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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
October, 2002, Vol. 02, Issue 10
CranioSacral Therapy vs. Cranial Osteopathy: Differences Divide
By John Upledger, DO, OMM
CranioSacral Therapy, which I developed in the 1970s, is compared frequently to cranial osteopathy, developed by Dr. William Sutherland. Although Dr. Sutherland's discovery regarding the flexibility of skull sutures led to the early research behind CranioSacral Therapy - and both approaches affect the cranium, sacrum and coccyx - the similarities end there.
What was to become cranial osteopathy began as the idea of an osteopathic student in Kirksville, Missouri, in the early 1900s.Dr. William Sutherland saw that the bones of the skull were designed to allow for movement in relationship to one another. It was a radical idea that flew in the face of American and British anatomy textbooks, which taught that skull bones fuse together before adulthood.
To test his theory, Dr. Sutherland filled a skull with dry beans and added water. This caused the skull bones to move along the suture lines, and ultimately to disarticulate. He also performed makeshift experiments on himself with helmet-like devices that imposed variable controlled and sustained pressures on different parts of his head. His wife recorded personality changes, head pain and coordination problems he displayed in response to different pressure applications.
Based on his experiments, Dr. Sutherland developed a system of examination and treatment for the bones of the skull that became known as cranial osteopathy. Because so little was known about how it worked - and patient results seemed miraculous at times - Sutherland's system acquired an esoteric reputation.
Conversely, the origin of CranioSacral Therapy can be traced to the accidental discovery of the craniosacral system during a seemingly routine surgery in 1970. At the time, I had a unique view of the dura mater, the outer layer of the meningeal membrane in the neck. Ordinarily compromised as part of surgical procedure, the dura mater was deliberately left intact during this surgery to prevent any risk of meningeal infection.
My task as a surgical assistant was to hold the dura mater still while the surgeon scraped a calcium plaque off its surface. No matter how I tried, I was unable to do it. The membrane continued to move rhythmically at a rate of about 10 cycles per minute. Neither my colleagues nor any medical text I consulted could explanation this phenomenon.
Still curious about what I had seen, I enrolled two years later in a seminar that explained Dr. Sutherland's ideas and taught some of his evaluation and treatment techniques. Coupling my scientific background with tactile sensitivity, I surmised that the rhythmical motion I had seen during surgery could have been caused by a hydraulic-type system functioning inside a membranous sac encased within the skull and canal of the spinal column. After further study and research, I refined Dr. Sutherland's techniques and successfully incorporated them into my private medical practice.
In 1975, I was invited by Michigan State University to lead the world's first task force to study and verify the mobility of cranial sutures and bones. For the next five years, I led a team of anatomists, physiologists, biophysicists and bioengineers, and together we researched the basics and potential for performing therapy on the craniosacral system.
Through an extensive series of studies and experiments, we demonstrated how the craniosacral system could be used to assess and improve numerous health problems involving the brain and spinal cord. Yet this was a very different approach than that used in cranial osteopathy. Here we were focusing not on the bones of the skull, but on the membranes and cerebrospinal fluid surrounding the brain and spinal cord.
We verified that the craniosacral system does indeed operate like a semi-closed hydraulic system. Pressures build as the amount of cerebrospinal fluid increases in the system, forcing the fluid to move up and down the spinal cord. When the fluid moves, the membranes containing it also move, normally at a rate of 6-12 cycles per minute.
CranioSacral Therapy practitioners are trained to gently monitor this rhythm to detect and release imbalances and restrictions in the membranes that could potentially cause sensory, motor or neurological dysfunctions. As such, CranioSacral Therapy is never intended to cure disease, but simply to facilitate the body's ability to self-correct. It offers a comprehensive, whole-body structural and functional evaluation protocol.
Even today, the focus of cranial osteopathy remains on manipulating the sutures of the skull. With CranioSacral Therapy, the bones of the skull are involved in that they serve as "handles" for the practitioner to use to access and affect the membrane system that attaches to those bones.
Another major difference between the two approaches is in the quality of touch. In general, the manipulations used in cranial osteopathy are often heavy and directive. Practitioners of CranioSacral Therapy usually use a light touch, scientifically measured to be between 5 and 10 grams. That's about the weight of a U.S. nickel resting in the palm of your hand. This gentle quality often belies the effectiveness of the therapy. Most patients report feeling nothing more than subtle sensations during a typical session.
Yes, CranioSacral Therapy and cranial osteopathy are quite different. Yet they remain linked in history by two osteopaths who trusted their observations and continued undaunted in their quests to prove their theories.
Click here for previous articles by John Upledger, DO, OMM.
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