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Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
August, 2001, Vol. 01, Issue 08
How to Say "No," Continued...
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
I am absolutely overwhelmed with the volume and heartfelt quality of your replies to my last challenge ("How do you say 'No' when your client says 'Yes'?").I received dozens of letters from all over the country, from people with extraordinary stories to tell. I was so excited to share with you the wonderful ideas and experiences people have sent me. And then my hard drive melted. I was able to salvage some things, but not, alas, any of my e-mail. It disappeared into the ether. It is gone, gone, gone.
I quickly (well, as quickly as I could think of it) sent a letter to Massage Today, asking if they could put a squib in the July issue to request that my respondents resend their wonderful letters --but of course, I missed the deadline.
So, wonderful letter-writers, if you still have copies of the letters you sent me, could you please send them again? I promise I'll be conscientious and save them not only in an e-mail file, but also in a place where they can be restored if necessary.
In the meantime, I did have a few letters that I have been able to save. It's hard to choose what topic to address, since so many rich ones came up, including...
This month, I decided to try to address the most common theme I heard. Here's an excerpt from a registered massage therapist in Texas:
I respond to these clients by educating them on the effects of a deep tissue massage on a body that has not been prepared for it (extreme soreness, nausea, headaches, flu like symptoms, and the process of how the body eliminates metabolic wastes and toxins from the body, etc.). I tell them that this is not the type of massage they will receive from me, as it is not in the best interest of their body at this time. If a deep tissue massage is what they want to work towards, then we set up regular scheduled appointments to accomplish that.
I refuse to do any type of bodywork, on any client, that I feel is not in their best interest at that time. I would rather lose that client.
My advice is, the massage therapist is the professional and educated person in these situations, and the client relies on us to know what we practice and what is in their best interest. We need to act like the professional educated people that we are, and say "no" when we know it's the right thing to do for that client.
Our profession loses many potential clients due to negative experiences resulting from a therapist not saying "no" when they should have.
Among many important issues raised here is who is in charge of a session. This therapist absolutely nailed my point: in the client-therapist relationship, the therapist is the authority. We are obligated to make decisions for our clients' best interest, even when it's not what they think they want. This writer went on to describe another situation in which massage therapist complied with a client's wishes for a deep tissue massage, against better judgment. The client was injured, she required extensive physical therapy to recover, and she will never seek massage again. How much damage is done to our profession when this happens?
Many writers had wonderful insights about how to frame difficult conversations with clients. Based on these and my own experiences with clients, students, and active listening skills, here are some basic guidelines that are pretty universally applicable:
This is a simple format for difficult conversations that can be applied to a wide variety of problems, from health concerns, to chronic lateness, to someone who has a habit of canceling appointments at the last minute. Sadly, when we're on the spot, sensible communication skills go right out of our heads. That's why it can be useful to have a simple, clear-cut formula for dealing with these difficult situations. In my next article, I'll outline some other communication guidelines that can make these relationships nurturing, fruitful experiences that can allow both therapists and clients to grow and benefit. I will also describe some of the other alarming scenarios that therapists have described to me in recent months.
Again, to those of you who wrote last time, and to any other readers who have problems they would like to see addressed, please, please, please resend your letters! Until then, good health and happiness.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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