Fall 2025_The Wisconsin Chiropractor

TABLE OF CONTENTS

BOARD

President

Vice

Treasurer

Secretary

Executive

Education

Corporate

Membership

Membership

Editor's Note

by John Murray, Wisconsin Chiropractic Association Executive Director and CEO

The September edition of the Wisconsin Chiropractor magazine reflects the transition from summer to fall in many ways.

Political Advocacy Efforts

Since the Wisconsin Legislature wrapped up the biennial budget in July and Congress went into recess in August, I spent a number of my days attending political fundraisers around Wisconsin. I enjoy attending these events for several reasons. One, having face time with these politicians to catch up on the latest political gossip and talk about chiropractic issues is valuable. Two, I get to spend time with WCA members like Dr. James Damrow (page 19) and Dr. Gene Yellen Shiring (top right) who are passionate advocates for the profession and good folks with which to hang out. Finally, it is critically important that we support the re-election efforts of these pro chiropractic candidates with ChiroStrong funds so they can continue to advocate for the profession in Madison and Washington, DC.

Recognizing Legacy: 2025 Legacy Awards Reception

Building on the success of the WCA Legacy Awards introduced in 2024, we are hosting this event in the evening on Friday, September 26 during the fall convention. The Legacy awards reception will recognize a number of long time WCA members for their legacy of accomplishments (page 49)

Preparing for the WCA Fall Convention

Finally, WCA staff are busy finalizing arrangements for the fall convention which will be held September 25th - 28th, 2025 at the Kalahari Resort in the Wisconsin Dells. As you can see from the photo right, the conference room at the WCA office is the staging area as staff are organizing everything for deployment to the Kalahari in a few weeks. Delivering a quality convention takes the work of many people - the WCA Education and Convention Committee, the entire WCA staff and Board of Directors and our marketing consultant, LeaAnn Odekirk. I want to thank all of them for their hard work putting together yet another great fall convention.

There is still time to register on-site and join us as we have a great lineup of speakers, breakout sessions and partner companies ready to make the WCA fall convention an experience well worth your time.

What Chiropractic & Natural Medicine Can Be — With Us

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Here, you’ll help patients move better, recover faster,and live with more vitality, while growing your skills with mentorship, continuing education, and the support you need to thrive. If you’re ready to heal naturally and change lives, we’re ready to welcome you.

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Meet Our 2025 Fall Convention Speakers

Get ready to be inspired, challenged, and energized! Our 2025 Fall Convention lineup is packed with dynamic voices from across the industry. These speakers aren’t just names on a program—they’re creators, innovators, and change-makers who’ve sent in personal video invites just for you.

Hear directly from our speakers below... what drives their work, what they'll be sharing, and why this event is one you won’t want to miss. Whether you attend Fall Convention for fresh ideas, professional growth, or a spark of creative energy, these previews offer a glimpse of the passion and insight waiting for you this fall.

Rebecca Scott Presents: "Compliant Data Gathering: The Key to Risk Management" sponsored by ChiroHealthUSA (Qualifies for 2 Professional Boundaries Hours)

Dr. Danielle Angela Presents: "Preventing, Diagnosing, and Managing Burnout," sponsored by ChiroPreferred

Dr. Michael Powell and Dr. Robert Silverman Present: "The Chiropractic Edge in Healthy Aging." Sponsored by Nutri Dyn and NCMIC

Dr. Cindy Howard presents "Ethical Practices and Communicating Effectively: Let’s talk about Sex," sponsored by Protocol 4 Life (2 Professional Boundaries Hours).

Dr. Davis McAlister Presents: "The Benefits of Extracorporeal Shockwave Therapy in the Recovery of Muscular Injuries." Sponsored by Zimmer Medizinsystems

Dr. Miles Bodzin and Holly Jensen present "Four Key Principles for Better Patient Compliance," sponsored by Cash Practice

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Sexual Health: A Nutritional and Functional Approach for Chiropractors

by Cindy M. Howard, DC, DABCI, DACBN, FIAMA, FICC

Sexual health is one of the most important—and least discussed—topics in clinical care. Patients often suffer in silence, whether because of embarrassment, lack of knowledge, or the belief that nothing can be done. Yet sexual health affects quality of life as profoundly as pain, sleep, or nutrition.

That’s why I’m dedicating time at the Wisconsin Chiropractic Association this September to address sexual health from a nutritional and functional perspective. My goal is to help you navigate these conversations with confidence, skill, and sensitivity—because when we remove the stigma, we can make a measurable difference in outcomes.

Why Chiropractors Should Talk About Sex

Sexual health concerns are more common than most realize. Roughly 30% of men and 40% of women report problems ranging from erectile dysfunction and painful intercourse to hormonal imbalances, infections, or loss of libido.

Many of these issues overlap with the musculoskeletal and systemic conditions chiropractors already treat. Consider a patient with recurring low back pain: underlying causes might include endometriosis, prostatitis, menstrual irregularities, or pelvic infections. Without a full historyincluding sexual health- we risk missing the root cause.

The Education Gap

Patients’ knowledge often comes from friends, family, or inadequate school programs. In many states, sex education is incomplete or outdated. One survey found

that one in ten women could not correctly identify a diagram of the female reproductive system, and over half misidentified the uterus. Such gaps hinder their ability to communicate effectively with providers.

We can correct misinformation, answer unasked questions, and give patients the language they need to advocate for themselves.

Key Clinical Considerations

Female patients often ask what’s “normal” in terms of discharge, cycles, or sexual comfort. Abnormal discharge, spotting, or cycle changes may signal infections, fibroids, or hormonal dysfunction.

For male patients, concerns may include erectile dysfunction, penile curvature, testicular changes, or semen abnormalities—possible indicators of vascular issues, hormonal imbalances, or infections. Both women and men may also face sexual side effects from medications, chronic illness, or post-viral changes such as those linked to COVID-19.

Professional Boundaries

Discussing sexual health requires clinical knowledge and clear ethical boundaries. Patients set the terms. Respecting consent, ensuring privacy, and offering a chaperone when appropriate reduce vulnerability and protect both patient and provider. Training staff to reinforce these practices creates a consistent, respectful experience.

continued on page 12 See Dr. Cindy Howard at the 2025 WCA Fall Convention on Saturday, September 27 for her seminar "Ethical Practices and Communicating Effectively: Let’s talk about Sex " sponsored by Protocol 4

Nutrition and Functional Support

Sexual health is tied to nutrition, hormone balance, and systemic wellness. Addressing inflammation, circulation, and stress can significantly improve function.

• HORMONES: Essential fatty acids, B vitamins, adaptogens

• CIRCULATION: L-arginine, CoQ10, antioxidants

• PELVIC FLOOR: Magnesium and targeted exercise

• STRESS: Cortisol balance through lifestyle and nutrition

By addressing both structural and functional care, we provide more than symptom relief—we support whole-person well-being.

Overcoming Provider Discomfort

Many physicians avoid sexual health discussions for fear of offense or lack of preparation. Yet 93% of patients say they would welcome the conversation if approached respectfully. Normalize it: use accurate terms, explain why questions matter, and maintain a judgment-free tone.

See You in October

Sexual health is integral to human experience, and as chiropractic physicians, we’re uniquely positioned to address it through physical, nutritional, and functional care. By building our confidence in these conversations, we can better serve patients and elevate our profession’s role in whole-person health.

I look forward to exploring these strategies with you at the WCA Fall Convention this September. Together, we can remove stigma, enhance skills, and help patients live healthier, more fulfilling lives.

Cindy M. Howard, DC, DABCI, DACBN, FIAMA, FICC, is a board-certified chiropractic internist and nutritionist specializing in finding the root cause of symptoms and diseases. She earned her Doctor of Chiropractic from the National University of Health Sciences and is in private practice in Orland Park, Illinois, where she focuses on individualized care. For more information, visit innovativehwc.com. If you’d like any information about this topic, please call Dr. Cindy M. Howard at 708479-0020 or email her at drcindymhoward@gmail.com. If you’d like more information about Dr. Cindy’s book, Positively Altered, or her blog, podcast, and speaking services, visit her at drcindyspeaks.com.

The 'Back to Basics' Podcasts Series

Hosted by WCA President Dr. Chris Resch

The Wisconsin Chiropractic Association podcast “Back to Basics” brings you conversations with leaders in the chiropractic profession hosted by WCA President Dr. Chris Resch. In each episode, we explore the people, ideas, and strategies shaping the future of chiropractic.

Episode 13 Featuring Dr. Cindy Howard

In this episode, my guest is Dr. Cindy Howard — a board-certified Chiropractic Internist and Nutritionist, DC, DABCI, DACBN, FIAMA, FICC — and the owner of Innovative Health & Wellness Center in Orland Park, Illinois. She’s also licensed in Florida and runs DC Consulting, where she helps practices strengthen communication, improve patient adherence, and grow their functional medicine and nutrition services.

Dr. Howard has been a driving force in our profession for decades, serving as Illinois delegate to the American Chiropractic Association since 2011, past president of the ACA Council on Diagnosis and Internal Disorders, and currently Vice President of the College of Pharmacology and Toxicology. She’s contributed to countless publications, served on medical advisory boards, and is a sought-after national speaker on topics ranging from concussion nutrition and GI disorders to leadership and business development for physicians.

Her work has earned her numerous honors, including the Illinois Chiropractic Society’s Chiropractor of the Year in 2020 and the Nutritional Professional of the Year in 2023. She’s also the author of Positively Altered: Finding Happiness in the Bottom of a Chemo Bag, a powerful and personal account of resilience and gratitude through her journey with Hodgkin’s Lymphoma.

In this episode, we’ll be talking about patient care, functional medicine, and Dr. Howard’s fascinating life journey.

Don't Miss an Episode!

Follow Our Podcast Channel on Youtube @wisconsinchiropractic/podcasts

Government Affairs Update

John Murray, WCA Executive Director and CEO

What’s Next for Expansion of Chiropractic within Medicaid?

The WCA-backed state budget provision expanding access to chiropractic care within Medicaid to extremity adjustments and therapies will take the next step towards implementation over the next four months.

So what exactly are the next steps?

Securing approval for this expansion from the Wisconsin Legislature and Governor Evers as part of the 20252027 biennial budget was a significant step, but only the first. This action appropriated the state funding for the expansion which represents 40% of the total required as Medicaid is a state/federal program. The budget provision also directs the Wisconsin Medicaid Office to prepare a plan amendment for submission to the Centers for Medicare and Medicaid (CMS) to secure the federal funding which represents the remaining 60% of the total funding required.

The WCA has met with the Wisconsin Medicaid Office to go over the plan amendment process. Wisconsin Medicaid officials indicated during that meeting that they expect the plan amendment will be submitted to CMS before the end of 2025. There is no certainty as to how long the CMS review process will take as some plan amendments are approved within a few months, some take closer to a year and some are never approved.

