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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."
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.
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.
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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
November, 2001, Vol. 01, Issue 11
By Steve Capellini, LMT
Author's Note: The Spa Letters column features news, personality profiles, trends, and plenty of professional possibilities for LMTs in the spa industry. The style is epistolary, meaning the articles are letters to a fictional massage therapist friend of the author.
I'm glad to hear you're staying on at the spa and learning in-depth about each of the treatments offered - you'll become an increasingly invaluable employee (not to mention a better therapist) as a result. There will be plenty of opportunities for adventure in other locations as you follow your spa dreams into the future, but for now, you should build a strong foundation in the fundamentals, e.g., spa therapies.
As I travel around the country teaching basic spa therapy course, as I have for years, I'm continually amazed to rediscover just how powerful the generic, no-frills treatments really are. I show people a simplified version of several of the most common modalities: herbal wraps; mini-facials; seaweed wraps; mud and clay packs; aromatherapy applications; hydrotherapy; and body scrubs. In hopes that it will help you better understand these powerful therapies and be able to explain them clearly to your clients, maybe I can give you a little primer, starting with my favorite: the herbal wrap.
Herbal Wrap Basics
Why do we wrap people up in spas in the first place? There are several reasons. First of all, when we apply therapeutic ingredients to the skin, at whatever temperature they're applied, people tend to get chilled really fast. This includes a hot application of products, such as in the case of the herbal wrap. Within minutes, your client will be shivering if not wrapped or otherwise kept warm. Some spas use infrared heating lamps to keep clients warm, which works fine but can be awkward if the lamps are placed around the table on stands, instead of attached to the ceiling. Another reason we wrap is to create a self-contained system in which the products we apply interact with the client's body over and over again, instead of escaping into the surrounding atmosphere. Lastly, many people like the sense of security and privacy that being wrapped creates.
The mere act of being wrapped can have a bit of a therapeutic effect because wrapped people sweat, and sweating is good. Too many people (probably including many of your clients at the spa) spend too much couch-potato time, and the sweating produced by simple wrapping is a way to get their largest eliminatory system working again. But the most powerful benefits to any wrap come, of course, from the ingredients applied to the client's skin.
When I visited the Golden Door Spa in California, I discovered that they grew their own herbs right on the property for use in the herbal wrap. Many spas worldwide do the same, but it is not necessary to have locally grown herbs to make an herbal wrap work, as I'll explain in a second. The herbs can be fresh or dried, and of course organic is best. A large handful immersed in a muslin bag can last all day. Most spas change the herbal solution each night.
Each herb has a specific effect: some increase circulation, others soothe the skin, others are diaphoretic, and so on. These herbs are steeped in nearly boiling water, then special canvas-grade muslin sheets are soaked in the solution. It is these herb-infused sheets, along with outer insulating layers, that wrap around the client.
You've learned the basics of wrapping there at the spa, and from what you've told me, I can tell that the technique used there is sound. There are several variations on the basic wrapping technique, with different equipment used for each. Many spas heat their sheets in hydrocollators which, as you know, were not originally intended for this purpose. They do work well, even though they don't get the sheets as hot as the original industrial-kitchen style boilers. Of course, rubber gloves are important to protect the therapists' hands. I've found in my workshops that simple wood clamps help when wringing the heavy muslin sheets out over the steaming herbal solution.
What makes a wrap work is the way the combination of heat and the properties of the herbs "trick" your body into thinking it has a fever. And we all know what happens when you have a fever - you perspire and try to throw of toxins and invading microorganisms. As you naturally begin to release these, the herbs stimulate the process even further. The result is a detoxification effect that can range from mild to extremely intense. I remember performing a series of herbal wraps on a gentleman who was at the spa to give up smoking. At the end as I unwrapped him, a powerful order of nicotine filled the room. The sheets smelled like a used ashtray.
I'm glad to hear that your spa promotes the massage therapists as wrap practitioners. That's the law here in Florida, but in other areas, wraps are performed by unlicensed technicians. It's always best to have a qualified professional working with the clients, someone who can explain the treatment and be ready in case of any emergency.
The herbal wrap is not a treatment to be taken lightly. It has profound effects on the body, and there are contraindications for wraps, just as there are for massage. Primarily, you must remember that the herbal wrap is a heat treatment; as such, it is contraindicated for anyone who is pregnant, hypertensive, or suffering from heart conditions or diabetes.
Also, a surprisingly large number of people feel claustrophobic when wrapped in heavy sheets and blankets. Fortunately, there is a simple solution that works for over 90% of the people with this problem. Instruct your clients to leave their arms out of the wrap, and they will feel quite comfortable. The most important thing is that they feel they can get out of the wrap themselves if they so desire. There will always be a few people who still feel trapped, even with their arms out; they're better off taking an herbal bath rather than a wrap.
Well, that's all the time I have now, Lou. I bet you didn't think there was so much to know about herbal wraps alone! Next time I write, I'll fill you in on some of the other spa treatments that I've personally seen help hundreds of people in spas over the years.
Talk to you later,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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