Dr. Lane’s Thoughts XIX

NEWARK

1) It is interesting for me to watch how conservatives (which is largely but not completely made up of Republicans) convince minorities that while their views may have started out as liberal or democratic when they were younger, that it is now time to ‘grow up’ to a more mature view which is encompassed by the conservatives and GOP.


The Republican message is clear to minorities: you were a member of a minority group when you arrived, now it is time for you to shun more immigrants who are not ‘like you’, you may have relied on social welfare when you arrived (e.g. food stamps, affordable housing, Planned Parenthood) now it is time for you to show solidarity to your ‘American’ neighbors (white) and work against these same programs, and so on.  They make the message clear – if you join with ‘us’ we will protect you from people who look and sound like you but aren’t you because now you are ‘one of us’.


It is easiest to turn people who come from European countries where brown-skinned people were rarely seen in a positive light.  Telling a person with white skin that the Democratic Party is largely made up of people with brown skin quickly makes a white immigrant into a Republican – they fail to understand that the programs they rely on when they arrived to the US came from the efforts of the Democratic Party.


This is why I find it so jarring when I see African-American faces at Trump rallies, or women, or Asian faces, or Latin-American faces.  These people are also routinely roughed-up at these rallies because they are suspected of being spies for liberal or Democratic groups, or at these rallies solely to cause disruption.  The leaders of these rallies know that directly or through coded words these same groups will be openly attacked or demeaning words will be directed at these same groups.


I am not saying that the Democratic Party is filled with only the best people but I can easily say this: The Republican Party has easily and comfortably worn the mantle of white supremacy, and has positions that are anti-woman, anti-Black, anti-immigrant, and has acted as a bastion of protecting the wealthy and mega-wealthy from all responsibility to their town, their state, and their country.


It is a cute myth that the major advances in the United States came largely from American-born white males but it is a myth.  A MAJORITY of the advances in the United States – the things invented and the ideas that changed the world that originated in the United States – came from people not born here.  Immigrants are what makes this country great and many of them came here poor and deserving of what this country offered.  Many of them came here as illegals.  Many of them came and overstayed their visas.  Many of them were not white and neither are their children.


When Trump stated in his speech to announce his Presidential run he said something that caught my attention.  He said about Mexico, “They’re rapists, they’re bringing drugs, they’re not sending their best people”.  He was talking specifically about Mexicans but he was implying all immigrants.


We are left with two strong ideas, (1) who was sent here by their home country?  Does Trump actually believe that countries send their citizens to the US and it isn’t the decision of the people who have come here? and (2) nobody leaves a country where their life is wonderful and they are fulfilled to go to another country that will offer them none of these same advantages.  People come to the United States primarily because in their home country they were not considered their home counties’ “best”they were despised, they were hunted, they were ostracized, they were ignored.  They left everything they have ever known to come to the US to start over again despite the hardship they expect to encounter because it is better than what they had.


The previous version of the Democratic party a long while ago were horrible racists and bigots but this is not the party today.  It doesn’t take much research to find that the Democrats kept the black man down, especially in the South and up to the 1970s was the instrument of oppression for black people in the South.  The Republican party truly was the party of Abraham Lincoln and his ideals from the early 1800s but that changed around the 1970s when instrumental people began to see the opportunity to take over the Republican Party and craft it into a party of the rich, privileged, and white.


The modern Republican policies have never been to help anyone get a start or thrive once they are here.  The Republican policies have largely contributed to helping people segregate themselves from ‘undesirables’ (read: brown and black people) or keep the money that have already gained from adding to the treasury through taxes that only benefit the very rich.  If you are reading this, they don’t mean you – they are talking about people far richer than you; people who did not earn their money but had it given to them through inheritance or nepotism.

2) I have written before about how the majority viewpoint of many people is that their opinion is as important or equal to your knowledge; even so much as their guess or their feelings is as important as your knowledge.  I see this all the time in my life with family and friends (I do not see it in my profession – the one thing that is ingrained in the medical profession is that guessing or scant knowledge can equal death so opinions are the sole dominion of true experts in a field.  Healthcare providers are held to a high standard and everything they do at all times is open to review).


