics that relate to their health andbody or offer thought-provoking commentson timely news articles. Make sure youkeep your readers engaged by askingquestions or encouraging their feedback.Their comments may inspire a new blogtopic or conversation you may not have considered.

When communicating with your clientsvia Facebook, Twitter or even a blog, bemindful of your patients’ privacy, especiallywhen they start a conversation about apersonal health concern. You might wantto suggest discussing over the phone or in person.

Finally, once you commit to using a socialmedia site or application, make sure youkeep it updated with fresh content withoutoverposting. Outdated information andoverposting might deter patients andreaders from coming back. Social mediaexperts recommend a maximum of fourtweets per day and no more than three tofour posts per week on Facebook.

Marketing Motivation

The Science of Social MediaUsing web-based technology as a marketing tool for your practice


What’s a “tweet”? Do I need to be on LinkedIn? Howdo I start a blog?

While traditional marketing methods are still important, social media tacticsallow you to provide information onvarious platforms as a way to engage with customers, fans and, in many cases, patients.

Not every social media platform maymake sense for you or your practice.However, there are sites that can help youconnect with potential patients as well asmaintain communication with currentpatients. When used correctly andconsistently, social media can be avaluable marketing tool for your business.

In this issue of Logan Speaks, we explorethe objectives of several key (and free)social media platforms.

Facebook: a social networkingwebsite that allows you to create

a page and post information

Opportunity: Whether you have apersonal Facebook account or not,consider creating a separate Facebook pagefor your business. When you encourageyour patients and community supporters to“like” your page, the information that youpost on your Facebook page willautomatically appear in your fans’newsfeed. Facebook is a great way tointeract with your patients on a morepersonal level and demonstrate customerservice beyond the walls of your office. Useyour Facebook page to link to positivenews about the chiropractic industry; postinformation about your practice or photos(perhaps by introducing a new hire orpromoting an event); or share a dailyhealth or “Did You Know” tip.

Twitter: a social media site thatallows you to read, write or share

information in 140 characters or less,otherwise known as a “tweet”

Opportunity: Take advantage of this social media platform for time-sensitive announcements, updates orreminders for your patients and membersof the community. Like Facebook, Twittergives you a platform for conveying yourbrand and driving awareness of yourpractice. It’s also a great way to gatherinformation about your followers, theirinterests and the word on the street.

Here are some examples of tweets that can help market your practice:

“Providing complimentary adjustments today at the Maplewood Community Center.”

“Our office is open until 9 tonight.”

Additionally, Twitter’s use of hashtags on subjects (for example,#carpaltunnelsyndrome) support condition-specific communications.

LinkedIn: a business-orientedsocial networking site that allows

you to post a professional profile ofyourself or your business

Opportunity: LinkedIn promotesnetworking with patients and professionalsin your community or industry. By creatinga profile (similar to an online resume) foryourself or your practice, you can networkwith people in your industry; promote newsor updates about your practice; createdialogue among a group; or recruitemployees. Ask your most trusted patientsto write a recommendation for you or your practice on your LinkedIn profile.Testimonials are a great third-partyvalidation of your work.

YouTube: a video-hosting sitethat allows registered users to

upload and share videos

Opportunity: If you don’t have thebudget to hire a professional productioncompany, one alternative solution isYouTube, which allows you to create andupload videos to its site as well as varioussocial networks and websites. WhileYouTube can be a catch-all for anyone andanything, it does have advantages forbusinesses. Consider making a compellingvideo that showcases your practice andstaff, demonstrates a chiropractictechnique, or highlights a patient successstory. A video can also offer a more visualdescription of your brand and values.

Blog: an online journal whereentries appear in a reverse

chronological order

Opportunity: Blogging provides anopportunity to communicate with yourpatients about common points of interest. You don’t necessarily need to be the world’sbest writer to maintain a blog. As achiropractor, keep your audience interestedin topics that relate to their health andbody or offer thought-provoking commentson timely news articles. Make sure youkeep your readers engaged by askingquestions or encouraging their feedback.Their comments may inspire a new blogtopic or conversation you may not have considered.

When communicating with your clientsvia Facebook, Twitter or even a blog, bemindful of your patients’ privacy, especiallywhen they start a conversation about apersonal health concern. You might wantto suggest discussing the matter over thephone or in person.

Finally, once you commit to using a socialmedia site or application, make sure youkeep it updated with fresh content withoutoverposting. Outdated information andoverposting might deter patients andreaders from coming back. Social mediaexperts recommend a maximum of fourtweets per day and no more than three tofour posts per week on Facebook.

Marketing Motivation

The Science of Social MediaUsing web-based technology as a marketing tool for your practice

by Jennifer Reynolds-Reed, Director of Health Centers Marketing

67021_SpeaksF12 8/15/12 9:47 AM Page 8

Non-Profit Org.U.S. Postage

PAIDLogan College of

ChiropracticA P U B L I C A T I O N O F L O G A N C O L L E G E O F C H I R O P R A C T I CU N I V E R S I T Y P R O G R A M S

1851 Schoettler Road, PO Box 1065

Chesterfield, MO 63006-1065

RETURN SERVICE REQUESTED

LOGAN SPEAKS

All programs on campus unlessotherwise stated

August 25-26Chiropractic AssistantCertification ProgramSession #12 Review and Final Exam Instructor: Courtney Zindrick-Lehmen, DC

September 8-9Logan Basic Technique #4Instructor: Patrick Montgomery,DC

Structural Management Instructor: Tim Maggs, DC

September 15-16Biomechanics,Biomechanical Distortionsand CorrectionsInstructor: Howard F. Loomis, Jr.,DC, FIACALocation: Paducah, KY

September 22-23Whole Food Nutrition #1Instructor: Joseph Olejak, DC

October 6-7Basic Acupuncture #1Instructor: Zev Myerowitz, DC,Dip.Ac.(NCCAOM), Lac.

October 20-21Whole Food Nutrition #2Instructor: Joseph Olejak, DC

October 27-28Basic Acupuncture #2Instructor: Zev Myerowitz, DC,Dipl.Ac.(NCCAOM), Lac.

Insurance Consultant/PeerReview #1Instructor: Mario Fucinari, DC,CCSP®, MCS-P

November 10-11Unique Options forEnhancing Your PracticeMultiple Instructors

November 17-18Whole Food Nutrition #3Instructor: Joseph Olejak, DC

Insurance Consultant/PeerReview #2Instructor: Mario Fucinari, DC,CCSP®, MCS-P

December 1-2Biomechanics,Biomechanical Distortions& CorrectionsInstructor: Howard F. Loomis, Jr.,DC, FIACA

Basic Acupuncture #3Instructor: Zev Myerowitz, DC,Dipl.Ac (NCCAOM), Lac.

December 8-9Insurance Consultant/PeerReview #3Instructor: Mario Fucinari, DC,MCS-P

December 15-16Whole Food Nutrition #4Instructor: Joseph Olejak, DC

Postgraduate Seminars August – December 2012


67021_SpeaksF12 8/10/12 11:31 AM

Fall 2012 Logan Speaks

Documents

Transcript of Fall 2012 Logan Speaks