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Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
April, 2001, Vol. 01, Issue 04
Touch and Rapport
By Keith Eric Grant, PhD, NCTMB
There go my people. I must hurry and catch them, for I am their leader
- Mahatma Ghandi.
The Path of Touch Unfolding
Facilitation, like true leadership, is paradoxical in that it often requires us to chase after those supposedly being led.Within such facilitation, there is a deep appreciation for the abilities and resources of the client, and an acknowledgement that the full outgrowth of the interaction will only become apparent as it unfolds. It is an orientation that obliges us to be flexible in our attitudes and approaches.
Depending on our therapeutic orientation, we may approach a client from a sensory-driven perspective of finding and gently releasing areas of unconscious holding and restriction. More formally, we might take the orthopedic perspective of assessing painful lesions stemming from structural and functional dysfunctions, then proceeding to systematically alleviate them. In any approach, having our interventions take hold often requires a change in body perceptions and use from our clients. I am particularly struck by Deane Juhan's (Job's Body) comments about massage opening a window for the client toward a new, less strained way of experiencing their body, and by his repeated emphasis on the importance of bodywork as client re-education:
Beyond what Juhan provides, there are several paths along which we can delve into underlying mechanisms and clinical experience. Pain researcher Ron Melzack continues on from the gate theory of pain (Melzack and Wall) in considering the neurological basis and implications of phantom limb pain. He conjectures that we possess an inherent neurological analog of our physical bodies . This analog system, he theorizes, can independently generate perceptions of pain until it is reorganized by new coherent sensory input, such as that provided by bodywork.
A second perspective is provided by psychologist E. L. Rossi's review of the new field of psychoneuroimmunology. In The Psychobiology of Mind-Body Healing, Rossi discusses research indicating that stress on the nervous system produces chemical messengers that have profound effects on immune system functioning. In providing a supportive emotional environment and nurturing touch, we address the effects these neurochemical systems have on perceptions of pain and quality of embodiment.
Choreographer Eric Franklin (Dynamic Alignment through Imagery) is one of a line of dance movement instructors who have achieved their results working with the interrelations of imagery, body use, and neuromuscular patterning. These dance educators have noted the role our mental imagery plays in organizing the neuromuscular patterns that facilitate the ease or strain of our posture and conscious movements. We have only to think of movement or conflict and our body has responded, beyond the speed of our conscious thoughts. Just imagining a movement or a posture causes the body to activate muscles and to integrate optimal pathways towards that vision. Our positive body images can act to alleviate tension that results in unnecessary limitations and wear as equally as our negative body images can limit our effective use of space and increase the effort of our movements. We begin to understand the wisdom behind Juhan's assertions that bodywork can add new possibilities to a client's world of embodiment.
The Dance of Rapport
Psychiatrist Milton H. Erickson was notable for his abiding faith that, apart from unnecessarily limiting beliefs and lack of experience, clients possess all the resources they need to live full and rewarding lives. Starting from an attitude of accepting and utilizing the client's worldview and abilities, Erickson was a master at providing the needed experience and flexibility that allowed positive changes to evolve naturally for his clients. Neuro-Linguistic Programming originators John Grinder and Richard Bandler similarly stress the importance of pacing and leading. Pacing is a process of acknowledging and matching a client's current experience in a manner to establish rapport. If we attempt to lead without rapport, our efforts will fall short. Likewise, if we limit ourselves just to pacing, we lose the opportunity to effect positive change.
Part of the skill of pacing is simply to be fully present with our clients. To promote this skill, I teach my students a simple yet unexpectedly profound exercise; actively pacing a supine client's breathing with a hand on their anterior torso while staying conscious and present to observe subtle changes in their appearance and position. It is hard to over emphasize the emotional impact of such quiet presence and support in a culture in which it is so rarely encountered. This exercise draws on our skill at pacing and leading our clients in their perception and use of space, effort, and time. These are ways of organizing our embodiment that are used by dance instructors such as Constance Schrader (A Sense of Dance). I find they provide useful frameworks for understanding a client's body image and use. Each can be further refined, such as dividing time into tempo, beat and rhythm.
When we work on people, we act to increase the ease and comfort with which they inhabit their body. Amid the gentle stretching of fascia and facilitation of muscles, we send countless sensory signals throughout their nervous system. We focus intently on them, pacing, nurturing and supporting their emotional needs. In so doing, we provide them with a new sense of themselves as embodied human beings.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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