The message to me about the people I encounter is that the end of their formative training (high school or college) is the end of their own perceived formal need for scholarly investigation and supporting information for their statements and a complete freedom to just extrapolate or conjecture what they say.  No more fact-checking or trying to get things right – “I’m a big kid now – no one can tell me what to do!!” their behavior suggests.

The issue that confuses me is how much easier it is today in 2020 for people to get the information they need to be informed.  There are many websites that will tell you the real answer to your question, whether it is the filing date, the deadline, the symptoms, the number or whatever it is you seek so that your ‘anal ventriloquism’ (my way of saying ‘talking out of your ass” or guessing without knowing) is no longer necessary.  There are many reputable websites and other sources of information which can support the true answer to issues of fact.


There was a time when people read newspapers which routinely went into some depth about the controversial topic that was being written about.  Next, we had news on TV which did not go into depth because to be entertaining about the topics the reporter or news anchor spoke about  – it needed to be encapsulated and condensed to be interesting and quick.  It told the boldest issues (headlines) but did not dwell on background of the subject.


Everyone knew that the TV news was brief and not complete but you only needed to pick up a newspaper to learn more about the controversial topic in greater detail.  It was built into the news cycle that a newspaper was more complete.  The better newspapers had the better reporters: The Sacramento Bee, The LA Times, The NY Times, The Washington Post and so on.  Many cities had 2 or 3 local newspapers.  Being a great reporter was a source of pride for a newspaper, hence the Pulitzer Prize which both commemorated and celebrated the best in newspapers.


Now we have lost a majority of our newspapers. Our news is whatever the person reads on TV which is, in turn, printed on a teleprompter to be read.  The news anchor knows nothing more than you do about the topic.  We have to trust our news source to be impartial and unbiased (cue the snickering and subdued laughter from anyone who reads this since the truth is that all news is written from a point of view of the writer and bias is inherent).


I have a love affair with a specific magazine – The Atlantic – which has been published since 1853 which has a certain style of writing I admire: it seems to clearly have editors who demand that all sides of an issue must be in every article.  You think that the author is biased and will never mention an opposing viewpoint?  No, it is there.  The author always addresses the other viewpoints and informs the reader why he may be against them or problems with the other viewpoint but it is there to be considered by the reader.  Also, the magazine uses flawless American English with a level of fluency that treats our American language as a delight of style and linguistic prowess.  Whether you read the articles to yourself or out loud to another person, the writers of the Atlantic make American English sing and capture the mind of the reader and therefore force them to understand the topic.


The best part of The Atlantic magazine is the ‘letters to the editor’ which either disagree or agree with the author of a previous article.  These letters also are written with profound intelligence and capture the type of reader, often learned with a deep understanding of the subject, who finds the same delight in the magazine that I do.


Knowing is better than guessing, admitting fault in understanding of a topic leaves you a place to explore so that you can become a better person and a better citizen.  We should all require ourselves to be better students of the world and leave conjecture and opinions to the ignorant.


It is easy for me to see my readers imaging that I am just not speaking to them about something that interests them – I am making a request that they do something that has fallen out of favor in the US: reading and studying, two things that have been supplanted by watching and listening.  Even our schools in the US have largely increased their emphasis on videos and the internet as teaching tools in a vain effort to either keep students interested and focused or just surrendering to the obvious forms of teaching as entertainment.


I leave you with a simple reason to take what I am writing here seriously: if you do not understand what is being told to you then you have given up the true purpose of democracy.  Thomas Jefferson made it clear in his writings that the cornerstone of participant democracy is an educated population.


No, I am not telling you that you should read, learn, and understand because you need to be a good citizen.  I am not telling you that this country depends on you working at being smart, rational, and using your intelligence to improve your life.  Those things are true and every idea held inside that thought would help you tremendously.


