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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.
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."
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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."
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
March, 2003, Vol. 03, Issue 03
Swimming Upstream Toward Effective Practice
By Keith Eric Grant, PhD, NCTMB
Every now and again, I find myself grabbing some morsel of thought and running upstream through the frothing waters of accepted massage opinion, much like a salmon returning to its home waters. Today's morsel stems from a question posed to me about "how to improve the profession of massage." The center current of opinion, down which most previous effort has run, is that credibility for massage practice is obtainable by coercing the profession together through licensing and mandatory certification. Licensing, however, was never a tool designed by the government to imbue credibility and excellence of practice. It was only intended to protect the public from practices that could cause great physical or economic harm, and for which reasonable consumer knowledge and caution were inadequate remedies. There are no medical statistics indicating that massage practices, especially at the levels covered by licensing, fall into this camp. Similarly, mandatory certification has fallen short of addressing needs of practice that are sufficiently focused to be evident and useful. Applied nonspecifically, certification exams needlessly eliminate many people who are not proficient at short-term memorization, yet could contribute successfully into the more kinesthetic subpractices of massage. Such exams also are often too general to benefit subpractices more dependent on the manipulation of remembered details.4,5
Instead of the route of government-coerced cohesion, I believe it is past time to acknowledge and value our diversity of subpractices. It is time to create guidelines that provide specific guidance to schools, students and employers for what we actually do in different venues or subpractices of massage. I have taken a rough cut at defining a set of such subpractices in Table 1.
Note that the subpractices do not organize in a single line of increasing knowledge and skills. Likewise, the various subpractices are not all at the same level of knowledge and skills, but simply in different directions of applied technique. Therefore, we can talk about tiers and experience meaningfully only within a given subpractice. Across the total scope of practices, there are different needs for details of anatomy and clinical technique; skills of basic touch and human presence; formality of personal appearance; business skills; and interpersonal skills of communication, psychology and sociology. In many of the areas, communication skills and understanding of the applicable psychology may be as or more important to outcomes than particulars of massage technique. The importance of attitude and support noted for sports injuries is equally applicable to supporting recovery from illness in hospital settings or enhancing quality of life for the aged.2,7
My examination of guidelines on the process of creating guidelines has resulted in Table 2. Key aspects of the process are that it be evidence-based; involve all key players; and allow for its own evolution. We must take on the intensive process of first defining massage subpractices, then working with all affected parties to define knowledge, skills and abilities needed to practice effectively in each venue. It is only by hammering out a rough consensus of all participants for each subpractice that we will achieve workable guidelines. It is only when such guidelines have proven to be both useful and widely used that they should be considered as standards.
In seeking to form guidelines that promote our ability to engage effectively in a subpractice of massage, it follows immediately that we need a measure for effectiveness. In this, we owe a debt to the Italian economist Vilfredo Pareto (1848-1923). In 1906, Pareto observed that 20 percent of the Italian people owned 80 percent of their country's accumulated wealth. This 80/20 rule of imbalance has since been found to be applicable to many situations.6, 8
Based on the 80/20 rule, we may reasonably expect that, day to day, 80% of the tasks will be performable using about 20% of the subpractice expert's domain-specific knowledge and skills. The implication is that, if a person entering the subpractice comes with this 20% of the subpractice down cold, they will be able to accomplish much without having to stop constantly to consult a mentor or information resource. In all likelihood, they will have much more time and leeway to accumulate incrementally via experience the subsequent 80% of skills and knowledge. By encoding such expectations into guidelines that meet the criteria of Table 2, I believe that we can do much to make our efforts at training and practice more effective.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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