​ No matter what you think of BJ Palmer, he seems to have been on to something.  In 1938, the public’s view of Chiropractic was at an all-time high.  Now, with the most recent Gallup Poll numbers, it appears that we have hit an unprecedented low.  The truth about the 2016 Gallup Poll, those touting it’s value are hiding is shown clearly in the infographic below.  So what is it BJ knew in 1938 which we may learn from today?  

In a recent webinar and blog post, a well-respected individual in injury evaluation, highly recommended replacing Range of Motion Assessment as an outcomes measure with subjective-objective evaluations (e.g. Oswestry).   Apparently, he has not seen the latest edition of the AMA’s book “The Practical Guide to Range of Motion Assessment,” where the DynaROM is presented as the new gold standard. This device is not only one of the most important technological breakthroughs in 30 years but significantly improves the validity of range of motion measures. To suggest in this evidence-based world that we opt for subjective report over objective data, as this author did, is a poor decision considering the increasing demand by insurers, courts and the public for healthcare providers to support their clinical decisions with objective data. John Gerhardt, MD, the inventor of modern range of motion technology, determined that range of motion, when augmented by simultaneous measurement of muscle guarding, significantly increased the sensitivity and specificity of range of motion measures. Clinically, he found 70% of his patients with muscle guarding and pain demonstrated normal range of motion values. The DynaROM quickly and easily presents muscle guarding in an objective, quantitative manner and the process is familiar as it’s simply performing range of motion measures with ECG electrodes attached to measure the muscle guarding component. 

​Can you imagine a world where IME’s and insurers no longer control patient care? With US Patent 9,808,172 B2, there’s no need to imagine. The newly patented DynaROM Motion EMG is the Gold Standard per the AMA Medical Text on Range of Motion Assessment and has been named “the lie detector for back pain” by prestigious attorneys for its ability to detect the presence or absence of soft tissue injury.

The DynaROM technology is actually quite simple; it combines wireless dual inclinometry with EKG technology to simultaneously measure range of motion and muscle guarding. It’s commonly known that muscle guarding is the body's natural defense in response to pain in motion; so, when you measure these two together, the results become significantly more sensitive to soft tissue injury and symptom magnification. This is because a significant percentage of the population has normal range of motion yet show muscle guarding and pain. A fitting example is the yoga instructor involved in a rear end MVA: they had excellent range of motion prior to the MVA and won’t be considered abnormal post MVA. When the muscle guarding component is measured alongside ROM, their normal ROM now becomes an abnormal DynaROM, as their muscle guarding is exposed, and injury is clear. 

First of all, what is the MyoVision? It’s a static sEMG scanner. It’s very likely that you have a negative point of view on sEMG, as it does have a rather dubious history. I can confidently say, with the support of the VA Hospital, , the MyoVision is not like other sEMG scanners, which are plagued with a history of technical issues. The MyoVision device is a very sensitive, accurate form of electronic palpation; it precisely measures the body’s natural defense mechanism to pain: muscle guarding and splinting. The levels of muscle activity are demonstrated with the length and color of the bars. They are proportional to levels of muscle tension, with arrows pointing in the direction of imbalance. Red readings are high, magenta moderate and yellow are low.  Both low and high readings are important as red indicates very high levels of muscle guarding, and yellow indicates potentially chronic levels of muscle tension.
The MyoVision system is a Class II diagnostic device, which has been used in VA Hospital studies and directly called “the most advanced type of equipment” by researchers at the VA.  It has been tested in control group studies and published in peer reviewed journals, and is the only device of its kind with this distinction. It’s also safer than most regulary used medical devices, like full body scans and X-Ray, where damaging radiation can negatively impact health. The MyoVision scanner is so harmless, it can be used on pregnant women, children and even on those with pacemakers. It is simply a measuring device with no radiation of any kind. 
I, David Marcarian, am the designer of The MyoVision.  It was designed under a National Institutes of Health Grant (NIH) after I completed my research work at NASA. As the designer of the device, I am the first to criticize those using it inappropriately. I have authored the paper, “A proposed quality assurance program for the clinical use Surface Electromyography in the chiropractic office,” published in the Journal of the Canadian Chiropractic Association and am well qualified to discuss the issues associated with public screenings and the use of sEMG technology. Healthcare practitioners who distort the MyoVision data to deceive the public into purchasing care plans not only damages my credibility, but my invention as well. I do not believe misrepresenting science to trick the public into chiropractic care has any benefit to the chiropractic profession. There is a legitimate and valuable application of Surface EMG technology in the screening setting when used properly, and when the results are presented accurately without embellishment. 
I once testified against a chiropractor who claimed the Static sEMG results proved the patient would eventually develop cancer if they were not adjusted. My testimony led to the loss of their license.  

