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From the desk of our President, Dr. David Mruz.

Wednesday, September 12, 2018

DHEC and Your X-Ray Facility

The South Carolina Department of Health and Environmental Control (DHEC) conducts radiological health inspections throughout the year.  If you have recently received notice that you are scheduled for an inspection, here’s what you need to know;

There are a number of items which you will have to have available for the inspector.  These include all records of x-ray equipment performance testing, including calibration and service records.  This “routine” testing must be carried out on an annual basis, at a minimum.  These records must be maintained for a period of five years.  Your x-ray vendor can assist you with testing your equipment.  Be sure to use vendors who sponsor the SCCA whenever possible.

If you delegate taking x-rays to a staff member, be sure that there is documentation on hand of machine specific training for this individual.  Of course, if a staff member operates your x-ray unit they must have South Carolina Radiation Quality Standards Association (SCRQSA) certification.  The SCCA offers classes from time to time to allow staff to achieve or maintain their certification.

Personnel monitoring reports must be provided.  If you provide monitoring devices or badges, you are required to have procedures which discuss how employees are advised to use these devices, the name of the person responsible for distribution, collection and reporting, and the location of the badges.  The policies for reporting and investigation of overexposures must be stated.  A prohibition against intentionally exposing any control or personnel badge must be included.  Procedures must be included instructing employees on how they may obtain the results of any monitoring.

A quarterly inspection of protective apparel must be performed and documented. 

If your facility still uses x-ray film, records of processor maintenance and cassette/screen cleaning must be available.

A record must be kept of repeat exposure analysis, to include overall repeat rates and reasons for repeats.

Misadministration records must be kept.  Misadministration as defined by SCDHEC includes the administration of radiation to the wrong patient, performance of diagnostic or therapeutic procedures other than that ordered by a prescribing physician, or a therapeutic radiation dose from a source such that errors in the source calibration, time of exposure or treatment result in a dose differing from the total prescribed treatment dose by more than 10%.  Much of this section does not apply in a chiropractic office setting, but evidence of a misadministration report must be present.

The DHEC inspector will want to see posted pregnancy warning signs, “radiation area” signs, posted “notice to employees” about DHEC rules, your technique charts, a patient log and a copy of your shielding plans with as-built drawings.

DHEC is a state agency which is tasked with protecting the public.  The inspectors are state employees and are often very helpful in answering questions or addressing concerns.  If you require any additional assistance or have questions about DHEC, do not hesitate to contact the SCCA.

This information is provided to you as a service of the South Carolina Chiropractic Association, and is by no means an exhaustive list of DHEC regulations.  For comprehensive information about Title B Rules and Regulations for Radiation Control, click on this link

Sunday, August 19, 2018

Headaches and Chiropractic Care. What Does the Evidence Say?

You may have seen a recent press release from the ACA which commended United Healthcare for restoring coverage of spinal manipulative treatment for the care of headaches.  This release was featured on the South Carolina Chiropractic Association Facebook page.  This restoration of coverage was won due to the efforts of the ACA and many other state and national organizations including your SCCA.  This is a huge win for chiropractors, but more importantly illustrates why research matters to those of us who are not academics. 

The ACA cited evidence from 8 studies which supported the use of spinal manipulation/adjustment for those patients who suffer from cervicogenic headaches; one of the most common forms of headache. 

One study in particular was published earlier this year in February, and was featured in the letter from the ACA to UHC; A Spine Journal study found that in patients suffering from cervicogenic headache, spinal manipulation cuts the number of symptomatic days in half:

“256 adults with chronic cervicogenic headache (CGH) were randomized to four dose levels of chiropractic SMT: 0, 6, 12, or 18 sessions. Participants were treated three times per week for 6 weeks and received a focused light-massage control at sessions when SMT was not assigned. A linear dose-response was observed for all follow-ups, a reduction of approximately 1 CGH day/month for each additional 6 SMT visits. Cervicogenic headache days/month were reduced from about 16 to 8 for the highest and most effective dose of 18 SMT visits. Cervicogenic headache intensity showed no important improvement nor differed by dose.”

Incidentally, SMT proved to be more effective than massage for CGH.

Haas M. et al. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine J. 2018 Feb 23

Your South Carolina Chiropractic Association membership lends clout to efforts by other state and national organizations to reverse discriminatory actions by organizations like United Healthcare. 

Your membership also serves to advance chiropractic services to those who might only consider pharmaceutical answers for their pain.

Thank you for being a member of the South Carolina Chiropractic Association.  You are part of a group of professionals who truly care about their patients and advancing the profession.  

Monday, August 13, 2018

The Adams Study

News That You Can Use!  Have You Heard About “The Adams Study”?

