resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
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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