Representing the Insurers: The State of Florida; 300 Insurers, 75 Attorneys, 9 Expert Witnesses and an MD/PhD
Representing the Chiropractic Profession: David Marcarian, MA and Dr. Richard Merritt

The Story:

• The State of Florida determined that MyoVision Motion sEMG lacked validity in evaluating soft tissue injury in auto accident cases, thus removing it from the list of "approved diagnostic devices."
• Richard Merritt, DC, challenged this rule, as he found Motion sEMG invaluable in properly documenting both the need for care & progress with his patients. This challenge was not taken lightly, ending up before an Administrative Law Judge for review.
• Merritt reached out to all the experts on sEMG in the Chiropractic profession to help him in court. To his surprise, only one person responded: David Marcarian, MA, former NASA researcher, former NIH principal investigator and designer of the MyoVision DynaROM Motion sEMG system.
• With the trial date set, a major twist: the State of Florida was to be joined by all the major insurers in the US, represented by 75 attorneys, 9 expert witnesses and millions in funding for this case.
• The insurers knew this tool was gaining momentum in published research as providing proof that chiropractic is the best approach to treating soft tissue injuries, and winning meant establishing soft tissue injury would be difficult.
• Against overwhelming odds, Mr. Marcarian and Dr. Merritt stuck to their guns and battled it out in the courtroom before a judge. Even with the testimony of a well known MD/PhD, Marcarian and Merritt prevailed.

The Decision:

• The Judge's 44 page landmark decision was comprehensive in its scope, leading to reimbursement in every state in the US.
• The case was appealed with Marcarian and Merritt winning the Superior Court appeal. It was then taken to the Supreme Court of Florida, where they were denied an additional appeal. 

This landmark case established this tool equal to the Cardiologist's EKG, providing the proof needed to make you the first choice of PI attorneys when it comes to treating PI Patients.

What this means for you: 

• Overcome the EMC with objective data you send to the MD or DO
• Reimbursement is at approximately $300/test per statute in Florida
• You now dictate care to insurers
• Win the respect of PI attorneys & other healthcare providers alike by providing the objective data needed to establish your expertise

Can you imagine a world in which the DC, MD and Attorney all view the patient from the exact same perspective? They may disagree on approach to treatment but they will agree on the veracity of the patient's complaint of pain - the illusive, subjective claim which thus far has been impossible to quantify. Other than weddings and funerals, where all agree on the appropriate emotion, getting everyone on the same page with regards to a patient's condition is more complex.
​
Philosophy, although fundamental to our view of patient care, can be questioned and debated, has a tendency to lead to divergence, and cannot be presented as a logical argument to a jury. Science, on the other hand, has a greater impact because of proofs that, over time, become indisputable facts. Facts are undeniable from any perspective. As the old saying goes, "A picture is worth a thousand words." Or to put it more precisely, the visual image speaks a thousand words. It is solid, visual proof. Graphs and charts, being visual mediums, provide very formidable and convincing evidence when proving facts. Everyone can see the visual representation of the data, and agree on the meaning of the image.

