resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
February, 2001, Vol. 01, Issue 02
Massage and Medicine?
By Cliff Korn, BS, LMT, NCTMB
I hope everyone found last month's issue of Massage Today informative and stimulating. Our profession is really coming into its own. In one of my volunteer roles, I recently had an opportunity to attend the International Spa Association Conference in Las Vegas.I was surprised to see that one of the "up and comers" in the spa world is the medical spa! Speaker Dr. Andrew Weil speculated that it was only a matter of time before there would be insurance coverage for spa services. He felt that the spas of tomorrow would be filling the void from all the small community hospitals that are now going bankrupt.
I'm wondering what all of you massage therapists employed in the spa industry think? Do you see a need for the medical spa? How about all of you therapists who work in a clinical setting now? Would you feel threatened by an expansion of medical spas?
These questions bring up another thought on massage and medicine. I see more and more attention being paid to the advent of insurance companies and third-party "middleman" companies establishing networks of massage therapists into "affinity" groups. They are calling these networks "approved providers" or other such terms which indicate to target markets that therapists within the particular network are credentialed to a standard, or have otherwise passed a vetting process, to provide superior care to a consumer.
One of Massage Today's columnists writes a monthly column on working within the insurance/managed care world. Another has written on the perils of becoming involved in that world. I am grateful that they both are contributing to this publication, as it clearly demonstrates several divergent choices we can make within the touch therapy field.
In this article, I'd like to explore further the role of these networks in our future. The networks are developed for two types of programs: benefit and access. Benefit programs are the traditional health coverage plans that provide specific benefits to subscribers. They include types of conditions covered, copayment criteria, number of treatments allowed per year, etc. These programs usually require providers working within the plan to obtain prior treatment authorization, and to agree not to charge their clients more than a predetermined copayment or deductible. Therapists working under a benefit plan are paid according to an agreed-upon "fee schedule." The number of benefit plans including massage therapy is negligible.
Access programs are not designed to pay for covered benefits. Consumer subscribers can be treated for any condition (or no condition at all) and pay out-of-pocket for the bodywork sessions. Prior authorization is not likely to be required. Therapists working under an access plan are paid by the client at a rate that is discounted from the rate charged for non-subscribers. Access plans are growing at a steady rate. Some would say they are growing at an alarming rate!
The rest of my examination of this phenomenon will consider the access plans only. The benefit plans have not yet reached enough critical mass within the massage field to warrant more than theoretical discussion; and in fairness, if they are going to pay for a service, they have a right to determine what it is that they are willing to pay for. I hope to look at the access plans based upon the credentialing process used to select therapists to populate their provider networks; the fairness to massage therapists and bodyworkers (the approved providers); and the integrity/honesty used to market their services.
I begin by suggesting that the very fact that this discussion needs to take place at all is good for our profession. It means that we have obtained enough economic "critical mass" to catch the interest of outsiders as a potential for enhancing their profitability. The determination still has to be made, however, as to whether or not this enhances the profitibility of the massage and bodywork profession.
Credentials: The word brings mixed reactions from practitioners. Some regard credentials as professional collector's items the more obtained, the better while others see them as an excuse by others to overstate dubious qualifications by virtue of a framed wall decoration. All of the access programs I have seen populate their networks by a selection process. One, in its brochure to massage therapists, states: "We are committed to educating the managed care industry on the value of massage therapy and assisting managed care companies and employers in offering high-quality massage therapy networks."
To me, that statement means that the selected participants are credentialed to a standard, so that the standard measures equal "high-quality" in differing geographical areas. The selection process of some involves a site visit from a review committee. Most involve a questionnaire outlining training and specialization. All want to know that a prospective provider is practicing legally within a jurisdiction. None (that I have seen) are very forthright with the actual "checklist" used in their selection criteria. The assumption I am left to make is that inclusion in a particular plan's network, in and of itself, is to be considered a credential.
Fairness. A fairly common theme among massage therapists is that they enjoy a fair amount of autonomy in their practice. Many enjoy working for themselves setting their own rules, prices, and hours, and establishing who they will take as clients and how they will interact with them in a session. A common thread in the arguments I hear against massage regulation and/or national certification is that an outside party is pushing an agenda or establishing its definitions and procedures in the practitioners' business. From my viewpoint, this argument holds for access plans in spades! One marketing brochure lists as a reason for a massage therapist to join: "Reasonable fee schedules for participating massage therapists." I ask, reasonable to whom?
This same plan caps fees that participating therapists can charge at $45. I see massage fees across the country ranging from $30.00 to $120.00. Is a cap of $45.00 reasonable? Certainly not to many. Another clause in the services agreement of an access plan company states, "Participating Massage Therapist shall provide an appointment for a Participant within seven (7) days of receiving a request for appointment." Now I don't know how busy your practice is, but a new client in mine will routinely have to wait three to four weeks for an appointment. If they need a late afternoon timeslot, they'll wait longer than that. Is it fair that I should have to see more clients per day than my (old!) body can comfortably handle to meet the contractual requirements of an access plan? Is it fair that I should not see full paying, private-pay clients so that I can meet disounted-rate clients on a short notice?
Another clause of the same agreement states, "Participating Massage Therapist agrees to furnish Access Services to Participants of any Payor upon request, . . ." Is it fair that this would likely preclude a practitioner specializing in maternity massage or battered women massage or gender specific massage from client determination?
Integrity/Honesty. Finally, I question the marketing tactics of the network-building firms. One touts: No fees to participate - No application fee - No membership fee - No recredentialing fee - No provider education fee - No onsite office evaluation fee. Why, I ask, should anyone charge a fee when they are requiring me to heavily discount my charges? They further say, "Access programs encourage members to utilize participating massage therapists. Member pays massage therapist directly. Massage therapist offers modest discount (25% off retail charges)." Really, this was in their marketing brochure! In most professions a 3% income increase is considered modest. Why is it that a 25% decrease in income should be considered "modest" to massage therapists?
OK, so my biases have been showing! The fact is that these programs aren't going away anytime soon. The names associated with plans like this are Blue Cross, Kaiser Permanente, Prudential, Aetna, CIGNA, Zurich, etc. Certainly individual therapists and the professional associations can, and should, educate those establishing networks in the issues that support growth of massage therapy. I think a colleague of mine put it best when he said:
"From what I've seen, we can only beat them, join them or ignore them. I don't think ignoring them is what we want to do, and I do not know how to beat them. My conclusions are simplistic, but how much energy should we invest in fighting this trend? I don't think we can stop them from going forward with this service, so maybe we can ride along with them and influence their standards."
So what do you think?
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be published in a future issue of Massage Today. Please send all correspondence by e-mail to
, or by regular mail to the address listed below:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
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