“The best case scenario is that expansion of chiropractic within Medicaid goes into effect in mid to late 2026,” said John Murray, WCA Executive Director.

The WCA team will continue to work with the Wisconsin Medicaid Office to advocate for approval of the state plan amendment and full implementation of this important expansion of access to chiropractic.

WC Fee Schedule and Elimination of Patient Choice Appear Dead at WCAC

Despite efforts by the management representatives to the Wisconsin Worker’s Compensation Advisory Council (WCAC) to implement a managed care style fee schedule on care provided to injured workers in Wisconsin and eliminate patient choice, it appears that the WCAC is going to approve draft legislation in September making fairly minor changes to the program. This draft legislation will then be introduced in the Wisconsin Legislature for their consideration.

The backdrop of this development is the deal struck in the recently passed state budget that ties an increase in the Wisconsin Hospital Assessment from 1.8% to 6% of gross revenues to a workers compensation fee schedule on hospital services only. Hospital assessment revenues are deposited into the Wisconsin Medicaid Trust Fund and used to draw down matching federal dollars to fund the Medicaid program in Wisconsin.

This budget agreement, which was approved by the Wisconsin Legislature and signed into law by Governor Evers ahead of federal legislation that would have frozen hospital assessments, seems to have placated efforts by the Wisconsin business lobby to impose a worker’s compensation fee schedule on all providers in Wisconsin including chiropractors. While this is a very positive development, there is nothing stopping the WCAC from coming back next session and trying to impose a fee schedule on non hospital providers or trying to eliminate patient choice for injured workers.

WCA will be closely monitoring the WCAC as one of the named health care liaisons.

Questions? Email WCA Executive Director John Murray at jmurray@wichiro.org

WCA Continuing Education

Andrea Murray, WCA Education & Convention Director | awmurray@wichiro.org |

2025 Fall & Winter Continuing Education

WCA's continuing education schedule is full of opportunities to sharpen your skills, earn CE credits, and stay current with the latest in chiropractic care.

Plan ahead and save 20% when you register 20 days in advance!

Dry Needling Level 1

This course is designed to meet state requirements for dry needling training and certification. Attendees receive a starter kit of dry needling supplies and the skills and training to start dry needling.

• October 4-5 | Oconomowoc | 20 CE DC

• Presented by: Dr. Michael McQueen

Nutrition 4: Nutritional/Drug interactions, Detox, Allergies & Hormones

This 48-hour course satisfies DSPS requirements for the Chiropractic Nutritional Counseling Certification in Wisconsin. Completion of the 48-hour course allows Wisconsin DCs to provide nutritional counseling in their clinics, and to recommend supplements and nutraceuticals.

• October 11-12 | Brookfield | 12 CE/12 Nutrition

• Presented by: Dr. Victor Carsrud

Chiropractic Radiological Technician Course

This 48-hour course is approved by the Wisconsin Chiropractic Examining Board and satisfies the legal requirements for chiropractic assistants to take X-rays. CRTs must attend all 48 Hours and pass a final exam in order to receive this certification.

• Oct. 11-12, Oct. 18-19 & Nov. 1-2 | Fond du Lac | 48 CE CRT

• Presented by: Dr. Wendy Varish

Online: Navigating Hormonal Transitions: Nutrients for Menopause

In this presentation, Dr. Loch will discuss targeted supplementation to support individuals through the natural hormonal shifts of menopause and andropause.

• October 14 | 2 CE DC/CT/CRT, 2 Nutrition

• Presented by: Dr. Lexi Loch

Online: Shockwave Therapy (ESWT) & High Energy Inductive Therapy (HEIT)

Dr. McAlister presents a practical overview of Extracorporeal Shockwave Therapy, a non-invasive, evidence-based treatment that stimulates healing in injured muscles and tendons. Dr. Yorick Wijting will present an introduction to High Energy Inductive Therapy, a breakthrough modality designed to accelerate healing, reduce pain, and enhance performance..

• October 16 | 2 CE DC/CT

• Presented by: Dr. McAlister and Dr. Wijting

Cervical Spine Imaging & Treatment Course

Learn from leading professionals in spine surgery, pain management, and radiology. Gain insights into surgical, diagnostic, and integrative treatment approaches.

• October 16 | Appleton | 3 CE DC

• Presented by: Dr. Brandon Rebholz, Dr. Amanda Greene, Dr. John Joseph,and Dr. Tim Mick

WCA Continuing Education -

Fundamentals of Exercise Rehabilitation

This 24-hour education course is designed to allow delegation of exercise to chiropractic assistants in compliance with Wisconsin’s Administrative Code. The course includes opportunities for practical applications and a final exam for CTs.

• Oct. 25 & Nov. 15 | Cedarburg | 24 CE DC/CT

• Presented by: Dr. Jeffrey Sergent

Functional Neurology: Advanced Applications for Your Most Challenging Patients

This course is for the doctor who wishes to be a unique resource to not only patients, but other healthcare providers. Dr. Powell will share effective methods for approaching and navigating challenging cases with brain-based chiropractic care.

• November 1 | Oconomowoc | 8 CE DC

• Presented by: Dr. Michael Powell

CT Certification, Electrotherapy, Ultrasound, Thermo-Cryo & Mechanical Therapy

This series of classes is for staff seeking initial certification as a Chiropractic Technician (CT) and for CTs adding modalities to their current license or seeking continuing education hours

• November 7-8 | Grafton | 22 CE CT

• Presented by: Dr. Brenda Holland

Online: HIPAA Compliance Updates on the Horizon: Key Takeaways

Understand the requirements needed to be HIPAA compliant. Earn CE from the comfort of your clinic or home!

• December 3 | 1 CE DC/CT/CRT

• Presented by: Zachary Jones

Online: CT Light Therapy

This course is approved for CTs to become certified in Light Therapy. Photochemical and photo biological effects of light will be discussed as well as the therapeutic window of light as applied within the clinical setting.

• December 8 | 2 CE

• Presented by: Dr. Wendy Varish

Dry Needling Level 2

Level 2 prepares students for more advanced techniques, and will include a brief review followed by advanced instruction in wrist flexors, wrist extensors, hand muscles, foot muscles, plantar fascia, rotator cuff, rhomboids, sub occipitals, inter spinus, intermuscular.

• January 10-11, 2026 | Green Bay | 20 CE DC

• Presented by: Dr. Michael McQueen

Chiropractic Nutrition Series

September 27-28, 2025

Kalahari Resorts & Conventions - Wisconsin Dells 1305 Kalahari Dr, Baraboo, WI 53913

Instructor

Ron Grabowski, BS, RD, DC

Professor at Texas Chiropractic Collage

NuMedica® Opinion Leader

for module 3 at wichiro.org

October 11-12, 2025

Sheraton Milwaukee Brookfield Hotel 375 S Moorland Rd, Brookfield, WI 53005

Instructor

N.D. Victor Carsrud, MD, PhD, DC, MBBS, MS, MS, DABCI, DCBCN

Lakeline Wellness Center

NuMedica® Opinion Leader

for module 4 at wichiro.org

Dr. Victor Carsrud

Dr. Ron Grabowski

Dr. James Damrow, Congressman Bryan Steil (WI-1) and WCA Executive Director John Murray at a recent fundraising event in Lake Geneva.

WCA Membership Director Zach Kasun, State Representative Mark Born (R-Beaver Dam) and WCA Executive Director John Murray at a recent fundraising event in Beaver Dam.

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INFORMED CONSENT IN CHIROPRACTIC: COMMENTARY ON BROWN & LEHMAN’S “INFORMED CONSENT REGARDING RISK OF STROKE FROM CERVICAL SPINE MANIPULATION”

ABSTRACT

Background: A recent article by Brown and Lehman [2025] advocates for the universal inclusion of cervical artery dissection (CAD) and stroke risk in informed consent for cervical spine manipulation (CSM). Their narrative review appears to rely on anecdotal and lowlevel evidence, raising concerns regarding its validity and potential impact on clinical and legal standards.

Objective: To critically evaluate the scientific, ethical, and legal foundations of Brown and Lehman’s 2025 recommendations and to propose alternative recommendations based on current evidence-based standards and informed consent jurisprudence.

Methods: A detailed appraisal of the papers cited in Brown and Lehman's review was conducted. High-level evidence, including epidemiologic studies, systematic reviews, and biomechanical analyses, was contrasted against the narrative sources used by the authors. Legal and ethical standards surrounding informed consent across U.S. jurisdictions were also reviewed.

Results: Brown and Lehman's article may exhibit confirmation bias, selective citation, and a reliance on case reports, commentaries, and narrative reviews that do not support the concept of universal informed consent related to CSM, CAD, and stroke. Major epidemiological and biomechanical studies appear to contradict their claims. Their review did not include

1 Private Practice of Chiropractic, 2 PostGradDC

contrary evidence, may have misinterpreted key studies, and contained logical inconsistencies. Legal analysis reveals that informed consent standards vary by jurisdiction, with no legal mandate for blanket disclosure of statistically unproven risks such as CAD post-CSM.

Conclusion: The conclusions presented in the BrownLehman review article appear to be based primarily on low-level evidence, including narrative reports, commentaries, and case series, which may not meet the threshold necessary to guide clinical standards or establish legal norms. Their recommendation for universal disclosure of CAD risk in informed consent, despite the absence of causative evidence, raises important considerations regarding clinical relevance and medicolegal implications. Informed consent practices should be aligned with the best available evidence, applicable jurisdictional statutes, and professional standards. Chiropractors are encouraged to consult current clinical guidelines, review applicable laws and rules, and seek legal counsel when determining appropriate disclosures within the informed consent process. (J Contemporary Chiropr 2025;8:259-265)

Key Indexing Terms: Cervical spine manipulation, cervical artery dissection, informed consent, chiropractic, medico-legal standards, narrative review, causation, stroke risk

INTRODUCTION

Informed consent is a cornerstone of ethical and legal healthcare practice, empowering patients with the necessary information to make informed decisions

Commentary on Informed Consent Wilder, Demetrious, Conway et al

Jeffrey Wilder, DC, DABCO 1 , James Demetrious, DC, DABCO 2 , Phillip Conway,BPE, DC, FCCPOR(C) 1 , David Graber, DC, DACBSP 1 , Peter Tuchin, DC, PhD 1

about their care. (1, 2) In chiropractic, CSM is a widely used intervention for managing neck pain and related disorders. (3)

However, concerns persist within the medical and public discourse regarding the alleged association between CSM and CAD, a rare but potentially serious vascular event that can lead to ischemic stroke. (4) There has been extensive biomechanical research to show that CSM does not stretch or injure vertebral arteries (10-17), and extensive epidemiologic research to show that CSM does not cause dissection or stroke when compared to medical treatment. (4,6,7,26,27)

In a recent narrative review, Brown and Lehman (1) advocate for the universal inclusion of CAD and stroke risks in the informed consent process for CSM. While increasing patient awareness is essential, their recommendation raises complex questions about the evidentiary threshold required to warrant such disclosures. The authors appear to rely primarily on lowlevel evidence, including case reports and anecdotal observations, to support a theoretical risk that remains scientifically unvalidated.