In this blog post, the writer, Andy Lewis, claimed the MyoVision was just another example of the "uneducated making false, unsupported claims." A distinct attempt to slander the Chiropractic profession. He goes on the write, "it would appear that the device appeals to chiropractors as it gives a scientific veneer to an invalidated diagnostic... The MyoVision device would not be the only type of questionable diagnostic procedure undertaken by chiropractors." 

Mr. Lewis' opinion on the MyoVision and Chiropractic are outdated and simply untrue. He made made several false assumptions here, but the 2 that stand out: 1. The MyoVision test has no research behind it, and 2. That the examiner he was questioning was a chiropractor. It turns out that Mr. Lewis was wrong on both counts. David Marcarian quickly responded to this blog post, providing over 70 indexed research papers to support the proper use of Static Surface EMG technology, and informed Mr. Lewis that it was in fact an osteopath who performed the test at the clinic in question, not a chiropractor. 

When you read the post, don't miss the comments at the bottom - they are more informative and entertaining than the article itself. It is in the comments where you will find Mr. Marcarian's response invalidating the whole blog post with his list of references and logical reasoning.

A friend, who is in criminology, once said that "behind a computer, everyone can feel like they have the credibility of a NY Times reporter, but the reality is, that's simply not true." Mr. Lewis proves this theory by posting a position where he has no support.

The American Chiropractic Association's position paper on Surface EMG has had a major impact on both insurance reimbursement and State Policy in regards to the adoption of Surface EMG.  In June, I received a denial letter (access all denial responses are located in the "member portal" tab of www.myovision.com - you must register and wait for approval) referencing the ACA position paper to deny payment. I took one look at their references and realized they were referencing the American Academy of Electrodiagnostic Medicine's Position Paper (written by Pullman, et. al. 2000) on Surface EMG. This position paper has been long retired by the American Academy of Electrodiagnostic Medicine due to the fact that Pullman had ignored 40+ studies in his review. So, with their main scientific reference no longer valid, I wrote the ACA informing them that their position paper was not supported by their own references, forewarning that legal action will be taken if they did not respond. Not even 10 minutes after I send this email, the ACA responded and removed their position paper from their website, stating it was "under review" where the position paper once was.  

View the ACA's webpage by clicking HERE.

It is so wonderful to see how many doctors have realized that each and every time they send a traditional ROM report vs. a DynaROM report, they are hurting their cases. The paradigm shift to DynaROM has changed the outcomes for patients throughout North America, as muscle guarding is crucial in evaluating for soft tissue injury.  Furthermore, it helps establish lack of injury was well as injury itself, and aids in determining when the patient is at MMI. Congrats to all you doctors integrating this new mindset into your practices. Not that it matters, but the fact that it pays 5 times more than ROM in about the same testing time is definitely a benefit. 

​One of the greatest advantages of Static sEMG over Thermography is the fact that it measures muscle activity, something they can "feel" and you can "show." Watch this 10 second video!

We've been indoctrinated into believing that the LOUDER and more PASSIONATE we are about our beliefs, the more likely patients will “buy in.” Watch this video and see if you can figure out what patients are trying to tell us when they say they "love this video." 

So what is it that patients love? They can relate; it speaks their language. The bottom line:  They don't care about your beliefs. They care about what you're going to do for them. People have become very data driven, which is why just TELLING them isn't enough anymore, you must SHOW them. MyoVision has produced the only research-based, reproducible Static sEMG on the market. It is the "Electronic Digital Palpation" tool, it's objective, shows patients what you feel and allows you to track progress over time.  E-Scan data puts the patient in control of their healthcare. Give them this control and they will trust you. 

By making Subluxation tangible, you no longer need to explain yourself or your value to your patients. Think of the E-Scan system as the "EKG for Spinal Health."

MyoVision's E-Scan has just received approval from one of the most prestigious hospitals in the world (yes, they are using the MyoVision Static sEMG in a hospital setting) as well as validation from the research department at a major University.  So why wait?  Capitalize on the "Evidence-Based Paradigm." A single test takes only 30 seconds - quick and painless!

