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News in Brief
Oregon Gov. John Kitzhaber (a medical doctor, no less) proclaimed October 2014 "Oregon Chiropractic Health and Wellness Month" in an official proclamation signed Aug. 25, 2014.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Detoxification for Athletes: The Key to Winning Performance
One of the most dangerous culprits that affects an athlete's ability to perform at an optimum level also happens to be one of the most elusive.
The Life & Legacy of James Sigafoose, DC (1933-2014)
Surrounded by his family and closest friends, Dr. James M. Sigafoose passed away quietly on Thursday, July 3, 2014. With his wife of 60 years, Patsy, along with his children, Tina, Daun, Kieth, Selina and Carey – all chiropractors – at his side.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Ringing in a Fiscal New Year With a Recommitment to Cost-Effectiveness
Back when the Foundation for Chiropractic Education and Research was in its heyday, I used to send out New Year's greetings and virtual noisemakers to some close friends on July 1 – the beginning of our new fiscal year – wishing for prosperity in the year ahead.
Decompression-Traction: A Core Treatment Method in Chiropractic's Future
We're all competing for new patients. We're competing for new patients with physical therapists, massage therapists, medical specialists and hospital fitness centers. We're even competing with side-effect-ridden medications that quit working every four hours.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Watch Out for Red Herrings
In clinical practice, when one condition mimics another, it makes it difficult to obtain an accurate and timely diagnosis.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
How to Find Your Ideal Patient – and Help Your Ideal Patient Find You
Just imagine: You're at the front desk looking at the scheduler and a smile creeps across your face. Row after row, name after name, hour after hour; you're blessed with an entire day of ideal patients. Every day should be like this, you whisper. Exactly!
Take Care of Your Skin: Tips to Pass on to Your Patients
Many of our patients are not aware that the largest organ in the human body is actually the skin. Accounting for 16 percent of total body weight and covering up to 22 square feet of surface area, the skin is more than just a "covering," as originally thought.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Don't Forget About the Performers
Donald Petersen Jr.'s recent article, "Your Chance to Go Back to High School" [May 1, 2014 DC], focused on the injuries incurred by high-school athletes and the subsequent opportunities for the chiropractic profession.
From the Other Side of the Table
People come to us to gain freedom from pain, to feel better, to live better. As D.D. Palmer stated, "We Chiropractors work with the subtle substance of the soul." Therein also lies the rub.
Building the DC-MD Bridge
From MDs practicing integrative holistic medicine to the family internist, many DCs are enjoying unprecedented attention from their allopathic colleagues.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
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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