What I can tell you is that when you lack knowledge on a topic you become prone to believing in conspiracy theories about how the world works.  When you do not know how politics works, how a vaccine is made, what the basis of other religions are, how other countries work, what the basis of ‘social distancing’ is, how diseases spread, and so on it is a great deal easier to listen to someone ‘explain it to you’ instead of having to read the answer from trusted sources which will cause you to need to learn about 10 or 100 other topics.  Conspiracy theorists love a person who doesn’t question them!  An uneducated person is their fertile soil for growing mistrust.


Here is why you should give your life to lifetime education and keeping up on information and the issues that surround you: if you do not read and learn, if you do not develop a deeper understanding of the world then you can be sure that people who do study subjects and do read will control their destiny much more than you will.  Many of those same people will work hard to sway your opinion and get your votes and your money and will then control you.  You will have to trust them because you will not know enough to oppose them or question their motives or demand accountability from them.  You will live in a world of not just one Trump but a political leadership of nothing but ‘Trumps':  powerful people created from scripted TV shows reading from teleprompters with a history of criminal and near-criminal enterprises and motivations of greed and self-dealing.  They will do to you what Trump and his syncophants do now to the mostly white population that put him in office: steal from you and mock your ignorance.


3) James Woods, an actor of many great movies, stated this about Trump, “Let’s face it. Donald Trump is a rough individual,” Woods tweeted. “He is vain, insensitive and raw. But he loves America more than any President in my lifetime.”


Really James?  That is your criteria as to why Trump should be in office and allowed to remain POTUS? Just so you know, my dog (Leo #4) loves me completely but I still won’t let him drive my car.  It is the same reasoning as you have offered and the outcome is the same.


Also, every POTUS  has loved this country and Trump may love it as much.  Nevertheless, it is very clear that Trump only looks for ways to enrich himself and his family at the expense of the citizens of this country.  That is his sole reason for waking up in the morning and the only thing he consistently pays attention to.


Just because the USA has had men as unlearned as Trump as POTUS in the past (and many degenerates have held this esteemed position in politics with little regard for the country they serve) does not mean that we need one in the office in 2020.


4)  I want to tell you something about my practice as a chiropractor in an effort to explain why the goal of being a ‘sports chiropractor” (which was the goal of many of my classmates in chiropractic college) is one of the biggest jokes possible. I do not doubt the desire is pure and the motivation is an excellent one until you get to the important topic: who is going to pay you?  Very few teams on your way to the professional teams will pay you for your time and education up to the point of being given that coveted spot of being the official chiropractor of a recognized professional team.


Just as an aside: the team physical therapist gets paid at every level of sports, from little league to middle school, to college to AAA teams – they all can expect to get a paycheck for every athlete they see.  Those professionals are sought out and given a contract with a stipulated salary and per diem.  More than likely the chiropractor had to approach the team and beg/negotiate the chance to work on the players – for free.

The chiropractor will do this for about 15-20 years at every chance he gets – he will follow the team on away games, go to every home game on his own unpaid for time, during his vacations, and so on and try to prove his expertise in building up his credentials so that, maybe, a team with grown-up athletes will hire him.  If he is lucky he may be considered so good that he will go to the Olympic games where he will get to treat the USA team members (for free) for 15-20 hours a day during either the Summer or Winter Olympics (not both since the number of chiropractors who want these spots is greater than the USA teams who want the chiropractors).  If you read this correctly, this DC has worked at this second job for 15-20 years for little to no money.  The PTs, MDs, DOs, and other health professionals did the same number of years for pay from these teams and would never have worked there for free.


For reasons I do not understand, ‘sports chiropractors’ chase the chance to work on athletes.  My association even has a group who get together to study how to be better at treating this group! Chiropractors love to work for free for the very healthy and very undeserving.