There are numerous published case reports in which CAD occurs after minor events (such as sports, hobbies, massage, beauty parlor visits, and spinal manipulation), but case reports are incapable of providing substantial evidence to support any theory of causation. (5)

Our commentary critically examines the clinical, legal, and ethical underpinnings of such a position. We explore whether the inclusion of CAD and stroke in routine consent is justified, given the current absence of a demonstrated causal relation between CSM, vascular injury, and stroke.

In doing so, we underscore the importance of aligning informed consent practices with the best available evidence, including current epidemiological and scientific research, prevailing jurisdictional standards, and professional guidelines. We should balance the patient’s right to know with the practitioner’s duty to communicate material risks, which are inherently foreseeable and causally attributable to chiropractic treatment.

Confirmation Bias

Brown and Lehman may exhibit confirmation bias by selectively citing studies that support their hypothesis that CSM causes stroke in the presence of an existing CAD, or by interpreting studies in a manner inconsistent

with the main conclusions of the study.

The Cassidy et al. study, widely regarded as a landmark, concluded that there was no increased risk of vertebrobasilar artery (VBA) stroke after chiropractic care compared to visits to primary care physicians. This suggests that patients who were later found to have cerebral ischemia were likely already experiencing dissection-related symptoms, which prompted their chiropractic care. (6)

Kosloff et al. “found no significant association between exposure to chiropractic care and the risk of VBA stroke.” (7) The Church et al. systematic review found no causal link between CSM and cervical artery dissection CAD, concluding that the evidence did not support a cause-and-effect relation. (8) Whedon et al. [2023] stated, “Our findings therefore suggest that the association between CSM and CeAD (cervical artery dissection) is not causal in nature.” (4) Tuchin [2012] (9) and Church et al. (8) each applied the Hill criteria to assess whether there was sufficient evidence to establish causation for cervical artery dissection following chiropractic manipulation and separately concluded that the evidence did not show causation had been established.

Despite citing these studies, Brown and Lehman draw conclusions that are contrary to the conclusions of the studies. Brown and Lehman continue to claim that CSM may provoke a thromboembolic event in the presence of preexisting dissection, thereby justifying universal stroke-related informed consent. This position directly contradicts the conclusions of those studies, ignoring the quality and meaning of the evidence.

Flawed Reasoning

Brown and Lehman’s conclusions are largely drawn from low-level evidence and speculative mechanisms, rather than rigorous scientific validation. Central to their argument is the suggestion that manipulation could dislodge a pre-existing thrombus, leading to a stroke. However, they provide no biomechanical data or highquality clinical evidence to support this claim.

Multiple high-level biomechanical research studies consistently demonstrate that CSM does not produce sufficient force to injure or significantly stretch the vertebral arteries in healthy individuals. (10-17)

Brown and Lehman cite Haldeman (18) as supporting their position on informed consent, but Haldeman actually wrote, “At this writing, a physician wishing to

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Beyond Burnout: A Nervous-System-Based Approach to Sustainable Practice

By Dr. Danielle Angela

Burnout has become an almost universal experience in healthcare. Chiropractors are no exception.

The long hours, emotional demands of patient care, and the increasing complexity of running a practice often create the perfect storm for exhaustion, overwhelm, and disconnection from the work we once felt called to do.

But here’s the truth: burnout isn’t just about being “too busy.” It’s a nervous system issue. If we don’t learn to diagnose, manage, and prevent burnout through the lens of how stress truly impacts the body, we risk not only our longevity in practice but also our physical and emotional wellbeing.

Diagnosing Burnout: More Than Fatigue

Many chiropractors recognize the early signs of burnout—chronic fatigue, irritability, brain fog, or the feeling of “going through the motions.” But what often gets overlooked are the subtler signals:

• Loss of fulfillment in patient care or a sense of detachment.

• Difficulty recovering after what used to be routine stressors.

• Physical manifestations like headaches, digestive changes, or sleep disruption tied to chronic stress load.

Burnout isn’t simply a mental health diagnosis—it’s a physiological response when our stress recovery systems are overtaxed. The nervous system, designed to keep us safe in short-term stress, gets stuck in survival mode. Over time, this dysregulation spills into every domain of practice and life.

Managing Burnout: A Nervous System Reset

When we look at burnout through a nervous-system-based approach, the path to recovery shifts. Management requires more than taking a weekend off or cutting back on office hours—it requires creating conditions for regulation and repair.

Some strategies I teach include:

• Micro-resets throughout the day. Simple breathing practices, posture resets, or even a few minutes outdoors help the nervous system exit “fight-or-flight.”

• Somatic awareness. Learning to notice where stress shows up in the body allows for earlier intervention before it becomes overwhelming.

• Redefining success. Many chiropractors carry perfectionist tendencies. Reframing productivity around sustainability rather than output can dramatically reduce pressure.

• Support systems. Colleagues, coaches, and even non-professional support networks play a vital role in breaking isolation and normalizing the conversation around burnout.

continued on page 26

Burnout - Cont. from page 25

These aren’t quick fixes. They’re tools to gradually restore a sense of safety and capacity within the nervous system, allowing us to reconnect with the deeper “why” behind our work.

Preventing Burnout: A Proactive Framework

While management is essential, prevention is where we create lasting change. Here are three preventative pillars I’ll be sharing at the upcoming WCA Fall Convention:

Regulated Rhythms – Building daily, weekly, and seasonal rhythms that align with the body’s natural stress/recovery cycles. This can include scheduling anchor points (like non-negotiable breaks, exercise, or family time) that protect against creeping overload.

Boundaries That Stick – Clear professional and personal boundaries are non-negotiable for sustainable practice. Saying “no” to what drains us—whether that’s certain scheduling patterns, administrative burdens, or community obligations—is a skill set that protects both practitioner and patient.

Restorative Leadership – As chiropractors, we are leaders in our communities. Preventing burnout means modeling what it looks like to prioritize well-being. When we operate from a regulated state, we create a ripple effect: healthier teams, healthier practices, and healthier patients.

Why This Matters Now

The chiropractic profession is at an exciting crossroads. We’re gaining recognition in integrative care, expanding our influence, and training the next generation of doctors. But none of that matters if we lose ourselves to burnout along the way.

By reframing burnout as a nervous system issue—and equipping ourselves with practical tools to diagnose, manage, and prevent it—we not only preserve our own health but elevate the profession as a whole.

This September, at the Wisconsin Chiropractic Association’s Fall Convention, I’ll be diving deeper into this framework: how to recognize the subtle signs of burnout, how to use nervous-system-based strategies to restore resilience, and how to implement structures in your practice and life that prevent burnout before it takes hold.

Because when chiropractors are regulated, resilient, and connected, we don’t just avoid burnout—we thrive. And our patients, our practices, and our communities benefit from the overflow.

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WCA Help Desk

Tammy McKeown, C.T. | Membership Services Director | wcahelp@wichiro.org | 608-292-1804

Did You Receive a Episource Records Request on behalf of Blue Cross?

The WCA Help Desk was alerted about a request that our members were receiving. Yes, it is legitimate, and you should respond.

WCA Help Desk Director, Tammy McKeown, reached out to Senior Government Relations Director, Wisconsin contact at Blue Cross/Elevance Health for confirmation and explanation of these requests.

Episource is a vendor engaged by Anthem for the purpose of retrieving records and/or performing reviews of medical charts. Anthem Blue Cross Blue Shield uses many vendors across all providers/plans for requests. Including Datavant and Episource. Because of this they are unable to provide a comprehensive list of vendors to the WCA. If the patient was not insured by the requesting insurance company during the time frame requested, you would want to let that vendor/requestor know, and the request would not be valid.

WCA members are receiving the request as part of Anthem’s ongoing obligation to CMS that requires MAOs to attest annually that, based on best knowledge, information, and belief, all risk-adjustment data sent to CMS is “accurate, complete, and truthful.”

It is common practice for providers to furnish requested records so the plan can validate diagnosis data submitted to CMS.

HIPAA expressly permits disclosure of protected health information for “health-care operations,” which include risk-adjustment activities; therefore, no separate patient consent is needed to release records to Anthem or its designees.

All records are transmitted via secure fax or encrypted email and handled under strict privacy and cybersecurity protocols consistent with HIPAA. If you ever have a question regarding the validity of a request, please feel free to reach out to that vendor or the WCA Help Desk.

WCA Insurance Advocacy Committee Sends Letter to Major Payors in WI

The WCA has contacted major payors in Wisconsin requesting clarification and specifics regarding their organization’s plans to implement the prior authorization reforms outlined by America’s Health Insurance Plans (AHIP).

See a copy of the letter signed below by WCA Executive Director, John Murray and Dr. Kay Fogeltanz, Chair of our Insurance Advocacy Committee. We will await their response and share in future communications.

Read the Letter

CIGNA Update: Administrative Policy Updates

In the Administrative Policy Updates email that was sent to providers and dated July 11, 2025, there is a policy named Evaluation and Management Coding Accuracy R49.

Cigna will review professional claims billed with the following CPT E/M codes for billing and coding accuracy in alignment with American Medical Association (AMA) E/M services guidelines:

• 99204-99205

• 99214-99215

• 99244-99245

Services must be adjusted by one level to reflect the appropriate reimbursement when the AMA guidelines are not met.

The WCA Help Desk is not sure exactly what that means as far as claims processing so we will have to see how claims process for dates of service October 1, 2025, and after. These denials should be appealed, and documentation should be submitted.

View Cigna’s Evaluation and Management Coding and Accuracy Policy >>

Complimentary Help Desk Member Webinars

ICD-10 Update

Coming Soon to WCA's On Demand Portal wichiro.org/WebinarsOnDemand

Dr. Mario Fucinari joined the WCA Help Desk for a 2025-26 ICD-10 Update on September 18. It covered everything you need to know about ICD-10 changes that will affect Chiropractic/Chiropractic claims starting October 1st. Check our website for an on demand recording available soon!

Personal Injury Made Easy

Tuesday, October 21 | 12 PM

Save the date for this exclusive WCA member Help Desk webinar featuring Michael Coates. Registration opens soon. Watch your email for details or visit our education calendar

Compliance Webinar

Thursday, November 20 | 12 PM

Join the Help Desk and Dr. Ty Talcott for this WCA member Help Desk webinar! Learn about AI, special advantages and special compliance protections needed. Information regarding Ransomware and a guided virtual compliance audit of a chiropractic office, scoring the results and action steps needed. Registration opens soon.

