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Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
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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