MCAournalJanuary 2016Volume XXV/ Number 1

FABulous Spring CE Forum Ahead! The 2016 Maryland Chiropractic Association’s upcoming Spring CE Forum will undoubtedly prove to be a FABulous time. The year’s Forum will feature the nationally renowned Dr. Fabrizio Mancini (Dr. Fab). Mark your calendar for March 5 and 6 and join the MCA at the beautiful Turf Valley Resort in Ellicott City, Maryland, conveniently located just outside of Baltimore. Up to 12 CE hours available.

Saturday, March 5The weekend will begin on Saturday, March 5 with a presentation by Dr. Mark Sanna from 8:30 a.m. to 12:30 p.m. He will present "Systematic Case Management." Coding and documentation compliance have risen to the top of the CMS list of items to monitor. This session will provide you with valuable insight into the science, documentation, and coding of the patient-centered practice.

The 2016 Legislative Update and General Membership Meeting and Luncheon will begin at 12:30 p.m. During the meeting, you’ll learn about the latest legislative issues in Annapolis that affect your practice and how the MCA Legislative Committee is working to protect our scope of practice. You will also have a chance to meet with members of the MCA Board of Directors and hear about the overall issues the board is addressing. Do you have some questions and concerns? There will be a segment during the meeting for a Q&A session. You’ll also be updated on the latest news on the development of the East Coast Association’s Independent Providers Network (ECA-IPN.)

Following the luncheon, from 2:30 to 6:30 p.m., Dr. Scott Banks will present "The Neural, Endocrine and Immune Influences on Neuromusculoskeletal Rehabilitation." The healthy individual exists in state of homeostasis with all body systems functioning within a tight range of ideal balance. Any stressor (chemical, mental, physical) generates allostasis or shifting from homeostasis to an altered state of functioning more suited to deal with the acute effects of the stressor. Participants in this course should develop an appreciation that the whole of the function of the human body is bigger than the sum of its parts learning both to evaluate allostatic load as well as developing natural programs for correction.

JAt 6:30 p.m. it is time to relax and socialize! Join your fellow colleagues for cocktails with the exhibitors. Your favorite beverage,

lite fare and conviviality will highlight the evening. Don’t forget to visit with the exhibitors and learn about their latest products to enhance your practice.

Sunday, March 6From 8:30 a.m. to 12:30 p.m. on Sunday, Dr. Fab, with special guest Dr. Steve Peyroux, will present "Chiropractic Philosophy: An Idea Whose Time Has Come." In this presentation, Dr. Fab will discuss how we have evolved as a profession throughout the last 120 years. He will also share how our role changed, why a natural and holistic approach is in demand, and what the opportunities in front of us are. You will also learn the four (4) things you "must do" to navigate the healthcare changes and be able to serve more people. He will go over the evidence behind what we do in Chiropractic and will discuss the everyday choices that are keeping us from living a healthy life. You will also be reminded why you chose Chiropractic and reignite the passion for what you do.

Chiropractic is an idea that its time has come, are you ready to share it with the world?

Proceeds from MCA sponsored events go towards the Association’s Legislative efforts to protect your profession. Overnight room reservations at $119 a night can be made by contacting the Turf Valley Resort directly at 888-833-8873. Make sure you mention the MCA Spring 2016 CE Forum. You can also make your reservation online at www.turfvalley.com. Use group code 27Z6AF. To lock in the lowest rate, make your reservation by February 8, 2016.

More information including course details can be found on the MCA website atwww.marylandchiro.com.

Welcome New Members

Michael Bartel, DCHampstead, MD

Teresa Dower, DCBaltimore, MD

Steven Elek, DCFallston, MD

OfficersRonda Sharman, DC

President Paul Abosh, DC1st Vice President

Anthony Hardnett, DC 2nd Vice PresidentNicole Ganz, DC

Secretary Don Hirsh, DC

TreasurerLouis Crivelli, DC

Past President

Directors At Large Tom Chaney, DC Jay Greenstein, DC James LeVan, DC District Directors

Chesapeake- Alan Sokoloff, DC

Metro Baltimore - Adam Fidel, DC Josh Levin, DC Howard Lewis, DC

Metro DC - David Fishkin, DC Mark Wells, DC

Western - Donald Berry, DC

ACA Delegate Louis Crivelli, DC

ICA Delegate Anthony Hardnett, DC

Tim McKenna, CAEExecutive Director

Monica ShanerFinancial Manager

Justine Harper Communications Coordinator

Molly Baldwin-Abbott Publications Coordinator

STAFF

BOARD OF DIRECTORS

EXECUTIVE BOARD

Maryland Chiropractic Association720 Light Street

Baltimore, MD 21230410-625-1155

FAX: 410-752-8295E-MAIL: MCA@assnhqtrs.com

www.marylandchiro.com

I would love to start by wishing you and your families a Happy New Year. I am hoping this year brings joy, prosperity and wellness to all of you. Personally, I am starting this year full of excitement and creative ideas for my life, my business and our association. I hope over the next two years, I can make some positive and lasting changes within the MCA that could improve your practice experience. In order for that to be achieved, we have to start with a clear vision for the future. I envision a thriving association full of thriving doctors. Thriving means a lot of things; well-managed, organized, efficient, productive, prosperous, influential, and effective. These