Research to Reality: Breaking Ground in Alzheimer’s Treatment

by Robert Silverman, DC | Republished with permission from Chiropractic Economics, December 2024

Recent research has begun to explore the idea that little can be done to slow, stop or even reverse mild cognitive impairment (MCI) or early dementia from Alzheimer’s disease (AD).

The proven approach of lifestyle interventions is entirely separate from recently approved immunotherapy drugs, such as lecanemab (Leqembi) and donanemab-azbt (Kisunla), which target amyloid plaques in the brain to slow Alzheimer’s disease but come with a host of severe side effects.

Alzheimer’s disease by the numbers

The number of Americans living with AD is increasing. According to the U.S. Centers for Disease Control and Prevention, nearly seven million Americans have Alzheimer’s disease; this number is projected to grow to 14 million by 2060. About one in nine people 65 and older (10.9%) have the disease. AD contributes substantially to the U.S. healthcare system’s economic and societal burden of illness. The total cost of treating individuals with AD and associated dementia is projected to increase from $321 billion in 2022 to more than $1 trillion by 2050.

Large-scale observational studies, such as the Lancet Commission of Dementia Prevention, Intervention, and Care, suggest that about 40% of all dementia cases are caused by one or more of 12 modifiable risk factors, such

as poor diet, lack of exercise, type 2 diabetes and others.1 Research suggests reducing or eliminating modifiable risk factors can also help reverse MCI and can help slow or reverse early Alzheimer’s disease.2 Lifestyle interventions can accomplish far more than risky AD drugs.

The Ornish study

Because MCI and AD have multiple modifiable risk factors, preventing and reversing these conditions requires a comprehensive approach rather than a single drug or diet strategy.3 Dean Ornish, MD, and associates conducted a recent randomized controlled trial of a comprehensive reversal strategy.4 For the study, 51 patients with clinically diagnosed MCI or early AD were recruited and divided randomly into two groups: the multimodal lifestyle intervention for 20 weeks and habits and care for 20 weeks. The lifestyle interventions in the trial included:

• A whole-food, minimally processed, plant-based diet low in harmful fats, refined carbohydrates and sweeteners, plus selected supplements

• Moderate exercise

• Instruction in stress management techniques

• Support groups

Endpoints included slowing the progression of MCI or early dementia due to Alzheimer’s disease as measured by standard assessment scales and changes in biomarkers, such as plasma beta-amyloid ratios.

continued on page 33

After 20 weeks, all 24 participants who completed the intervention program showed overall statistically significant improvement on three standard tests of cognition and function. The plasma Aβ42/40 ratio increased in the intervention group. In the control group, these markers stayed the same or decreased.

In addition to a strongly plant-forward diet, the intervention participants took several dietary supplements known to be helpful for brain health, including:

• Omega-3 fatty acids. People 65 or older who eat omega-3 fatty acids (primarily from fish) at least once a week have a 60% lower risk of developing AD.5

• A daily multivitamin tablet with minerals (no iron).

• Magnesium L-threonate. Mg deficiency may be a risk factor for Alzheimer’s disease, and magnesium supplementation may be an adjunctive treatment for AD.6

• A probiotic. The patients in the intervention group significantly improved their gut microbiome diversity.

• Lion’s mane mushroom (Hericium erinaceus). Compared to placebo, this fungus may significantly improve cognition and function in healthy people over 507 and in MCI patients.8

The Ornish study, though it had only 51 participants, strongly suggests an intensive intervention with a near-vegan diet, moderate exercise and improved stress management can be effective for reversing MCI and early Alzheimer’s disease.

Diagnosing dementia

The hallmark of AD is tangles and plaques of beta-amyloid and tau in the brain. The amyloid plaques can be seen on a standard PET scan; the fluorodeoxyglucose (FDG)-PET shows changes in brain function and highlights areas where neurons are less active, much like a heat map of brain activity. The Amyloid-Tau-Neurodegeneration (ATN) Profile, a new blood test for Alzheimer’s disease, looks at biomarkers for beta-amyloid proteins, tau proteins and neurodegeneration.

The role of lifestyle

The central role of amyloid and tau in cognitive decline is increasingly in question, and the significant role of lifestyle factors for prevention and early treatment is becoming increasingly apparent.

Numerous studies show interventions to improve lifestyle factors, such as diet and exercise status, along with

interventions to improve blood flow to the brain, can help preserve cognitive function and reduce the risk of cognitive decline in older adults.9

Dietary interventions

Many studies have shown the value of a healthy, plant-forward, Mediterranean diet for preventing or delaying cognitive decline.10 The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet, developed by the Rush Institute, incorporates the Mediterranean diet with elements of the DASH diet to treat hypertension. This approach lowered the risk of Alzheimer’s disease by as much as 53% in participants who adhered to the diet rigorously and by about 35% in those who followed it only moderately well. This diet has also been shown to slow cognitive decline with aging.11

Other research has shown the importance of diet for amyloid status. A high intake of fruits, vegetables, low-glycemic-index food, polyunsaturated triglycerides and fatty acids contributes to healthy amyloid status. Little or no alcohol intake is also associated with improved amyloid status. Adequate amounts of trace minerals, such as calcium, iron and zinc, are also crucial for healthy amyloid status.12

Exercise, sleep, stress reduction

Numerous other factors may play a role in preventing and reversing MCI and early Alzheimer’s disease. Regular gentle exercise, adequate sleep and stress reduction have all been shown to help prevent and even reverse early impairment.13 Other lifestyle improvements, such as treating hypertension and quitting smoking, are also helpful.14

Additional supplements for cognition

The essential nutrient choline is needed to produce the neurotransmitter acetylcholine (ACh), which plays a role in many brain functions, including learning, memory, thinking, motivation and arousal. Among other roles, ACh is crucial for forming short-term memory. Imbalances in ACh are a known factor that causes AD. It’s possible that choline supplementation could help delay or prevent AD.15

A study of nearly 500,000 U.K. Biobank participants aged 40 to 71 found that over 11 years, zinc supplementation was associated with a 29% reduced risk of all-cause dementia and AD. Zinc plays a central role in antioxidant production; supplementation may increase the protective effect of antioxidants on brain neurons.16

continued on page 34

Don't miss Dr. Robert Silverman at the 2025 WCA Fall Convention on September 25-26. He is co-presenting "The Chiropractic Edge in Healthy Aging: Preventing and Managing Neurodegenerative Disease," with Dr. Michael Powell, sponsored by NutriDyn and NCMIC

Alzheimer’s - Cont. from page 33

Low-level laser therapy

Robust studies have revealed outstanding clinical outcomes using low-level laser therapy (LLLT) to combat MCI and AD.17 Reduced blood flow to the brain can be an underlying cause of MCI and early dementia from AD. Improving blood flow through transcranial LLLT can help treat cognitive impairment by stimulating the neuronal mitochondria across the mitochondrial electron transport chain.

Violet light, for example, impacts complex I (where electrons enter the chain and coenzyme NADH is oxidized) and affects tau and alpha-synuclein; red light impacts complex IV (where the final steps of ATP production occur) and affects beta-amyloid plaques. In one study, elderly patients who received red light transcranial photobiomodulation showed significant improvements in critical measures of cognitive function, such as action selection and mental flexibility.18

Final thoughts

Today, cognitive impairment from Alzheimer’s disease and other causes must no longer be seen as an unavoidable part of aging. We now know that cognitive

impairment can not only be treated and reversed but can also be prevented or delayed. This is an area where integrative DCs can make a real difference. Our skill set in diet, supplements, exercise therapy, non-thermal LLLT, and our trusted role as health and lifestyle coaches position us well for a brighter future that will increasingly demand our expertise.

Dr. Robert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR, is a doctor of chiropractic, clinical nutritionist, national/international speaker, author of Amazon’s #1 best-seller Inside-Out Health and founder and CEO of Westchester Integrative Health Center. He graduated magna cum laude from the University of Bridgeport College of Chiropractic and has a master’s degree in human nutrition. The American Chiropractic Association Sports Council named Silverman Sports Chiropractor of the Year in 2015. He is on the advisory board for Functional Medicine University and is a seasoned health and wellness expert on the speaking circuits and in the media. A thought leader in his field and practice, he is a frequently-published author in peer-reviewed journals and other mainstream publications and was the principal investigator in two Level 1 FDA laser studies. His book, Amazon best-seller Immune Reboot, was released in December 2022. drrobertsilverman.com

View article references here >>

Fuel Your Cells, Protect Your Mind

Mito Recharge fuels your body’s energy factories (mitochondria) to keep you energized, protected, and performing at your best.* When used as directed, Mito Recharge can help:

• Boost natural cellular energy*

• Support immune, heart, & brain health*

• Promote circulation,

Dr. Gene Yellen Shiring with Congressman Scott Fitzgerald (WI-5) at a recent fundraising event in Oconomowoc

Dr. Gene Yellen Shiring with House Judiciary Committee Chairman, Congressman James Jordan (OH-4), at a fundraising event for Wisconsin Congressman Scott Fitzgerald (WI-5).

Revolutionizing Musculoskeletal Care:

Evidence-Based Applications of Radial Extracorporeal Shockwave Therapy

Dr. Davis McAlister, DC, MEd, MS, CSCS | Author, Speaker, Veteran, and Sports Chiropractor

In the evolving field of chiropractic care, radial extracorporeal shockwave therapy (rESWT) has emerged as a transformative option for managing musculoskeletal injuries. Backed by strong scientific evidence and FDA approvals, rESWT provides a non-invasive and effective solution for chronic pain and injury rehabilitation. Advanced devices, such as the enPulsPro, demonstrate how technology has refined shockwave therapy, giving chiropractors precision, reliability, and accessibility.

A Brief History

Extracorporeal shockwave therapy (ESWT) began in the 1980s for non-surgical kidney stone treatment. By the 1990s, researchers found shockwaves also stimulated bone healing and reduced tendon calcifications. Radial ESWT, introduced in the early 2000s, delivers low- to medium-energy acoustic waves radially, making it particularly effective for superficial tissue injuries. FDA approvals soon followed, including chronic plantar fasciitis in 2002, with later endorsements for tendinopathies and calcifications.

How rESWT Works

Radial shockwave therapy promotes healing through mechanical and biological responses:

Neovascularization & Angiogenesis: Microtrauma from shockwaves releases VEGF, encouraging new blood vessel growth to oxygenate damaged tissue.

Collagen Remodeling: Fibroblast activation enhances collagen synthesis and alignment for tendon and ligament repair.

Pain Modulation: Reduced levels of substance P and CGRP lower pain perception while neural desensitization interrupts chronic pain pathways.

Calcification Resorption: In cases such as calcific shoulder tendinitis, rESWT helps fragment and resorb deposits, restoring function.

These effects explain why rESWT is so effective for chronic conditions resistant to standard therapies.

Clinical Evidence

A growing body of research supports rESWT:

• A 2020 meta-analysis in Clinical Rehabilitation of 25 RCTs with 1,800+ patients found significant improvements in pain and function compared with placebo or conventional care.