5) Every insurer that you have heard of are just like people in the same family with the same last name.  It is just a way of grouping people – each health insurance company has a name.  Each company has many plans, each of them differ from each other.  In the same way that just because people have the same last name does not mean that if you know one member of the family that you know all of them and it is even more clear that if you know one family that you do not know all of their relatives.  Welcome to the world of insurance reimbursement!  Which is to say, I could try 3-4 times before I got the definitive answer, which was almost always “no” to payment.


How many times do you need to be asked for your notes before you realize that they will never “get them” (by fax, email, or mail) and they will never tell pay you?  If you are a man, you can understand that when you leave 3 messages for a girl and she never calls you back there is a message there that she will never come right out and say, which is “stop calling me”.  She will never tell you right out; you are just supposed to understand.


I understand: the insurer will never pay me for this patient’s visits.  They are not required by any set of rules or laws to pay me.  I just have to ‘get the message” and stop accepting their patients.  The patient will go on to to another chiropractor who hasn’t learned what I know until he stops seeing them and the patient wanders until there are no new chiropractors for him to see in his area – until all of them have wasted their time trying to get paid and tell the patient that they will not see them any more.


Do you want to know what happens when I tell the patient that I will not see them any longer because their insurer will not pay me?  The patients tell me something along the lines of, “yeah, I have heard that they don’t pay the doctors” and they move on to the next chiropractor stupid enough to agree to perform treatment.

At this point I want to tell you that I do not take insurance money any longer as a chiropractor.  I tried this losing game of taking insurance payments from Blue Cross/Blue Shield, AETNA, Medicare, Medicaid, and so on until it became apparent that they would rarely pay me and when they did, it was many months after the work, and only if I asked them 3-4 times to be paid for the same date of service.

Before the reader tells me that I could have hired a billing service (for 8% of the collections) I will remind you that 8% of an unsuccessful billing is still 8% of zero.  What billing service is interested in working with a practice that bills $8,000 a month of which $800 is collectible?  Yes, you are lucky to get even 10% of what you bill when you are a chiropractor – the insurance companies actively work against paying you for anything you do!


A billing company cannot force an insurer to pay you any more than the doctor can do it.  We all follow the same rules and use the same modifiers for the same services and suffer the same consequences when we don’t get paid.  Just to make this more confusing, each insurer interprets the rules of billing in its own unique way and no 2 insurers accept bills the same way.  No 2 plans within the insurer accept the rules the same way.

Let’s tell you about being paid as a chiropractor as if it was you being hired by a company.  They offer you a contract to work hourly for 5 days of the week, for a total of 40 hours.  This is just an normal job.

After the first week you look at your paycheck and you see that there are 8 hours missing from your pay.  When you inquire, you are told this, “oh yeah, you have to work all five days  of the week but we don’t pay you for Tuesdays.  You work Tuesday for free for us if you want to get paid for the other days”.  This is what happens when you treat a patient – you do 5 different things for the patient (called modalities) but they only pay you for one thing – the chiropractic adjustment.

When you protest to the insurance company they inform you that that is all they will pay for but they require that you do the other 4 things in order to get paid the $35-45 for the adjustment.  Basically, you are required to do your best work and use your training but you are only paid for one item.  Failure to do the other 4 (unpaid) things can be considered malpractice if it is questioned by a disciplinary board but the insurance company will not pay you – they know that you will do the other (unpaid) things because you have LEGAL REQUIREMENTS in your scope of practice.  The insurance companies have no legal or moral standards – they are just a business.

You ever go to a chiropractor and he rushes you through a session where he puts you on heat and muscle stimulation for 5 minutes and then presses on your back quickly and leaves?  Why should he do more than that when it is only the pushing on your back that he will get paid for?  He gets paid more for supervising the physical therapists in his office than for treating you (a PT gets $95 an hour to treat 4 patients simultaneously and the DC who supervises the PT will get about $300 for those 4 patients.  The DC will get about $70 if he sees 2 chiropractic patients in that same hour and he has to chart 20-30 minutes for each chiropractic patient to even get that $35 for each patient).

