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Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
April, 2003, Vol. 03, Issue 04
The "Medical Massage" Controversy
By Vivian Madison-Mahoney, LMT
After this article appears in print, some may ask for it to be my last; however, I feel the need to express my thoughts on medical massage, for what they're worth. I am certainly not an expert on this particular subject, so it's important to note that the following are just opinions.
I've read several excellent articles published of late on the subject of medical massage, and heard various discussions of what constitutes medical massage; reasons for and against further training and certification; and what kind of training is necessary (and who should do the training) if further instruction is required.
Reasons given in favor of medical massage include setting higher industry standards and providing additional credentials.For some, medical massage simply means more money-making opportunities gained from teaching; for others, it is possibly nothing more than an ego trip; and for others still, it is truly about care, safety and success in treating patients. This last motivation is the only reason I feel any specific medical massage training or education should be considered. Does it really need to be defined as "medical massage"? I don't think so.
Massage therapy necessarily becomes "medical massage" when it is performed according to a prescription from a physician who has diagnosed a medical condition. Insurance companies have reimbursed medical massage therapy for many years, whether performed by licensed or certified massage therapists, or any other health care providers authorized to provide and/or bill for massage.
Many insurers in Florida have reimbursed massage therapists directly since 1984. This therapy does not have to be referred to as medical massage; however, perhaps such a requirement exists in other states. In general, insurance companies do not reimburse for massage (or anything else) not considered medically necessary. A patient's condition is what determines medical necessity, and only a licensed physician can diagnose that.
We have accomplished a great deal in the past few years by informing the medical profession of the benefits of massage therapy. Many physicians now assume that if we are licensed, certified or trained, we can perform massage safely and effectively. They don't have time to check our specific credentials. There is no easy way to inform the medical profession who of us are licensed, certified or qualified, or with what specific titles or in what techniques or procedures.
In my opinion, basic massage school training is ever enough, no matter how significant it seems at the time. I also don't think any specific course of training can fulfill all needs. The well-rounded information one gains from taking hands-on courses over the years, from a variety of instructors and in various areas, is what most benefits the outcomes of patients' medical conditions.
We can only retain so much information at one time, and ideas, knowledge and opinions change. We can learn more at certain times than others, and from certain people more than others. However, one thing is clear: If therapists do not continue to learn and acquire additional training, they will not be able to retain their client base. We need the additional training throughout our practicing years - not just to obtain specific credentials, but to maintain interest, feel good about ourselves, and provide the most effective care to our clients.
Most students enter the field of massage therapy with little clue of exactly what they want to specialize in, and most never know when a physician will refer a patient to them, or when they will be asked to work in a physician's office or other medical setting. Consequently, medically oriented massage needs to be taught to all therapists in all schools. Therapists who intend to specialize or work in a medically oriented field will need to continue to pursue specialized areas of training as they become more familiar with their own needs, and the needs of their patients: the elderly, cancer victims, infants, and workers' compensation, auto, or other personal injury cases, etc. Therapists who do not wish to work on medically related clientele will be able to pursue further training or avenues that best fit their interests, but they will at least have a basic medical knowledge, so they can attend to their clients' needs based on their own learned skill sets.
Am I making sense? I attribute a great deal of my success to the varied courses I have taken over the years. The wide range of information I digested helped me treat patients with varying injuries and illnesses. Schools teach contraindications; patient care; safety; muscle origins, insertions and function, etc. However, I do not think enough classroom hours are dedicated to helping students understand what they are taught, particularly with respect to specific medical conditions (and how to treat those conditions, if the situation arises). The short amount of time, if any, spent on each subject in school is not enough for most students to truly get it - to truly comprehend it and become skilled at applying it.
These are just my opinions, but I also speak from personal experience, which comes from having spent a little over 15 years working almost exclusive with medically related cases prescribed by physicians from nearly all specialties. I am neither bragging nor complaining, but I want to make it clear that I have a good deal of experience handling medically related cases. In my practice, approximately 90 percent of our cases were medical referrals. We averaged 28 to 32 patient visits a day, six days a week, for years - that's over 600 medical cases/visits a month. I teach insurance billing procedures and medically related practice-building not just to make money; but because I know it and have lived it. I am happy to help others experience the same successes we did. Hopefully, we can help them avoid the many pitfalls we ran into in those early days.
Next time: Working with injured or unwell patients.
Click here for previous articles by Vivian Madison-Mahoney, LMT.
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