• A 2021 study in Archives of Orthopaedic and Trauma Surgery reported a 60% pain reduction and 77% functional improvement in plantar fasciitis patients after three rESWT sessions.

• Research by Scholten et al. (2021) confirmed that devices like the enPulsPro improved mobility and reduced pain in lateral epicondylitis, emphasizing rESWT’s safety and versatility.

Conditions and Protocols

rESWT is most effective in conditions involving chronic inflammation, fibrosis, or calcification, including:

• Plantar fasciitis

• Achilles and patellar tendinopathy

• Lateral/medial epicondylitis

• Rotator cuff tendinopathy

• Myofascial pain syndromes

Typical Protocols

• Frequency: Once weekly, 3–6 weeks

• Energy Levels: 60–185 mJ, adjusted per tissue type and tolerance

• Pulses: 2,000–3,000 per site

• Duration: 5–10 minutes

Care - Cont. from page 37

Devices like the enPulsPro allow chiropractors to fine-tune treatments with adjustable frequencies (8–15 Hz) and energy settings, ensuring precision and patient comfort.

Case Example: Plantar Fasciitis

A 48-year-old male with six months of plantar fasciitis unresponsive to stretching, orthotics, or NSAIDs began rESWT. Protocol included 90 mJ energy, 12 Hz frequency, and 2,500 pulses weekly for five weeks. Pain reduced by 50% after three sessions and reached 2/10 on the VAS scale by the fifth. At follow-up, the patient maintained functional gains, walking 5,000 steps daily without discomfort. This case mirrors research outcomes and underscores rESWT’s long-term value.

Safety and Approvals

The FDA has approved rESWT for chronic plantar fasciitis and calcific shoulder tendinitis. Side effects are minor and temporary, typically mild soreness or redness. Contraindications include active infections, malignancy, coagulopathies, and pregnancy. Studies confirm device reliability, consistent energy delivery, and minimal patient discomfort, reinforcing its safety profile.

Integrating rESWT Into Chiropractic Practice

For chiropractors, adopting rESWT expands treatment options while aligning with evidence-based care. Keys to successful integration include:

1. Training: Proper use ensures optimal results and safety.

2. Patient Education: Clear explanations of mechanisms, expectations, and outcomes build trust.

3. Outcome Tracking: Tools like the VAS or FAAM measure progress and document success.

Conclusion

Radial extracorporeal shockwave therapy represents a major step forward in conservative musculoskeletal care. Supported by decades of research and refined by advanced devices such as the enPulsPro, rESWT offers long-term relief for patients suffering from chronic pain and injury. By adopting this technology, chiropractors can provide innovative, evidence-based care that strengthens outcomes and enhances patient trust.

Dr. Davis McAlister, DC, MEd, MS, BS, BA, CSCS, is an author, speaker, veteran, and sports chiropractor with more than 20 years of experience. He coaches strength and conditioning and powerlifting and works with high-performance athletes. He has served as a sideline physician for the WNBA, XFL, PRCA, and more. He holds degrees from Mississippi State, Sul Ross State, and Parker University, including a Doctor of Chiropractic. Dr. McAlister is also a key speaker for Zimmer MedizinSystems. Learn more about this technology at www. ZimmerUSA.com or by calling 800-327-3576.

References

1. Mani-Babu, S., et al. (2020). "The effectiveness of extracorporeal shock wave therapy in common lower limb conditions: A systematic review including quantification of patient-rated pain reduction." Clinical Rehabilitation, 34(2), 259–272. 2. Gollwitzer, H., et al. (2021). "Radial extracorporeal shockwave therapy for chronic plantar fasciitis: A randomized, controlled trial." Archives of Orthopaedic and Trauma Surgery, 141(7), 1021–1030. 3. Scholten, P., et al. (2021). "Effectiveness of enPulsPro radial shockwave therapy for musculoskeletal conditions: A retrospective analysis." European Journal of Physical and Rehabilitation Medicine, 57(6), 789–797. 4. Notarnicola, A., et al. (2022). "Efficacy of radial shockwave therapy for the treatment of lateral epicondylitis: A randomized controlled trial." Journal of Orthopaedic Surgery and Research, 17(1), 72.

Previously published: Feb 2025 The American Chiropractor

Don't miss Dr. Davis McAlister at the 2025 WCA Fall Convention on September 26 for his seminar "The Benefits of Extracorporeal Shockwave Therapy in the Recovery of Muscular Injuries," sponsored by Zimmer Medizinsystems.

Help Patients Control Their Blood Sugar with Clinically Studied Hintonia

Cheryl Myers, Chief of Scientific Affairs and Education at EuroMedica, Inc

The CDC reports that over 97 million Americans aged 18 or older have pre-diabetes—high blood sugar but not quite type 2 diabetes. That’s in addition to the over 38 million Americans who do have diabetes and includes almost nine million adults who are likely not aware they have the condition. 1

The high number of people affected by pre-diabetes may be due to dietary habits (including more availability of snacks and refined foods), hectic schedules, and an increase in sedentary lifestyles. Nonetheless, it is not surprising if your patients have expressed their concerns about high blood sugar or complained about neuropathy symptoms.

While the statistics on diabetes are not encouraging, the condition does not have to be inevitable. Along with the right diet and sensible exercise regimen, one of the best botanicals for anyone with elevated blood sugar or diabetes is Hintonia latiflora.

Hintonia latiflora grows in the Sonoran Desert in Mexico in a very harsh climate, which actually helps create the powerful defensive compounds in the plant that help reduce high blood sugar. It has been clinically studied in Europe for over 70 years and approved for use in people with type 2 diabetes. From the beginning, research showed that hintonia could help people avoid the need to go on medication or reduce medication in individuals unable to control their blood sugar by diet alone.2

In a 2014 study, a dry, concentrated bark extract of hintonia combined with additional nutrients (vitamins B1, B6, B12, folic acid, chromium, zinc, and vitamins C and E) significantly lowered A1C values, fasting glucose levels, and postprandial blood sugar levels. Factoring all of the diabetic symptoms, the scores improved from 4.8 points to 1.3 points at the end of the study. Participants also saw improvements in blood pressure, lipids, and liver values.3

Individuals taking anti-diabetic prescription drugs stayed on their medication throughout the duration of the study, with the hintonia and nutrient combination simply added on to

their existing regimen. By the end of the study, of those still using medication, 39 percent could reduce their medication levels. Some were able to stop their medication entirely.3

In another clinical study, adult participants with type 2 diabetes were provided with the same Hintonia latiflora extract nutrient combination for six months. Once again, for fasting and postprandial blood glucose numbers and A1C levels, hintonia significantly and clinically reduced these numbers. The study also showed that the botanical helped normalize cholesterol and triglycerides.4

One of the reasons that hintonia works so well is that its bark contains a compound called coutareagenin, which stabilizes blood sugar levels by partially inhibiting an enzyme that releases sugar from carbohydrates called alpha-glucosidase, allowing for more stable insulin resistance instead of large peaks and valleys.5,6 It also plays a role in reducing insulin resistance.

Of course, the best route for maintaining blood sugar and overall health is to reduce carbs and eliminate simple carbs altogether and focus more on proteins, healthy fats, vegetables, and fruits. But that can pose a major challenge for many of your patients as they adjust their diets and habits. That’s why Hintonia latiflora, combined with additional nutrients, is so valuable for making a significant difference in patients with diabetes. With over six decades of study to back it up, this clinically proven solution may be exactly the extra push your patients need to normalize their blood sugar again and get on track to optimal health.

References:

1. “National Diabetes Statistics Report, 2020.” Centers for Disease Control and Prevention (CDC) web site. Accessed: June 20, 2025. Available here.

2. Kuhr, R. Oral Diabetes Therapy with an Euphorbiacean Extract. Der Landarzt, 1953. 29(23):1-8.

3. Schmidt M, Hladikova M. Hintonia concentrate - for the dietary treatment of increased blood sugar values: Results of a multicentric, prospective, non-interventional study with a defined dry concentrate of hintonia latiflora. Naturheilpraxis. Feb. 2014. (Translated article).

4. Korecova M, Hladikova M. Treatment of mild and moderate type-2 diabetes: open prospective trial with Hintonia latiflora extract. Eur J Med Res. 2014 Mar 28;19:16.

5. Mata R, Cristians S, Escandón-Rivera S, Juárez-Reyes K, Rivero-Cruz I. Mexican antidiabetic herbs: valuable sources of inhibitors of α-glucosidases. J Nat Prod. 2013 Mar 22;76(3):468-83.

6. Korec R, Heinz Sensch K, Zoukas T. Effects of the neoflavonoid coutareagenin, one of the antidiabetic active substances of Hintonia latiflora, on streptozotocin-induced diabetes mellitus in rats. Arzneimittelforschung. 2000 Feb;50(2):122-8.

Why Personal Injury Should Be One of Your Specialty Segments

by Michael Coates

For many DCs, personal injury (PI) is a loaded phrase they meet with a surge of apprehension.

Attorneys? Lien agreements and letters of protection? MedPay and PIP? Lowball offers and delayed payments? It’s easy to dismiss personal injury as more trouble than it is worth. But here’s the thing: DCs who crack the PI code don’t just survive; they thrive—financially, professionally and in ways that can be transformative.

What is it about PI that turns skeptics into its biggest advocates? The answer might surprise you: Personal injury offers DCs the opportunity to work with patients who stay on their treatment plan for improved health outcomes. These cases involve less paperwork than health insurance reimbursement. And, when approached correctly, PI offers the ability to be paid at or near full out-of-network rates while feeding all other practice segments.

This article explains why PI should be one of your specialty segments and provides tips for how you can increase success in this rewarding field.

Personal injury offers business advantages

Personal injury is not just another specialty. It can be the most lucrative and validating segment of your practice. Unlike traditional health insurance-based care, where treatment caps, denials and low reimbursements are the norm, PI often allows you to bill at full out-of-network rates and for treatment health insurance denies.

Skeptical about being paid in full? Don’t be. When you approach personal injury the right way—by positioning yourself as a value driver through proper intake, providing only medically necessary treatment, documenting the suffering and healing journey through SOAP notes, maintaining billing transparency and making timely and appropriate specialist referrals—you demonstrate your worth and earn every penny of your full fees. This doesn’t mean you’ll always get paid in full: Bad results, dropped patients or attorneys pushing for reductions can happen. Yet, getting all or most of your full-rate bill paid can become the norm in PI when you do it right. Your treatment, documentation and billing are the foundational support for your patient’s pain and suffering, which the attorney

uses to get higher settlements. Good attorneys recognize and appreciate providers who handle PI the right way, rewarding them with full payments whenever possible.