I gave my patients everything I could do – all the newest therapy ideas, all the best approaches and, in the end, I got very poor reimbursement.  I was declined reimbursement most of the time for unknown reasons with no repercussions.  When I inquired I was told to bill it again and I would be declined again.  No one at the insurance companies is required to tell you what was wrong or why you won’t get paid (“we can’gt tell you how to bill or how to practice” I would be told).   Because this can take months the patient you are seeing 3-5 times has already finished treatment and is gone by the time you realize you are not getting paid.  You can never bill the patient because you already agreed to accept their insurance and it is not the patient’s fault that the insurer will not pay you.

For 10 years I tried to be a great chiropractor and do 30 minutes of care per patient for that bad reimbursement.  I got very popular when patient found great care in my office when they were used to that 10 minutes of in-and-out that the previous chiropractors had done.  The minute that I stopped taking insurance money (November 15, 2019) and made my care $65 per session [it is now $70] all of my patients left to go back to the bad and quick chiropractic care because it was paid for by their insurance.  I expected that.


I can tell you that 10 minutes of care does not get the results of 30 minutes of devoted care but no one is going to do work that they do not get paid for.  Every chiropractor knows what works and they will not do it if they do not get paid.  I understand and so do they.

I still see patients but it is a rare occurrence. I am happy to do my CDL medical exams and get paid well.  I don’t need the stress of begging for money.

I have not accepted insurance money since November 15, 2019.  Monthly, I continue to get letters from the insurance companies informing me that they have audited my accounts and they have decided that what little money they paid me was too much and they want their money back!  Yes, it has been 6 months as of this writing that I took any money from them and the insurance companies are still trying to take back the little money they paid me.

It is OK, they tell me that they will take their money back from future payments.  I hope that they are not depending on that money. I will never work for them again.


When a doctor works for me I make sure that they are paid well.   I am not certain that this respect would be returned under other circumstances if they paid me but I have to follow my moral upbringing.  I cannot base my behavior on the expectations of reciprocity; my behavior and my actions are only my own and they must follow my own moral teachings and my own understanding of my [Jewish] faith.


In my years I have learned that everyone expects moral and decent, fair behavior toward them.  What they do when they are in charge should be equivalent but it is not always so.  It is a very odd world when you work for someone else – they suddenly because very problematic and see themselves as a ‘clever’ and ‘strong’ and a ‘business man” (it is almost always a man who behaves like this) and try to screw over anyone who works for them and anyone who does business with them.  This guarantees that no employee stays very long and no one works with them more than once.  The money that they ‘save’ by their behavior guarantees them very few friends.

6) When Trump leaves power you should expect many Republicans to pop up their heads and immediately exclaim how much they worked against him in every way they could but ‘behind the scenes’.  They will list their ‘brave’ efforts to ‘try and stop him’ and how they met often with their enlightened colleagues to plot Trump’s downfall.  Quietly, where no one could see them or know about their efforts.


Those brave freedom fighters!  Those bold disrupters!  The guerrilla fighters of the GOP!  Don’t believe them for a minute!  The time to speak is now in mid-2020!  The time to act is now, not when Trump and his presidency of liars, cheats, and white supremacists are in power!  Your silence is your agreement.


I only wish that when Trump is gone he not only takes his own people but also takes the weak members of the GOP who have supported him!  He can also take that human tortoise Mitch McConnell with him as well – a man happy to keep Trump in office because it was good for his brand of white Southern hypocrisy and supported his vision of a ‘pure’ white America.


Since you have reached this far, you should know that Mitch McConnell is married to Elaine Chao (US Secretary of Transportation) who is part of the largest shipping family in CHINA.  You can be assured that she is looking after her own interests and those of her family first and only then does she show concerns for the citizens of the USA.  


Every item you get that is shipped from China helps her and her family (father and sister own FOREMOST GROUP).  To be clear, Trump did not put her in office, it was George Bush when he was president.


We have a president who puts his own interests first so why not have a cabinet secretary who does the same?

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