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Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
June, 2002, Vol. 02, Issue 06
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.
You see? It wasn't as bad as you thought. When you were able to convince management that the "open book" policy might work for your spa, and that it was a good idea to disclose some of the costs of doing business with the therapists, everyone calmed down a bit. Now the therapists are happier doing the same work they were before, and they feel more a part of the big picture, too.
The open-book policy can be a good one for many spas, and you've seen it work. But now the therapists have just one last bone to pick as far as what they want from the spa, and on this topic I'm going to have to side with them. They want the spa to pay for part of their continuing education in the field, and I think that's right.
Of course, once again you're stuck in the middle as the spa treatment supervisor, needing to appease the therapists on the one side, and management on the other. I think there might be a solution that will make everyone happy.
Retention vs. Detention
I know you might have trouble convincing the spa ownership to invest in furthering the education of their therapists. The first thing you're likely to hear is something along the lines of, "Why should we pay for them to get more training, when then they might just take off and work for a competitor? We'll end up paying for their education and another spa will swoop in and pay them slightly more per treatment, thereby receiving all the benefits of our generosity."
That is a viable concern on the part of your spa management and owners, but guess what? There are countermeasures the spa can employ to minimize worries of this kind.
First of all, certain spa managers and owners need an attitude adjustment. Specifically, they need to alter their concept of the phrase "employee retention." For many managers and human resources departments, retention means something more like "detention." Due to the high costs of hiring and training new people, they will do anything they can to keep the employees they already have, but instead of coming up with inventive ways to make their employees want to stay, they try instead to instill in them a fear of leaving. "What if you loose your insurance?" they say. Or "That other spa might fire you within the trial period. You'd better stay here where you have security." Employees can end up operating out of fear rather than motivation. They feel trapped rather than inspired - detained rather than retained.
Spa management can get around this problem by encouraging their therapists to learn new skills that would make them valuable to competitors. Yes, that's right. It's counter-intuitive, but it works. And the way it works is through incentives and recognition.
Incentives and Recognition
As you well know, Lou, what massage people want most, in addition to good pay and the satisfaction of helping people one-on-one, is some recognition from the people with whom we work. We want our skills and abilities recognized and appreciated.
Some spas offer to assist their therapists with the expense of continuing education, and then when they come back to the spa to use their new skills, they are given special recognition as they move toward becoming "advanced therapists." An advanced therapist is someone who can perform most or all of the modalities offered by the spa and who has been with the spa for a certain period of time. Someone who can perform Swedish, neuromuscular, stone massage, reiki, reflexology and Lomi-Lomi, for example, will help the spa by being available to cover many guest requests during all possible shifts. This person becomes highly valuable and deserves to be considered an advanced therapist, as long as her skill levels are satisfactory in each modality.
That's the recognition part.
The incentive part has to do with pay, of course. Once a therapist reaches the "advanced" level, he or she is paid a little more per treatment, which makes sense because the spa usually charges more for these services as well. In addition, if the spa helps out with the tuition for the classes taken, that adds another incentive to stay with the same company. Imagine working for people who actually want to help you become more qualified so you can earn more! This is the situation at some spas, and the therapist turnover rate in these facilities tends to be much lower than the average.
How Much Is Enough?
There are differing thoughts on the matter of how much is enough when it comes time for a spa to actually shell out money for their therapists' education. Many spas opt to pay for a trainer to come on site and offer classes to the entire staff, which is often more cost-effective than subsidizing therapists' individual classes. However, those that do offer a form of "scholarship" usually give a certain percentage, not the entire amount of the class. A 50/50 split is typical. Sometimes the spa only pays a quarter of the class fee, or a flat rate, such as one hundred dollars per class.
Really, any amount, even just a $50 voucher toward a class, is enough, as long as it demonstrates management's commitment to furthering the skills of their staff.
You also need to be realistic when it comes to what the spa will be willing to provide. You can't expect the moon. I can think of no spa that would offer their therapists a full ride to the Rolf Institute, for example. Financial help is only given for classes and workshops that will give therapists skills they can put to use in the spa immediately after training. If a therapist wants to learn Thai Massage, but it's not on the spa menu, it wouldn't make sense for the spa to subsidize part of the training. However, if several therapists are interested in a new technique, that may be a good opportunity to expand the menu at the spa and add the new modality.
Recognition of Specialists
Of course, some therapists want to stick with what they know best. Becoming an advanced therapist who knows several techniques is of no interest to them. They'd rather hone their skills in one area or technique. In this case, the spa can provide some assistance and incentive for the therapist to take advanced courses within the modality, becoming an advanced practitioner in one specific technique. Often, therapists who get proficient enough in a certain modality end up leaving their place of employment to set up their own studio or clinic, and that too should be encouraged!
Put the Money Where It Matters
Do you see where I'm heading? In my last letter, I told you that therapists need a refresher course on the bottom line of spa operations so they don't get unrealistic expectations about their salaries. I believe therapists, especially newer ones, should be happy to receive a reasonable wage even a little lower than what they might expect. Then at the same time the spa can offer some incentives and recognitions for those therapists who improve and help the spa over the long haul, nurturing those who are willing to commit to the growth and success of the overall enterprise. The cost of subsidizing some training will be lower than trying to keep therapists on board with higher salaries, and it will foster an environment of loyalty.
Even if therapists eventually leaves you to open their own business, you'll have created such good will that they will probably have someone to recommend to you to take their place.
My advice is to tell your spa owners it's smarter to put the money where it matters, in recognition and incentives, rather than an ill-advised raising of pay to try and "detain" a team of therapists.
Talk to you later,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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