That said, be aware that healthcare insurance reimbursements are shrinking. Fortunately, though, the financial resources available for PI cases are increasing. Many states have recently increased minimum auto insurance coverage requirements, with others planning to follow suit. That means more funds available in PI cases for patients, attorneys and medical bills.

Set yourself up for success

While you need a lot more to successfully navigate the PI space, here are three essential steps to setting yourself up for success:

Master documentation

Poor documentation by DCs is prevalent, an unfortunate truth that gives you a chance to stand out. Your treatment notes are more than medical records—they are the backbone of your payment claims and the foundation of any legal case. Attorneys rely on them to establish the existence and extent of a patient’s injuries and suffering to justify settlement demands. By ensuring your records are detailed, accurate and tell the story of your patient’s suffering and recovery, you increase your chances of securing full or near-full payment.

Mandate transparency

Too many attorneys hide too much from medical providers. The only remedy to this is mandated full transparency. If an attorney requests a bill reduction, require that they share the intended proceeds disbursement breakdown detailing how funds will be allocated. Confirm whether other recovery sources (e.g., MedPay, underinsured motorist coverage or other third-party defendants) exist. Understand your legal rights and those governing attorney ethics in your state. You might be surprised to learn that in most states, you have legal leverage over lawyers to get the information you need to make good business decisions about your bill.

Use the right lien or letter of protection

A proper lien is a contract for deferred payment. Contracts are the protection all commercial businesses use. It’s no different in personal injury. In PI, a well-crafted

continued on page 45

lien or letter of protection (LOP) is your contractual safeguard. Unfortunately, many providers rely on weak, outdated agreements. Make sure your lien and any LOP issued by an attorney include critical provisions, such as fiduciary duties to you, MedPay turnover, settlement transparency and patient payment responsibility. A solid and comprehensive lien or LOP can make all the difference when it comes time to be paid.

Personal injury allows you to lead

In many areas of healthcare, DCs are relegated to the sidelines, seen as supplementary rather than essential. Often, DCs face skepticism, dismissed as fringe or non-essential. PI changes that dynamic. Here, you’re not just part of the healthcare team—you are often the quarterback, diagnosing injuries, directing care and managing patient recovery from start to finish. Attorneys rely on your assessments to establish the medical damages determining the case’s value. Patients depend on you to restore their health and quality of life.

Indeed, PI is the only health segment where chiropractic is the leading medical specialty nationwide. So, lead that charge for your practice!

Document well

Your detailed treatment notes and professional insights are indispensable to attorneys. These documents form the backbone of their cases, establishing the extent of medical damages and enabling them to secure fair settlements. Your role isn’t supplementary, but pivotal. This leadership doesn’t just validate chiropractic—it positions you as a key medical professional whose expertise is essential in both the legal and medical communities.

For patients, the impact is equally validating. PI patients often arrive in acute pain, their lives disrupted by injuries. For many, this is their first experience with chiropractic care. Your treatment restores mobility, function and quality of life. Your medical magic is on full display for you and the chiropractic industry.

Own your new role

PI places DCs at the forefront of the healthcare recovery process. Here are three ways to own this leadership role:

Master the nuances of personal injury

PI has unique requirements for patient intake, documentation, legal processes and negotiation. Invest in education and skill development to navigate the complexities. You lead from the front.

Own your value

Don’t let outdated perceptions diminish your contributions. Highlight the critical role your documentation, treatment and billing play in determining case value and achieving settlements. Support your fees with data attorneys can use to counter adjusters and defense tactics. Doing this right will benefit the patient, their attorney and your practice. While you are a neutral medical professional when it comes to the PI case results, you are an advocate for the healthcare of your patient.

Take decisive action

Success in PI requires proactive effort. Develop skills, implement better processes and control negotiations with law firms. Leadership isn’t passive—step up, and success will follow.

Personal injury provides an opportunity to grow

PI offers three avenues for growing your practice: patients, peers and law firms.

• Patients. When you deliver exceptional care, patients become loyal advocates who will refer others to your office. By educating them about your full range of services, you can grow all your practice segments.

• Peers. PI fosters medical collaboration. Referring patients to specialists who accept liens or LOPs opens opportunities to educate those specialists, building stronger relationships and improving outcomes for shared patients.

Personal Injury -

• Attorneys. Good attorneys value providers who deliver exceptional care, compelling documentation and defensible fees. By doing PI right, you become a go-to provider because your bills can withstand attacks by adjusters and insurance defense attorneys.

What other practice segment offers such diverse growth opportunities? With PI, you gain three distinct funnels to elevate your reputation and expand your practice.

Build relationships

PI gives you an opportunity to build a practice that’s not just bigger, but better—through relationships that truly matter. Here are three action steps for building these relationships:

Create and arm patients who are “raving fans.” When you deliver exceptional care, treat patients as individuals and “wow” them with your expertise, you create raving fans. Equip them with knowledge about all your practice segments through educational emails and testimonials they can share.

Work that peer network. PI naturally fosters medical collaboration, offering opportunities to expand your professional network. When you refer patients to specialists, their positive experiences with your care often speak volumes. Use these connections to educate peers about chiropractic’s value, strengthening relationships and opening doors for mutual referrals.

Be a value driver for attorneys. Stand out by demonstrating how you approach PI and how you avoid practices that can harm a PI case (e.g., diagramming accidents). Focus on value-driven processes like storytelling documentation, supportable bills and timely specialist referrals when appropriate. By remaining neutral and patient-health-focused, you boost settlement values, making you a go-to provider for referrals.

Final thoughts

Personal injury done right is a game-changer. Too many miss the mark without even realizing it, but when you master this segment, the benefits are undeniable—both for your practice and your patients.

Let this article be your starting point, not the finish line, to sharpen your skills, seize the opportunities in PI and transform your practice for your patients, your staff and yourself.

MICHAEL COATES, ESQ., is a California-licensed attorney. Over the last decade, Coates has established himself as a national authority on medical lien law, lien recovery and negotiations. He is a recognized innovator, advocate, coach, instructor and mentor. Having seen the good and bad in the PI business, he has helped hundreds of providers recover millions of dollars from law firms of all shapes and sizes. Coates is the US’s top lien and LOP negotiator. His company, Personal Injury Made Easy, gives providers, owners and staff a true business advantage in the PI space. Coates also has a company that serves as an outsourced lien negotiator for medical providers, personalinjurybillingpros.com. He wrote a book, Personal Injury Made Easy, to help guide providers; it is available on amazon.com. For more information, email mcoates@pimadeeasy.com.

Save the Date: Personal Injury Made Easy

Tuesday, October 21 | 12 PM

Save the date for this exclusive WCA member Help Desk webinar featuring Michael Coates. Registration opens soon. Watch your email for details or visit our education calendar

2025 LEGACY AWARDS

In 2024, the Wisconsin Chiropractic Association introduced a new tradition: the WCA Legacy Award.

This award recognizes and honors WCA members who have demonstrated 25 years or more of dedication, service, and commitment to advancing the chiropractic profession in Wisconsin.

It reflects the WCA’s deep appreciation for the contributions of our long-standing members and their continued support of the our mission: to advance the chiropractic profession and empower our members to better serve their patients, their communities, and each other.

Join us at the Legacy Award Reception on September 26

This year, our 2025 Legacy Award recipients will be recognized at the Legacy Awards Reception on Friday, September 26 from 5-7 PM. The event will take place at the Fall Convention, located at the Kalahari Resort & Convention Center. All convention attendees are invited to join us at the reception and to take part in celebrating the legacy of our 2025 recipients.

Meet our 2025 Legacy Award Recipients:

Go ahead, make your day.

Compliance Isn’t Optional: Why Now Is the Time to Get Your Practice in Order

Dr. Ray Foxworth, DC, FICC | Founder and CEO of ChiroHealthUSA

W ith recent decisions by the U.S. Supreme Court reshaping how healthcare fraud enforcement works, chiropractors have a critical opportunity—and responsibility—to ensure their practices operate compliantly and profitably. (Elberg, Adashi, & Cohen, 2025)

While these rulings may limit the government’s ability to pursue fraud through administrative channels, they also shift more responsibility onto providers to get things right. If your documentation, billing, or discount policies are slightly out of line, this isn’t the time to take chances. It’s time to get your house in order. At ChiroHealthUSA, we believe compliance and profitability can—and should— go hand in hand. Let’s explore what’s changed, why it matters, and how tools such as ChiroHealthUSA and ChiroArmor can help protect your practice.

The Legal Landscape Is Changing

Two Supreme Court rulings—Jarkesy v. SEC and Loper Bright Enterprises v. Raimondo—have limited the government’s ability to enforce laws through agency-run proceedings. For chiropractors, enforcement actions will likely shift from fast-moving administrative processes to slower, more expensive courtroom battles. That may sound like a break—but in reality, it means more legal ambiguity, more risk, and higher stakes if your practice ever faces scrutiny.

If there’s one message providers should take from these decisions, it’s this: compliance isn’t just about avoiding penalties—it’s about protecting your future.

Clean Up Your Processes from the Front Desk to the Back Office

Compliance isn’t a one-person job. It’s a system—and everyone in your practice plays a role. Every detail matters from front desk staff managing time-of-service collections to doctors documenting services and coding visits correctly.

Now is the time to audit your processes:

• Are your notes accurate and consistent?

• Are your discounts legal and documented?

• Are you billing for services actually rendered?

• Does your team understand the “why” behind the rules?

If you’re not 100% sure, it may be time to bring in reinforcements.

Outsource Your Compliance with ChiroArmor

One of the smartest moves a busy practice can make is outsourcing compliance to a trusted partner. That’s where ChiroArmor comes in. Designed specifically for chiropractic offices, ChiroArmor offers a full suite of compliance

continued on page 52 See Dr. Ray Foxworth in person for his seminar "Risky Business: Navigating the Financial Risks in Healthcare" at the 2025 WCA Fall Convention on Friday, September 26.

- Cont. from page 51

services—from documentation audits and HIPAA training, to billing oversight and customized policy creation.

Think of ChiroArmor as your in-house compliance department—without the payroll. They handle the details so you can focus on patient care, confident that your practice is protected from costly mistakes, outdated procedures, or unintentional fraud.

Offer Discounts the Right Way with ChiroHealthUSA

Many practices try to attract or retain patients by offering "special rates" or unstructured discounts. While well-intentioned, these efforts can land you in hot water with insurance contracts and federal regulations.

That’s why thousands of chiropractors use ChiroHealthUSA’s Profitable Discount Strategy. We provide a legal framework for offering compliant, affordable discounts to your cash, underinsured, or non-covered patients.

You stay compliant, your patients get the care they need, and your practice grows profitably and ethically.

Don’t Wait Until It’s Too Late

Supreme Court rulings may slow down enforcement, but they won’t eliminate it. In fact, with more cases likely heading to trial, the financial and reputational risks of non-compliance are higher than ever.

