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Chiropractic Websites, ADA Compliance and Legal Threats
Chiropractors, ADA Website Compliance and Legal ThreatsI received a call last week from Kathy Jones of NACA Texas about letters surfacing around the country (Texas, New York, Connecticut) from law firms threatening civil litigation against Chiropractors stating their websites discriminate against individuals with visual, hearing, or physical manual dexterity impairments under the Americans with Disabilities Act (ADA). The letters threaten civil litigation or a payment in lieu of litigation since their websites were inaccessible, violating the ADA. Unfortunately, many DCs have out of fear and lack of understanding have paid these ransoms to the plaintiff’s law firms. After giving two webinars on the topic last week with NACA Texas last week I decided I better share the information with more Chiropractors across the US.Web accessibility lawsuits and threats are only the latest exploit of the ADA, volumes of cases have been threatened and litigated over physical barriers in businesses and now websites. The new slew of ADA website threats in Texas comes on the heels of verdicts against major retailers Target, Winn Dixie and a few others with substantial payouts. Chiropractors and other healthcare business have been targeted in these new legal threats in Texas from Austin ADA attorney Omar Weaver Rosales. Understanding the Law – Enacted in 1990 the Americans with Disabilities Act prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, State and local government services, public accommodations, commercial facilities, and transportation. The American Disability Act is comprised of 3 parts: Title I, II and III. Title I pertains to employment and hiring, II is for state and local government, and III applies to any businesses private or public that offers public accommodations. The ADA lists twelve separate categories of business, one being doctors’ and dentists’ offices. The suggested violations in the letters fall under the American Disability Act’s title III. The Department of Justice has taken the position that title III covers websites of public accommodations, although title III does not specifically mention the Internet. The only guidelines for websites mentioned in the entire act are located in title II, Accessibility of State and Local Government Websites to People with Disabilities (June 2003) which refers to the Web Content Accessibility Guidelines from the World Wide Web Consortium (W3C®) and the ADA tool kit. What makes a website accessible? The Web Content Accessibility Guidelines (WCAG 2.0) from the World Wide Web Consortium (W3C®) that the ADA references are a set of programming standards that most professional web development companies and programmers integrate into their websites. The W3C is an international community of the foremost experts in programming and web development that creates open standards to ensure the long-term growth of the Web. These standards were developed to ensure universal parameters for adaptive hardware and software to improve the internet browsing experience of those with impairments. Almost all of the items criteria would not be noticed by an internet user unless they were using adaptive technology. They include language that describes pictures, captions for videos and name descriptions for links, flashing items, audio that auto-plays and much more.As a chiropractor and owner of a web development firm, the above information is difficult at best. Unless you are a web programmer not much will make much sense. It would be on par with explaining how to palpate and adjust C1 to a non-Chiropractor. I found a number of website checkers. Just enter your url and results populated. Unfortunately, they all offered varying results and did not include all aspects of the guidelines and many were outdated.If you are now afraid that your websites may not be accessible, one exception does exist. According to the DOJ your business may meet its legal obligations by providing an accessible alternative for individuals to enjoy its goods or services, such as a staffed telephone information line. The website alternative must provide an equal degree of access in terms of hours of operation and range of options and programs available, so it would have to be available 24 hours a day, seven days a week. If you do not have a call service keep reading. Chiropractic Websites - My staff and I completed a check of the largest providers of Chiropractic websites and generated these results. I choose sites of friends, colleagues and individual chiropractor’s websites listed on chiropractic websites development companies’ sites. Based on the ADA guidelines, our reviews of Chiropractic websites and claims made in the lawsuits we created this list of areas of concern:♦ Ecommerce and shopping cart. All images need alt tags and the checkout process needs to have labels on every form♦ Downloadable Forms – If you have new patient forms posted on your site as downloadable files include them not only as .pdf but html and .rtf formats. Make sure if it is a fillable form online that it ♦ includes descriptive HTML tags for all images and links.♦ Make an appointment - If this is an application on your site make sure that it includes descriptive HTML tags.♦ Video – Avoid Flash. If the video is embedded from youtube.com add the caption option. Complaints have been made of youtube.com’s caption service, but it is better than nothing. Instead of embedding the video just include a link (with an alt tag) and let another company take responsibility for the captions.♦ Frames – Don’t use them on your website.♦ Jump Navigation Now that you are good and scared that a letter will show up in your mail box disparaging your website, what do you do? If you receive a letter call an attorney familiar with healthcare law and these cases. (We know a few.) Most Chiropractors, unless they are web programmers are not going to be able to discern if their websites meet these requirements. You can ask your web developer if your Chiropractic website is compliant, but how do you really know? For any Doctors of Chiropractic stressed out after reading this article we are offering a $99 Peace of Mind Review. We will review your Chiropractic Website, generate a report, help you correct the ADA compliance issues, offer suggestions to your web programmer and recheck the site once the corrections are made.CE Cruncher also offers ADA compliant Chiropractic Websites, with editable content, built in SEO, email blasts and practice specific content creation.
