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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.
November, 2002, Vol. 02, Issue 11
Exploring with Science
By Keith Eric Grant, PhD, NCTMB
As a scientist, I am often bemused by the apparently prevalent assumption in massage therapy that the role of science is as a sort of gatekeeper of proven methods.It's an outlook that I believe is derived more from a limited view of science as a promoter of mechanical technology than from the spirit of inquiry that beckons most research scientists. I have long recalled an article I read years ago on why people enter the pursuit of science. The title was "Whoa, look at that!" That simple title captures the spirit of curiosity and delight at nosing into the unexpected and unknown, better than anything else that I have since encountered. It's in that spirit that I'm writing today.
We do well to remember the gap that can exist between observation and understanding. Herbs containing salicylic acid had been used for centuries to relieve pain and fever before aspirin was purified in 1897. It wasn't until 1971 that Sir John Vane demonstrated that inhibition of cyclooxygenase (COX) by aspirin was responsible for its effects, sharing the 1982 Nobel Prize in medicine for that discovery. Only recently, a research group led by biochemist Daniel Simmons of Brigham Young University discovered a new variant of the COX enzyme that might explain the previously unknown action of acetaminophen.13 For massage and simple touch, I believe that many of the effects will be even slower and more difficult to elucidate, simply because they extend beyond the mechanical into simultaneous emotional, neurological, and neurochemical interactions. As with the complex connections involved with climate, better understanding of the whole picture may wait on our ability to use computers to simulate the entire system at work. Increasingly, such simulations are becoming a third branch of science - bridging experiment and analytical theory - because they make it possible to investigate regimes that are beyond current experimental capabilities, and to study phenomena that cannot be replicated in laboratories.
Within the last several decades, there have been several medical research developments that create a basis for some intriguing speculations on the effects of touch. In 1975, Dr. Robert Ader coined the term psychoneuroimmunology (PNI), beginning a new discipline of research linking the mind to the immune system.2,12 A recent small sample study with cellular analysis is consistent with massage having a positive effect on immune function.8 I tend to couple the research on PNI with the research and clinical experience of ideokinesis pursued by Eric Franklin and his predecessors.6 This material connects our mental imagery with creation and activation of our low-level neuromuscular patterns. In juxtaposition, PNI and ideokinesis substantially motivate respecting simple touch and relaxation massage as profound and deep reaching interventions toward managing stress and promoting health.
In a comparison of the co-location of acupuncture points and trigger points, Ronald Melzack and his colleagues found a remarkably high degree (71%) of correspondence.9 They concluded that "this close correlation suggests that trigger points and acupuncture points for pain, though discovered independently and labeled differently, represent the same phenomenon and can be explained in terms of the same underlying neural mechanisms." Based on further research into phantom limb pain, Melzack's group later proposed that we have an inherent neuromatrix, essentially forming an analog body within us.7,10 This neuromatrix acts to integrate our myriad sensory input into a coherent perception of a body. It also has a memory of its current state, helping to explain hypersensitivity towards experiencing benign sensations as painful. As a bit of blue-sky thought, I speculate that this research provides a basis for a western understanding of the meridians of traditional Chinese medicine. In this picture, the meridians don't lie within our physical bodies, but are a kind of circuit diagram of sensory relationships in how we form a cohesive sense of body from an overwhelming input of sensory information. There is no inherent conflict with an acupuncture point having non-local effects, because the important proximity is in neurological processing rather than physical space. There are some remarkable analogies to patterns of communication between individual processors in modern massively parallel computers. I find the possibilities intriguing.
When it comes to statements made about "energy work", I am rather an agnostic. Yet, nevertheless, I have experienced profound effects from such work and cannot discount the genre off hand. At this point, I see no basis for proposing fields of energy beyond the electrical and magnetic, so I return to consideration of these fields as recently reviewed by James Oschman.11
While what Oschman covers indicates that we all project fields around us, it doesn't support a conclusion that we are designed to emit beams of energy. Simply speculating on the maximum gain for the least energy required, suggests to me that something must occur in energy work akin to the improvements of tuning a piano.
Those talented in such work may simply possess perceptive skills akin to perfect pitch.1 Some recent studies with savants indicate that we all have neurological and mental capabilities beyond those to which we normally have conscious access.5 Some simply gain access by having the cloaking superficial layers of consciousness peeled back. These extra perceptional abilities include, for example, the ability to find the "sweet spot" in a room at which the sound from multiple speakers arrives simultaneously.5 There is every indication from such studies and from experience with biofeedback, that we are well-designed to detect and correct differences in "tuning" and coherence if we can perceive them. There is an additional observation that those with perfect pitch have a higher incidence of synesthesia, a mixing of senses. When hearing a sound, some, also perceive it as a color.1 This is suggestive that subtle sensations from bioenergetic fields could map for some into the visual, auditory, or tactile senses, giving person to person field interactions a rational basis. I think it likely that much that is taught about the techniques of energy work is simply a metaphorical roadmap to help train perception and focus the mind appropriately to enable subtle manipulations of bioenergetic fields.
While we must be careful not to interpret the perceptions stemming from cross-sensory mapping too literally, we should be equally careful in not dismissing them. Our neurological capabilities are turning out to be a lot more interesting than once thought, as science explores into the windows facing towards our inner selves. Whether we see two faces or a chalice can simply depend on our perceptions of foreground and background.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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