April 2006

Introducing ...

A member of the International Scientific Advisory Panel

When David Jackson, DC; Matthew McCoy, DC; and Robert Blanks, PhD founded Research & Clinical Science (RCS), they realized that the credibility and validity of the program would rely in great part on the quality of researchers chosen to analyze the data collected by chiropractors around the world.

They sought out a world‑class group of respected scientists with unimpeachable credentials and proven expertise in health care research. The result of their efforts was the RCS International Scientific Advisory Panel, a multi‑disciplinary group charged with overseeing the collection of, and analyzing, data compiled on hundreds of thousands of volunteers and chiropractic patients across the globe.

Each month during this special series, The Chiropractic Journal profiles one member of this prestigious panel.

Mimi Sutherland, BSN, RN, MPH

Elderly Americans are the most rapidly growing segment of our society. Currently, those eligible for Medicare (65 years old or older) represent 11.9% of the overall US population and this number is expected to grow steadily to 20% by the year 2050, according to the US Census Bureau.

Medical and health insurance literature indicate there is a strong correlation between age and health care costs: Health care costs rise with age and are highest during the last year of life.

One of the newest members of the RCS International Scientific Advisory Panel members is Melinda (Mimi) Sutherland, BSN, RN, MPH.

In joining the panel, Sutherland brings with her 13 years of experience as a practicing as a geriatric nurse, and 13 years experience as an insurance broker specializing in health insurance products for Medicare‑eligible individuals. This combination of fields gives her a unique view of the challenges facing the health care infrastructure in the US.

In particularly, it has given her the ability to help patients deal with the confusion with the burgeoning new insurance products implemented since passage of the Medicare Drug Improvement and Modernization Act of 2003, also known as the Medicare Modernization Act (MMA).

Sutherland entered the field of nursing because she "just always loved caring for people." She completed her nursing training at the University of the Incarnate Word Nursing School in San Antonio, TX where she graduated with Summa Cum Laude in 1993.

She then completed her Masters Degree in Public Health from the University of Texas in Houston where she graduated ‑‑ again Summa Cum Laude.

In pursuing her love of nursing and caring for the elderly, she conducted her master's thesis topic on new integrative systems of health care for seniors called PACE (Programs of All‑Inclusive Care for the Elderly).

Continuity of care and the seamless integration of health services have become serious issues in public health, and these are the questions that have also guided Sutherland's career choices over the years.

She first discovered chiropractic as a result of a personal health crisis. During her nursing training, she suddenly became plagued by severe bouts of migraine headaches. In spite of numerous tests and treatments, conventional medical care had little or no effect.

At one point she even considered dropping out of nursing school, because of the debilitating nature and the frequency of the headaches (50 events over the six month period).

In desperation, she self‑referred to a local chiropractor who correctly detected a problem with the atlas complicated by a recent whiplash injury, and began regular chiropractic care. The headaches stopped within a matter of weeks and she has been symptom free for the past 12 years.

Her son‑in‑law is a chiropractor and a graduate of Parker College of Chiropractic in Dallas. Sutherland and her family receive regular chiropractic care and she routinely recommends chiropractic and other complementary and alternative health services to her patients.

Sutherland describes the chiropractic lifestyle as the ideal preventative health model and believes that "people undergoing regular chiropractic care are proactive rather than reactive about their health, and this is the way it should be."

In her role as nurse case manager, Sutherland spends many hours conducting regular visitations and discussions with small groups of seniors, "baby boomers" who are caregivers for their parents and grandparents, and providers and residents in nursing homes, assisted living facilities, senior centers and private homes.

She serves on the board of the largest senior service organization, Christian Senior Services, in San Antonio. This organization assesses the health, nutritional, physical and spiritual needs of seniors through three innovative programs 1) Meals on Wheels which delivers 2700 hot meals daily to shut‑in seniors, 2) the Senior Companion Program which trains seniors to help other seniors, and 3) Grace Place, with two locations in San Antonio, which are Adult Day Care Centers for Alzheimer's patients and their caregivers.

Additionally, as an insurance broker, she coordinates Medicare health benefits for major employers in the region. She has the ideal background to guide employers through the complexities of the Medicare Modernization Act (MMA). Medicare‑eligible individuals comprise a large part of the US work force. The MMA has become not only a major asset for seniors, but also for employers who can transfer much of the cost of health insurance for eligible employees to Medicare at considerable savings to the company.

The new MMA programs can be confusing, Sutherland admits, but she explains that plan selection depends greatly upon what type of medication the patient is taking. For example, Gleevec is a drug used for treatment of leukemia. Under the new Medicare reforms, the patient requiring this medication pays only $720/yr co‑pay and Medicare PDP premium costs of $420/yr. The actual cost before the Medicare reform act was $28,000/yr. While this is an extreme exception, the average drug cost savings under the new Medicare PDP plan is 50%.

She also clarifies the new relationship forged between private insurance companies and the Medicare Administration. In a bold step, the MMA privatizes a large part of the health services for seniors. The new products (MA‑PD, PFF, PDP) must be purchased from private insurance companies, and there are between 40‑60 different companies offering these products. The federal government is heavily subsidizing the new Medicare plan. However, the insurance companies are under partnership agreement with the government to return part of profits back to help subsidize Medicare. The thinking is that private insurance companies are better set up manage medical costs than the government.

Sutherland looks forward to obtaining health statistics from RCS data repository, evaluating these data in relation to the current health trends, and publishing the results in support of evidence‑based chiropractic.

She points out that prescription drug utilization in the United States is high, particularly among seniors. Medicare recipients in the institutional setting are taking an estimated 18 different prescription medications; the number is only slightly lower (12 or more) for Medicare recipients in community dwelling situations.

Thus, whereas the potential for PDP drug savings for the patient is substantial, the added cost to the government to manage health status under the MMA is substantial. It is hoped that a greater understanding of the health benefits of the chiropractic lifestyle can improve the general health of the population. Such a wellness trend across all age groups could ultimately impact the accumulative cost of medical services for individuals, with a potential cost savings to MMA as these healthy individuals enter the Medicare system.