Issues which in the past have only been discussed in medical publications are now making their way to the popular media. Time magazine1 recently examined the furor surrounding managed care, and made insightful comments while asking some important questions about the future of health care:
"Prodded by large companies fed up with rising medical costs, the new medicine's entrepreneurs have turned health care into a corporate battlefield increasingly governed by the promise of stock market wealth, incentives that reward minimal care and a brand of aggressive competition alien to front-line doctors for whom dressing for success still means wearing khakis and a lab coat.Reference"No one disputes that managed care has at last put the brakes on medical spending, or that it has proved an effective vehicle for rationing health care, a profoundly sensitive subject in a culture raised on the notion that even the most expensive and esoteric treatments should be available to all. At issue, rather, are the costs of the process itself -- the effort and delay inherent in acquiring care and the extent to which considerations other than mere health are brought to bear by corporate managers who must approve even such minor procedures as blood tests and mammograms. Yet the most fundamental question raised by the new medicine is one largely missing from public debate: Can you still trust your doctor?"
1. "The Soul of an HMO," Time, January 22, 1996.
MUA through a Child's Eyes
Affirmation for manipulative therapy is becoming more common in published research. Two medical physicians reported very positive results when they examined the use of manipulation under anaesthesia (MUA) for "acute subluxation between atlas and axis in three children":1
"The patients were three girls between 6 and 10 years. One case occurred after general anaesthesia with intubation for arteriography, and two after trauma with fracture of the clavicle. In all three cases, there was rotation of at least 30 degrees between atlas and axis, but the anterior arch of the atlas remained in close contact with the odontoid, unlike true dislocation of the atlas. Pain was so intense in each case that exact manual examination, let alone mobilization or manipulation without general anaesthesia, was out of the question. As the only alternative was surgical intervention, manipulation under general anaesthesia was carried out, following the x-ray findings.Reference"In all three cases there was immediate improvement after manipulation. One patient was immediately free of symptoms, one was manipulated twice, and one required mobilization after the first manipulation -- this was well-tolerated. The effects are well-documented by conventional radiographs in two cases, and by CT in one case (treated by Dr. Rosina in Poprad)."
1. Lewit K, Rosina A. Manipulation under general anaesthesia for acute subluxation between atlas and axis in three children. J Orth Med 17[3] 1995.
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