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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.
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.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
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 Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
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."
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
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.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
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.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
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.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
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.
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 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.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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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