What is our market share? What do we believe about our market share?  How does the public perceive our profession?  You will be amazed at the information which is revealed in The Adams Study. This study could be one of the most important pieces of scientific literature relating to the profession of chiropractic.  My bullet points about this very recent, very relevant study are below:

The Adams Study: The Prevalence, Patterns and Predictors of Chiropractic Usage in the United States among U.S. Adults  

Why is this paper interesting AND important?

  • The study was published in late 2017 (very current) in Spine, a very reputable journal.
  • The study was conducted by non-chiropractic researchers from Australia, Germany and Sweden.  These people don’t have any political axe to grind in the United States, and they are not in our profession.
  • The study was based on data derived from the U.S. National Health Interview Survey, 2012
  • 2012 is the LATEST set of data available from the NHIS system.  This is as current as it gets!
  • NHIS is “the principal and reliable source of comprehensive health care information in the United States, utilizing a nationally representative sample of the civilian, non-institutionalized population of the United States.”  It is a product of the Federal Government.
  • 42,366 households were eligible for participation and 34,525 households responded to the survey—a whopping 80%!

What does it mean for your practice?

Some important figures / data to note from the survey results:

  • In the U.S. 24% of households have used the services of a chiropractor in their lifetime while 8.4% have done so in the preceding 12 months
  • 54.6 million adults in the United States have used chiropractic services and 19.1 million did so in the previous 12 months
  • Chiropractic services were sought primarily for back pain (63%) and neck pain (30.2%)

The takeaway here is our marketing efforts should focus on how we are best perceived to help the public: back and neck pain relief.  But the reality is that once they become patients:

“…the majority of users reported chiropractic helping a great deal with their health problem and improving their overall health or well-being.”

Once chiropractic users engaged with chiropractors, with back and neck pain bringing them into the office, they continued to engage with chiropractors to improve their health and well-being.

Chiropractic usage was identified as involving “A substantial proportion of US adults”


Predictors of chiropractic use:

  • Greater than 30 years of age.
  • More highly educated.
  • Living in a relationship.
  • Light alcohol consumers as opposed to abstainers.
  • Persons with spinal pain, headache or migraine or arthritis.

Reasons to use chiropractic (after engaging):

  • General wellness, general disease prevention: 43.3%
  • To improve energy: 16.3%
  • To improve athletic or sports performance: 15.4%
  • To improve immune function: 11.4%
  • To improve memory or concentration: 5.3%

Did chiropractic motivate (you) to:

  • Eat healthier: 10.7%
  • Exercise more regularly: 21.6%
  • Cut back or stop alcohol consumption: 2.6%
  • Cut back or stop smoking: 5.9%
  • Eat more organic foods: 5.8%

Did chiropractic lead to:

  • Give a sense of control over health: 32.5%
  • Help reduce stress level or to relax: 40.2%
  • Help sleep better: 41.9%
  • Help to feel better emotionally: 27.4%
  • Make it easier to cope with health problem:38.5%
  • Improve overall health and make you feel better: 66.9%
  • Improve your relationship with others: 13.3%
  • Improve attendance at job or school: 17.0%

How important was chiropractic for maintaining health and well-being?

  • Very important: 47.9%
  • Somewhat important: 29.6% 91.4%
  • Slightly important: 13.9%
  • Not at all important: 8.7%

Used chiropractic for a specific health problem: 66.9%

Specific health problem:

  • Back pain or back problems: 63.2%
  • Neck pain or neck problems: 30.2%
  • Joint pain or stiffness: 13.6%
  • Muscle or bone pain: 9.0%
  • Severe headache or migraine: 4.7%
  • Arthritis: 4.7%
  • Chronic pain: 3.9%

Chiropractic helped for specific health problem:

  • A great deal: 64.5%
  • Some: 25.8 96.4%
  • Only a little: 6.1
  • Not at all: 3.5%

Chiropractic practitioner was seen because:

  • Medical treatment was too expensive: 6.3%
  • Therapy combined with medical treatment would help: 64.8%
  • Medical treatments do not work for your specific problem: 33.8%
  • Medications cause side effects: 18.1%
  • It is natural: 37.5%
  • It focuses on the whole person, mind, body and spirit: 24.9%
  • It treats the cause ant just the symptoms: 81.9%
  • It was part of your upbringing: 10.6%


Patients arrive in your office primarily for back and neck pain.  They stay in your office because of overall health improvement, and you motivate them to have a sense of control over their health.

Chiropractic services are an important component of the healthcare provisions for patients affected by musculoskeletal disorders (especially for back pain and neck pain) and/or for maintaining their overall well-being.

