resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
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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