Don’t gamble with your livelihood. Whether you're fine-tuning your billing procedures, implementing a compliant discount strategy, or outsourcing your entire compliance process, now is the time to act.

ChiroHealthUSA and ChiroArmor are here to help you build a profitable and fully protected practice. Schedule your free compliance Gap Analysis today!

Let’s get your practice in order—the right way.

Dr. Ray Foxworth, DC, FICC, is the visionary behind ChiroHealthUSA, serving as its esteemed founder and CEO. With over 39 years of dedicated service in chiropractic care, Dr. Foxworth has navigated the complexities of billing, coding, documentation, and compliance firsthand. His rich experience includes roles as the former Staff Chiropractor at the G.V. Sonny Montgomery VA Medical Center and past chairman of the Chiropractic Summit and the Mississippi Department of Health.

Dr. Gene Yellen Shiring, US Senator Tammy Baldwin (D-WI) and John Murray, WCA Executive Director at a recent fundraising event in Madison.

Dr. Gene Yellen Shiring, Congressman Mark Pocan (WI-2) and John Murray, WCA Executive Director at a recent event in Madison.

Dr. Gene Yellen Shiring, State Senator

Melissa Radcliffe and WCA Executive Director John Murray at a recent fundraising event for US Senator Tammy Baldwin (D-WI).

The Hidden Risks in Chiropractic Documentation— and How to Fix Them

by Rebecca Scott, CPC, CPCO, CPB, CPPM

In today’s ever-changing compliance environment, chiropractic providers face increasing pressure to not only deliver excellent patient care, but also to prove—through documentation—that their care was medically necessary and appropriately billed.

Unfortunately, errors in documentation are one of the most common reasons for audits,recoupments, and compliance penalties in chiropractic practices. The good news? With the right systems in place, practices can protect themselves while boosting revenue and patient trust.

Why Documentation Matters

Too often, documentation is seen as a burden rather than a tool. Yet, accurate and complete documentation is the single most important line of defense when payers, auditors, or regulators come knocking.

Without it, practices risk:

• Claim denials and lost revenue

• Recoupment of previously paid services

• Legal or compliance penalties

• Damaged relationships with patients and insurers

The stakes are high, and it’s no longer enough to “just get by.” Practices need a proactive plan for documentation and billing compliance.

Common Pitfalls in Chiropractic Documentation

Through my work with practices across the country, I see the same issues come up again and again:

• Copy-and-Paste Records: While templates can save time, over-reliance can create identical notes that raise red flags in audits.

• Insufficient Detail: Notes that don’t reflect the patient’s condition, progress, or rationale for care leave providers exposed.

• Incorrect Use of Codes: Failing to link codes to the correct diagnosis or using time-based codes inaccurately can quickly lead to compliance risk.

• Neglected ABN Protocols: Misunderstanding how and when to use Advance Beneficiary Notices (ABNs) is a top trigger for Medicare audits.

Practical Steps Toward Compliance

Improving documentation doesn’t require an overhaul overnight. It’s about steady, practical steps that create habits and consistency.

Some of the most effective strategies include:

• Audit Yourself Before Someone Else Does: Conduct internal chart reviews or engage an external consultant to identify gaps before auditors find them.

• Train the Whole Team: Documentation isn’t just the doctor’s job. CAs, billing staff, and compliance officers all play a role in ensuring claims are correct and defensible.

• Focus on Medical Necessity: Every note should clearly answer: Why did the patient need this care today?

• Use ABNs Correctly: Ensure staff know the difference between covered and non-covered services and use ABNs appropriately.

Turning Risk Into Opportunity

One of the most exciting shifts I see in practices that prioritize documentation is the sense of empowerment that comes with compliance confidence. Instead of fearing audits, providers feel assured that their records will withstand scrutiny. Instead of leaving money on the table, they see cleaner claims and faster reimbursements. Patients, too, gain confidence when they know their provider runs a compliant, professional practice.

Final Thoughts

Compliance isn’t about checking boxes—it’s about protecting your practice, your patients, and your peace of mind. By improving documentation habits now, chiropractic offices can avoid costly mistakes and move forward with clarity and confidence.

● Same- and next-day appointments with evening and weekend hours

● Subspecialized and DACBR radiologists who interpret patient exams and are available for consult

● Customized protocols:

● Weight-bearing imaging

● Flexion/extension imaging of the spine for a detailed diagnosis

● MRI options:

● 3T

● High-field open

● High-field wide-bore

Wisconsin Practices For Sale

1/2 Hour NW of Milwaukee. Fully equipped office with excellent lease. All cash practice, collected at time of service! Gross $474,105. Skilled staff. Doctor retiring. Financing available.

Milwaukee. Close to freeway & Lake Michigan. Asking only $70,000 including seller transition assistance.

Wausau. Solid referral practice. $127,626 gross in 3 days/week. Poised for growth! Very low overhead. Balanced cash-ins mix. In-network most major med plans. 2 part-time CA’s. Div, some Act.

Milwaukee. Practice and building for sale in high-demand location. Attractive apartment upstairs. $338,000 gross. Low overhead. Doctor retiring and will provide assistance for smooth transition. Financing available.

Manitowoc/Two Rivers Solid practice with secure income and quality lifestyle. Located in one-story professional building with parking lot. Steady $243,000 gross. Very low overhead, rent only $1,406/mo.

Wausau. Interested in learning Functional Medicine? Dr will provide training. Learn techniques to complement your adjusting skills. This is a cash practice with $176,000 net operating income.

Stevens Point/Plover. Consistent, solid family referral practice. Ideally located. 530 patient visits per month. $508,269 gross. Experienced staff and favorable lease. Doctor retiring.

Contact Loren Martin, Practice Opportunities, Inc.

Phone: (952) 322-1177

Email: martin@practiceop.com Website: www.practiceop.com All

State Representative Clint Moses (R-Menomonie) with Assembly Majority Leader Tyler August (R-Walworth) at a recent event in Chippewa Falls.

Dr. Michael Court, WCA NW District Board Member with State Representative Clint Moses (R-Menomonie) at a recent event.

WINDING DOWN?

You have spent your entire career developing and growing your practice. Now is the time to look ahead. If you do not have an exit plan, LSM may be your solution. Consider joining this large, patient-centered practice and see how smooth your move to retirement can be. Please contact Sarah Pavlik at 608-316-6972 or spavlik@lsmchiro.org for more information.

STUCK OR PLATEAUED?

Running a chiropractic practice is not easy. Consider joining with LSM to revitalize your career. With 18 clinics, support staff and the latest technology, LSM can help you flourish. All benefits including healthcare, dues, malpractice and 401K plan. Work as the Chiropractor you were meant to be. Please contact Sarah Pavlik at 608-316-6972 or spavlik@lsmchiro.org for more information.

DOC FOR A DAY - JOIN OUR LOCUM TENANS TEAM!

Are you semi-retired, between positions or looking for extra income? Like the thought of being able to assist other chiropractors who need time away? Doc For A Day is a locum tenans company that assists clinics while the doctor needs time away. We are looking for coverage doctors to help us fill this growing need. We assist with not only vacation time, but maternity leave, surgery recovery, illness and semi-permanent coverage. Must have current chiropractic license & malpractice insurance. We have seasonal and year-round coverage needs all over the state of Wisconsin. Call or Text Maggie: 847-367-9641 or info@docforaday.com

THE WELLNESS WAY: PROTEIN CALCULATOR

Determine your optimal protein intake with our brandnew protein calculator. Launched in unison with our Protein Optimization Guide, our calculator uses a special formula that outputs the ideal intake for optimal health. Enter your weight, activity level, and fitness goal for a Wellness Way suggested daily allowance.

Want to host the calculator on your website? Download our FREE official WordPress plugin now to host the calculator on your own website. Customize the calculator to match the styles and colors that emulate your brand. It's even possible to customize your own formula to come up with different recommendations. Plus, explore our other popular resources, like the transformative "Power of Protein Challenge" and the game changing "No Sugar Challenge."

OFFERING $5,000 SIGN-ON BONUS FOR WISCONSIN DOCTORS! JOIN OUR TEAM OF 150+ DOCTORS AND 130+ CLINICS!!

• Resident-In-Training Program starting with competitive compensation.

• Full-Curriculum-based learn program and leadership development.

• Flexible work week.

• PTO, parental leave, 401k, medical, dental, and vision options. Average salary of $150k-$200k across multiple markets. We are one of the largest privately-owned, fastest growing, chiropractic companies in the country complete with experienced teams of specialists including: marketing, clinical operations, legal, revenue cycle, HR, IT, maintenance, and more!! This robust team allows our doctors to focus on great patient care. Contact: claudia.wright@ medullallc.com or Call: 708-595-5227

WISCONSIN PRACTICES FOR SALE

• 1/2 Hour NW of Milwaukee. Fully equipped office with excellent lease. All cash practice, collected at time of service! Gross $474,105. Skilled staff. Doctor retiring. Financing available.

• Milwaukee. Close to freeway & Lake Michigan. Asking only $70,000 including seller transition assistance.

• Wausau. Solid referral practice. $127,626 gross in 3 days/week. Poised for growth! Very low overhead. Balanced cash-ins mix. In-network most major med plans. 2 part-time CA's. Div, some Act.

• Milwaukee. Practice and building for sale in high-demand location. Attractive apartment upstairs. $338,000 gross. Low overhead. Doctor retiring and will provide assistance for smooth transition. Financing available.

• Manitowoc/Two Rivers. Solid practice with secure income and quality lifestyle. Located in one-story professional building with parking lot. Steady $243,000 gross. Very low overhead, rent only $1406/mo.

• Wausau. Interested in learning Functional Medicine? Dr will provide training. Learn techniques to complement your adjusting skills. This is a cash practice with $176,000 net operating income.

• Stevens Point/Plover. Consistent, solid family referral practice. Ideally located. 530 patient visits per month. $508,269 gross. Experienced staff and favorable lease. Doctor retiring.

Contact Loren Martin: Practice Opportunities, Inc.

P: 952.322.1177 | Email: martin@practiceop.com | www.practiceop.com. WCA Member/Licensed Broker

DOC FOR A DAY, LLC: WE'VE GOT YOU COVERED!

Our professional locum tenans doctors are ready to fill in for you while you are away. Vacation, surgery and recovery, maternity leave, and semi-permanent coverage. All of our Docs are licensed, insured, experienced and have had background checks. Contact us to schedule your time off today!

Call or Text Maggie: 847-367-9641 or Email: info@docforaday.com

EQUIPMENT FOR SALE - RIVER FALLS, WI

Newer Zerona Z6, Non-invasive, cold laser for fat loss. This is the only treatment FDA market cleared for overall body circumference reduction. Very lightly used. Bought to partner with staff member but their plans have changed. FREE DELIVERY anywhere in WI. Safe & effective with very easy set-up.

Asking $17,000. If interested, Email: jazsky@aol.com Click here to learn more.