My thanks to Dr. Stu Hoffman and Dr. Gerard Clum for bringing my attention to this important information!

Sunday, August 5, 2018

Membership Matters!

As a South Carolina Chiropractic Association (SCCA) member, you belong to the oldest and largest chiropractic association in the state dedicated to advancing the chiropractic profession.  This means there are a lot of benefits for you.

SCCA membership sets you apart.  As an SCCA member, you belong to the only organization whose mission it is to promote and protect all of chiropractic in South Carolina. (emphasis is mine)  What does this mean?  As an SCCA member you choose to belong to an organization which unites chiropractic as a unified voice to protect our great profession from threats both within and from outside of South Carolina.  There is no division among our member chiropractors along political party or philosophic grounds. Our one (and only) common ground is the protection of all of us.  Examples?

State Health Plan Preservation
The SCCA has effectively fought off efforts over the years to reduce or eliminate chiropractic's role in the State Health Plan.  Most recently, these efforts have included devolving the plan into managed care, cutting reimbursement rates, and limiting patients to three visits before additional authorization was required.  In each instance, the SCCA developed and pursued a comprehensive strategic plan that yielded successful results.  These were huge wins for the SCCA and for chiropractic in South Carolina.  Our leadership still meets regularly with the Director of the State Health Plan and the Public Employee Benefit Authority to make sure we are up to date on any proposed changes and to offer input.

Defense of the Practice Act
Each year, the SCCA monitors any potential changes to the chiropractic practice act and regulations.  When changes were required in 2012 by the State Board of Chiropractic Examiners, the SCCA shepherded the changes through the General Assembly without harm to the profession or patients.

KR Jones Philosophy Forum
The SCCA has sponsored a CE eligible event to honor our past president; Dr. Ken R Jones.  This event has hosted some of the most impactful speakers in the realm of chiropractic philosophy for many years.  In honor of Dr. Jones, the SCCA established the Dr. K. R. Jones Memorial Scholarship "to promote the art, science and philosophy of chiropractic; to ease the burden of tuition and living expenses of those who love the things he loved; to expand the vision and practice of chiropractic; and to give something back to the chiropractic principle that changed his life and the lives of so many others."  The first scholarship was awarded in 1991 and has been awarded on an ongoing basis ever since.  The scholarship is funded through proceeds generated by the Philosophy Forum and through private donations.

When it comes to marketing chiropractic;

All of our marketing efforts are designed to encourage patients to specifically seek out an SCCA chiropractor.

One of the most important marketing efforts places an SCCA chiropractor in a position of high visibility with some of the most important decision makers of South Carolina; 

The SCCA conducts a "State House Chiropractor" program which allows member chiropractors to serve our lawmakers and their staff members on site in the South Carolina State House.  This highly successful program gets rave reviews from our lawmakers and provides the SCCA an unprecedented opportunity to increase awareness of chiropractic care and its health benefits to these highly influential decision makers.

The SCCA initiated a preceptorship bill, which became law.  This law allows chiropractic students to participate in residency programs with approved chiropractors in South Carolina.  Because of this law, the SCCA has helped to advance the foundational knowledge of students and aided them in transitioning into the practice of chiropractic.

New Graduate Perks
The SCCA has greatly reduced membership rates for recent graduates.

In-House General Counsel
All SCCA members have access to our in-house attorney as a legal resource including legal bulletins and consultation.  This benefit alone could cover your membership investment!

Annual Coat and Toy Drive
This event which was the brainchild of past president Dr. Tyrone Wallace.  The event was created to provide warmth for the neediest across South Carolina, and it brings recognition to the local Doctor of Chiropractic with a tag on each item stating it is provided by the South Carolina Chiropractic Association.  Press events are coordinated for this effort to highlight the SCCA's philanthropy.  

And FUN!

Membership can also involve having a great time with colleagues.

Our Legislative Golf Tournament is one of the highlights of our year!  Known as the most successful golf tournament in the state, the annual "Tee It Up For Chiropractic" golf tournament enables us to fund a strong legislative initiative.  Led for 20 years by past president Dr. Evan Cohen, the golf committee has raised over $1,000,000.00 to protect us.  These dollars fund our entire Governmental Affairs Program including House and Senate contributions and SCCA membership in the business round-tables in the House and Senate.

Our Annual Sporting Clays Tournament affectionately known as the "Shuck and Shoot" is a time of fellowship and fun for all members and guests.  The event has grown every year, and is another example of how our leadership has creatively funded initiatives without increasing our dues structure.

As a member, your engagement matters.  Work to promote the SCCA with non-members.  Take a non-member to lunch and share why you joined.  Pay for the first year membership of a new doctor in your community.  