adjectives could and should apply to all areas of our organization from membership to legislation to insurance to education. We all know that any positive outcome only comes with planning, goal setting, action steps and participation. We started our first board meeting with making new agreements and definitions of duties for board members so that we can hold ourselves to a standard of excellence and better serve you. We have scheduled a strategic planning session that is unlike any done in the past for our association. Once we have a clear and concise strategic plan, we plan on using it as a path to achieving our goals. We also plan to utilize some innovative tools to monitor and track our progress. We hope to improve engagement of members, value of membership, connection with new doctors, and the climate of insurance/reimbursement as well as the quality of our convention and education programs. Once we get through our first stage of strategic planning, I will be able to share some more concrete and streamlined goals with you.Just as we are holding our board and the leaders of our association to a standard of excellence, I would not be a very good President if I didn’t also ask you to rise to the occasion. Let me first remind you of how important and exceptional you are. You are the "why" behind the MCA. We all share something extremely important in common. This thing is the "why" behind the MCA. We all lift a burden off of the nervous system that allows people to express health to a fuller potential. We give something to the people of Maryland that they can get nowhere else or from anyone else. And we give this thing in a cost effective way, with great patient outcomes and with a high level of patient satisfaction. That thing is the chiropractic adjustment. It doesn’t matter if you give it alongside PT modalities, rehab and massage. It doesn’t matter if you give that and that only. It doesn’t matter if you deliver it with your hands, with an Activator, with a ProAdjuster or any other tool. All that matters to me is that you know how to deliver a chiropractic adjustment. And the fact that you know how to do this makes you very important. You are important because the work that you do is important. And necessary! And profound! And effective! The world is begging for the solutions that we give. Because your work is so important, I want you to be happy, healthy, prosperous, and business savvy. So, it is the MCA’s mission to protect and advance the profession of chiropractic in Maryland. That means that we want to protect and advance the work that you do. That means that we want to protect and advance YOU. And when you are too tired to do the work, too old to do the work, or whatever the case may be...we want you to be able to sell you practice to someone else who can do the work, or train associates to do the work, or get young ones excited to go to school so they can do the work. And make no mistake, if the MCA doesn’t work to protect and advance the profession, if the MCA disappeared tomorrow, others would step in to contain or eliminate our profession faster than you can blink an eye. Then no one would be doing the work of chiropractic. There is no chiropractic without the chiropractor. You are the chiropractors and we are here to protect your ability to prosper and enjoy your profession. So now that you know how exceptional you are, I am going to ask you participate in making our vision a reality. Here are four simple ways that you can help:1.) Find one non-member and get them to join the MCA and/or come to a convention.2.) Commit to coming to at least one MCA convention a year...even better, two!3.) Donate something to CPAC.4.) Look into yourself and think of a way you can help the MCA. Is it input on a committee? An idea for a speaker? To volunteer attendance at a political event? If you think of something, e-mail me at rondasharman@msn.com.It is truly an honor to serve you. I hope together we can create an exceptional experience of practicing chiropractic in the great state of MarylandSincerely,

President’s Welcome

Ronda Sharman, DC

Chiropractic Marketing: Your Best ChannelsBy Dr. Ray Foxworth, president of ChiroHealthUSA

As far back as 1880, department store magnate John Wanamaker became famous for saying "Half of the money I spend on advertising is wasted. I just don’t know which half."Even with today’s measureables such as Google Analytics, open and click-through rate tracking, etc., it’s still difficult to know exactly what kind of marketing outreach works best. But that doesn’t mean you should give up and stop marketing your business. Here are the options we at ChiroHealthUSA recommend you investigate:

• Yelp – increasingly, consumers of all kinds of services and products are going to Yelp to read reviews before committing their dollars. Yelp can give your practice quite a boost, but there’s a downside. You can’t delete negative reviews, even if they have no factual basis. You can, however, promote positive interaction and encourage patients who have had good experiences to leave enough good reviews to outweigh the occasional negative outlier.

• Facebook - Facebook is becoming an increasingly tough nut to crack (the social media giant want you to buy ads, so their algorithm suppresses business-related posts), but you can mix up sales-oriented posts with more lighthearted ones for better reach. Note: Facebook "likes" infographics and videos, and tends to show them to more "likers" than posts that are text only.

• Twitter - Twitter has better reach than Facebook, but it also trends toward a younger demographic, so phrase your tweets accordingly. Your tweets can refer your followers to your website or Facebook post. One thing to remember, learn to craft your messages concisely. Tweets are limited to 140 characters.

• Pinterest - What started as a place to gather photos a la scrapbooking or vision boarding has rapidly turned into a viable marketing tool. Share visual information here such as infographics, photos of your office and/or staff, blog posts if you have a business blog, even recipes for healthy eating, or graphics of exercises.

• Mass E-mail Marketing - Whether you use Constant Contact, MailChimp or another e-mail service, you can get a lot of mileage out of a monthly or bimonthly newsletter. Consistency is key here. "Train" your mailing list to expect your newsletter at a

specific time or times of the month and they’re much more likely to read it. Note: you MUST get every recipient’s permission to add them to your mailing list. Create a sign-up sheet at the front desk, so that you can make signing up for your mailing list a natural part of your new patient procedures.

• Local event sponsorship - does your community have fairs, farmer’s markets, school events and other places where you can set up a booth? Visibility within your community is a gift that gives both ways.

No matter where you advertise or market your practice, it’s critical that you avoid the no-no’s that can get you in trouble

with the Office of Inspector General (OIG) such as inducements via outrageously low discounts or coupons, and/or potentially illegal dual fee schedules by offering one fee for insured new patients, but another for cash paying new patients.

