resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
June, 2001, Vol. 01, Issue 06
We Get Letters & E-Mail
By Editorial Staff
Editor's note: The first two letters reference "When Massage Meets Managed Care," from the February 2001 issue of MT. The article can also be viewed on line at http://www.massagetoday.com/archives/2001/02/04.html).
"I don't agree with pushing these managed care plans"
I really enjoyed your article in the February issue of Massage Today regarding massage therapy and insurance/managed care.I am a licensed massage therapist and have been practicing for 10 years. I have always been in a clinical environment, and I think it is a huge mistake for massage therapists to join these insurance plans.
Insurance is very destructive in a lot of cases. The insurance companies control the provider and the insured. They dictate the type of care people can receive and also dictate how much the provider receives for providing these services.
I think managed care will devalue the massage profession. If people truly understand the benefits of massage therapy, they will pay for it. Those who will only come if their insurance will pay are usually not interested in getting better or overcoming any type of problem, and they will drain you in numerous ways.
Why are we pushing this so strongly? I truly do not understand the mentality of the therapist who would want to join managed care. I have a very strong practice - completely booked with standing appointments (seeing 30 people per week); a waiting list; and all cash-paying clients.
I know there may be differences in the type of practice and type of clients other massage therapists have, but I still think we shouldn't be pushing these managed care plans. We should be able to have thriving practices simply by educating people and putting the appropriate value on the work we provide.
Lisa E. Kirk, LMT
"It's the game we should be preparing to play"
I received your February issue, and I have to say that your article on health insurance plans is right on track. What you have failed to mention is how the insurance game is typically played today by those already accepted into the "system." Inflated prices are commonplace in medicine, directly because of (in my opinion) these "modest discounts." And at one point I'm sure that they were just that: modest discounts. Doctors charged a fair price for their services, and people paid the doctor directly. Then came the third-party payor system and the progression of policy to what we see today. According to their tables (which are based on inflated prices), a 25% discount is modest. It is their world with their own benchmarks and standards. Doctors are forced to increase their rates disproportionately to get the insurance company to eventually pay a little more. We can see the evidence of this in the inflation rate of health care costs which are growing at 200% that of inflation (according to my memory from past news spots). It is commonplace for doctors to bill $300 and get paid $50 by insurance, while those paying cash get stuck with the whole bill.
It is clear that medical costs in general have become grossly distorted. However, we as massage therapists have not yet played the game of insurance long enough to become equally inflated. However, we have played the game of what the competitive market will bear, in which there is no room for grossly inflated prices. In order to survive financially and play their game, we too will have to become inflated in price to absorb the cost of discounting services. If we do play, we will become dependent upon the system, because no one outside of our contracts with the insurance company will be able to afford us. Moreover, the discretion of the therapist to appropriately treat the client will automatically be limited to what the prescribing physician orders and the insurance approves. For example, a physician writes a script for "massage" therapy for a patient's low back pain, and insurance approves the treatment for x # of sessions. Those who know little or nothing about holistic therapies will limit your ability to treat beyond the region specified (L1-L5). If you do treat beyond what was prescribed, your services will not be reimbursable if they "catch you committing fraud," and you will also have to contend with the potential legal consequences. It's precisely the same string that doctors complain of regarding HMO's -- the practitioner with the knowledge and skill isn't allowed to decide what is best for the patient.
There is another option, one that is becoming a major trend among many physicians: cash-based practices. Medical practices are firing billing departments, (on average it takes two full-time staff to handle insurance billing for every physician) cutting prices to fair/competitive levels, and going to cash payment for services rendered. In turn, the doctor provides patients (now customers) with a form detailing their diagnosis code, treatment codes, necessary physician information, and the amount paid by the patient. If patients desire to be reimbursed by insurance, they submit their claims to their insurance carrier and the carrier reimburses them directly. This is the type of game we can play where everyone wins, and it's the game we should be preparing to play as an industry.
Peter C. Kassner, ND, LMT
"I don't ever want to take insurance payments..."
I am a certified massage therapist in Virginia and just read the second issue of Massage Today. I agree with your article about "Massage and Medicine." (See the front page of the February issue, or access the article on line at http://www.massagetoday.com/archives/2001/02/06.html.) I had the option to participate in the networking program (access) and decided not to participate.
I am having trouble understanding why any massage therapist would participate. The only benefit a massage therapist gets is "possible" referrals. I am a business owner and started my business 1 1/2 years ago. The business has grown and continues to grow. I advertise some, but most of my new clients come from referrals, from other clients (word-of-mouth). With some hard work and patience, the referrals come and I don't have to take a cut in pay.
As a business owner, I can decide at any time who to give a discount or coupon to, for whatever reason. I would never agree to giving too many discounts, because I have monthly business expenses (office rent, phone, laundry, supplies, self employment taxes, etc.). I also earn my living solely on the profit of the business, so I cannot afford to give to many discounts. I opened my own business because I wanted to be the decision maker and not dictated to about policy and procedure.
I am also worried about HMO payments with the set price of $45 per hour (because that's the set price that all participating MTs have agreed to). Massage therapists participating in this sort of arrangement will never be able to get raises as they desire.
I only charged $45 per hour during my first year, but have since raised the price to $50 per hour. I will always try to keep my prices affordable for my clients. I pay out-of-pocket for my chiropractic care and at times, massages. I think enough about my health that I don't mind paying out of pocket for alternative health services. I don't expect any more from my clients than I expect from myself.
I don't ever want to take insurance payments because that will come with all kinds of problems (treatment dictation, three-month wait for reimbursement, etc.). I work extremely hard at my business. It's more than just doing massages. It's cleaning the office; washing the sheets; client chart paperwork; self-employment and tax paperwork; designing and printing my own brochures; newsletters; advertising; mailing birthday cards and newsletters to clients; etc.
I realize that $50 per massage sounds like a lot of money, but after my expenses and the time that I actually invest, I'm lucky if I'm making $12 per hour. I work too hard to make any less.
So honestly, what is the reason that MTs would participate in the networking program? Why not go out and get your own referrals, and charge what you think is fair to your clients?
Susan Cumpian, CMT
Reward Wellness, Not Sickness
I read your article in Massage Today concerning "Massage and Medicine. I was very taken with the article. As a massage therapist, I have many clients ask me if I take insurance. My reply is always, "No!" for the simple fact that I do not want to be dictated to. I work for myself on purpose. This way I have control over my business in its entirety. I know that Blue Cross and Blue Shield are involved in the alternatives now. Many organizations have approached me about belonging to their group. The reason I say "No" is because they want to tell me how to run my business concerning their clients, as you so aptly stated in your article.
I am 52 years old and have been practicing for 5 1/2 years. My practice is doing very well and I am grateful to all of my clients. If they choose to submit their time with me to their insurance carrier, I will give them a receipt for that purpose. This is as far as I am willing to go. People need to be responsible for their own health. Insurance carriers should be reimbursing clients for their wellness, not the other way around. It is just a matter of time before insurance companies reward people for maintaining wellness instead of rewarding them for sickness.
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