Fox uses kinder, gentler approach to spinal adjustments

Susan Schell
of the Gateway
Published: 01:55PM July 15th, 2009


A poster in Dr. Greg Fox’s chiropractic office shows an underwater view of a gigantic iceberg with the usual tiny portion sticking above water, the only part visible to the human eye. The poster reads: “Symptoms are misleading. We find the hidden cause.”

That’s Fox’s general philosophy.

“Chiropractic is not just about backaches and headaches, although it’s good at resolving those issues at a low cost,” Fox said. “It gets to the core of the problem and helps the body to function better so you have less doctor visits. Dis-ease leads to disease. We find the hidden causes of health problems.”

Fox said most medications help ease pain, but they don’t cure an illness.

“What we’re working with is the nervous system, which is the body’s communication center,” he said. “You raise the body’s functioning and stay focused on improving that function and let the body take care of itself.”

Fox specializes in the Koren Specific Technique, a method that involves gentle yet powerful adjustments that don’t use twisting, turning, cracking or popping of joints. The method can correct subluxation, a distortion in the spine and body structure that can cause serious nerve stress.

Fox has been practicing for 32 years. His wife, Pam Fox, is the office manager.

“I’ve seen so many miracles here,” she said. “You can do a scan (on a patient) and see all the nerves lit up. There’s that specialty of being able to connect the nerves that feed the vital organs. It’s a science predicated on the vertebrae being misaligned. When that happens, it’s like a dimmer switch, and the body’s communication gets interrupted on all different levels.”

Pam Fox said patients come from all over to see her husband. She recalled when a baby came in and couldn’t move his head.

“As soon as he was adjusted, he could move his head and he started breathing a lot easier,” she said.

“Babies are fun because they respond so quickly,” Greg Fox said. “They don’t come in with a lot of baggage.”

Fox said chiropractors often see patients who have tried everything else and come to them as a last resort.

“They’ve tried all the conventional methods, like drugs and surgery, and that’s upside down,” he said. “The vast majority don’t try a natural approach. It makes sense that people should try the least invasive forms of therapy first.”

“I’ve seen people who’ve had back surgery that can’t walk right,” Pam Fox said. “When you have surgery, it’s about 50 percent successful. But what about the other 50 percent?”

Sharon Browning has been seeing Fox since 1994, and she swears that chiropractic treatment has greatly improved her life, as well as her husband’s.

“He’s a miracle worker,” Browning said. “I felt 85 percent better that first time I was here.”

Browning said her husband had slowed down and was always grouchy — a factor he contributed to old age. After prodding from his wife, he finally saw Fox.

“He completely changed after his treatments,” Browning said. “This guy’s happy again.”

“When someone is in chronic pain, it changes their personality,” Pam Fox said. “We’re living longer than ever before. We need to ask, ‘How do we live those extra years full of vitality and not be a burden?’ In this economy, we can’t afford to be sick. We want people to be able to continue to do what they love.”


Fox Chiropractic Wellness Center

Dr. Greg Fox’s office is located at 3715 56th Ave. NW in Gig Harbor. For more information, call 253-851-5138.

By Dr. Kenneth Best, D.C., Community Contributor -- Published: July 15, 2009


Dr. Ken Best Eliminates Harmful Belief Systems and Rewrites Patients’ Lives with Thetahealing. Dr. Kenneth Best, D.C. is a Los Angeles based chiropractor, who also specializes in Applied Kinesiology ("AK") and Thetahealing™. Dr. Best has healed thousands of patients through combinations of physical and energetic therapy and spiritual guidance to change the inner being. Dr. Best has developed a program utilizing the tools for inner change, as a result of these healings, called “Rewriting Your Life™.” Often called on by the entertainment industry for his abilities, Dr. Best has been the onset chiropractor for 24, Alias, Brothers and Sisters, Minority Report and has shared his expertise with the viewers of Extra, The Doctors, KTLA5 Morning News, KCAL News, and Fox 11 News in Los Angeles.