And, what is the definition of "outrageous?" It is anything more than $10.00, or a total of $50.00 in a year according to the 2009 OIG Special Bulletin Alert on Gifts and Inducements. Hardly outrageous, do you think?

ChiroHealthUSA is a network that works in conjunction with a Discount Medical Plan Organization (DMPO). Using this model, doctors can get paid well

when insurance is available, yet keep care affordable for their cash and underinsured patients, including Medicare. Want to know more? We now offer our free informational webinar, "Risky Business: The Five Little Things That Can Cause Big Problems in you Practice," on-demand for your convenience. And the process to become a provider is even easier with our simple online application. Find out more by visiting chirohealthusa.com.

Dr. Ray Foxworth is a certified Medical Compliance Specialist and President of ChiroHealthUSA. A practicing Chiropractor, he remains "in the trenches" facing challenges with billing, coding, documentation and compliance. You can contact Dr. Foxworth at 1-888-719-9990, info@chirohealthusa.com or visit the ChiroHealthUSA website at www.chirohealthusa.com. Join us for a free webinar that will give you all the details about how a DMPO can help you practice with more peace of mind. Go to www.chirohealthusa.com to register today.

SponsorsPavilion

Saluting MCA’s 2015 Sponsor!

Gold Sponsor Foot Levelers, Inc.

www.footlevelers.com

Thanks to MCA SupportersMCA has a Supporting Membership category for suppliers of goods and services. We encourage you to consider the following 2015 Supporting Members when making purchases. Support those that support YOU!

Anabolic Laboratories, Inc.Bryan Miller 410-296-7574

Ashton Rehab ClinicEdward Ashton, DC

301-587-9717

Foot Levelers, Inc.Yolanda Davis

ReachLocalAlan Moore

410-963-8226

ACA Report: National Campaign Launched for Medicare Equality: ACA Seeks Full Physician Status in Program

\The American Chiropractic Association (ACA) has launched a national grassroots effort to eliminate ablatantly anti-competitive provision of Medicare law that arbitrarily limits reimbursement for medically necessary services delivered by doctors of chiropractic (DCs). The statutory change ACA seeks would define DCs as “physicians” under Section 1861 of the Social Security Act for the provisioning of any existing Medicare covered service that falls within the scope of practice of an individual DC as defined by their applicable state law. The centerpiece of ACA’s campaign will focus on generating a robust level of patient grassroots support aimed at Congress that seeks to ensure that Medicare beneficiaries have full access to a broader range of covered services provided by chiropractic physicians than current law permits. The level of support needed will be largely generated via the distribution of a National Medicare Equality Petition that will raise awareness of how the current Medicare system shortchanges seniors who want and need the essential services provided by DCs to stay healthy, pain free and mobile.

"Studies have shown that essential services provided by chiropractic physicians can help aging Americans live healthier lives, yet every day our nation’s seniors are being unjustly denied reimbursement for Medicare-covered services by chiropractic physicians that could improve their quality of life," said ACA President Anthony Hamm, DC.

According to Dr. Hamm, the federal government continues to rely on an antiquated statute that discriminates against Medicare’s chiropractic patients by not covering medically necessary and mandated services delivered by DCs. The federal Medicare program, which in many cases serves as a model for private insurance plans, currently serves more than 55 million Medicare beneficiaries. Various projections forecast the number of people age 65 or older increasing by about one-third over the next decade. Chiropractic inclusion in the Medicare program was established in 1972 and has seen little change since then, other than elimination of the X-ray requirement in 1997.

ACA strongly encourages DCs across the country to recruit the active support of patients and other chiropractic supporters to sign the petition and add their name to a growing list of Americans who demand coverage for all services provided by chiropractic physicians for the Medicare population. The plan is to let signers of the petition have their voice heard in Washington through a series of targeted grassroots campaigns whereby they contact their members of Congress and seek a solution to the problem.

Doctors and patients who wish to support the campaign may access the equality petition at www.acatoday.org/equality. They may also follow the progress of the campaign and receive updates on Facebook and on Twitter and Instagram at #MedicareEquality.

If you have any questions or feedback, or would like a copy of the petition to distribute to your patients, please contact Dr. Louis Crivelli at drcrivelli@yahoo.com or 301-474-5505.

PAUL’S TECHNOLOGYBy Paul M. Abosh, DC C

ORNER

Ah, technology - you love it and you sometimes hate it, all at once. Technology and apps change so rapidly, it’s hard to keep up. When I met my wife, we met on one of those online dating/matchmaking websites and I thought that was the height of technology. Well, lo and behold, I am now officially and old fuddy-duddy. My wife and I have a friend who is single and dating and to her, dating websites are obsolete. She has an app on her phone that allows her to not only look at a guy’s profile but she can "swipe left" if she doesn’t like him or "swipe right" if she does. If she swipes right, it instantly starts an instant message conversation between them and they arrange to meet up for a date later that day/night. She sometimes arranges two or three dates on the same night in five minutes from her phone. If only we could schedule our patients that easily...well, on to apps that can help us.

1.) iXpand Synch, by Scandisk - this app is free, but does work hand in hand with a USB stick that you have to buy, called a Scandisk iXpand. You can get a 32GB one for $55 from Amazon. The beauty of this is that the USB stick is a high-capacity USB stick like any other, but is also has a lightning connector to plug in to your iPhone/iPad. With the app, any files you have on your USB stick can be viewed/played/edited/save on your mobile apple device. You can have videos on the stick that you can show to your patients on your phone or iPad without taking up precious storage space on your device.

