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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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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."
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.
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.
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.
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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