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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
February, 2001, Vol. 01, Issue 02
Attention to Learning
By Keith Eric Grant, PhD, NCTMB
The last couple of weeks, I have succumbed to the pleasures of revisiting some long fallow kinesthetic roots. When I was a graduate student in physics, I started taking massage and dance classes to enforce some sense of balance in my life. Surprisingly, many of the movements required to massage effectively seemed intuitive to me. Years later, when I began teaching massage, I realized the reason. There had been a period when, for much the same reasons of balancing life, I had baked the majority of the bread I consumed.
I learned to move with my whole body to knead the bread, rather than relying only on the easily fatigued intrinsic muscles of my hands and forearms. I developed a relaxed and steady tempo that allowed me to maul the dough into its required elasticity without tiring. I also developed my sense of touch, to feel the subtle changes in texture that occurred as the dough neared the point at which it was ready for its first rising.
Thinking back, as I recently made bread once again, I acknowledged that my first massage "instructor" used no words, but nonetheless gave me much feedback. From a behaviorist viewpoint, my attention and efforts were rewarded and reinforced by the bread I ate and shared with friends. When I began to learn massage, these neuromuscular patterns were already in place to transfer to a new and equally rewarding application.
What this story exemplifies for me is the diversity of kinesthetic and interpersonal skills that we bring to our first formal massage class. Both skills of interpersonal awareness and communication and those that require learning movement patterns can be transferred to new applications. Our minds and bodies don't care that we originally learned such skills for another purpose. Often, we learned them early and use them without being conscious of that use or of when we practiced and perfected them. In thinking of such skills as innate or intuitive, we fail to acknowledge those who modeled and reinforced them, in some instances before we had words capable of expressing our gratitude. We also fail to remember the amount of attention, awareness, and practice that was required of us. Returning our awareness to these early lessons allows us a model for what we already do well, and for extending our learning in new directions and to new depths.
Stages of Competence
Robert Jolles is a trainer of trainers for Xerox. In his book How to Run Seminars and Workshops, he presents a model for the stages of learning a new skill. The four stages are unconscious incompetence, conscious incompetence, conscious competence, and unconscious competence. Following this model, in the beginning we are unaware that we don't have a skill in place, and may also be unaware of our need for the skill. As we progress, we become aware that we need a skill and that we haven't mastered it. We then turn our focus and attention to learning and practicing the skill. Sometimes someone breaks it down into small increments for us; sometimes we practice the whole of what we see demonstrated as best we can. As we practice, we begin to learn new perceptions and motor skills that can add further refinements to practice. At last, when we consciously think about it, the skill is ours to use, and with more use and practice, the skill becomes natural and we begin to use it unconsciously. We have progressed through the learning stage, but over time will have to bring our attention back to it again and again to adapt to changing conditions, regain proficiency after a lapse of use, and keep current with new innovations.
Awareness Follows Attention
Learning occurs by becoming aware of interactions we previously did not perceive, and by consciously practicing movements until they become part of our kinesthetic vocabulary. In perception, awareness follows attention. As we consciously remind ourselves to attend to what our sense of touch is telling us as we massage a classmate or client, our awareness of differences in shape and tissue texture sharpens. As we consciously attend to nuances in others' gestures and body postures, our abilities to consciously be aware of the communications we are receiving increases. We can enhance our nonverbal perceptions by exposure, such as watching a movie with the sound off or observing the body motions of those con receiving increases. We can enhance our nonverbal perceptions by exposure, such as watching a movie with the sound off or observing the body motions of those conversing in a coffeehouse. Finally, as we practice movements with attention, we become aware of what we tried and what resulted. When we observe ourselves and noncritically note the results, we allow ourselves to learn new kinesthetic vocabulary short, habitual patterns of movement and balance that are the basis for our abilities to walk, dance, ski, play a musical instrument, and practice massage.
As we learn and practice, the behaviors and skills that are reinforced by our environment and our internal values take hold, as they did in our early lives. Given motivation and a gentle hand, there are few limits to what we can accomplish via the direction of our attention.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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