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Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
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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