Private Practice, Greenwich, Connecticut, 1979 – Present
EDUCATION AND LICENSURE
Doctorate of Chiropractic, New York Chiropractic College, Old Brookville, New York, 1979
Residency: Columbia Outpatient Facility, 1977-1980.
Assistant Clinical Director: Columbia Outpatient Facility, 1979-1980.
Doctor of Chiropractic, Licensed in the states of:
New York, License #1979-82
Connecticut, License #270
National Board of Chiropractic Examiners, Part I & II, 1979
BS in Biological Science, Stony Brook University, New York, 1976
Adjunct Associate Professor: University of Bridgeport Chiropractic College, Department of Clinical Sciences.
Differential Diagnosis Instructor: 1994-1996.
Radiological Anatomy Instructor: 1990-1996.
Faculty Advisor to the Gonstead Technique Group.
SELECTED HONORS AND AWARDS
Distinguished Service Award, Director at Large, Board of Directors,
Connecticut Chiropractic Association 2003-2005,
Connecticut Chiropractic Association 1979 – Present
American Chiropractic Association 1979 – Present
New York Chiropractic College Alum. Association 1979 – Present
Stony Brook University Alum Association 1976-2001
Board of Directors, Director at Large, Connecticut Chiropractic Association 2003-2005
Director of Membership committee
Board directors members responsible for supervision and coordination of
finance, legislative, insurance and National Association members
Board of Directors, Wellspring Center for Natural Healing, 1997-2002.
“Not-for-profit “Natural Health Center based in Ashland, Oregon, annex in Darien Connecticut; under the direction of Donald Yance. Responsible for supervision and coordination of health care center’s financing and professional staff appointments.
Greenwich Hospital, Courtesy Privileges, Department of Radiology, outpatient referrals for diagnostic imaging including: MRI, CT, Diagnostic Ultrasound, Radiological Modalities, and interdepartmental referrals.
Guest Lecturer New York Medical College, Chiropractic liaison to medical residents for Complementary and Alternative Medicine
Yale New Haven Health Services, Chiropractic Consultant for Workers’ Compensation Medical Care Plan, Greenwich Hospital Network of providers. 2009-2012
American Fitness Institute, Chiropractic Consultant for Physical Therapy Department, 1982-2014. Chiropractic Consultant responsible for supervision and coordination of center’s Chiropractic interprofessional referrals. Michael Acocella RPT, Director, 500 West Putnam Ave, Greenwich CT.
Peak Wellness Health Center, Chiropractic Consultant for Physical Therapy Department, 1997-2010. Chiropractic Consultant responsible for supervision and coordination of center’s Chiropractic interprofessional referrals. Carlon Colker MD, Director, 195 Field Point Rd. Greenwich CT
MEDIQ Review Services, Chiropractic claims, conducted physical examinations and reviews for patient “medical necessity” evaluations, 1990-1995.
CMME of New England, Chiropractic claims, conducted physical examinations and reviews for patients ”medical necessity” evaluations, 1994 –1996.
The Travelers Insurance Company, Medical Review Services, Case Manager Liaison for Chiropractic claims, 1994-1996.
Connecticut Conference of Municipalities
Greenwich- Representative Town Meeting (RTM)
Elected Member District 11: North Central District, 1983- 2005.
Planning and Zoning Committee, 1983-1985.
Finance Committee, 1985 –1986.
Health and Human Services Committee, 1986-2005.
TECHNICAL AND CLINICAL EXPERTISE
Motion Palpation Institute, Gonstead Technique,
Cox Flexion Distraction technique, Thompson, Palmer, and Diversified Techniques. Presently in hiatus for Manipulation under Anesthesia Program, Institute for Manual Medicine, Temple Hospital, Houston Texas, affiliate of Texas A&M.
Certificate in Workers Compensation Impairment Evaluation. Over three decades of trial experience as treating physician and/or expert witness on numerous Personal Injury and Workers Compensation cases.