You want your patients to understand you, so communicate in a way they can comprehend - using E-Scan; it's fast, easy and visual. Now, with the ability to send all your contact info directly to their smartphones, they'll PROUDLY show their friends and family how smart they are for not choosing just any regular Chiropractor, but a Chiropractor with a high tech vision - MyoVision to be exact!

Both the 2012 and 2014 Gallup Poll asked the public "how would you rate the honesty and ethical standards of people in these different fields?” In the category “very high,” MDs were rated at 70%, while DCs were rated at a paltry 38%.

Why is this when just 15 years ago MDs and DCs were rated more closely? What has changed? What are we doing wrong? What are they doing right? It seems unfair.  We know as Chiropractors, we are the best at spinal healthcare, yet despite this, the public perception does not seem to agree.  ​

We have spent a fortune on all different types of marketing campaigns, including endorsements from well-known sports figures, so why have we not broken beyond that 5-6% of the population? Perhaps we are asking the wrong question. Maybe we should be asking "what would B.J. do?"

In 1924 Chiropractic was relatively unknown. By 1935, Chiropractic became the top alternative healing art in the US. So, what did B.J. do to alter the course of Chiropractic forever? Although B.J. Palmer was probably one of the best at palpation to exist; he knew the importance of "show over tell" when it came to influencing the population. In addition to marketing campaigns - via radio - he knew that testing each and every patient with the Neurocalometer would have a major influence on how patients perceived Chiropractic. Science, at the time, was growing and the need for scientific tools was something he capitalized on. 

Though some did not like "how" it was presented, all recognized, conceptually, that it worked. It was significantly better than palpatory findings alone.

The study below was published in an actual peer-reviewed, high quality journal. It found statistically significant differences between those with chronic low back pain and controls. 

It is completely understandable that the average Chiropractor prefers to avoid PI in their practice. Why?  Oh, so so many reasons.

1. It is dirty. There are SO many games which need to be played.
2. Attorneys will never refer to us anyhow.
3. Who wants to deal with the stress of being deposed?
4. The income from PI is so much greater, that I would not know what to do with the added income!
5. It is a violation of my philosophical orientation, as I want only patients who want to see me for wellness.

I'll start with the last one first. Really?  You're going to deny patients who need you more than ANY patients?  Those injured in auto accidents, with the most serious of soft tissue injury..that thing you are absolutely best at treating your skilled hands?  Forget about the fact that you have more latitude in how often and for how long you see PI patients, but the fact that you as a doctor are needed, and don't feel obligated to help is kind of a way of ignoring your most important oath.  

Why is PI perceived as a "dirty game"?  Because it has always required we do things which we know are unethical for the purpose of obtaining patients. Some pay for a list of DMV accident records. Some spend time and money taking attorneys to dinner.  There are all kinds of "tricks". The best trick of all, is to have tools which prove your value to attorneys. This way you don't have to chase them down, but they chase you down.  

Change the game from opinion vs opinion to data vs. opinion.
Attorneys tell me all the time, that they prefer to work with MD's over DCs.  I started to ask.  "Clearly the public perception is that the MD has more credibility over the DC" is what I heard.  Is this the case for the DC armed with objective data?  Not at all. As a  matter of fact, doctors that used to fear being before a jury or even in a deposition now gladly accept such challenges, as they have their trusty DynaROM Data to protect them and their patients. 
Focus on the data, and opinion means nothing. Literally. 

By Allen Fraley, DC and David Marcarian, MA

Insurers had seen the MyoVision technology's impact on settlements and were going to do everything in their power to invalidate it.  In a major blow to the Chiropractors case, the State joined forces with over 300 insurers, 75 attorneys and the resources to put an end to this argument for good.  A loss to the State and the insurers meant Chiropractors would lose the right to protect patients rights to chiropractic care due to the fact the evidence-based model was quickly becoming the norm.

