resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
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.
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.
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.
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.
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.
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."
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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."
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.
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.
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.
April, 2003, Vol. 03, Issue 04
We Get Letters & E-Mail
By Editorial Staff
Editor's note: The following two letters are in response to Ralph Stephens' December 2002 column, "No Better Time Than Now." The second letter is accompanied by a reply from Mr.Stephens.
Responding to the Call for Activism
It is not often that I comment on articles written in publications. However, as a massage therapist in Texas who is not a prostitute, I was compelled to write after Ralph Stephens' column. Ordinarily, I would have dismissed his statements as erroneous and ignorant, and felt assured that only a few people in Texas would read them. However, since your paper boasts of more than 1 million Internet hits, his published comments raise deep, genuine concern here in Texas.
I accept Mr. Stephens' challenge for each individual massage therapist to become active and "do his or her part" to correct this misconception about Texas. In particular, I ask that Mr. Stephens show documentation to support his statement that "As the emergence period ends, the co-opting period is beginning. It is going quite well in Texas. Prostitution has just about reclaimed the term 'massage' there. Many of what are called 'massage schools' in Texas crank out prostitutes faster than therapists," or retract the statement with an appropriate apology. I also ask that the above quotation (or the entire article) be deleted from your Web site.
By the way, I agree with Mr. Stephens' assessment that massage therapists must defend and protect our scope of practice through individual legislative activism. Thank you for your consideration of my concerns; I look forward to Mr. Stephens' reply (either his research or his apology).
Orbie Ratliff, RMT
"It is now time to do the right thing"
This e-mail is regarding Mr. Stephens' comments about Texas massage schools producing prostitutes. I am no longer comfortable leaving Massage Today in the reception area where I work. Mr. Stephens' comments were not supported by facts and could easily cost us accounts to provide massage services. The way I see it, Mr. Stephens has two choices. He can name names and make a report to the Texas Department of Health; if it fails to do its job by taking action against such therapists, you can complain. The system in place is complaint-driven, at least to some degree. Mr. Stephens has an ethical obligation to file a report. If not, he is "aiding and abetting." On the other hand, if Mr. Stephens is unable to provide specifics to back up his comments, they are nothing more than hearsay. In my opinion, his only other choice in this case is to make an unqualified apology; specifically acknowledge the information is hearsay; and resign his position. His irresponsible comments jeopardized a profession we have spent years building. Our most difficult struggle with our clients is in helping them get past the notion that massage is about sex. Presently, myself and others are researching legal options regarding some sort of libel lawsuit. I suspect our options will be limited, but we believe that as long as Mr. Stephens' comments stand, our practice is threatened. It is now time to do the right thing.
Lori Dupree, RMT
Getting the Toxins Out of Massage
Many thanks to Keith Eric Grant for his article, "Flushing Out Myths" (MT, Dec. 2002). For 10 years, I have heard from clients that they are "full of toxins"; most of them have this impression because they heard it from massage therapists, or from others who heard it from massage therapists. I think it is a disservice to encourage people to think they need massage because they are "toxic," and that massage therapy helps correct this problem. People who already may be anxious or uncertain about their health status do not benefit from the erroneous, alarming image that they are being poisoned by metabolic sludge. I also think some massage therapists may avoid taking responsibility for using inappropriate depth of pressure on sensitive clients by explaining that postmassage discomfort is merely from "getting the toxins out."
I'd like to see more honest and responsible discussion of the role of massage in cellular metabolism. I think we should share accurate information with our clients on the known, positive effects of massage, and we should not be afraid to say, "We don't know yet" in response to some questions. We will all benefit if we eliminate misleading, toxic claims from our interactions with the people we serve.
Margaret Caro, LMT
Editor's note: James (Doc) Clay's January 2003 column, "The Clinical Track: Introduction, With a Response to AMMA," inspired considerable letters to the editor, one of which is printed below. Massage Today regrets that it cannot publish all of the letters we received. The complete text of Mr. Clay's article appears online at www.massagetoday.com/archives/2003/01/12.html.