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World Spine Day
How Are You Celebrating World Spine Day?
World Spine Day 2016 – “Straighten Up and Move”October 16th, 2016 marks the fifth World Spine Day. This year’s theme: Straighten Up and Move. World Spine Day is a collaborative effort from the Global Alliance for Musculoskeletal Health, World Federation of Chiropractic, and numerous other health organizations to promote awareness about spinal health. They provide education about posture, physical activity, and the impact of spine conditions on work and life while promoting a collaborative interdisciplinary approach to care.To spread the message of World Spine Day the organization encourages health care providers and organization to coordinate an event to raise awareness. To support the efforts, they have created social media content, brochures, videos and even an app about spinal health for providers to download for free. This year’s event so far include: spinal screenings, health fairs, exercise classes, yoga classes and a Spine Climb event.The World Federation of Chiropractic https://www.wfc.org/website/ has added a cash incentive to coordinating a WSD event by hosting an annual competition open to chiropractic organizations and Chiropractors worldwide to show off their World Spine Day planned activities. Chiropractic Colleges, Chiropractic Organizations and Individual Doctors of Chiropractic can submit their project and activities for cash prizes. Dr. Richard Brown is the committee chair for World Spine Day and the Secretary-General of the World Federation of Chiropractic (WFC).Prizes Include:Chiropractic Associations: First prize: US$600 Runner up: US$300Chiropractic Colleges: First prize: US$600 Runner up: US$300Clinic/individual DC: Best entry: US$500Entries need to be submitted by November 15, 2016 to Sarah Villarba at email@example.com . Winners will be featured in the December issue of the WFC Quarterly World Report.The project also encourages individuals to talk about their own experiences with spinal conditions by using the hashtag #MyBackStory World Spine Day Toolkit Become an official supporter Check out the funny video for World Spine Day written, directed and starring their Global Coordinator Dr. Robyn Brown
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Chiropractic Continuing Education
Largest Chiropractic Convention in 2016
The Largest Chiropractic Event of 2016The Florida Chiropractic Association’s National Event in Orlando August 25 -28th 2016 has evolved into the largest event for Doctors of Chiropractic in the World. The FCA reports over 4,500 attendees including: DCs, LMTs, CAs, vendors, and friends of the profession. No longer just a coveted event for Florida Chiropractors, DCs in attendance traveled from over 45 states for the grand event.The 4-day spectacular featured heavy hitting speakers from all facets of the Chiropractic profession. The FCA truly provided something for everyone, which is not easy in this profession. A motivational speech from Dr. Patrick Gentempo, Dr. Joseph Mercola discussed natural medicine, sports guru Dr. Spencer Baron showed a few moves, Dr. Carrick explained TBI and PTSD , Dr. Fabio Mancini led a congo line out of one of his classes, and the Acupuncture legend Dr. Paul Jaskoviak detailed practical applications for everyday practice. I have to admit that I have never enjoyed a required course as much as I did with the FCA's panel series. NO more boring power points of materials from years past. Every expert Chiropractor offered real insight and valuable information that made the hours slip away. Over 20 hours of Chiropractic CEs were offered with continuing education credits available in over 40 states, thanks to Texas Chiropractic College.Eager DCs filled the expo area to find the latest and most innovative products available. New comers, CerviPedic Neck-Relief, offered a new idea in travel pillows that also functioned as a portable cervical traction device. Foot Levelers unveiled their newest orthotics the AM7™ and CPOYA™. Over 400 vendors filled the grand hall with information, demonstrations and much to add to your chiropractic practice.If you missed this year’s event, not to worry it will be back again in 2017. Impatient for Chiropractic continuing education then check out one of the other FCA’s four regional stretched across Florida in the next twelve months.
