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Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
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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