SELECTED POST-GRADUATE EDUCATION, CERTIFICATIONS AND DIPLOMATES
Whiplash Associated Disorder: Stress View Studies and Impairment Rating. Computerized X-ray analysis of the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm. Joint Sponsorship with the University of Bridgeport Chiropractic College and the Connecticut Chiropractic Association, April 2017
Neurology of Ligament Pathology, the neurology of ligaments (strain/sprain) and the permanent implications of trauma. Mastermind with vascular neurologist Academy of Chiropractic Post Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards April 2017
Spinal Biomechanical Engineering, Triage and Documentation, Utilizing principles and algorithms of spinal biomechanical engineering to analyze chronic and trauma patients in creating diagnostic, prognostic and treatment protocols. University of Bridgeport College of Chiropractic Post-Doctoral Division, Program of Chiropractic Licensing Board.
Physical Therapy 101, the physics and clinical use of microcurrent, cold laser therapy, hydroculation, cryotherapy, high volt galvanism, interferential current, low volt galvanism, ultrasound, electrical muscle stimulation. The practitioner is updated on the development of a clinical management plan utilizing adjunctive therapies. University of Bridgeport Health Sciences Post Graduate Education, February 2017
Evidence based practice, compare different interventions, perform a literature search and report the clinical questions; data based searched, papers found and their quality. The practitioner determines whether a given intervention has quality evidence supporting its use. Connecticut Chiropractic Association approved by University of Bridgeport, Health Sciences Postgraduate Education Department, November 2015
Comprehensive MRI Imaging of the Spine, Everything One Needs to Know. Radiographic presentation of T1, T2, STIR imaging of spinal soft tissue pathologies that clinicians may see in field practice. Connecticut Chiropractic Association approved by the University of Bridgeport, Postgraduate Education Department, November 2012
Chiropractic and Sports Performance, exercises to improve musculoskeletal function, integrate PreActive StretchingSM protocols to improve agility, understand modifying factors for RTP. Compare professional Position Papers, discuss the role of Chiropractors and concussions. Connecticut Chiropractic Association, approved by University of Bridgeport, Health Sciences Postgraduate Education Department, October 2012
Manipulative Therapy for Lower Extremity Conditions, Update of Systematic Review. Physical examination technique for the lower extremities special maneuvers for treatment of the hip, knee, foot and ankle, Connecticut Chiropractic Association, October 2011
Treating the Many Phases of Pain, A Nutritional Approach, summarized protocols for treatment of acute inflammation and nociceptor activation, comparison of the various protocols for selective kinase inhibition modulators and mechanisms of acute repair, nutrients necessary for optimal remodeling during various phases of recovery. University of Bridgeport, Health and Sciences Postgraduate Education Department, May 2011
Breakthroughs & Assessment in the Rehabilitation of Musculoskeletal Injuries & Disorders, Review the causes behind Musculoskeletal Injuries, Contrast the differences between high school, collegiate, and professional athletic injuries, summary of how gold-standard management drives lower injury rates and duration, demonstration of a Kinetic Chain Assessment, discussion of why indirect causes of injury can be disabling due to tissue overuse and overload, contrast and compare male vs female most common extremity injuries, University of Bridgeport, College of Chiropractic, October 2010
Biomechanics of Manipulation-New Research. A short summary of the recent literature on the utility of spinal manipulation, critique a recent study on the importance of cavitation in the autonomic nervous system (ANS) effects of spinal manipulation, review the scientific literature on the validity and reliability of the common methods used by chiropractors to inform the choice regarding where spinal manipulation is to be applied once it is deemed an appropriate treatment, explore biomechanical and neurophysiologic mechanisms of manipulation.Connecticut Chiropractic Association, Connecticut, January 2010
MRI Interpretation of Spinal Cord, Spinal Disc and Spinal Canal Disorders, MRI Interpretation of herniated, protruded, extruded, bulged and sequestered discs & spinal stenosis as sequelae of ligamentous hypertrophy, congenital malformation, spinal cord pathology. Clinical necessity and contraindications. New York Chiropractic Council. New York 2009
McKenzie Technique, Cervical and Lumbar Spine, Robin McKenzie, DPT. Discussion of a dynamic stabilization model for the logical sequence of active rehabilitation. Radiation pain from disc injuries. “Centralization” vs “Peripheralization” of pain during rehabilitation. Review muscles affecting ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes. Description of core muscle activity during physical fitness exercises. Introduction to dynamic neuromuscular (core) stabilization and athletic performance. Introduce the basics of exercise prescription. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, November 2009
