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Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
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.
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.
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
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
June, 2002, Vol. 02, Issue 06
Step Six: Construction
By John Fanuzzi
This month's topic is the actual construction of your spa. If you have done your homework and worked in conjunction with your spa consultant and interior designer or architect, you should be well prepared.The more detail you've provided on the design and specs, the easier it will be to get bids that will not be susceptible to huge overruns and misunderstandings with the builder.
Its time to decide whether to choose a general contractor, whose job it will be to coordinate the entire job, including carpentry, electrical, plumbing, tile, painting, finish details, etc., or to serve as your own construction manager (general contractor). With the latter option, you'll bid out and coordinate all of the subcontractors and do most of the pricing, purchasing, and scheduling yourself. You will have to also get the permits as an owner/builder. I would only recommend this option if your job is a renovation and if you have construction or management experience. You will also be responsible for the quality control of your own job. This may also take away from your spa operation planning, but, could save you as much as 10% to 20% of the construction cost.
Whether or not you use a general contractor or not, you will still be shopping for the best quality for the least price. You should get at least three bids from reputable general contractors, or from each subcontractor if you are the general contractor. If your plans and specs are well-prepared, the lowest bid will work fine. However, if your plans are not well-detailed, a low bid could actually cost you more in the end, particularly if there are changes needed that are not detailed enough on the plans. For example if the concrete floor is poured and your floor drain is in the wrong place, the wrong size, or forgotten because the equipment was not specified, this could represent a major extra cost. Sometimes a low bidder can see that your plans are not clear enough and will come in with a low bid, knowing he or she will get the job, but make up for the low bid on the extras and change orders, and at the same time not have to be accountable for delays. In any case, make sure you know the hourly rate you will pay in case of changes. It is also important to require a finish date, with a penalty clause if the work is not completed on time.
You should time your construction to be finished about two-to-four weeks before you open, to allow for a little cushion and to schedule a training period. This overlap will give you the option to train in your own place if the building is done on time; if more time is required for construction, you can still do offsite training. (It is much better to do the training onsite if at all possible.) The extra cost of an offsite training facility rental should be figured into the cost of non-performance to be paid by the contractor. You should also keep an ongoing punch list of incomplete work and withhold a part of your final payment until such work is completed. There should also be a workmanship guarantee clause - especially for plumbing, electrical, and mechanical problems that could arise as a result of improper installation or use of inferior materials.
Make sure that you completely understand your contract before you sign it. If you have any questions your builder cannot explain and you cannot understand, you probably should get legal advice before you sign. You should also have your spa consultant review your contract and final contract plans before you sign, just to be sure. If you been independently creative and have not hired a spa consultant from the beginning, this is your last chance to avoid potentially costly mistakes before construction begins.
Another important bit of advice is to make sure the contractor is licensed and insured, including liability and workers' comp. It is actually legally possible that you could be liable for personal or property damages caused by a construction accident even if you are leasing the property.
Don't forget to put up your "Coming Soon" signs to let the public know your spa is in the works! Next month, we'll change gears and start to talk about the actual business operations master planning.
Click here for previous articles by John Fanuzzi.
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