Dr. Kenneth Best D.C. of ManyLevels™ uses Thetahealing™: a revolutionary technique that heals patients physically, mentally and spiritually. Dr. Best uncovers patients’ core belief systems or belief programs that often function as obstacles, restricting the patient from achieving certain goals and even causing pain and illness. Dr. Best using Thetahealing™ taps into the creative force to rewrite these negative core beliefs into positive ones. Thetahealing™ is a process of connecting with the creative force and using our own theta brainwaves to communicate with the cells of the body on deeper level of consciousness. The result is a remarkable improvement in the patient’s health and well being.


Recognizing that belief systems control most aspects of our lives, Thetahealing™ roots out the limiting belief systems (core beliefs) that cause us harm and keep us from achieving our goals. Dr. Best utilizes the ‘theta’ brain state to pull and correct these negative core beliefs. Core beliefs are both conscious and unconscious belief systems; they can block a person’s ability to succeed in areas which are important to them (love, career, health, etc.) Thetahealing™ replaces these negative core beliefs with a belief system to support the goals and needs of the person. This can be useful for anything from the removal of a disease to improved mental health and well-being.


“If we think of our brains like a computer that maintains our body, shapes our perceptions and reacts to the outside world, then it is our core beliefs which function as the software,” said Dr. Best. “How many of us hear ourselves saying, ’I’m so stupid’?” asked Dr. Best. “This is a common thing we will often hear people saying, yet this type of self-talk is an indicator of a subconscious negative core belief. Even though on the surface we believe ourselves to be smart, deep down in our psyche we may hold a core belief that we are stupid and it can influence our decision making processes, lifestyle choices and hold us back from living the way we want to live,” concluded Dr. Best.


It is no secret that an overwhelming majority of Americans believe in God or a higher power (over 90% according to a 2006 CBS News survey). Thetahealing™ looks to this higher power, called the Creative Force, or God, to intervene on behalf of the patient through the healer to help rewrite these core belief systems. Dr. Best, through prayer and consciously accessing a 'theta state', works with the co-creative force of God by asking God to find the dysfunction or 'dis-ease' in the body, to show us the cause and finally, to correct the problem. The practitioner is there to be a witness to the changes made in the body. Recurring illness and disease can be due to several reasons, among them being core belief issues that manifest the illness originally or constant exposure to toxins.


These core belief programs come from four sources:

1. Subconscious Programs: These types of programs can get in our subconscious as a child; they also can come from repetition or poor discernment later in life - i.e. believing everything about yourself that other people say about you.


2. Genetic programs: These are programs involving everything from eye color, to the way we talk, these are intuitions and there are programs similar to subconscious programs above. Genetic programs come from your parents DNA and their parents DNA and so on. While many of these may have been necessary hundreds of years ago, they often serve to prevent people from enjoying life in the present day. For example "I need to hide" "God is a punishing God", "I'm a sinner, I need to be punished", "I don't deserve to live". Such programs could be a reason a person's body has accepted a disease like cancer. These programs as well as deep genetic programs tend to be the causative effect of predisposing our body to an illness or a disease. These programs may need to be cancelled in order for the body to rid itself of the disease.


3. Deep Genetic Programs: Are similar to genetic programs but go much further back in the DNA and may refer to what is termed as a 'past life'. A person who subconsciously remembers a past life may be picking up on their own genetic line which they lived then or it may be a ‘real’ past life which is not related genetically. An atrocity that happened to this person in their past life may be manifesting itself as a negative core belief system today.


4. Soul Level Programs: These are deep programs which are carried with the soul. Most of the programs that influence our lives are not on the soul level, but if they are they can have profound effects on our lives and health. For example, some souls may feel they are disconnected from the source of all things through some experience, and as a result when testing the person the program “I am abandoned by God” shows up. This can affect them on a very deep level, feeling abandoned in all of their personal relationships as well.