2.) Chrome - if you like Google Chrome as your web browser on your computer, the good news is that you can now download the app as a web browser for your apple mobile device too. Best of all, it’s free. It functions just like the desktop/laptop version.

3.) Coursera - again, another free app. This one lets you take courses and provides lectures/educational seminars on almost any topic you can think of - business, HR management, health care-related topics, etc.

4.) Lumosity – Some of you might have heard of this one before. It’s a great brain-exercising app. You play games on your device

and it trains/retrains your memory, attention, logical thinking and problem-solving skills. Great for us who need to exercise our brains just as much as our bodies, and not just fill up our heads with Chiropractic facts and insurance figures. This is also great for your patients who have had a concussion. In addition to the physical treatment, this helps rehabilitate their mental pathways. It is recommended by a few neurologists I know for their concussion patients (obviously it is case-specific and depends on the severity of the concussion). It is also free.

Finally, one update from my previous article:

5.) Flipboard - not directly business-related or Chiropractic related, but a great news feed app that allows you to create news feeds on as many and/or as specific topics as you like. This feed doesn’t subscribe to any one news source, so the article you get comes from all sources around the world, most of them internet-based. And each article in a particular news feed includes the original Zite news feed that it came from in case you want to add that feed to your favorites list. Also a free app, not hidden fees. **NOTE** - As of this writing, Zite is going offline for good, but if you currently subscribe to Zite, they have an article about how to migrate your news feeds to Flipboard. It is very easy. Flipboard is also a free app.

If any of you use these apps or download these apps, I’d love to hear from you about your experiences with them, good or bad. As always, please feel free to e-mail me at pabosh@wmhealthwellness.com. I’ll have more tips for you in the next newsletter.

ICA Report: Fitness Council Set to Celebrate its 24th Symposium on Natural Fitness & SportsICA’s Council on Fitness and Sports Health Science is announcing its special all-star lineup of leading educators and guest celebrity athletes at the 2016 Symposium on Natural Fitness and Sports!

Mark your calendars for March 3-5, 2016 and come to a full and fantastic weekend of powerful presenters, fitness stars, champion athletes, and innovative, practical chiropractic continuing education offerings. There’s no other program on exercise, sports, and chiropractic like the ICA Symposium on Natural Fitness, which features special highlights - including entry to the huge Arnold Schwarzenegger Sports Festival and our personal keynote presentation by Arnold Schwarzenegger right at our Symposium!

For more information and to register, go to icafitness.org and chiropractic.org/Symposium. Read more at www.chiropractic.org/.

Join the MCA ListservThis is a reminder for you to take advantage of a member benefit; the MCA ListServ. The ListServ is a convenient membership tool to find advice from your peers concerning business operations, insurance, equipment, record keeping, etc. The MCA has a diverse and knowledgeable membership that you can access for clinical, research, business and political issues.

The ListServ is open to all members of the MCA. The link below will direct you to the sign-up site and also provides the rules for using the ListServ. The list is password protected and has dedicated servers so that your e-mail address is safe from spammers and viral problems. Al Sherry, DC and Tim McKenna carefully monitor the ListServ to make sure communications are on the up-and-up, and civil.

If you haven’t already signed on to the ListServ go to ww3.chirolists.com/cgi-bin/mailman/listinfo/mca-chirolist, which will let you subscribe, and will give you further information.

*This list includes all donations between January 2015 - January 2016.

Delegate ($100 - $364)Dr. Kathryn P. AlexanderDr. Frank AlfanoDr. Lisa BailesDr. Susan BatesDr. Gregory BelcherDr. Chad A. BlakerDr. F. Keen Blaker Dr. William BoroDr. Maria Luisa CareyNadine CarrickDr. Stephanie ChaneyDr. William G. DolengoDr. Mary Jane Cleaves-DuncanDr. Paul Ettlinger Dr. Stewart J. FalkDr. Adam FidelDr. Illene FidelDr. Robert G. Frieman

Dr. Brian ParisDr. Starr ParsonsDr. Robert PoaneDr. Robert Joseph ReierDr. Anthony RicciDr. Mark Roberts Dr. Scott SamsonDr. Richard SantangeloDr. Ronda SharmanDr. Mark Shulman Dr. Mitchell R. SilvermanDr. David M. SortisioDr. Karen ThomasDr. Ronel WilliamsDr. Daniel T. WiseDr. Mahmoud Zai-Shakeri

Dr. Cynthia HamannDr. Paul Henry Dr. Donald HirshDr. Brandon S. HollenbergDr. Eric HorneDr. John T. JenningsDr. Ross KennardDr. Audie G. KlinglerDr. John Koloski Dr. Daniel J. KrausDr. Blaise M. LaVorgna Dr. Joshua LevinDr. Howard F. LewisDr. Steven Lipschutz Dr. Thomas LoDr. Kevin McKenzieDr. Jonathan NouDr. Giuseppe Nunnari

Member ($25-99)Dr. Veronica AnticoDr. Richard AskewDr. Raymond BarryDr. Chris BrandoliniDr. Joanne BushmanDr. Robin CohlDr. Alvin ColeDr. Enid Cruise-BrooksDr. Richard Fidanza

Dr. Lisa Beth HepferDr. Scott Irrgang Dr. Kathrine Kadin Dr. Alicia KovachDr. Brian KrupinskyDr. Peter Mellon Dr. Jack MurrayDr. Larry Plotkin Dr. Michael Welch

President ($1,000 or more)

