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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
November, 2002, Vol. 02, Issue 11
We Get Letters & E-Mail
By Editorial Staff
Who We Are
Like yourself, I have a passion for definitions. In my experience, to truly understand the meaning of a word, I often find it necessary to look at the word's etymology.A favorite example is the term "idiopathic." Doctors use the term to mean "disease of unknown origin" - a euphemism for "It's all in your head!" Literally, idiopathic means "suffering unique to the individual." This latter definition respects the fact that everyone is different, and that even the best physician doesn't know everything.
Likewise, "therapy" has two quite different definitions, depending on which Greek root word you use, therapeia or therapon. The former means "healer," but the latter means "witness" or "attendant," probably in much the same sense as the Society of Friends uses the term. Many, perhaps most practitioners of anything who call themselves "therapists" see themselves as healers, but their "clients" are the ones who do the healing. And only the clients know, albeit subconsciously, what they need to heal. The best we as practitioners can do is to use what skills we have to facilitate that healing.
Incidentally, the word "client" means "One who uses a professional service." A "patient" is "A person to whom something is done."
The main reason I am responding to your editorial is the question at the end: "Into which pigeon hole should massage therapy be placed?" (Editor's note: See "Who Are We?" by Cliff Korn, NCTMB, in the September 2002 issue.) Since entering massage practice in 1988, I have heard the question, "Are we a personal service?" asked many times. On every occasion, it was made clear that the politically correct answer was, "No, of course not! We are professionals!" Just this year, it dawned on me that all health care is personal service! The public would be far better served if everyone in the "health care" community realized that.
Warren Marsh, NCTMB
"We are individuals in our work and our dress"
While I respect for Dr. Benjamin's opinion, it needs to be noted that it is just that: his opinion. His comment that someone dressing in "sloppy workout clothes" to do massage is unprofessional, but not unethical is truly only his opinion. (Editor's note: See "Ethics, Values and Principles" by Ben Benjamin, PhD and Cherie Sohnen-Moe in the August 2002 issue.) I think the so-called "white-collar workers " set a dress standard at one time, and if someone didn't dress exactly like all the others (in dark suits, panty hose for women, etc.), they were considered unprofessional. I would like to think that such a diverse group of massage professionals would not have us all wearing white lab coats or khaki pants and tucked-in shirts. We are individuals in our work and our dress.
When I get a massage, I want a therapist who is clean, and clean, cared-for hands, and does not smell like cigarette smoke. Beyond that, I truly don't care if he or she wears shorts, long pants, a sweat suit or a flowing dress, as long as his or her clothes don't touch me while I'm receiving my massage. It is a misguided concept that you can't be comfortable and casual and still be professional. Even corporate America is changing its views and allowing casual wear and even jeans in the workplace. I certainly don't want someone who dresses like a nurse or doctor to work on me. I don't want to think I'm in a medical office. I don't want someone in a suit working on me, either!
I suggest that those who think we all have to dress in one particular fashion to be considered professional should rethink their position! My own clients see me in a variety of clothes, ranging from shorts in summer with T-shirts, to sweat pants in the winter. They may not dress like I do (although many do), but they certainly value my work and consider it professional.
Sandi Russ, LMT, NCTMB
Massage in the States: Let's Look at the Data
In your June 2002 issue, Chris Castanes of North Myrtle Beach, South Carolina wrote that he was having a hard time understanding why massage therapists would want licensure laws. (Editor's note: See "We Get Letters & E-Mail" from that issue.) Since he could not come up with any positive answers, and since I want to believe that massage therapists are balanced people, I thought I'd brighten his day.
I am sure there is no better census of massage therapists than your mailing list. I ran the subscription figures for MTs in your June circulation count against the last U.S. census estimates (July 2001) for population. I know we should do more detailed study (one that considers the data in adult/child categories, for example), but go with me on this. The average ratio of the general population to massage therapists in the United States (50 states and the District of Columbia) is 3266 to 1. Amazingly, of those 20 states with a better ratio -- that is, having more access to and choice of massage therapists -- fully 85% (17) are licensed states. For convenience, I am counting those few certification states in the licensing category as well. Of those 31 states with a massage therapy "shortage" (below the U.S. average), more than half (17) are unlicensed states.
Here's another way to evaluate the data. In the 31 licensed states (evaluated as a whole), the availability of massage therapy, measured by the per-capita ratio, is 40% greater than in the unlicensed states. Starkly, those above-average 17 licensed states have an availability that is over three times greater than the availability in the below-average 17 unlicensed states.
For those who believe that the collective mission of massage therapy is to make its benefits available to all, licensing has good data to offer. Perhaps what this all means is that states which support a great deal of massage are most likely obtain licensing. Or perhaps, as I think, it means that licensing of massage therapy at the state level increases the availability of massage therapy, contrary to the intuition of libertarian economics. Libertarian critics surprised by this data may have failed to consider that state licensing is potentially less restrictive than local patchworks of varying impositions on the massage market.