About Dr. Kenneth Best, D.C. -- Dr. Kenneth Best, D.C. is a Los Angeles based chiropractor, who also specializes in Applied Kinesiology ("AK") and Thetahealing™. Dr. Best has healed thousands of patients through combinations of physical and energetic therapy and spiritual guidance to change the inner being. Dr. Best has developed a program utilizing the tools for inner change, as a result of these healings, called “Rewriting Your Life™.” Often called on by the entertainment industry for his abilities, Dr. Best has been the onset chiropractor for 24, Alias, Brothers and Sisters, Minority Report and has shared his expertise with the viewers of Extra, The Doctors, KTLA5 Morning News, KCAL News, and Fox 11 News in Los Angeles.


www.ManyLevels.com

NCLC 2005 Multi-Discipline Practices Resolution # 2 Multi-Discipline Practices (MDP)

Submitted by: ACA Insurance and Managed Care Committee

RESOLVED, that the American Chiropractic Association considers the following statement, “Multi-Discipline Practices,” official policy:

The American Chiropractic Association is the preeminent professional organization representing doctors of chiropractic in the United States. We have an obligation to our membership and to the profession as a whole to comment on topics that support or harm the profession and the public it serves. The topic of Multi-Discipline Practices (MDP) is receiving increased attention in the media, as a quality option for treating patients. The goal of this policy is to provide general education as opposed to specific legal or practice advice. It is incumbent upon each doctor of chiropractic to determine relevant state or federal laws, local board regulations and/or association recommendations that may be pre-emptive.

Background: The ACA fields an increasing volume of calls from doctors of chiropractic as to the advisability of entering into a MDP, and who also seek more detailed information on its acceptance, structure and operating philosophies. At the same time, ACA receives complaints from payers that certain arrangements appear to emphasize financial gain for providers rather than clinical appropriateness and the best interests of patients. With respect to providing education to both the chiropractic and insurance professions, ACA established a Fraud Sub-Committee under the Insurance and Managed Care Committee to research and provide commentary on this topic and others. This committee includes doctors in private practice from across the country, chiropractic leadership, insurance industry representatives, legal counsel, and consultants who have experience in this field. The committee recommends that doctors thoroughly review the following issues before entering into, being an employee of, or owning (in part or in total), a Multi-Discipline Practice.

NCLC 2005 Multi-Discipline Practices

These recommendations are not all-inclusive, but are intended to encourage thoughtful consideration and examination.

ACA RECOMMENDATIONS

Scope of Practice: The ACA encourages state associations and licensing/examining boards to adopt rules, regulations and laws that define the scope of practice for doctors of chiropractic and specifically comment on new and emerging practice arrangements including but not limited to Multi-Discipline Practices. Attention to the provision of ethical care and accepted treatment standards is important, as is identifying potentially illegal or unethical practice(s) that may constitute a danger to the health, safety and welfare of the public or that violate state statute. The Arizona Board of Chiropractic Examiners under section ARS 32-924(15) and a Chiropractic Practice Alert issued by the New York State Education Department Office of Professions http://www.op.nysed.gov/chiroalertmulti.htm may provide a model for discussion and action in other states.
It is also recommended doctors of chiropractic maintain a current license in good standing in the state in which they practice, and comply with the full letter and intent of that state’ s chiropractic scope of practice statute. All care provided by a doctor of chiropractic must fall under the applicable scope of practice regardless of who recommends or orders it.

Seek Expert Opinion and Counsel: To assist associations, boards and individual providers, ACA may be contacted for information on the National Association of Chiropractic Attorneys (NACA) as one source of possible legal counsel. There are many potentially complex legal issues that one should keep in mind before getting involved in a Multi-Discipline Practice. You may consider seeking legal advice on specific issues, including the following:

• All licensed healthcare providers are held to administrative, civil and criminal law considerations. In addition, state and federal law impacts compliance, formation, ownership structure and operational issues and may present certain complexities requiring the advice of an attorney specializing in professional limited liability (PLLC), Partnership (PLLP) and/or other arrangements.