Upgrade your membership to the Palmetto Club level.  (Membership will pay for all of your CE costs and convention registration!)

Get involved!  Be an active participant in YOUR association.  We need you in decision making roles as a district director, and to help the SCCA to continue to promote and defend chiropractic in South Carolina.

Thursday, August 2, 2018

How Golfers Can Benefit from Chiropractic Care

It's a warm sunny day with a bit of a breeze, you are on the back nine about to sink a putt. When you swing, your back seizes up with severe pain. The beautiful day of golf turns into painfully riding in the golf cart back to the clubhouse, and you limping painfully to your car. 

Did that sound familiar?

If you have ever strained your back during a golf game, you are not alone.   It's estimated that of the 30 million golfers in the United States, 80% have experienced some sort of back pain. As fun as it is, swinging at golf balls puts an individual's body in an awkward position, creating the opportunity for injury.

While some golfers suffer through the pain by popping over-the-counter medications, others back away from playing as often, or stop altogether. There's another way to combat back injuries caused by golfing, without meds. It's not a magic wand, it's chiropractic care!

Golfers are increasingly finding chiropractic care to be a valuable tool to help them deal with back injuries, but how does chiropractic care help?

Consistent spinal checkups and when needed, spinal adjustments help golfers avoid injuries in the first place.

Golfing can be more enjoyable if an individual's body is in top condition and operating normally. Periodic spinal checkups and adjustments keep the body functioning at maximum capacity and reduce the chances of being injured. If the neck and back are aligned correctly, awkward positioning such as a golf swing will have a less negative impact.

Chiropractic treatment can reduce a golfer's pain.

Back injuries can be extremely painful, and many golfers turn to pain medications to gain relief and comfort. By treating the origin of the pain instead of just the symptoms, a chiropractor helps their patients manage the pain through manipulations and rehabilitation instead of drugs. Over the course of a few treatments, pain is often drastically diminished and much more manageable.

A golf injury can heal quicker with chiropractic care.

Injuries to the back or neck can heal faster when chiropractors are involved in their management.  An experienced chiropractor can adjust the spine, and work on the joints and surrounding tissue that can cause pain and hinder healing. Chiropractic evaluation considers the body as a whole. By evaluating the entire body, a chiropractor promotes faster healing.

Increased mobility can be gained through chiropractic care.

Golfers who play often as well as those who only play a few times a year know mobility is essential to a good golf game. Stiff joints and a weak back not only hinder your golf game but can be the very issues that end up causing an injury.

A chiropractic treatment schedule keeps the body loose and strong and working in optimum fashion. This prevents injuries and increases the chances of playing the game of your life.

Golfers need to realize the sport they enjoy can cause serious injuries just like football or other contact sports. It's a good idea to stretch before playing, stay hydrated, and avoid overexertion.

If you are a golfer, chiropractic care is a valuable tool in staying healthy. Regular checkups can keep your body on track and performing with maximum mobility at the top of your game. If you do suffer an injury, a chiropractor can help you manage your pain and decrease the time it takes to heal.

Contact us today at 803-772-9376  or simply go to our Doctor Finder page for more information on how a South Carolina Chiropractic Association member chiropractor can help reduce the chance of injury for golfers.  

Sunday, July 22, 2018

The Easiest Way to be Successful in Practice

This weekend, I began my journey as the 2018-19 president of the South Carolina Chiropractic Association (SCCA). Your district directors, our past president Dr. Aly Shariff, our president elect Dr. Chris Black, and Executive Director Annie Wilson met together in Greenville to plan for the upcoming year. When I announced our theme of “Building Bridges” during the convention, I shared what it was like to begin practice and to have a mentor to help guide me past pitfalls and to encourage me in the direction which has shaped my 38 years in practice. One of the most important points of advice from my mentor was the encouragement to join the SCCA.

During our meeting, I asked each director to share their experiences about starting a practice and to share about whether they had a mentor who made a difference in their life. It was exciting to hear the stories of beginnings in chiropractic practice, especially the stories of mentorship and even “antimentorship” (Those bad experiences which sometimes occur when starting out).

The take away from this weekend was the common denominator of being a part of something larger than oneself. Our state association leadership is composed of chiropractors who care about our profession and especially about our members. The SCCA is so much more than just an association, it is a group of chiropractors and professionals who are here to serve you! If you are starting out in practice, you can find information and even a mentor among us to help you begin your journey. Be a part of a chiropractic family! Join with us and become a member of YOUR state association! Your path to success in practice can be smoother when you add the SCCA to your team.

David H. Mruz, DC

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