Basic Diagnostic Procedures for a Chiropractic Clinic, Recognize the importance of the Review of Systems (ROS) as a means to develop a more complete view of the total patient. Develop and deploy the ROS in a focused and efficient manner. Integrate ROS with other exams and diagnostic tools. Leverage the ROS as a means to expand your diagnostic perspective. Modify, refine or expand the clinical management of the patient by including information from the ROS. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, April 2009
Chiropractic Flexion-Distraction and Decompression Adjusting, Definition of spinal decompression therapy. Demonstration of decompression table structure and use. Description of the relevant anatomy of the lumbar spine. Critically examine published reports of clinical outcomes of decompression therapy. Present and discuss clinical outcomes of decompression therapy. Determine spinal decompression treatment protocols. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, December 2008
An Integrated Approach to Myofascial Pain and Fibromyalgia, Explain the concept of central sensitization and appreciate its relevance in clinical practice, summary of the mechanisms of neural plasticity pertaining to pain perception in the central nervous system, training and positive influence on neural plasticity in the motor cortex in fibromyalgia patients, highlight key components of motor-skill training that provide the greatest potential in rehabilitation, the state of the literature on our knowledge about Myofascial Pain Syndrome. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, October 2008
Rehabilitation of the Spine, Application of core exercise to facilitate improved lower limb mechanics in women. Recognition of the connection between improved lumbar multifidus function and clinical improvement after spinal manipulation. Discussion on the potential of full kinetic chain manual therapy treatment for osteoarthritis. Assessment of muscle activation and spinal loading profiles during common Kettlebell exercises. Description of specific exercises that could improve strength and body mechanics in women with back pain. DC Seminars, in conjunction with the University of Bridgeport College of Chiropractic, March 2008
Ordering and Viewing Digital x-rays, MRI and CT scans on your office computer, determining what advanced imaging might be warranted for each of the vertebral conditions. Description of general features of each condition such as incidence, clinical presentation and treatment options. Discussion of the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it, classification by both direct & indirect radiographic signs of specific etiologies based upon imaging findings. Advanced Radiology Associates in conjunction with Connecticut Chiropractic Association, January 2008
Low Thyroid. Condition which can cause Fibromyalgia and chronic fatigue syndrome as well as medical myths (effects of high cholesterol), Connecticut Chiropractic Association, in conjunction with the University of Bridgeport College of Chiropractic, November 2007
The Pediatric Practice, Determine the epidemiology of low back pain in children and adolescents. Assess the risk factors associated with back pain in school children. Outline the effect of an intervention to improve sitting habits in schoolchildren. Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children. Connecticut Chiropractic Association in conjunction with University of Bridgeport, College of Chiropractic, May 2007
MRI Pathology and Kyphoplasty, Definition of vertebral fractures and the various synonyms. Recognize the key radiographic signs essential to the diagnosis. Establishment of the various underlying mechanisms or causative mechanical forces. Correlation of underlying mechanism to potential short- and long-term clinical implications. Incorporate this knowledge to formulate a rationale and basis for management. Connecticut Chiropractic Association in association with Tully Center, Stamford Radiology Services, April 2007
Sacral Occipital Technique, Anatomy of the spine, cranium and spinal cord components, discussion on the development of the theory of Sacro-occipital Technique. Explaination of the categories of Sacro-occipital Technique. The physiology of the Cranio-sacral respiratory mechanism. Categories I, II, & III, diagnosis and application. Demonstration of blocking adjustments for each of the categories. Connecticut Chiropractic Association in conjunction with University of Bridgeport, College of Chiropractic, October 2006
The Fascial System, Musculoskeletal Disorders and Shoulder and Scapular Dyskinesis, Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, October 2005
Systematize Your Practice, The Key to Revolutionizing Healthcare, Documentation for Medicare, Assessments and Plan of the SOAP Note, Medicare Diagnoses. Define the R of P.A.R.T. from Centers for Medicare/Medicaid Services, illustrate the different methods of evaluating spinal range of motion, define the T of P.A.R.T. from Centers for Medicare/Medicaid Services, describe the timing of the first re-exam, demonstrate proper coding for range of motion measurements, illustrate different outcome assessments for the T of P.A.R.T. Demonstrate the POMR and P.A.R.T. formats for the initial patient encounter, integrate the POMR and P.A.R.T. formats for subsequent patient encounters, define proper assessments, demonstrate proper documentation for timed codes, define the short, moderate and long term diagnoses for Medicare. Connecticut Chiropractic Association in conjunction with the University of Bridgeport, College of Chiropractic, October 2005
