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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
February, 2003, Vol. 03, Issue 02
By Steve Capellini, LMT
Author's Note: The Spa Letters column features news, personality profiles, trends, and plenty of professional possibilities for LMTs in the spa industry. The style is epistolary, meaning the articles are letters to a fictional massage therapist friend of the author.
So, the medical spa is open, and you're interfacing with doctors and nurses and physical therapists. You're looking at forms, charts and files. You're wearing blue surgical scrubs to work, and feeling a little different about your massage career than you did a few months ago at the luxury spa. It's not exactly the way you thought it would be, is it? I understand you're feeling a little let down now, after all the anticipation of getting the medical spa up and running. Reality is seldom as romantic as imagined.
Your two main complaints about your new position are ones I had myself, when I first worked with plastic surgeons who were converting their offices to mini-spas. Complaint number one -you feel there's too much emphasis on the external beauty aspect of the services rendered at the spa, rather than true health and well being; complaint number two - you didn't fully realize you'd have to wait until the insurance reimbursements came through to receive the commissions on the services you give.
I'll talk a little about these issues, and see if there's a way I can help put you more at ease when it comes to working in the medical spa environment. You don't want to bail already; after all, it's only been a month, and you're not even sure the spa will be a success or not. I think you should give it more time and see what happens, especially considering you've just relocated to a new city.
More Than Skin Deep
I can see why you might feel the spa is focusing too much on the aesthetic aspects of health (tummy tucks, liposuctions and face lifts), rather than the holistic/preventive aspects that inspired you to join the field in the first place. You're at a medical spa, where you thought you'd have the chance to interface with people on a more in-depth level, and you've ended up dealing with more superficial issues than you did at the luxury spa. There, you were free to deal with clients as you saw fit, but now things are more regimented. How can you apply your deeply therapeutic skills to someone interested primarily in reducing hip measurement?
I think we're at an early phase of the entire medical/spa integration, and we have a long way to go to reach the lofty plateau you thought you were going to step into right away. Indeed, a handful of spas offer guests serious medical screening and comprehensive lifestyle assessments, such as those at La Quinta Spa, the Chopra Center for Well Being at La Costa, and the Ojai Valley Inn & Spa's Destinations Health programs. I believe this is the wave of the future, even though it's taking a while for the general public to catch on and fully embrace the new paradigm.
What we have to deal with right now, however, is that a majority of the public regard spas as places where they can go to look and feel their best. These are the famous "Baby Boomers" who want it all, and want it now; the me, me, me, me, me generation. I know this doesn't sit well with your natural therapist's instincts of wanting to help people on a meaningful level, but I don't think you should write off the medical spa just yet.
The way I feel about this issue can be summed up in the words of Jen Kerr, who once said "I'm tired of all this nonsense about beauty being only skin deep. That's deep enough. What do you want, an adorable pancreas?"
In other words, it's OK for people to be focusing on their beauty, Lou, and you can help them get the most out of their experience, rather than fighting against what you called the "superficial culture" of the spa.
I know it must be tough, waiting months for a good chunk of your money to come through, but hey, you knew buying into the medical model was going to have some drawbacks. The insurance labyrinth is one of them. I agree it's not an ideal situation, and as an employee, you shouldn't have to wait to receive compensation, just because the business hasn't received payment for the services you've rendered. But remember, you are not just an employee; you're a partner, with stock options, and you're partaking of both the upside and the downside of the business's cash flow.
Consider yourself lucky that a large percentage of the medical spa's business is "out of pocket" because these are for the most part elective cosmetic procedures not covered by insurance. Can you imagine what it would be like if 80 percent of your paycheck was withheld, rather than 20 percent?
Give It Some Time
Lou, it concerns me a little that you're already thinking about leaving the medical spa. You should at least give it a couple more months. Sometimes those of us in the spa industry for a long time refer to the high-turnover rate in soap-opera terms - "As The Spa World Turns." People are constantly hopping from one property to another, sometimes to the detriment of the spa guests' experiences.
I'd like to see you hang in there for a while and see where this medical spa paradigm will take you. Who knows? There may be some unknown reason you are where you are right now. Perhaps it's not the stock options, or even the chance to work in a medical setting, that has brought you to where you are, but something else entirely - something hidden, something about to be. Just wait and see.
Until next time,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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