Let's track these figures over the next several years and see if this difference is not just a snapshot, but a trend. May your publication prosper so that we always have your circulation numbers, which are almost impossible to reproduce for unregulated states. Of course, there are many assumptions that go into my twist on these figures, but it will take a lot of debunking to knock down that 3:1 ratio.
Returning to the points made by Chris Castanes, let's spotlight South Carolina and also Arizona, the state that prompted his letter. Presently, Arizona is 35th in massage therapists per capita, with 939 MT subscribers and 5,652 people per identified therapist. Thus it's chances of climbing after licensure look good, given the upside potential. Since Minnesota is 34th, and has the new Freedom of Access law, it could be an interesting horserace. Every Massage Today reader can run his or her own data study on these states or the next state to get licensure. Keep your eyes on those circulation numbers! South Carolina has 958 MT subscribers, which represent about 0.024% of the 4,063,011 people in the state. That's 4,241 people per massage therapist; a good year's work if you can get it (I do 17 massages a day, don't you?). Next door in Georgia, the last standing domino in the eight southeastern states, there are 9,410 people per therapist clamoring for massage services (wishfully). The upshot: South Carolina, with uniform state licensure, has over twice as many massage therapists per capita as Georgia, which has no state licensure. And that's a good thing.
John Fred Spack
"I am completely insulted..."
I am completely insulted by your interpretation of part-time therapists. (Editor's note: See "Part-Time Professionals" by Cliff Korn in the March 2002 issue.) I have worked as a part-time therapist for six years. I have a very successful practice and maintain a full-time job as an accountant. My decision to keep my "day job," as you put it, allowed my husband to pursue his career dream. My intention is and has always been to work full-time as a massage therapist. I keep myself up-to-date on what is happening in the massage community, and I consistently update my education and credentials. Balancing a full-time job, a part-time job and home life is certainly not easy. I do not always get to attend the conferences that full-time practitioners do; however, to imply that I am any less knowledgeable or capable as a full-time therapist is outrageous.
I believe many circumstances play into why an individual chooses to work part-time. Some are not as fortunate to have a partner who is able to support the household while they build their practice. Others are not blessed with the opportunity to start their practice with the assistance of a chiropractor, where the client referral is much bigger. Either way you view it, the bottom line remains that there are hardworking, dedicated, ethical and professional people working in every field -- and none of that has nothing to do with the amount of hours they put in.
To say that part-time therapists do not meet the requirements of full-time therapists is irresponsible. You were completely out of line to put such a negative perception out there for people to see. The small bit of backpeddling at the end of the article, stating that full-time vs. part-time will not equal more professional, is just not enough. I expect to be supported andencouraged by other professionals in the massage community. I did not receive either from your article.
Jennifer Wagner, LMT
A New Perspective on Massage
My comments are in response to Mr. Stephens' recent series on "Massage Education Failing." (Editor's note: The five-part series by Ralph Stephens, BS, LMT, NCTMB, is available online at www.massagetoday.com/columnists/stephens/articles.html.) From Ashley Montagu's Touching comes the quote: "I know that touching was and still is and always will be the true revolution." When we touch people with bodywork, we have the power to change their lives and and our own. This power comes not only from technical skill, but from our intention. In a recent guest editorial in Massage Magazine, Dr. John Upledger wrote: " I think loving compassion is the kind of medicine that is needed today... if you keep your attitude and intention positive, you're going to do a lot of good... you will be offering compassion."
I've been a massage instructor and program supervisor for nearly 10 years, and while I agree that the quality of massage education could use improvement, I totally disagree with Mr. Stephens' suggestions! I wonder, has he ever taught an entry-level class? Many of my students have struggled with academia all of their lives; massage school is finally a place for them to succeed in a hands-on profession. These students bring their hearts and hands to their work and offer their clients the loving, nurturing touch so desperately needed to help heal our society. To require them to complete two years of college as a prerequisite for entering massage school would put an undue burden on them -- for what gain? Many of my students with masters' degrees cannot hold a candle to students with GEDs who put their hearts and souls into their work. Academic success does not translate into great bodywork.
Unfortunately, all of Mr. Stephens' ideas (including mandatory accreditation!) are based on such traditional, academically oriented approaches to schooling. Massage demands an entirely new perspective. This perspective can be found in Howard Gardner's book, Frames of Mind, The Theory of Multiple Intelligences. Written in 1983, this book proposes that most education targets language/logic learning approaches, to the detriment of those with other learning styles. Certainly academic achievement is predicated on reading, writing and arithmetic! Mr. Gardner details multiple intelligences or learning styles: intrapersonal; interpersonal; visual/spatial; musical; bodily/kinesthetic, naturalist; and of course linguistic and logic/mathematical. Can you guess which styles are strongest among massage therapists? As an educator, I adhere to the Latin meaning of educate: "to bring forth the potential within." When we limit our teaching to fit preconceived, outmoded approaches to learning, we lose many potentially successful students. The challenge of quality education is not to standardize teaching that promotes only the academically gifted, but to seek creative approaches that embrace all learning styles.
I sincerely hope that massage schools will succeed where our traditional institutions of "higher learning" have failed so miserably!
Gail Frei, LMT
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