The Enigma of Pain, Summary on the current state of knowledge of neuropathic pain, with focus on how it differs from nociception. Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome. Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions. Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain. Connecticut Chiropractic Association, in conjunction with University of Bridgeport College of Chiropractic, June 2005
Natural Alternatives to Pain Control, Answering Your Patient’s Questions in the Time of Uncertainty, Extrapolate the use of Complementary and Alternative Medicines (CAMS) for Pain Management as it pertains to prevalence of use, safety and cost. Discuss the Epidemiology of Pain. Assess pain in patients. Classify pain by extrapolating the physiology and biochemistry of pain. Compare the sensation, attention and behavioral aspects of pain. Recognize the anthroposophic concepts of pain. Summarize concepts of pain in spiritual healing, homeopathy, naturopathy, osteopathy and traditional Chinese medicine. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, May 2005
Radiographic Terminology, Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it. Identify, describe, and classify fractures by both direct & indirect radiographic signs. Review fractures of specific etiologies based upon imaging findings. Evaluate fracture alignment issues, complications, and healing. Identify non-accidental injury of childhood, as well as normal structures that mimic fractures. Connecticut Chiropractic Association, in conjunction with University of Bridgeport College of Chiropractic April 2005
Anatomy of Personal Injury Lawsuit II, Robert Hirtle Esq, Personal injury attorney takes you through the trial process from voire dire, treating physician testimony, expert witness testimony, direct examination, cross examination, re-direct, plaintiff and defense perspectives. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, February 2005
Proper Foot Examination & Common Foot Conditions, How to address common problems associated with prescribing orthotics. Provide an overview of orthotic therapy. Review orthotic casting processes and contrast differences and potential pitfalls in them. Discuss common problems arising from orthotic prescription (blisters, pain during use, pressure spots, etc). Propose mechanisms for why problems occur biomechanically. Present remedies for common problems that arise. Connecticut Chiropractic Association, in conjunction with University of Bridgeport College of Chiropractic, June 2004
Neurophysiologica, Biomechanical and Clinical Advances in Chiropractic, Neurosciences for the Chiropractic Clinician, Evidence-based Chiropractic Medicine, Neuromusculoskeletal Medicine, Orthopedic Evaluation and Management, Neurological Evaluation and Management, Pain Evaluation and Management, Diagnostic Imaging, Neurodiagnostics. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, May 2004
Anatomy of Personal Injury Lawsuit I, Robert Hirtle Esq. Personal injury attorney prepares you for the trial process from treating physician perspective, narrative exam report essentials, depositions, expert witness, plaintiff and defense perspectives, Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, January2004
Extremity Adjusting for Chiropractic Stabilization and Rehabilitation, Techniques and principles of examination for peripheral joints, important surface anatomy of the shoulder, elbow, wrist and hand. Range of motion of the joints of the upper extremity, examination of the upper extremities, common musculoskeletal abnormalities. Special maneuvers for the evaluation of carpal tunnel syndrome, special maneuvers for the evaluation of shoulder impingement syndrome. Important landmarks necessary for the exam of lower extremities, physical examination technique for the lower extremities, range of motion of the hip, knee and ankle, common abnormal findings through physical examination, special maneuvers for examination of the hip, knee and ankle, special maneuvers for the evaluation of knee instability. Special maneuvers for the evaluation of an inversion ankle sprain. Treatment plan for acute patients with myofascial dysfunction for the upper and lower extremities. University of Bridgeport College of Chiropractic and The College of Naturopathic Medicine, October 2003
The Latest Advances in Chiropractic Research. Review the literature for cases of back pain treated by chiropractors or other manual therapists, analysis of provider specialties in the treatment of patients with back and joint problems, assessment of whether the availability of chiropractic care affects use of primary care physician (PCP) services. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, September 2003