Dr. John DeMaio Dr. Jay Greenstein

Dr. Keith Scott Governor

($500 - $999)Dr. Paul Abosh

Dr. Thomas Chaney Dr. Neil B. CohenDr. Nicole Ganz

Dr. Gregory Lewis

Senator ($365 - $499) Dr. Michael Fedorczyk

Dr. Eric Fisher Dr. John F. Kibby

Dr. James S. LeVanDr. Ian Newman

Dr. Thomas SchrepplerDr. Young-Sung Song

Happy New Year! The Maryland legislative session begins January 13. We will be interacting with many of the General Assembly’s 47 Senators and 141 Delegates. The goal of CPAC is to support legislators that have supported the chiropractic profession and to work with those legislators that have not yet supported us to do so in the future. CPAC provides opportunities for us to meet legislators at their fundraisers and for them to get to know who we are. We need to educate them about what we want for our patients and our profession. To do this we need your contributions and your participation. If you do not see your name on this list then you have not contributed in the twelve months. We need your support and help. Please consider making regular contributions to the PAC. If each of us contributed 1/10th of 1% of our office’s collections we would be a very strong force in Annapolis. The PAC is non-partisan, so your participation is welcome regardless of your party preference. I thank you for your support of the PAC. If you are interested in attending some of these events, please let me know. Thanks to Tim McKenna of the MCA, Marc Cohen, our MCA counsel and Bill and Julie Pitcher, our lobbyists, for their invaluable assistance.

In the middle of December 2015, news outlets reported on a new study showing that mothers taking selective serotonin reuptake inhibitors were more likely to give birth to autistic children (1). This study was consistent with earlier ones that suggested a similar relationship (2,3). The strength of the associations is still being debated and this will likely continue as more studies are done.

From my perspective, the bigger issue is how we as chiropractors can help women to avoid depression and the associated use of SSRIs and thus, eliminate a potential risk factor for autism. To do this, we must understand the biochemical nature of depression, which typically gets confusing because we mostly view it from the perspective of how medications work. SSRIs target serotonin receptors, so the global view of depression is that it is a problem with serotonin metabolism. And since SSRIs inhibit serotonin reuptake, the implication is that depressed people do not make enough serotonin. The supplement industry has taken their lead from this information and produces supplements to help increase serotonin levels, such as 5-hydroxytryptophan (5-HTP), which functions as a precursor for serotonin synthesis. I take a different view of depression because the available evidence does not suggest that people are unable to make adequate serotonin.

Since chronic inflammation is the basis for most conditions, it is important to look for an inflammatory answer to a question about a health problem. When it comes to depression, we now know conclusively that chronic inflammation is a promoter (4,5). We also know that inflammatory cytokines increase the breakdown of serotonin (5), which means our impression should not be that depressed people are unable to make enough serotonin. In summary, the problem with depression is that a chronic inflammatory state is associated with a loss of normal serotonin levels and speaks directly to helping patients reduce chronic inflammation. The remainder of this article will discuss treatment options available to chiropractors that help to reduce chronic inflammation and depression.

Most chiropractors encourage their patients to exercise more, and interestingly, it is known that exercise helps to reduce chronic inflammation (6). Studies have shown that exercise can be as effective as Zoloft in reduce depressive symptoms (7). We also know that there is a hedonic or well being effect that is promoted by exercise (8). Exercise intensity should be gauged based on a patient’s level of fitness and tolerance. Many women exercise throughout their pregnancy.

A pro-inflammatory diet is known to promote chronic inflammation and depression (9,10). Thus, we should urge out patients to "deflame" their diets by eating anti-inflammatory foods.

Several basic supplements have also been shown to help reduce depression, including a multivitamin, magnesium, fish oil and vitamin D (11-14). All of these supplements have a mild anti-inflammatory effect.

Spinal manipulation may help reduce depressive symptoms.

A case history demonstrated that depression was resolved in a 71-year old female with low back pain. The authors conclude that this outcome may have been due to a variety of factors, such as natural progression, therapeutic effect of touch, patient–doctor interaction, or improvement secondary to the improvement of her back pain (15).

References1. Boukhris T, Sheehy O, Mottron L, Bérard A. Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children. JAMA Pediatr. 2015; Dec 14:1-8.

2. Croen LA, Grether JK, Yoshida CK, Odouli R, Hendrick V. Arch Gen Psychiatry. 2011;68(11):1104-12. Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry. 2011;68(11):1104-12.

3. Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics. 2014;133(5):e1241-8.

4. Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9:46-56.

5. Rosenblat JD, Cha DS, Mansur RB, McIntyre RS. Inflamed moods: a review of the interactions between inflammation and mood disorders. Prog Neuro-Psychopharmacol Bio Psych. 2014;53:23-34.

6. Mathur N, Pedersen BK. Exercise as a means to control low-grade systemic inflammation. Mediators Inflamm. 2008, 2008:109502.

7. Blumenthal JA, Babyak MA, Doraiswamy M et al. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Med. 2007;69:587-96.

8. Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psycho Rev. 2001;21:33-61.

9. Akbaraly TN et al. Dietary pattern and depressive symptoms in middle age. Brit J Psychol. 2009;195:408-13.

10. Pina-Camacho L, Jensen SK, Gaysina D, Barker ED. Maternal depression symptoms, unhealthy diet and child emotional behavioral dysregulation. Psychol Med. 2015;45:1851-60.

