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The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
August, 2001, Vol. 01, Issue 08
Money and Ethics
By Ralph Stephens, BS, LMT, NCTMB
As the insurance debate heats up, emotions are kindled. As emotions become involved, logical thought goes out the window. Please try to put your emotions aside as you read the following five points regarding financial and ethical considerations in being an insurance provider.Ponder them carefully, and use them to help form your opinions, rather of rallying to the call of your emotions.
"We could help more people if we could get insurance reimbursement," is the rallying cry to justify monetary cravings. If helping more people is indeed the true desire, offer your services on a donation basis. Then everyone can afford you. You'll have all the people you have the strength to work on. Of course, this is unacceptable to most therapists who seek insurance because, in reality, it is the money they seek. That's fine - there's nothing wrong with getting paid for your services. Massage is a valuable service, and a physically demanding one at that. This limits how many hours a day one can work -- something not understood by insurance companies. You deserve to live a comfortable life. Money is required for that.
Now the question becomes, "Is there more money available to a therapist working for insurance, or working in a cash practice?" Let's do the math on insurance network programs. Let's accept their claim that they will send you 30% more clients if you accept a 25% rate cut, and see what eventually happens.
If you add their 30%, you gain six new clients. If only those new clients are participants with the "Alternative Care" company plan, here's what happens:
However, if your regular, full-paying clients find out about this "deal" and go with the insurance company, what will happen? Let's say 10% of your clients sign up, so now 40% of your clients (10.4, which I'll round off to 10) are now paying $37.50. That's $375 + $800 = $1,175. You should note that you will now be doing six extra massages for $175 total ($29.16/hr., not $37.50/hr.).
As 60% of our clients join the company, our income slowly dissipates as we work more hours.
At 100% of clients belonging to the company, which is not unreasonable considering what PTs and DCs do, and how fast the word spreads: 26 clients @ $37.50/hr = $975/week.
In other words, you make $25.00 less than when you "only" had 20 clients. Do six more massages, make $25 less. Work more for less. That is what insurance plans bring. Note that the insurance networks cap what you can charge. A therapist who now charges $70/hr. will only get $35/hr. tops on some plans -- a 50% deduction from regular fees.
The above example is for an access plan in which you get paid at the time of service by the patient. If you want third-party payment insurance reimbursement, you get to spend the additional time necessary to file and follow-up on all the paperwork or e-filings. More work, for the same or less pay. Gets better all the time, doesn't it? What would possess a logical, thinking mind to do this?
In other professions, providers/therapists have jacked their rates way up so that, after the insurance discount, they still make what they want/need. Responsible clients/patients are punished so severely that they have no choice but to buy insurance. They cannot afford health care because of insurance. This is by careful, premeditated design.
Back to the issue of helping more people. Helping more people now is not possible, because those people have made choices that prevent them from affording our services at the prices we want to charge. Soon we will not be able to help patients because the gatekeeper sends them to a PT or limits the number of appointments they can have. A plan or physician could allow only eight massage therapy visits a year, even for chronic conditions, like fibromyalgia. Worse yet, with insurance driving up prices, few people will be able to afford massage out-of-pocket. This has happened to every other profession, and it will happen eventually with massage.
If you do not have enough patients now, insurance may look like a way to get ahead fast. It may even look like a way to reach new patient populations -- to help those who choose not to afford massage. "80% of something is better than 100% of nothing" makes insurance cases sound tempting initially. The reasons most therapists have low patient loads is they do not have adequate therapeutic, personal and/or promotional skills.
Invest in acquiring better skills, rather than in learning how to play the insurance game. Skilled therapists become very busy no matter where they live. More people in stress and pain are looking for help than we can ever serve. Acquire the skills to help them and you will never need or desire to subject yourself or your patients to the abuses of insurance.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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