"Medical massage truly is holistic medicine"
I am a graduate and a student of the Blue Heron Academy of Healing Arts and Sciences [Grand Rapids, Mich.]. In addition, I maintain a private practice in the Blue Heron Clinic and have been a member of the American Medical/Manual Massage Association (AMMA) for three years. I am a medical massage therapist, but more accurately, a manual therapist. In the article, Mr. Clay states, "We do not treat conditions according to medical diagnostic criteria, but according to clinical massage therapy assessment criteria"... and then says how he would treat it. As a Blue Heron graduate and a medical massage therapist, I treat according to medical diagnostic criteria, not the way either an medical doctor or you would treat. That being said, I'm sure there are plenty of similarities too. Tendonitis (can also be spelled correctly as tendinitis) also is called "medial epicondylitis" or "golfer's elbow." It results from injury to the common flexor tendon. A simple test for this condition is active wrist flexion against resistance. I palpate the affected area; fold the tissue; perform deep tissue to periosteum massage (not painful, because the tissue is folded and because I use a soft-hand technique); note adhesions and fibrosis; do joint physics;bony lever at the joint junctions; etc. If you could watch me, or any of my peers, do this, I suggest you would be witnessing something you have never seen anyone do, anywhere. We use a dry-hand technique and achieve unique results. Some of these techniques are original, courtesy of Dr. Gregory Lawton, DC, DN; some are 100-year-old naprapathic techniques. It's medical massage/manual therapy - what soft tissue work was meant to be before the advent of "swedish massage." It's our heritage as massage therapists.
Mr. Clay also says problems with the wrist and hand are traceable to the forearm, elbow, shoulder or chest. The first thing I do when a patient tells me he or she has wrist and hand pain is inquire about any recent or old neck injuries. If not localized fibrosis (wrist, hand, forearm, or just above the elbow), this type of pain is usually indicative of brachial plexus nerve impingement. The brachial plexus is a plexus of five nerves that grow out of the spinal cord at C5-T1and innervate the neck, shoulder, arm and hand. Pain is on the ulnar or radial side of the limb helps differentiate which of the five nerves is involved. My point here is that medical massage therapists who graduate from Blue Heron know neurology: We know where the nerves track, and what soft tissues the nerves innervate. If there is a problem with that soft tissue, we go to the nerve root at the joint and work there. We work at the nerve root. If I find adhesions in the neck related to a patient's pain, that's the area I'm going to focus on. Do you see my point? This is all medically based. You pointed out the incorrect spelling of "biceps," but more important than that, do you know that is does little good to do considerable soft tissue work on any biceps muscle belly? If a patient has pain in a biceps muscle, you would best spend your time and your patient's money by working at the joint at which the biceps attach/insert.
One hundred years ago, MDs touched their patients, and did so based on scientific findings. They were physicians, and they did soft tissue work - imagine that. In fact, some of them wrote a book called, Medical Massage. Dr. Lawton didn't just dream this stuff up; we have the book to prove it. This is what medicine used to be.
Mr. Clay also states, "I can't help feeling that the use of the word "medical" in designating our profession betrays a desire to enhance our prestige ..." As far as I'm concerned, there is nothing prestigious about being an MD these days. Certainly they want to practice medicine well, but their training has steered them far afield. If you have consulted with or been referred patients by an MD, you know it's not a real pleasant experience, but nevertheless a necessary one. I'm ashamed and embarassed by the MDs and DCs who refer patients to me. What passes for a physician is in shambles, and so are patients' bodies. The MD sends me the people he's poisoned, cut and burned, and the DC sends me the patients he's used his newfangled hammer on. They wonder if there is anything I can do for them; yes there is, thanks to my training. encourages us to get out into "the field" and deal with these real clinical issues based on our holistic training. You can call it "clinical" or "medical," but I prefer the latter term because that's what it is: medicine.
The allopaths took the word medical from us. Holistic treatment was considered medical before most of us were born. All soft tissue workers who want to practice noninvasive, holistic medicine by touching people based on the modern discoveries of science and anatomy are denied this privilege by the modern allopaths and some chiropractors.
Mr Clay says, "We would do well to maintain our independence from more traditional disciplines." Allopathic medicine is more accurately called modern medicine. What we do, as soft tissue workers and as massage therapists, is traditional medicine. We are holistic. Medical massage is science-based, holistic ... and it works. It's the way medicine used to be, and the way it will be in the future, including new techniques based on new research. What goes around, comes around.
Mr Clay says, "Massage is not inherently holistic." If it's not, then what is it? In my opinion, medical massage truly is holistic medicine. The AMMA is not frozen, petrified, closed-minded or institutionalized. We simply approach soft tissue work/massage based on the most up-to-date knowledge of anatomy, physiology, etc., the way the serious medical practitioners of old practiced.
This discussion is worth having. I enjoyed Mr. Clay's article. Thank you for providing a venue to voice our opinions.
Lisa Townsend, PMT (Professional Manual Therapist)
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