HIPPA Made Simple Program, HIPAA Security Risk Self-Assessment, Prepare for Meaningful Use Requirement, protect electronic health information (Conduct or review a security risk, assessment of the certified EHR technology), Executive Summary Risk Assessment Reports, Additional Security Recommendations, Threats Analysis / Risk Determination, Compliance Testing, Employee Certificates, Administrator Training Reports, New Employee Training, Security Tips and Reminders. University of Bridgeport University of Bridgeport College of Chiropractic, February 2003
Mock Trial, Personal injury attorneys take field practitioners through the trial process. Experience due process with treating physician essentials, treating physician testimony, direct examination, cross examination, re-direct, volunteers will be “put on the stand” to experience first-hand how it feels to have a defense lawyer put you “under a microscope. University of Bridgeport College of Chiropractic and The College of Naturopathic Medicine, October 2002
Neurology of Chiropractic, Neurophysiology and neural cellular anatomy are discussed. The structures of the sensory, motor and special sense systems and pathways are presented and reviewed. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, May 2002
Spring Sports, Assess the role for compression and tensile load in typical tendinopathies encountered in clinical practice. Outline the relationships between biomechanics, tendon pathology and function in individuals with lateral epicondylosis. Synthesize outcomes and potential mechanisms for loading programs to rehabilitate Achilles and patellar tendinopathy. Summarize the current state of research literature on tendinopathy. Apply current research to the in-season management of athletes with tendinopathy. University of Bridgeport College of Chiropractic, April 2002
Percutaneous Laser Disc Decompression. Critically examine published reports of clinical outcomes in laser decompression therapy, discussion of logarithmic light amplification for penetration through retroperitoneal and disc structures, review the physics of cauterization on annular fibers and nuclear sublimation, understand “ vacuum effect” and decompression of thecal sac and neural structures. Connecticut Chiropractic Association, March 2002
Functional Neurology Clinic Workshop, Contrast and compare the physical neurological examination with the physical examination of other body systems. Perform a neurological examination in a logical, physical sequence from sitting to standing, supine and prone. Describe and perform “Waddell’s Tests and six other special tests described in the literature to detect complaints without a physical basis. Itemize pitfalls and critically review special tests described in the literature to detect complaints without a physical basis. University of Bridgeport College of Chiropractic, December 2001
The Differences Between Open and Closed MRI, Gantry configurations, open bore low field strength comparisons of .5 Tesla to closed 1.5 Tesla high field magnets, software effects on image quality. Connecticut Chiropractic Association, March 2001
AMA Guides to the Evaluation of Permanent Impairment 6th Edition, Clinically coordinating spinal pathology with neurological and functional sequelae including station & gait, migraines, sleep & arousal disorder, paroxysmal disorders, radiculopathic disorders and central nervous system disorders. Connecticut Chiropractic Association, 2000
Integrated Health Care, Health and Wellness: definition and components, dimensions of wellness, Healthy People initiative. Discussion of the various models of health and the need for wellness lifestyles. The effects smoking has on back pain and other musculoskeletal conditions, several methods of smoking cessation and their relative chance of success. Nicotine addiction cycle and the link to smoking, several strategies to help your patients quit smoking. Epidemiology, etiology and background on obesity, theories of obesity development and pathophysiology, risks and morbidities related to obesity. Management of obesity, assessment of obesity for the busy clinician. Review of the literature on the dietary management of obesity. The role of exercise and physical fitness in the management of obesity and overweight. Connecticut Chiropractic Association in conjunction with the University of Bridgeport College of Chiropractic, November 2000
Clinical Spinal Anatomy, Study and identify the rami and divisions of the lumbar plexus, peripheral nerves that arise from the lumbar plexus, review the anatomical landmarks that surround the lumbar plexus, review the structures supplied by the nerves of the lumbar plexus. University of Bridgeport College of Chiropractic, December 1998
A Rehabilitation Approach to Cervical Spine Patient, Review the proximal and distal attachments of selected muscles of the neck. Summarize the differential diagnoses associated with trigger points of the neck. Connecticut Chiropractic Association in conjunction with University of Bridgeport College of Chiropractic, October 1998
Herbal Medications, Natural analgesic and anti-inflammatory agents. Identify how free radicals are formed and what parts of the body are affected, the relationship between antioxidants and cardiovascular disease and cancer, the role that herbs have in pain control, inflammation and the pro-inflammatory state. The role of Proteolytic enzymes and inflammation and review sources of fatty acids. Connecticut Chiropractic Association in conjunction with Norwalk Community-Technical College, October 1997