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Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
June, 2001, Vol. 01, Issue 06
With Legislative Intent
By Keith Eric Grant, PhD, NCTMB
I take on this month's topic with the "slight" hesitancy characteristic of following my two sons into an unheated swimming pool in winter. There are few issues that can polarize massage practitioners as quickly as that of licensing and regulation. Not coincidentally, there are also few issues that could benefit from dialog and critical reflection as much as this one.
Massage is a profession seeking credibility, a useful scope of practice, and freedom from the vagaries of local regulations. We habitually seek such goals within the realms of state occupational regulation (OR). Such regulation has been the most successful strategy for wresting control of massage from local agencies. However, local laws may apply even in states with licensing, unless the state's statute specifically forbids this.
In many states, the practice of medicine is defined so broadly that there is no unclaimed area of health care practice.8 Under such definitions, only professions that have their scope of practice carved out by a licensing law are free from the potential of prosecution. An alternative approach, recently taken in Minnesota and under consideration in California (SB577), is to redefine the business and professions code to specifically allow the unlicensed practice of noninvasive complementary methods.
The Legislative Intent of Occupational Regulation
For most states, the motivation for OR is to protect the public from harm that is recognizable and not remote. Without likely harm, there are fundamental rights for a person to be free to choose a profession.5,7 Motivations of legitimizing or recognizing the credibility of a profession are notably missing from state statutes defining the purpose of OR. So the key question becomes, what is the likelihood of harm occurring at a level of practice that licensing would prevent?
In 1997, the Georgia Occupational Regulation Review Council concluded that there was minimal potential for harm from massage.3 Recently, the British Columbia Health Professions Council concluded that there were no massage practices that warranted being declared as restricted acts.1 These conclusions, coupled with extremely low liability insurance rates, indicate that harm from massage is remote. Massage licensure would have rough sledding in states with sunrise (review) acts.5,7 and such states, like Florida, that currently regulate massage, would be much less likely to do so if the regulation were newly proposed.2 The assumption that unlicensed massage results in client harm is a dog that won't hunt.
Standards and Quality
Licensure is often promoted on issues of standards and quality, yet when closely examined, these are far from clear. When quality is measured by client satisfaction and availability of service, the relationship between licensure and quality is often weak.4,5,8
Measures of quality based on hours of education have been driven more by eligibility requirements for federal financial aid9 than by the need for specific training. In contrast, massage school owner Ramona Moody6 provides one of the few starting points that is based on examining the training needed to achieve minimum competence:
I participated in a task force initiated by the BPPVE [Bureau for Private Postsecondary and Vocational Education], which legislates massage schools among others. The purpose of the task force was to decide what the absolute minimum requirements should be for massage training. The massage schools, owners who participated in the task force decided that rather than develop a curriculum for the 250 hours suggested by the Bureau representatives as a minimum, we would discuss what knowledge we feel the students really need, and how many classroom hours it realistically takes to impart that knowledge. It was a really interesting discussion, carried out over several meetings, and the conclusion we came to was that it takes about 200-300 hours in the classroom to impart to students the minimum education we felt they really need in the marketplace. This included more than one massage modality, along with health and safety, anatomy and physiology, business practices and ethics, as well as communication skills. We felt this would make the student competitive in the marketplace, as well as no danger to the public.
Similar to massage, piloting a plane requires both kinesthetic skills and technical knowledge. Piloting, however, is much less forgiving of incompetence. The FAA requires 250 hours of flight experience to issue a single-engine commercial pilot certification.10 Coupling this FAA requirement with Moody's observations, it seems clear that minimal training requirements for massage are being significantly overestimated. It is incongruent to advocate integrity for the profession of massage when we have not assured the integrity of our own claims for licensing. If we are truly committed to improving the delivery of massage services, we need to take account not just the hours, but the modern teaching concepts and the social fabric for increasing the availability of massage.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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