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Chiropractor Eliminated from DOT Physicals in New York
When New York Chiropractors certified to do DOT physicals received a letter saying that they would be removed from the National Registry of Certified Medical Examiners Doctors of Chiropractic in New York and across the country wanted answers. An alphabet soup of agency, registries and organizations are all part of this frustrating puzzle with no quick fix in sight. As of June 1st 2016 New York Chiropractors are no longer able to provide DOT physicals and have been classified on the Federal Motor Carrier Safety Administration (FMCSA) list as not currently certified, compliments of the New York State Board of Chiropractic. The New York State Board of Chiropractic decided to reverse their opinion on DOT physicals that had been in place for over 10 years late last year. On September 24th of 2015 the New York State Board of Chiropractic sent letters to New York Chiropractors on the National Registry of Certified Medical Examiners (NRCME) list explaining that DOT physicals were, “beyond the scope of chiropractic practice as defined under New York State law.” To make matters worse they also stated that it would take a legislative decision to expand the scope of practice. The Chiropractic board's decision resulted from strong arming by the New York State Education Department, no member of the Chiropractic Board signed the letter. The history behind this controversy starts in 2005 when the New York State Board of Chiropractic sent a statement to the FMCSA through the Federation of Chiropractic Licensing Boards (FCLB) that the components of the DOT physical exam were within the scope of practice of Chiropractors in New York. In 2014 the FMCSA created the National Registry of Certified Medical Examiners requiring all providers to pass a national exam to become certified and listed on the National Registry of Certified Medical Examiners. Federal and New York State law supports Chiropractors inclusion in the NRCME. 48 DCs in New York were listed as providers and performed over 30,000 exams before being removed this June. Currently hundreds of Chiropractors across the country are certified and conducting DOT exams on truck drivers every day. Currently challenges are being made to return New York Chiropractors to the NRCME list by petitioning the Federal Motor Carrier Safety Administration over the procedures of their recent ruling. Other options include having the New York State Board of Chiropractic reversing their decision or a legislative change to the chiropractic practice act.The New York State Chiropractic Association is also working on changing the state practice act part of their agenda this year. They want to add a number of law changes to expand the scope of chiropractors in New York. The changes include the ability to diagnose and differentially diagnose, along with the examine; which includes stand-alone examinations such as those required for DOT exams, school sports physicals, scoliosis screenings, and more. Without changes the ability of Chiropractors in New York to perform any type of physical exam beyond the spine could come into question. Medicare and Insurance carriers could question a Doctor of Chiropractic's ability under the New York scope to provide exams and treatment. Fortunately for New York Chiropractors and DOT certified DCs nationwide the Safe Drivers, Safe Road Coalition (SDSRC) stepped up to battle this fight. This 501 (c)6, formed by a group of dedicated DOT educators and certified Chiropractors that want to protect, defend and expand the rights of chiropractors in their participation in the performance of DOT physicals. They believe maintaining Chiropractors on the national registry will allow truckers and the trucking industry greater access and lower costs for exams.The trucking industry agrees with the SDSRC. The Owner-Operator Independent Drivers Association (OOIDA) sent a letter to the New York State Board for Chiropractic asking them to reconsider their decision and that they shouldn’t make truck drivers’ lives any more difficult.A larger battle could be brewing in other states based on the New York situation. According to the SDSRC, they believe challenges in Connecticut over DOT physicals two years ago from the Connecticut Medical Association, Connecticut Orthopedic Medical Society and other groups could be part of a strategy to eliminate Chiropractors state by state. After recent online statements on an industry list serve they fear theses attacks are being fueled by a few medical doctors in the transportation industry. Extra Opinion: After having the opportunity to meet with Dr. David Thorpe of the the Safe Drivers, Safe Road Coalition last weekend I understand the potential set backs that face the entire Chiropractic profession. The real problems generated from this biased attack against Chiropractors in New York and others in recent years, namely in Connecticut and Texas, shows with legal and administrative challenges to state laws can eliminate the ability to provide school physicals, order and perform diagnostic tests, receive and accept referrals, plus much more. The right to practice is being eroded by malicious factions using the state chiropractic practice acts against DCs. Today they are coming for New York DOT Exams, who will be next? It is time for Chiropractors to stand up and demand to practice to the extent of their education. The Safe Drivers, Safe Road Coalition (SDSRC) wants to defend Chiropractors across the US and is asking for help. Donate to the SDSRC
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Chiropractic Online Reputation Part 1
