resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
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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