• A federal health care criminal statute, along with related state health fraud statutes, criminalize any “ scheme or artifice” intended to obtain reimbursement from any healthcare plan or entity under false pretenses. Federal mail fraud concerns are included in this level of analysis, among other potential violations. (18 u.s.c. 1341, 1343)

• Another issue deals with legal concerns regarding federal and state anti-kickback laws. These are enforced for the most part by civil versus criminal sanctions. This requires a comprehensive review and careful consideration of “ safe harbor” provisions of the Civil Monetary Penalty Act (42 u.s.c. 1320a-7a).

• Legal prohibitions against self-referral for some healthcare services, or “ Stark Laws” (42 u.s.c. 1395 nn) are enforced through civil sanctions and relate to the provision of certain designated health care services. Mini-Stark laws may also exist at the state level and should be considered in any MDP analysis.

• The Internal Revenue Service (IRS) may also have specific compliance standards in the reporting of MDP revenue, investment gains and/or other financial situations.

Another source of advice may be the local or regional FBI (add website), or your state Attorney General’ s office as to types of activities in the healthcare industry that may prompt investigation or indictment. Currently we are not aware of any national MDP directives or policies employed by the FBI, but we understand that initiatives exist in certain states.

The Department of Health and Human Services Office of Inspector General 'Compliance Program for Individual and Small Group Physician Practices' (65 Fed. Reg. 59434, Oct. 5, 2000) found at http://oig.hhs.gov/authorities/docs/physician.pdf is also another source to consult, and your malpractice carrier may also have additional recommendations based on risk management protocols and actual claim experience.

Other Considerations and Questions to Answer

• Hiring Licensed and Unlicensed Providers/Professionals: Are you comfortable with providing oversight and supervision for licensed and unlicensed providers/professionals for services that are not included within the scope of practice for a doctor of chiropractic? Is this allowable by state law? Remember you are responsible for all acts of licensed and unlicensed employees and staff in your employ.

• Patient Supervision: Are you available and on-site with sufficient frequency and predictability to oversee patient care provided by all licensed and unlicensed employees and staff? Is continuity of patient care a major priority? In the event of an emergency, do you have sufficient oversight to direct employees and staff to appropriate action that protects patient safety and the best possible clinical outcome? Are there written compliance procedures in place and are they reviewed periodically for safety and confidentiality compliance? Remember that absentee ownership may create unnecessary risk and liability.

• Patient Referrals: If a patient is referred to you within a MDP owned by a physician other than a doctor of chiropractic are there delineated criteria for referring patients that may benefit from your specialized care?

Is the referring physician or provider familiar with chiropractic principles of care and fluent in your evaluation and diagnosis protocols, treatment and techniques, therapies or related services? Is the referred patient aware of the same principles and are they educated as to the expected results?

Is there an expected clinical outcome that is anticipated by making a referral either within or outside the MDP? Is there a plan of care and an expected time frame for results recorded and reported between providers and the patient?

Is there an adequate level of clinical documentation to support the referral and all care and treatment? What kind of written communication will the referring provider expect of the doctor of chiropractic, and do the DC’ s clinical records provide enough objective evidence to continue care?

Have steps been taken to steer clear of “automatic” referrals that lack clear and convincing evidence of the need for specialized care?

• Coding and Billing: Are all codes and billing procedures consistent with CPT definitions and policies, and do they not duplicate services the patient received prior to or during concurrent care at the MDP facility?

• Incident-to services: Incident to billing procedures can vary from carrier to carrier, and may be state specific. Always check with the particular plan to assess whether billing a chiropractic service as “incident to” another physician’s service is authorized.

Are evaluation and management services and/or consultation services appropriate and properly documented? Are the billed procedures separately identifiable? Do these services require significant patient time, assessment, cognitive skills and patient care management over and above existing recorded information on the patient? Under what situation does a patient require complex and/or multiple complex assessments by the same or different provider in the MDP facility?

