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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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."
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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."
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.
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.
March, 2003, Vol. 03, Issue 03
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.
Danger! Red flag! After only a few months in the medical spa business, you're heading to a lawyer's office downtown to give your first deposition.This is definitely not something you envisioned back in those idealistic days when you were attending massage school, is it?
I know you're nervous about all the legal implications, but it's probably best to stay calm. Take this thing one step at a time. It's important for you to know people are on your side; they believe in you. It's great that Barbara, your fellow massage therapist at the medical spa, is on your side. When things get tough, it's easy to see who your real friends are, isn't it?
Of course, I'm on your side too, as always. I trust 100 percent that you had only the best interests of your patient in mind, even though she's now suing you - and the spa! Before you get caught up in the emotions of the situation, remember to focus on the facts first.
Fact: You were giving a cellulite-specific massage to a woman, using a technique known as Endermologie.® This technique employs two mechanical rollers and suction to effect the subcutaneous fat layers. The woman came to the spa for three treatments before she stopped and called her lawyer.
Fact: The woman signed up for this series of treatments of her own free will, and signed a waiver excusing the spa from liability.
Fact: The woman is blaming you and the procedure for creating a ping-pong-ball-sized indentation in the flesh of her right thigh. Yes, the depression is quite noticeable - you could rest a boiled egg there and it would not roll away. In tens of thousands of hours of Endermologie® treatments given worldwide, there has never been another recorded instance of this happening.
Fact: As a member of the American Massage Therapy Association, you have substantial liability insurance coverage. The owners of the medical spa are saying you should bear the burden of this lawsuit yourself, even though they, and the company that manufactures the Endermologie® machine, have more resources than you do.
So, what conclusions can you draw from these facts? First of all, I'd say your new bosses, the ones who promised you the stock options and the partial ownership of this "hot" new medical spa, should perhaps not be counted among your true friends. If they truly believed in you, they would be taking your side in this issue. The fact that they're distancing themselves from you, when you need them most, speaks volumes about their character.
Second, I'd say that regardless of what the woman claims, there's a good chance neither you nor the treatment caused her problem. Look hard, and I feel reasonably sure you'll find another reason. The fact that no other such case has been recorded should give you a clue. The woman feels hurt by this blemish on her body, and she is quite likely lashing out against the only source of the problem on which she can put her finger.
Finally, something definitely is going on here. The deformation of this woman's leg is real, and the situation should be addressed head-on. Even though it makes you nervous, you're doing the right thing by heading in for that deposition. When you talk to the lawyers, just be as upfront and communicative as you can.
What Does Liability Look Like?
I know it must be causing you a good deal of anguish to think that your actions (and perhaps even a lack of skill) caused physical harm to someone else. No matter how strongly I or other people might council you otherwise, there's still a part of your mind that will entertain doubts on the issue. So, let's explore your liability (or lack thereof) for a moment, and try to put your mind at ease.
You were trained by the manufacturers of the Endermologie® equipment on the device's use, and the mechanical massage maneuvers you performed could not possibly lead to the deterioration of this woman's muscle tissue. Still, let's say for argument's sake that a judge were to find you in some way liable. What would that mean? What does liability look like?
In my view, liability looks like the price you have to pay when you put yourself "out there" in an attempt to help people. If you had stayed at your position at the resort spa doing primarily Swedish massage and didn't learn cutting edge mechanical massage techniques like Endermologie,® chances are you wouldn't be in this situation now. However, you'd also be a different person. Sometimes, liability is the price we pay for being who we are. Responsible people are liable.
You should feel some small measure of comfort in the fact that you've had the courage to choose a path that is not always easy. When you put yourself into hands-on contact with the public, you're never sure exactly what's going to happen. It will always be this way.
I think the most valuable lesson you can take away from this experience so far is this - you have a good friend in Barbara. She's standing by you, even when it would be much easier for her to side with the spa owners, or at least to distance herself from you in this matter. Remember, I mentioned in an earlier letter that I thought the real reason you were working at the medical spa wouldn't be revealed until a later date? Well, perhaps this is the real reason: You were meant to strike up a friendship with your fellow massage therapist. You two are already bouncing ideas around about possible other projects on which the two of you can collaborate.
Look for the secret gold in this situation, even when things look so dire right now. Spend more time with Barbara. Write me anytime. Hold your head up high and remember who you are: a therapist with integrity, skill and a sincere desire to do right by every client with whom you come in contact.
Talk to you soon,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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