resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.