11. Suarez EC. Plasma interleukin-6 is associated with psychological coronary risk factors: Moderation by use of multivitamin supplement. Brain, Behavior, and Immunity 17 (2003) 296–303

12. Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67:362-70

13. Kiecolt-Glaser JK et al. Depressive symptoms, omega-6:omega-3 fatty acids, and inflammation in older adults. Psychosomatic Med. 2007; 69(3):217-24

14. Vieth R, Kmball S, Hu A, Walfish PG. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutrition Journal 2004, 3:8

15. Rowell RM, Lawrence DJ, Hawk C. Relief of depressive symptoms in an elderly patient with low back pain. Clin Chiro. 2006;9:34-38.

Author information:David R. Seaman, DC, MS is a Professor of Clinical Sciences at National University of Health Sciences in Pinellas Park, FL. He is a consultant for Anabolic Laboratories and has been writing and lecturing about the topic of diet, inflammation, pain and chronic diseases for over 20 years. He makes this information available to the general public at his website – deflame.com. He has just written a new book for laypeople and patients entitled The DeFlame Diet.

Pregancy, Antidepressant Use and AutismBy David R. Seaman, DC

Let me start by announcing that the Legislative committee has now become the proverbial two-headed monster, as it were, in the best possible way. Dr. Louis Crivelli and I will be co-chairing this committee. As always, we invite you to become as involved as you would like and welcome any and all assistance. I am inspired by the drive and enthusiasm of our new President, Dr. Ronda Sharman. As Dr. Sharman and I, along with the rest of the MCA Board have been discussing in recent months, we have a goal of creating a long-term plan and a unified vision and mission for the MCA for many years to come, that will carry us through not just the next few years, but the next few decades. So how does relate to legislative concerns, you ask? Well, let me tell you...

We’ve asked for PAC contributions before, and that remains true. We are just about to start the 2016 legislative session, and as I write this article, even now, some bills are being pre-filed in the House or the Senate, and some of those bills will affect us for the better, or for the worse. In order to support the bills that will help our profession and oppose the bills that will hinder our ability to provide care for our patients, we need your PAC contributions just as much now, if not even more so. We need to meet our elected officials, old and new, and discuss with them the agendas that are important to our profession. That takes money. Let’s also keep in mind that they will want to get reelected in the next campaign and that also takes money. We need your help. Contribute $100, $200, $500, $1,000 or more to the PAC. Get out there and meet your Senator and State Delegate(s) from your district. Make friends with them, invite them to your office, maybe they need a good Chiropractor. The prime time to get to know them is now, while they are getting settled in their office, before they get busy in January with the 2016 Legislative session.

Now, I know a lot of you are thinking "I just bought holiday gifts for my family and staff, I’ve already paid for joining the IPN (you have, haven’t you?), and now you’re asking me for more money? What am I, a piggy bank?" No, we’re not saying that, and yes, the IPN is very important and a worthwhile investment. No one is asking you to give money to the PAC right this moment - but keep it in mind. Set aside $10 or $20 a week, and in a month or two, send us that money you’ve set aside. Believe me, our political efforts are just as important as everything else we do.

As it relates to my opening paragraph, we want to strategically

plan for the future of our profession, again, not just for this year, but for many years to come. Some of our political efforts take years to bear fruit, and we need to plant the seeds now. Think long term, look at the forest, not the trees.

As I mentioned in past articles, and even earlier in this article, each committee, including the Legislative committee, needs help. Whether you can donate an hour of you time one day, or want to help out once in a while or on a regular basis, we at the MCA board can only get so much done by ourselves. Feel free to come to any MCA board meeting, listen in and see if something piques your interest. You can always call me or any board member anytime, not just with questions, but also just to say "hey, I want to help with the Medicaid issue" or "I want to go to Annapolis one day and meet my State Delegate” and we will happily help you out."

This February, we will most likely be having our annual Legislative day in Annapolis, where we meet as many State Delegates and Senators as we can, especially those who sit on committees that vote on bills that affect us. The more Chiropractors we get there, the more of them we can talk to at once. So please come out in February and help us. We will send out the date, time and location when we have it. There might be many new Senators and House Delegates attending who have never met us before and may not even know much about Chiropractic care. Do you want them to learn about it from outside sources? Wouldn’t you rather have the opportunity to explain the benefits of Chiropractic care to them directly?

As always, I send out my thank you’s to all those who help in our Legislative actions, and I thank those of you who send in your support and your donations to our PAC.

If you have any questions regarding any Legislative issues or Legal issues (for which I would refer you to our Board council, Mr. Marc Cohen of Ober/Kaler), my door is always open, so to speak. Please feel free to call me at 410-256-8511 (office) or 301-523-6078 (mobile) or e-mail me at pabosh@wmhealthwellness.com. I look forward to helping you and helping all of us in the coming year.

Legislative Update By Paul M. Abosh, DC, CCSP, CCEP, CKTP

MCA Mentor ProgramNew Members and Licensees,

Welcome to Maryland! This is a great state to practice in and the Maryland Chiropractic Association would like to lend you a hand in getting you started. Below is a list of doctors with many years of experience who have volunteered to help with questions you may have along the way. Pick a name and make the call, MCA members help each other all the time. This is your chance to find out more about the MCA community. If you have questions about the Mentor Program or MCA in general, feel free to give me a call.

