Dr F Kahn

Insurance carriers appear to demonstrate an undue level of concern with the designation of healthcare professionals administering Laser Therapy. This article is designed to clarify this issue. First it should be noted that Laser Therapy can be administered by a duly trained physician, physiotherapist or chiropractor, based on the knowledge and expertise acquired at our certification course, complemented of course with subsequent experience. Moreover, the above designated healthcare professionals can perform an assessment and prescribe the protocols as required. They can then administer Laser Therapy directly or delegate it to any certified laser therapist under their supervision, someone who may not be licensed to diagnose. Despite this, some carriers will pay a physiotherapist but not the other designations and other carriers will pay the chiropractor but not the other two professionals and so forth. To anyone with a functional IQ, this would appear to be irrational and indeed qualifies under that category. In essence, there is no logical or legal foundation for this position.

At Meditech, a team of healthcare professionals participate in the process of assessment, protocol prescription and the actual administration of the therapy. All the individuals involved in the process are qualified laser therapists and are able to integrate this technology into their therapeutic programmes, as clinically indicated. At our facility, laser therapy is generally utilized as the basic treatment platform, although sometimes complemented by other modalities.

Within the team concept, the various disciplines work collaboratively to provide the "best practice" standard in order to achieve an optimal clinical outcome. It is important that everyone particularly insurance carriers, clearly understand this process, designed to produce the best possible result, a matter that should protect the patients best interests.

To summarize - At Meditech, we offer a comprehensive therapeutic programme designed on an individual basis in order to achieve an optimal clinical outcome. This may include periodic participation by the physician, the physiotherapist and/or the chiropractor, along with those who apply the therapy under supervision. The latter include kinesiologists, laser therapists, massage and exercise therapists, again working on a collaborative basis.

Recently an article in the New York Times dated January 25, 2010 caught my attention; the title - "Insurer Steps Up Fight to Control Health Care Cost". With regard to this publication, I state as President Obama did in his healthcare speech late last year, "that this issue must be resolved before healthcare can be delivered with the primary objective of providing the best possible care available, directly to patients."

Increasingly, in my office practice the single most pervasive and negative factor each day are the therapeutic restrictions imposed by insurance carriers. In my personal opinion, patients are entitled to the best care available for any particular problem. This should be the basic platform of quality healthcare, yet insurance carriers have become increasingly obstructive in allowing this process to take its course. If the proposed mode of treatment is not covered, permission to initiate treatment is invariably delayed. Consequently, the healing process is prolonged, is generally less effective, the condition may become chronic and the cost of care is substantially increased. Currently, my office requires one full-time secretary to assist patients in attempting to resolve these issues in order to permit the initiation of proper treatment.

For example - just 3 weeks ago, a patient presented on a Saturday morning having sustained a severe skiing injury to the right shoulder on the previous day. At the resort where this occurred, an X-ray had been taken and interpreted as being normal. The patient was provided with analgesics and a sling and was sent home. On the Saturday morning following the injury of the previous day, the patient presented at our clinic in acute distress. Over the next 3 weeks, 12 laser therapy sessions were administered. This resulted in complete resolution of the problem.

An orthopedic consult, requested initially, has still not reached the head of the waiting line. An MRI performed 2 weeks after treatment had been initiated, reported the presence of a Hill-Sachs fracture and extensive ligamentous and other soft tissue damage.

If the parents of this 15 year old boy had not been willing to short-circuit the system, institution of therapy would have been delayed, the course of treatment prolonged with undoubtedly a less than an optimal outcome. This is a clear-cut example where early treatment consistently applied and monitored can achieve an optimal result, devoid of any other considerations. It has still not been determined whether there is insurance coverage although both parents are high level professionals and are "supposedly" covered by several insurance policies. Incidentally, the patient has made a complete recovery, including a normal pain-free range of motion of the left shoulder, while the insurance battle rages on.

The hours of secretarial time wasted on paperwork and telephone calls required in order to stimulate carriers to honour their obligation is becoming increasingly complex and invasive. As we all know from personal experience insurance companies and their sales minions are happy to sell policies and collect premiums. Their glowing ads promise security, unlimited benefits and infiltrate the media at all levels. At the same time, the series of hurdles imposed on the way to compensation is becoming insurmountable. These imposed economics overshadow the need for both urgent and high quality care, which should be the primary concern. The result - an impasse in the delivery of healthcare, strangled by carriers primarily interested in profit margins. The ramifications of this state of affairs are negative from every perspective, particularly when an immediate and positive approach is so essential. No one appears to be pro-active in the struggle to correct these deficiencies, which play a major role in the breakdown of healthcare delivery systems. Before we can continue to move forward in a positive manner, this impediment must be removed.

Enclosed is a Bulletin Board communication that demonstrates what is possible.

When I first received this inquiry, I was caught in a dilemma whether to treat or let nature take its course. Fortunately, I made the right decision which is what we attempt to do at all times. The results speak for themselves.

We have seen a number of similar cases of this type in the past, however this one is somewhat special, particularly in view of the result.

At the same time, we offer our congratulations and thanks to therapist Donna Rasplica, MSc., R.Ac., Dr. TCM, who made it all happen. It is highly probable that this patient will continue to improve over a prolonged period of time.

The lesson to be learned from this case is - "that you cannot succeed unless you try." In addition, the healing potential of Laser Therapy is once again emphasized.