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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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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."
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
January, 2002, Vol. 02, Issue 01
Welcome to the Great Spa Conversation
By Robin Zill, LMT
As we begin The Great Spa Conversation, I'd like to introduce you to the 10 Elements of the Spa Experience. This is an evolving paradigm, developed to give some structure to the philosophy of spa and to facilitate communication among industry professionals.Given the social and spiritual climate since September 11, 2001, it is all the more poignant that we find new ways to connect using new tools. We hope that this column will be a place where we can explore our roots and traditions, and brainstorm new ways to connect with clients and better serve the world in which we live.
Part I: The Genesis of the 10 Elements
The history of the 10 Elements helps to tell the story of the contemporary spa movement. The 10-elements construct has two broad goals. The first was to help define the elusive and ever changing nature of the spa experience. The second was to create a foundation, a common language and career path for the emerging spa professional.
Embarking on this task was difficult, as you can imagine. More often than not, it seemed impossible to wrap our arms around this quickly evolving, growing and diverse industry. However, the ISPA Education Committee members believed we had the opportunity to help give definition to this 21st century profession. The diversity and experience of the committee allowed us to examine the evolution and growth of related professional organizations such as fitness, massage/bodywork, and aesthetics, and to compare that growth to the spa industry. We wanted the spa industry to embrace the new need of professionals to have their lifework and career path be more integrated with their personal life. We also wanted a career path that acknowledged the rich life experience people bring to their work, as this was so critical in creating a memorable spa experience, which in turn creates client retention.
Key words and ideas that framed the dialogue and inspired the 10-Element Circle:
Part II: Understanding the 10-Element Circle
My belief is that spas have the potential to be the sacred spaces for understanding and nurturing the contemporary human spirit. What creates excellence in "the spa experience" is difficult to capture and articulate. There are many levels to the dialogue and they are interrelated in nature. On the surface, a spa treatment is about feeling good. But to achieve a memorable experience and not just a great massage, facial or wrap, we need to encourage each client's connection to a deeper sense of self. What we really want to do is create a space for self-discovery and growth. The 10-element circle can give form and structure to this search, both for the professional and the consumer. After all, the healing dynamic of giving and receiving is at the heart of this exchange.
First, take a moment to understand the circle pattern. You will notice that there are eight pieces of the pie, but 10 elements. The center and the circumference of the circle make up the final two elements: Integration (element five) and Time, Space, Rhythms (element 10). Elements one, two, three, four, six, seven, eight and nine sequentially fill in the pie. Within the circle, all 10 elements are related and interact dynamically with one another. Each is dependent upon the other.
Part III: The 10 Elements
Key words: The transforming power of water.
Water is the heart of the spa experience. Fundamentally transforming, it is used for cleansing, purifying and basic survival. Both the external use of water through compresses, showers, bathing, and swimming, and the internal uses of water through drinking and other internal cleansing procedures, are included.
Key words: Nature as nourishment.
How do we feed ourselves to maximize our experience of life? Yes, a healthy, well-balanced diet is necessary, but how we combine it with our nutritional supplements, medicine if we are ill, and the nine other elements give us the tools to expand our experience of optimal health.
Key words: Our body as a vessel for growth.
The third element envelops movement of all forms: aerobic and cardiovascular exercise, yoga, walking meditation and dance. Movement is within the spa space, or transition from one treatment to another consideration.
Key words: Experience of other. The fourth element involves embracing touch through massage and bodywork modalities to connect with the client on a deep level and enhance vitality and growth from within. As professionals in our industry you know this just hints at the depth of what we do and why we do it. Touch is not only one of the most profitable services in the spa, it is at the heart of helping people move to new and deeper levels: physical, emotional, and spiritual. Visit the Great Spa Conversation at www.spaelegance.com/gsc.asp or the International Spa Association (ISPA) at www.experienceispa.com and see the recent profile we developed regarding what qualities are most valuable for a massage therapist working in the spa environment. See if you agree. We want to hear from you.
Key words: Experience of self.
Located in the center of the circle, this element is the "ousia" or essence of the 10 elements. Ousia (oo SEE ahh; Greek in origin) is a concept that describes when mind, body, spirit all merge into one to make a memorable and meaningful experience. The definition of ousia is: essence; being; that which makes us who we are (but not a material substance) as well as our search for something greater than ourselves.
Key words: Earth as healer.
The appreciation of beauty, both inside and out is paramount to element six. Practically, it means feeling beautiful and embraces our current concepts of beauty, which include the outward manifestations of fashion, skin, hair, nails etc. Understanding this and enhancing this service in the context of total health bridges the chasm between feeling and looking beautiful.
Key words: Earth as home.
Environment is our place on the planet. Are we in the city, the coast or the desert? The treatments we choose are related to the season, the time, the weather. How we change and react to and with our environment as well as our commitment to be stewards of the earth are all contained in this element.
Key words: Sense of place in community.
Broad, yet basic in scope, the eighth element embraces the science, politics, belief systems and cultural appreciation of the arts in healing.
Key words: Integration of daily work as purpose.
What is our life's work? What is our heart's passion? There are at least two ways we are rewarded or satisfied by our work. One is monetary; the other is giving of oneself. This element explores the exchange or energy (including commerce) between service provider, client, spa and community.
Key words: Vehicle for transcending self.
The 10th element encircling all the others is actually metaphorical in nature as is the fifth element in the middle. It holds all the others, as a vessel from which the other domains interrelate and reflex into each other. This element embraces the seasons and rhythms of the human experience, incorporating the life cycle; biorhythms; chronobiology; the therapist's role as timekeeper; and more.
PART IV: A Call to Participate in the Great Spa Conversation
In summary, the Great Spa Conversation is about evaluating, expressing, and embracing our values; it is about our shared purpose. It is up to us to address and define professional competency, standards of practice and levels of excellence.
After all, spa is a peoples' movement. It is up to us to come together: to heal, to encourage, to challenge, to dialogue, and to question. It is great to connect with my roots in the massage and touch industry. I look forward to writing this series of articles featuring the 10 elements, but look forward to your feedback even more.
I can't believe how far we have come as an industry in the last 20 years. Have we made mistakes? Yes. Are we wiser? Sure. Can we do better? Absolutely. It is time for our collective professional voice to have more political and social influence. In the words of Margaret Mead: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it is the only thing that ever has."
Imagine what we can do as an integrated industry. Please join me on line at The Great Spa Conversation. Your voice makes a difference.
Click here for previous articles by Robin Zill, LMT.
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