Good, bad or absent, we all have an online reputation. When someone types your name, practice or chiropractor in your town into a Google search the results will be their first impression about you and your practice, making your online reputation. Your online reputation is composed of every site, post, mention and reference to you on the web. Most Chiropractors are not aware of the condition of their reputation. Just because you have a website don’t think that will be the first or only thing that appears and the search from your laptop in no way reflects what everyone else sees.If you do one thing for your Chiropractic practice’s online reputation this year, own your Google Business Listing. Many of you have probably already done this, but there is more . . . stay tuned. Internet sources report that 44% of Google business listing are not owned.I remember a professor telling our class in Chiropractic College (circa 2001) that when he started into practice he walked three miles around his first office looking for phone booths. He placed his business card in each phone booth’s phone book in the Chiropractor section. Most recent Chiropractic graduates right now will have a puzzled look on their face wondering what I am referring to and many experienced Chiropractors are probably nodding their collective heads.The days of phone booths and phone books are over. Today’s new patients are not thumbing through a big yellow book. They are searching for you on Google. With over a trillion searches a day, a few of them are looking for you. Truth be told, not everyone is searching for you on Google; just the majority.Just like the days of old you can buy a big ad on some directory, even Google, but before you do that there is a much simpler free way to improve your ability to be found on Google for free. The goal is to ensure a return on investment (ROI) that meets or exceeds the markets expectation. This is no different than any business in the world, what you get in return has to be significantly more that is costs you.This is not an introduction manual, but a simple guide. To get started with your Google Business Listing go to Google maps and search for your business, your name, and any other provider that has ever worked in your office. Make a list of the URLs (Web addresses) of all of the listings. Hopefully you only have one. If you have more than one listing that can be a problem, which is a conversation for another day.Find your listing, claim it, and verify it. Google, the Master of the Internet tries to add every business that it can find to its maps. That is why we all love them. Unless you opened your doors in a brand new building, you probably have a listing. When a listing is verified, it lets Google know that this information is accurate and that listing will rank higher in Google searches.Claim your business then verify it. Google will send you a postcard or call your office to verify that you are at the address of the listing. Your updates and additions will only be seen if you verify the listing. When a listing is verified, it lets Google know that this information is accurate and then that listing will rank higher in Google searches.Many Chiropractors have fallen into the trap of having third parties set up their Google business listing account not under your Gmail address. My professional experience with working with Chiropractors for years to improve their online reputation, I can safely say that half of Chiropractors do not have access to their listing. I also recommend you set up your business listing in your own name, with your own Gmail account and then add Manager permissions to any providers helping with your online reputation.This is vital in the event that relationship ends and you are shut out of your own account. If another company or person claims your listing you have some work to do.Now that you have your listing, add some pictures. Potential patients want to see your face, even if you have a face only fit for radio. They are not searching for a super model; they are looking for someone they can trust with their health. Add your logo, office hours a description about your business that talks about things potential patients might be looking for. They are looking for help from back pain and headaches not for wellness, and their subluxations to be removed. Save that conversation for your office.Add pictures of the outside of your office and the inside to give your potential patients the comfort of knowing what to expect inside. Clean up the room. I have seen pictures with dirty face paper on the table. Patients do not know what to expect so leave anything that could resemble medieval torture out: Knee to chest tables and anything with multiple leads. You might be excited about your new traction table, might be a little scary to a potential patient. Electric rehabilitation equipment, computerized systems have a great visual appeal, start there. Take a picture of your staff, unless you burn through receptionists. A smiling face at the front desk is more inviting than an empty chair.Do you need a professional photographer to shoot the pictures? It wouldn’t hurt. If that is not in your budget then it can be as simple as a millennial and a smart phone. Now you are set. Want to know the value? You can track how many times your listing is viewed, someone calls from the listing, when they call and reply to reviews in the Insights section on your new Google Business Listing.Think about how many more patients you could help, if they could just find you. I had an upset chiropractor tell me recently that numerous new patients did not show for their first visit because they went to his old address still on Google maps.
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Humor > Holiday
Chiropractic Holiday Humor
Winter Chiropractic Humor
Send CE Cruncher pictures of your Chiropractic Christmas Tree, Hahanukkah Menorah, Festivus Display or Chiropractic Themed Holday Display for a little internet fame.
Dr. Lisa Erikson of LifeSport - Chiropractic for Hyper Athletes
From Koren Publications
4th of July Chiropractic Fun
Chiropractic Office event Hosted by New Directions Chiropractic in Allen Texas
Spring Chiropractic Humor
A little Chiropractic Humor from the Art / Marketing Department at CE Cruncher.
Happy Halloween for the Chiropractor
Pumpkin Carving by Active Care Chiropractic
From the Chiropractic Blog of Dr. J J Gregor
How do you Adjust a Pumpkin?
Old Time Chiropractor Adjusting in the Afterlife
Dr. Pumpkin adjust gourds of patients - Burt Chiropractic Clinic
Q: How does a Chiropractor decorate their 20 ft fiberglass spine for Halloween?
A: With black widow spiders of course
Turkey Day with the Chiropractor
Valentines's Day witha Chiropractic Flare
An ad last year from Health for Life Spine and Disc Center in Odgen UT