Are your services billed under your tax ID number and not under a higher level or specialty ID number?

Are your services billed under your tax ID number, and not under the ID number of a higher-level specialty?

Remember, coding abuse—especially for frequently performed E/M services or for frequently billed complex services that are not clinically supported—is a red flag for investigation. Financial recovery, penalties and even license sanctioning can be an outcome of intentional coding irregularities. An argument for determination of intentional abuse is easily made when claims data shows an established business pattern.

CONCLUSION The above is a sampling of important considerations, and is provided to help promote the creation of innovative patient-focused healthcare entities that are lawful and ethical. ACA provides this education to help prevent undesirable situations that could inadvertently occur when there is inadequate analysis and preparation for new and emerging business collaborations. Related commentary may be found in ACA’ s Code of Ethics found at www.acatoday.com.

For more information please contact the ACA Office of Professional Development and Research at (703) 276-8800 or submit a written inquiry to the ACA IMC Fraud Sub-Committee at:

American Chiropractic Association 1701 Clarendon Blvd., Suite 200 Arlington, VA 22209

A compliance consultant was instructed that they should ensure that prior to their conducting practice audits for health care professionals that their client retain legal counsel and that the audit be performed ‘only’ under the direction and supervision of the client’s attorney.


This requirement of clients allows 1) the provider client a level of protection from outside investigative entities demanding the consultant’s audit report should they learn of the audit, and 2) the provider client to obtain the audit report from their counsel after counsel had the opportunity to review the audit findings to provide legal advice on how to respond to (substantiated) misconduct identified.


Unfortunately, the consultant did not follow the instructions and conducted practice audits for providers not represented by counsel, and this consultant found themselves in federal court, relevant to one particular client, faced with demands by federal law enforcers for the ‘unprotected’ audit report.

May a doctor delegate the administration of therapeutic procedures to unlicensed staff and bill payers as if they actually administered them?


A number of boards opine that therapeutic procedures can be delegated to unlicensed staff. Some ‘certify’ chiropractic assistants who complete (minimal) training programs, and these boards purport that the certification is similar to those of boards for other disciplines (i.e., physician assistants and physical therapy assistants). Is such a comparison analogous to comparing ‘apples to oranges’ with the stark differences between physician assistants, physical therapy assistants and chiropractic assistants, particularly, on requisite clinical education, training and experience?


Scott Whitehead, D.C., opining in 2007 at the request of his State Association writes: “As a doctor you can delegate therapeutic procedures to whomever you wish to perform those services. You simply must be in the building at the time services are rendered to ‘supervise’. You do not have to perform the treatment yourself, nor do you have to stand over them and watch…. However, as far as I know, no insurance company has any policy in place to prohibit you from delegating to staff. As far as statute goes in Texas, if an insurance company did write that into their policy, we would have to go to the [Texas Department of Insurance] with [a] complaint. The P.T.’s (sic) would love to have those rules in place as well.”


- Dr. Whitehead’s position is reflective of the position many providers have taken, but that position is violative of applicable laws, rules, and regulations. Doctors may delegate therapeutic procedures only to those individuals who are qualified and properly trained, not to whomever they wish.


- It is true, as Dr. Whitehead proclaims, insurers (e.g., payors) don’t have policies to prohibit doctors from delegating to staff; however, they do have policies that limit and/or prohibit payment of provider services administered by non-providers (e.g. unlicensed staff).


- To add to the confusion, contrary to Dr. Whitehead’s contention, the board jurisdiction in which his opinion was provided does not require chiropractors to be on premises to supervise services administered by unlicensed staff.