Dr. Jim LeVan(301) 585-5350

Name Phone # LocationPaul Abosh, DC (410) 256-8511 Perry Hall, MDBill Boro, DC (410) 266-5054 Annapolis, MDTom Chaney, DC (410) 216-9180 Annapolis, MDNeil Cohen, DC (410) 656-8400 Essex, MDAlan Cornfield, DC (301) 585-2225 Silver Spring, MDDennis Cuzzo, DC (732) 547-2335 Pocomoke City, MDCharles Descalzi, DC (301) 942-2200 Silver Spring, MDJohn DeMaio, DC (410) 721-2222 Gambrills, MD Jeff Deschamps, DC (301) 663-8707 Frederick, MDPaul Ettlinger, DC (410) 356-9939 Owings Mills, MDAdam Fidel, DC (410) 484-5642 Pikesville, MDIlene Fidel, DC (410) 358-0060 Park Heights, MDJoe Fiori , DC (410) 766-2322 Pasadena, MDMarc Gamerman, DC (301) 797-3737 Hagerstown, MDNicole Ganz, DC (301) 929-8301 Kensington, MDJoel Goldwasser, DC (410) 882-0720 Baltimore, MDMark Goren, DC (301) 949-0440 Kensington, MDJay Greenstein, DC (301) 518-1006 Washington, DCPaul Henry, DC (410) 285-2600 Baltimore, MDDon Hirsh, DC (301) 490-2600 Laurel, MDRay Infanti, DC (410) 573-5733 Annapolis, MDDiane Kelly, DC (410) 757-8989 Arnold/Annapolis, MDAudie Klingler, DC (301) 777-0110 Cumberland, MDJames S. LeVan, DC (301) 585-5350 Silver Spring, MDMarcia Levi, DC (301) 362-5868 Laurel, MDMary Ann Ley, DC (410) 628-9355 Timonium, MDThomas K. Lo, DC (410) 721-3338 Crofton, MDKaren McDermott, DC (410) 257-7106 Prince Frederick, MDJack Murray Jr., DC (301) 722-4400 Cumberland, MDMichael Nelson, DC (410) 828-0900 Towson, MDRobert Poane, DC (410) 420-7676 Bel Air, MD Mark Roberts, DC (410) 931-2096 Baltimore, MDPhilip Romano, DC (301) 924-6444 Olney, MDJohn Sampson, DC (410) 213-0900 Ocean City, MDRick Schmitt, DC (301) 717-7187 Annapolis, MDRonda Sharman, DC (301) 870-4277 Waldorf, MDAl Sherry, DC (410) 598-5721 Baltimore, MDAlan Sokoloff, DC (410) 766-4878 Glen Burnie, MDNorman Spector, DC (410) 249-3454 Baltimore, MDRonel Williams, DC (301) 334-3180 Mt. Lake Park, MDSean Williams, DC (410) 213-1233 Ocean City, MDDan Wise, DC (410) 592-7300 Phoenix, MDMahmoud Zia Shakeri, DC (410) 213-1233 Ocean City, MD

ClassifiedsTo place a classified ad in the MCA Journal please fill out the appropriate form on the classifieds section of the MCA website. The cost for a 50-word ad is $20 for MCA members for two months (4 months for $30) or $30 for two months for non-members.

Registered Radiology Technologist - Energetic, punctual, R.T. that wants to become a chiropractic assistant and x-ray for a busy office. Willing to test for the C.A. I also have an Engineering associate that shows I can learn easily. titzlerdj@verizon.net.

Who Else Wants to Run a Super Successful Practice - Busy doctor who has a large patient base is looking for an associate doctor who wants to learn and grow. The right candidate must be coachable and eager to learn how to run their own practice. Two year commitment is required and have PT licensee. Competitive salary and bonus structure. Please e-mail your CV to backdoc96@gmail.com.

Chiropractic Office Coverage - Chiropractic Office Coverage. New for 2016... Lower Fees! Now more affordable for smaller practices. Get Full-Day Coverage for as little as $450+mileage/travel covering all of MD. MCA discounts. Expert, multi-technique, Supvr DC with PT. 10 yrs coverage/30 yrs clinical exp. Personal AAA+ service will guarantee your patients will be in the best of hands. Refs avail. Text/ Call Dr Nunnari: 240-731-0264 E-mail coverage request details to drjoe.dc@comcast.net.

OFFICE COVERAGE - Rest assured that your patients will be well cared for while you are away. Seasoned Supervising DC/PT privileges with 24 years experience. Personable, Professional & Reliable. Cheryl Kalb, D.C. 410-790-7744, drcek@comcast.net.

Office Share in Bel Air, MD - Family based Chiropractic Office Share Available Monday, Wednesday and Friday Starting February 1st. Rent includes internet, utilities, use of adjusting tables, therapy equipment etc. Please e-mail DrJillMoore@gmail.com for more information.

Doctor Needed For Multi Location Practice - Growing practice with multiple locations looking for a dynamic doctor. Located near beaches, boating, golfing and hunting while enjoying the culture of the local university. Looking for the right person to treat, with an approach towards exercise and diet, and an established patient base. Six figure potential and benefits. E-mail CV to chirojobsby@gmail.com.

Part time associate - Looking for a part time associate for practice in Prince George County. Must have PT privileges, a good personality and excellent adjusting skills. Please call (301) 651-7384.

Chiropractic Tables for Sale - Used Chiropractic tables for sale, office equipment. Two hydraulic Thompson Hi-Lo, Activator table, Flexion/Distraction Table, desks, filing cabinets, shelves, waiting room chairs. Everything must go by January 29, Doctor retiring. (410) 838-7706, kbpick66@verizon.net.

