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5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
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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