A chiropractic regulatory board, in 2003, provided the following in response to my inquiry on behalf of my clients in that state: “Rule … expresses the Board’s policy on the issue of delegation - designed to give its licensees a threshold standard which they must adhere to in their practice or be subject to disciplinary action if in delegating a procedure the standard of care is not met. That determination for disciplinary purposes is determined on a case-by-case basis. The Board expects its licensees to be properly trained and knowledgeable in chiropractic services. Each licensee is expected to determine for his or her own practice the specific procedures that are appropriate for delegation under their license and Board rules and whether his or her employees are properly trained for such delegation. Likewise, a licensee must make his or her own determinations about adequate supervision under the circumstances. The Board does not set training standards for chiropractic assistants or dictate detailed protocols that licensees must follow. Neither does the Board determine how a chiropractor should bill third party payers for therapeutic procedures…”


- The failure to adequately address the issue of delegation poses great harm to licensees to whom the above-referenced Board owes a fiduciary duty. The Board fails to identify what constitutes a qualified and properly trained individual to whom such delegation may be made. Make no mistake, unless an applicable state regulatory entity (e.g., Board) either licenses or otherwise certifies the basic requirements of those individuals to whom the services are delegated, that regulatory entity has no authority to determine whether that individual is qualified and properly trained. That regulatory entity’s authority begins and ends with those over whom it may exercise that authority (e.g., licensees).


Samuel Collins, in his article “Denial for Services Done by Staff“ (Dynamic Chiropractic, 12/2/08), reports it is becoming more common for carriers to ask chiropractors who administered the (therapeutic procedures) with an apparent trend for carriers to not pay for services done by unlicensed or noncertified staff. Further, he indicates it is a tricky legal question of whether an insurer has a right to exclude payment for services done by unlicensed support staff, and that the chiropractic profession will have to battle this legally and force payment per state regulations or implement certification of chiropractic assistants.


- Collins brings out some thought-provoking points in his article. The apparent trend he notes of carriers not paying for services performed by unlicensed staff might be more accurately identified as a strong indicator that carriers are becoming more diligent in their efforts to evaluate health care claims so that only proper claims are paid. Additionally, his claim that tricky legal questions are involved to determine if a payor can refuse to pay for provider services administered by non-providers is just not correct! Payors set the standards for reimbursement and doctors must follow them when seeking the payors money!


In 2002, following a joint investigation by the Federal Bureau of Investigation, Internal Revenue Service and the Texas Workers’ Compensation Commission, John Schmidt, D.C. entered a guilty plea on tax evasion and admitted to fraudulently billing for supervision of work-hardening services.


The government asserted in their investigation and subsequent prosecution that the approved codes for medical procedures require the chiropractor or a licensed therapist to supervise work hardening. Prior to sentencing the defense asked the Court to withdraw the guilty plea, and brought in a doctor from a local chiropractic college who testified as an expert witness. Schmidt’s expert witness testified that Schmidt could lawfully delegate supervision of work hardening services to unlicensed individuals under the Texas Board of Chiropractic Examiners (“TBCE”) rules, stating that TBCE’s rules take precedence over the CPT codes.


The judge asked if the expert’s position justified health care fraud by chiropractors as a group. The defense argued that Schmidt was obligated to practice under TBCE’s rules. The judge then asked, even if in doing so he commits fraud? The defense responded that the comments appeared to accuse all chiropractors of fraud. The judge replied he did not say all chiropractors commit fraud, but understood the expert, in effect, to advocate that chiropractors may engage in activity that is at variance with the CPT codes, as long as the Chiropractic profession, as a group, approved of such activity.


The defense asked the judge to recuse himself, arguing that the Court had a bias against chiropractors in general, and Schmidt in particular. The judge denied the defense motion, stating the Court had merely expressed its surprise at the seemingly outrageous legal position advocated by the defendant during the course of the hearing. Schmidt was sentenced to three years in prison, ordered to pay a $30,000 fine, and $72,145 in restitution. (“Texas Chiropractor Draws Judge’s Ire, Three Years in Prison,” Fort Worth Star-Telegram, 8/16/02)