Maryland / Annapolis Associate to Own - Long term established Annapolis MD multidiscipline practice interviewing for an Associate with the intention to Buy. Doctor retiring and desires a great transition to care for the patients. Associate will receive training; salary plus bonus and paid malpractice. E-mail resume and letter of introduction to drkate1989@gmail.com.

Full Time Chiropractor with PT privileges - Our practice is currently looking for a doctor who is passionate about Chiropractic. We are a busy, well run Chiropractic office. I would like to invite you to our office and meet for an interview. Please call me to set up a time. I look very much forward to speaking with you & having you visit our practice. (301) 585-2225.

ASSOCIATED WANTED - Looking for a Chiropractor to take over an existing patient base for an established, busy, multi-DC family practice in Baltimore. No need to generate your own new patients or do any billing or managing employees, this is all done for you by support staff. Just looking for a chiropractor who wants to help patients full-time. Malpractice & CE credits covered. Call Dr Cohen at 410-440-8857 or e-mail cohen79@aol.com.

Maryland Chiro PT Privaleges wanted - Full time Position in the Baltimore area. Competitive pay based on experience. Benefits include Health, malpractice, vacation, sick leave, CEU’s, license, holiday pay and bonus. Busy PI office with support staff. Friendly fun atmosphere with a family environment. Please fax resume to 410-578-1492. Immediate opening seeking long term commitment.

Associate position - Looking for an associates DC W/PT privilege work in Annapolis location. Base salary + vacation + Benefits for seeing PI patients. Bonus structure available if you want to work on the non-PI side of the practice, please call 301-928-8508 to apply.

Looking for a great staff person/CA - Looking for a team player/CA or willing to obtain CA certification to join busy practice with

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ClassifiedsContinued from previous page

Chiropractic, Massage, and Acupuncture.Front desk oriented, billing, and insurance knowledge preferred.Ideal candidate will have a great personality and good approach with patients as well as eagerness and reliability. Great learning and growth. Salary negotiable, good benefits. Docblock21@hotmail.com.

Office Coverage - OFFICE COVERAGE and ASSOCIATE PLACEMENT STATE WIDE SINCE 1986 Full and half day rates. Emergency, maternity, short, and long term coverage. Large selection of licensed and insured chiropractors. We can help with your coverage and associate needs. Free 90 minute orientation with our cover doctor. Back ups just in case. Call for a FREE quote. 1-800-501-6111, mmachiropractors.com.

Associate Wanted - Northern VA- Bright office seeks energetic associate for long term associate-ship. Ideal candidate: superior adjusting skills, can educate patients, high energy, highest ethical standards, team player, truly believes in the healing powers of chiropractic. Clinic specializes in spinal correction & rehab (will train right candidate). Excellent salary w/base + bonus potential of over $70k, time off, health benefits. Please e-mail resume to chiro368@aol.com.

ASSOCIATE CHIROPRACTOR WANTED - Established clinic in Silver Spring, MD looking for FT/PT Chiropractic Associate with Supervising and PT privileges. Ideal candidate should have excellent adjusting and manual therapy skills. Competitive salary plus benefits. New graduates and experienced doctors are invited to apply. Please send CV to chironrehab2@yahoo.com for more detail.

Help Wanted - We are growing and looking for office help! Pikesville chiropractor needs front desk manager, billing manager and CA. Approx. 30 hours per week each position. Send resume to dr.blaxberg@gmail.com and drtonydc@hotmail.com. Salary commensurate with experience.

Office Coverage - Professional, Caring, Reliable - Experienced Supervisor Chiropractor with PT Privileges available for office coverage. Professional, Reliable, Caring, Positive Energy, Great Patient Management Skills and Tableside Manner, Full or half days, short or long term, short notice ok, 1984 NYCC graduate, large or average volume office (had own larger volume practice), Experienced in many techniques, Coverage references available upon request. Dr. Larry Berlin, DrLBerlin@gmail.com or text/call cell phone 443-306-8676.

WE WANT YOU! Chiropractic Associate - Rockville - Multidisciplinary facility looking for Chiropractor with PT Privileges to join our integrated team of professional. Visit www.AdvancedWellnessSystems.com for more information. We want a team player who is focused on further career development. Competitive salary, performance bonus, plus benefits. E-mail CV to drparis@parischiro.com.

CERTIFIED CHIROPRACTIC ASSISTANT - Looking for energetic, enthusiastic, personable Certified Chiropractic Assistant to work M,W,F from 8:30 a.m. - 12:30 p.m. in Baltimore. Please call 410-790-7744.

Associate Needed - Established practice in Carroll County seeking Associates. Full or Part time opportunities. Will also consider candidates interested in an Associate to Purchase transition. Diverse practice with solid insurance base and additional cash based services. Contact recruitinggreatemployees@gmail.com with your interest.

Share or Sublease Office Space - 1800 sf office with nicely equipped rehab area, four treatment rooms, open reception area, and kitchenette in Class A professional building in Rockville, MD. You can use our existing front desk staff or your own. Send inquiries to drjpark@gmail.com for details.

Associate Wanted - Immediate F/T associate position available in a busy chiropractic office in Columbia. Offering excellent salary plus bonus based on performance. Malpractice and CE credits are covered. If interested, call 443-962-9722 for further details.

Practice for Sale - Waldorf, MD. well established for 32 years. Fully furnished and equipped 1550 sq ft office. Located in a medical complex with plenty of parking. Great turn key opportunity for a satellite office or graduate doctor. Low buy in. Rental or purchase of the office space is very negotiable. E-mail at tmkline10@gmail.com..