PRACTICE OPPORTUNITY

Well established (32 years) chiropractic office located in Fond du Lac. I am hoping to retire in the next 2 to 4 years and I have an office sharing opportunity for a self-motivated doctor or doctors to establish and build their independent practice and assume my patient base upon my retirement. I am NOT looking to hire an associate.

The office is located on one of the busiest throughfares in Fond du Lac. Fully furnished and equipped - including adjusting and exam tables, therapy equipment, digital x-ray system, practice management, and clinical documentation software. There is a large parking lot with ample spots for patient and staff parking. Signage for your practice on building exterior as well as in a large lighted sign bank near the road.

Reasonable graduated rent structure to allow you to focus on building your practice rath than on overhead and startup cost debt. Immediate practice buyout is open for discussion.

Contact Dr. Jeff Walters: Preferred Chiropractic

O: 920.924.9600 | Email: fdlprefchiro@gmail.com | C: 920.948.8141

PRACTICE FOR SALE - THIENSVILLE, WI

In the center of affluent Mequon, WI is Thiensville, WI - a quaint town on the beautiful Milwaukee River. Practice for sale is located in a stand-alone building with the best parking on Main Street shared with two massage therapists and a nurse practitioner. Doctor only working 1 1/2 days per week and averages 100 visits per month with a long standing 19-year patient base. Averaging $6000 / month collections. Owner financing available. Price, equipment, and office lease is negotiable.

Text: 262-384-1274

Email: artofwellnesschiro@sbcglobal.net Click here to learn more.

ASSOCIATE WANTED - LA CROSSE, WI

Looking for a motivated associate to join high volume family referral practice. Staff of doctors and upbeat supportive members provide a welcoming environment for employees and patients. Credentialed on most insurance plans. Generous compensation commensurate with ability.

Contact Loren Martin: Practice Opportunities, Inc. P: 952.322.1177 | Email: martin@practiceop.com

JOIN OUR TEAM AT THE WELLNESS WAY!

We're seeking a passionate, motivated Chiropractor to join our growing team! At The Wellness Way Green Bay, we do health differently - focused on restoring health where others can't. Enjoy a supportive, dynamic environment with training, wellness perks, and a steady patient base. Full-time position (Mon-Fri) with occasional events. Benefits include dental, vision, PTO, and more. Must have an active Chiropractic license, strong diagnostic skills, and a commitment to excellent care. Knowledge of The Wellness Way approach is a plus.

Ready to make a difference in healthcare? Apply today!

• Email: kkoehler@thewellnessway.com

• Phone: 920-429-2844

NOW HIRING MULTIPLE ASSOCIATE POSITIONSNORTHEAST

WISCONSIN

Associate DC position(s) available in an award-winning practice based out of Northeast Wisconsin. Ability to potentially run your own practice someday if you are the right candidate. Starting pay range is $70,000$120,000, company paid malpractice insurance and continuing education after 2 years, $5000 Student Loan forgiveness every 5 years, IRA match, health insurance reimbursement, PTO, and paid maternity/paternity leave.

• Job Type: Full-time

• Pay: $70,000 - $120,000 per year

• Benefits: Employee Discount, Health Insurance, PTO, Professional Development assistance, Retirement Plan, and Tuition Reimbursement.

***If you're someone motivated and willing to grow with a passion for chiropractic; please apply! ***

Email: drbuss@thechiroadvantage.com Click here to learn more

OFFICE SHARING OPPORTUNITY

Looking for professional office space within an established chiropractic practice? Caledonia Chiropractic Clinic in Racine, Wisconsin offers a unique opportunity for a chiropractor to rent space in a collaborative, supportive environment. Our goal is to find a self-motivated doctor to build their independent practice in our low tech, patient centered office, eventually purchasing our practice upon my retirement.

Our office is 1850 sq. ft. in a professional building located in a busy area in northern Racine. This is a great opportunity to develop and grow your own practice without many of the up-front costs associated with establishing a practice. Flat monthly rate.

To learn more, contact Timothy Schneider, D.C. at:

• Email: Caledoniaclinic@gmail.com

• Phone: 262-681-8829

ASSOCIATE WANTED - OWN YOUR FUTURE IN JEFFERSON, WI!

Join our vibrant, 40-year rural practice in charming Jefferson, WI! Seeking a motivated DC eager to experience Chiropractic care at its best and serve patients. Potential ownership within 3 years. Earn a $50k-$75k base salary + collection bonuses, with mentorship to run a thriving clinic. Enjoy a family-friendly, "Mr. Roger's Neighborhood" community, 4-day workweek, and paid malpractice.

Please email resume to: southcentralwichiro@gmail. com to shape lives and your legacy!

EQUIPMENT FOR SALE - GREENFIELD, WI

If interested in either piece of equipment below, please contact Eileen at: 414-281-5266

• Pictures available upon request.

• Must pick up.

Hydromassage Table

• Sidmar Pro S10 (2003). Asking $1,250. New Tables sell for $3,799.

• Great Condition - Like New - Well taken care of with Blue heated upholstery.

• Not many running hours on this table.

• Parts are still available at Sidmar.com

Zenith Hi Lo Chiropractic Table

• Cream colored base with tan leather upholstery in good condition.

ASSOCIATE WANTED - BRILLION, WI

Are you a passionate and driven chiropractor looking to make a real impact on patients' lives? We want YOU to join our dynamic, patient-centered practice!

Groskopp Chiropractic is a well-established, thriving clinic committed to helping our community by delivering effective treatments while building lasting relationships.

• Earn above-average compensation with opportunities for bonuses and growth. IRA match, health insurance reimbursement, paid CE, malpractice, license renewal, etc.

• Enjoy flexible hours and a positive work environment.

• Work in a modern, fully equipped clinic with the latest technology.

• Be part of a practice with an established, loyal patient base, plus build your own clientele. 25+ new patients a month.

If interested, contact: davemeyerdc@gmail.com

WE’RE HIRING AN ASSOCIATE CHIROPRACTOR AT GROUNDED ROOTS CHIROPRACTIC!

Location: Sheboygan, Wisconsin

Start Date: Looking to hire right away - but can be flexible on start date.

Click here for clinic details & benefits package.

We’re looking for a passionate, driven chiropractor ready to make a difference in our thriving, wellness-centered community. Our office is rooted in neurological-based chiropractic care with a special focus on prenatal, pediatric, and whole family wellness. We serve young families, growing mamas, and those committed to creating the healthiest versions of themselves.

What We’re Looking For:

• Someone coachable, committed, and confident

• A strong adjuster who educates and inspires patients

• Someone aligned with a holistic lifestyle and wellness mindset

• A heart to abundantly serve and a passion for community connection

• Certification (or willingness to become certified) in TRT, MC², Webster Technique, and PX-pediatric care

• An energy giver, team player, and someone eager to grow with us long-term

If you’re ready to step into a practice where your purpose meets your passion, we’d love to hear from you! Email a resume, cover letter and a short video of why you would be a great addition to our Grounded Roots Tribe to: drerika.groundedrootschiro@gmail.com

ASSOCIATE WANTED - NEENAH, WI

Busy chiropractic team looking for an associate. We have multiple clinics throughout the Fox Valley. Our clinics are growing, and we need another DC to be the clinic director of our Neenah location. Fully furnished office and new patients are provided. Our associates focus on diagnosing patients, giving treatment plans, and follow through on patient care.

Benefit package for new associate doctors:

• Starting salary $50,000-$65,000 with the potential to make upwards of $100,000.

• Malpractice insurance covered.

• Continuing Education (CE) allowance

• 2 weeks paid vacation/PTO & paid sick time.

• 401k matching

We are Integrity Doctor clients and have awesome clinic systems in place. Interested? Please email resume to: drdornchiro@gmail.com

ASSOCIATE WANTED - GREATER MILWAUKEE AREA

Chiropractic Company is a rapidly expanding group of clinics in the greater Milwaukee area, and we are currently looking for associate doctors. We are unique in the profession in that doctors have the opportunity to advance from associate to clinic director, to shareholder in the corporation all based on their personal performance.

In addition to a salary and bonus structure we also offer health insurance, short term and long-term disability insurance, and a matching 401k plan. Continuing education, chiropractic coaching, 50% off a gym membership, license, CPR training, and malpractice insurance are also covered benefits of working with the Chiropractic Company.

For more information go to: www.chiropracticco.com/ careers OR Email: drmcleod@chiropracticco.com

JOIN OUR FAMILY AT BACK IN ACTION CHIROPRACTIC!

Back in Action Chiropractic in Baraboo, WI is seeking a passionate chiropractor to join our family-based, patient-centered practice. We offer a supportive team environment, strong patient base, competitive compensation, and mentorship opportunities. If you're licensed (or eligible) in Wisconsin, compassionate, and eager to grow both personally and professionally, we'd love to hear from you! Join our mission to help families thrive!

Interested? Apply by emailing your resume and cover letter with the subject line "Chiropractic ApplicationBack in Action Chiropractic"

Email: DrJason@BackInActionBaraboo.com

OUTSTANDING OPPORTUNITY! - ADAMS, WI

FREE 20 yr clinic when you rent building for 5 years. Large apartment upstairs available on separate lease. Outstanding opportunity for New Doctor wanting private practice. Doctor retiring. If interested, please call: 608487-1959. Click here to learn more.

CLINIC WANTED FOR PURCHASE - GREATER MILWAUKEE AREA

Chiropractic Company is currently looking to purchase a clinic in the Greater Milwaukee area. If you have interest in selling, a merger or are contemplating retirement and need an exit strategy:

Please contact: Kent McLeod at 414-213-4808 or drmcleod@chiropracticco.com or visit chiropracticbuyers.com for additional information.

EQUIPMENT FOR SALE - NEKOOSA, WI

Best offer on all items. Buyer must arrange transportation.

• Zenith 240 electric adjustment table

• Free standing adjustment table

• Metal professional office desk

Interested? Contact Angela Bulgrin:

• Email: OLDFOLKS24@hotmail.com

• Phone: 715-886-5452

• Click here to learn more

ASSOCIATE WANTED - STATEWIDE

Are you a self-motivated Chiropractor? We’re looking for someone like you to join our growing team at The Wellness Way! If you’re passionate about quality patient care and wellness, we want to hear from you. You’ll have the opportunity to manage a solid new patient base in a rapidly expanding practice, and we’ll provide training you need to run a successful practice.

We Offer:

• Benefits: Dental and vision, PTO, and life insurance.

• Training: Comprehensive training to help you thrive in our unique approach to wellness.

Responsibilities:

• Adjusting and managing patient care.

• Providing lifestyle improvement tips to patients.

• Tracking patient information and maintaining detailed records of conditions and care.

Sound like a good fit? Reach out to Ashley Zeutzius:

• Email: azeutzius@thewellnessway.com

• Phone: 920-569-6882 Ext 138