The task was daunting:  How would David Marcarian and Dr. Richard Merritt prevail against all odds?  As is typical, everyone underestimated the knowledge of those from our profession: ​

Allen Fraley, DC
Dr. Fraley has more than 17 years experience working with personal injury and injured-worker cases, and has testified in court on behalf of these patients. He is a frequent guest speaker on chiropractic topics for the Washington State Association of Justice, and is a featured speaker for MyoVision.
dcfraley@scml.us​  |  509-764-1836

Jason O. Jaeger, DC, fCBP
Dr. Jaeger holds adjunct faculty positions at four chiropractic colleges, and was awarded the 2014 Chiropractic Biophysics™ Researcher of the Year Award for the Advancement of Chiropractic Science. He also holds the 2015 CBP™ Chiropractor of the Year Award, and applies his extensive clinical experience to his treatment of injured patients.
drjaeger@alianteipm.com  |  702-396-4993                   ​

John K. Maltby, DC, FICA, FICAC(H)
Dr. Maltby is a respected expert witness and two-term past-President of the International Chiropractors Association (ICA). He also served as ICA Chairman of the Board, and was ICA’s Chiropractor of the Year in 2007. Dr. Maltby has represented the ICA on the Board of Directors of the World Federation of Chiropractic.
jmaltby@frontier.com
760-922-7353

David Marcarian, MA
NASA-Trained Researcher and inventor of high-tech biometric instrumentation, including the patented Wireless DynaROM Motion sEMG System which graphs muscle guarding and ROM simultaneously. This technology has established chiropractors as the leading experts in soft tissue injury. Upcoming CE Seminars can be viewed at www.myovision.com  or by emailing david@myovision.com.

References:

1. Geisser, ME, Ranavaya, M, Haig, AJ, Roth, RS, Zucker, R, Ambroz, C, Caruse, M, A Meta-Analytic Review of Surface Electromyography Among Persons with Lower Back Pain and Normal, Healthy Controls. Journal of Pain, November 2005; Vol. 6, No. 11; pages 711 to 726.

1. Ambroz C, Scott A, Ambroz A, Talbott EO. Chronic low back pain assessment using surface electromyography. J Occup Environ Med 2000;42:660-9.

1. American Medical Association: Guides to the evaluation of permanent impairment, 5th edition.

1. Richard W. Merritt, DC vs. Department of Health and The Florida Insurance Council. (Case No. 04-1149RX).

We want to ensure your test are as accurate as possible - one way is to make sure your electrodes are in good condition. Below are examples for both the E-Scan static electrodes and the DynaROM electrodes.

DynaROM:
For your DynaROM tests, you are using the Dynamic Electrodes (item# pb-50). The image to the right shows both good and bad electrodes. To get the best connectivity and results, you want to make sure the gel in the middle of the electrodes are dark and moist (as shown by the 3 right-most electrodes). When they become dry (as shown by the 2 electrodes on the left) your test results will suffer. 
Dynamic electrodes are good for one-time use only and must be thrown away after each use. So make sure you have plenty in stock - visit www.store.myovision.com  to purchase. 

OK, so now that Windows 8 has gotten pretty stable, the only thing which annoys pretty much everyone is the fact that it takes SO much longer to do everything without a Start button. Having worked in several Ergonomics labs, including at NASA and IBM’s Santa Teresa Lab, I know for a fact Windows 8 violates all the basic tenets of “sound ergonomic design”. Why? The psychology of it has to do with our ability recall vs. recognize. For example, to use Windows 8’s search function to access the Control Panel, you have to remember “Control panel." With a start button, you click the button and see "Control Panel” as one of your choices. That means that there are significantly less errors and less inputs to find it.  Now, how do we add it back when Microsoft says it is impossible? The easy way, using a feature called “Classic Shell,” a freeware program which adds the start button back in Windows 8./8.1.

To get this, go to www.classicshell.net then download and install. I would deselect all the check boxes and hit “decline” on the offers. Then voila, you’ve got your start button back!