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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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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."
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
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.
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.
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.
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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
June, 2001, Vol. 01, Issue 06
How Do You Say "No" When Your Client Says "Yes"?
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Heads up, readers: we have some work to do! Put yourselves in the place of these bodyworkers:
What do you do? What do you say? How do you handle it when your client says, "yes," but your instinct says, "no, no, NO"?
Massage therapists are better trained in contraindications today than we've ever been, and I'm proud to be part of that movement. Our clients depend on us to make informed decisions about whether Swedish massage or other types of bodywork are the best choices for their needs. Still, it is inevitable that some people who may be at risk may seek massage - and the responsibility for causing any harm rests squarely on the massage therapist. All of the scenarios described above are based on real-life situations in which clients could be injured or have their condition dangerously neglected. It could happen to any of us, at any time - in some instances, it already has.
I believe that getting good training in pathology in the context of massage and bodywork is the first step in being able to work with clients who aren't perfectly healthy. We must develop critical-thinking skills so that we can make wise choices about different types of bodywork in different situations. But the next step, often the harder step, is taking action on those choices when they may not be in agreement with our clients' wishes.
How do you do that? How do you say, "No, we can't do this today, because if we do you could end up in the hospital"?
So many obstacles are in our way: staying within our scope of practice; not wanting to lose clients; not wanting to make a mistake or overreact; not wanting to get sued; but above all, not wanting to inadvertently hurt someone!
I have some ideas about how to frame these difficult conversations with our clients (which I will share in my next column), but I work in a bit of a vacuum. I am not in a full-time practice, and I don't work in a setting in which I see a lot of people who may be ill. Instead, I spend the bulk of my professional hours teaching and writing. This is a topic that needs to be addressed by the people who are really doing it - that's you!
So here is your invitation - no, here is your assignment:
Think about the last time you had to change your plans with a client to adapt to his or her health situation. Maybe you couldn't do Swedish massage, but had to switch to something else. Maybe you had to avoid an area the client hoping to have worked on. Maybe you had to reschedule your appointment altogether. How did you do it? Did your client object? How did you handle it? Would you do it differently next time?
Send me a description of your experience. It doesn't have to be eloquent or fancy; it just has to be real. I'll edit it, and change the names to protect the innocent. I'll clear my final draft with you, and then it will appear in Massage Today so that we can all learn from your experience.
This column is meant to be a forum to share our success stories and, maybe more importantly, our mistakes for the benefit of all massage therapists. Be brave. Let us know how you handle this delicate issue. Allow us to learn from each other.
I'm looking forward to hearing from you. Until then, good health and happiness...
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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