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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.
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.
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.
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.
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.
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.
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 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.
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).
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).
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.
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.
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%.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
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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