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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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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."
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.
May, 2003, Vol. 03, Issue 05
Ancient Trade Routes
By Keith Eric Grant, PhD, NCTMB
By the end of the first century B.C., there was a great expansion of international trade involving five contiguous powers: the Roman empire, the Parthian empire, the Kushan empire, the nomadic confederation of the Xiongnu, and the Han empire.Although travel was arduous and knowledge of geography imperfect, numerous contacts were forged as these empires expanded-spreading ideas, beliefs, and customs among heterogeneous peoples - and as valuable goods were moved over long distances through trade, exchange, gift-giving, and the payment of tribute. Transport over land was accomplished using river craft and pack animals, notably the sturdy Bactrian camel. Travel by sea depended on the prevailing winds of the Indian Ocean and the monsoons, which blow from the southwest during the summer months and from the northeast in the fall.2
Cities along the silk, spice and incense trade routes are prime material for adventure and romance novels. Even the names of the routes conjure up visions and suggestions of exotic sounds, scents and textures. So great were the influences of ancient trade cities that even today, we can almost imagine the cries within their marketplaces. Cities such as Petra and Palmyra once grew rich providing services to merchants and acting as international centers of trade. They also became cultural and artistic centers, where peoples of different ethnic and cultural backgrounds could meet and intermingle. They were the commercial and intellectual hubs with links extending to touch every corner of the known world.
Interestingly, we are only now gaining full understanding of how pervasive such links and hubs are in our lives. In his recent book on networks, physicist Albert-László Barabási provides an overview of ongoing research into the laws governing the way connections form within networks as they evolve and grow.1 Common structuring seems to exist: from the number of chemical reactions linking key molecules together within a cell; to structures within our bodies for communication, transport and support; to associations between actors who have made films together; to ancient trade routes; to the links between the ever-increasing information nodes on the Internet. It has become apparent that, on all spatial scales of organization, the linking between nodes or sections is not random. There are patterns with small local clusters of linking, with few links per individual, and certain individuals or places that act as major hubs, with many connections leaping to distant parts and places.
One of the studies Barabási discusses found that job seekers more often succeeded through their acquaintances than through their closer friends. A person's friends were in the same "small world" cluster in which everyone basically shared the same information. One's acquaintances provided links to other clusters of people in which new opportunities were available. In marketing our practices, this concept of long-range links yields the insight that we should seek to find and develop connections with those who will be our gateways to other groups. As we become known for offering services that add to individual support networks, ameliorate stress, and resolve problems of body usage and history, our personal links will multiply, and our practices will prosper.
Several conceptual keys open doors to understanding and modeling what we observe in diverse worlds of interconnectivity. First, making the interconnections needs to be a dynamic process of growth and change. Second, when a new person or item in the network is added, key hubs already possessing many links will be favored to get the new link (literally a type of "the rich get richer" favoritism). Finally, a solution or place providing a better fit to the current need will preferentially attract links, even to the detriment of well-established key hubs.
This last point, in particular, explains how new trade cities might grow, and old ones decline, with the introduction of a newly discovered route or technology. It equally explains how, as an instance of adapting to strain in accordance with Davis's law, the fascia within our bodies will adapt to a change in posture and body usage following the start of a new activity, or following an injury.3,6 Our unifying webs of fascia grow from an embryological viewpoint and modify continually from a life usage viewpoint.3,5Tom Myers, particularly with his work on "anatomy trains," seems to have captured the aspects of our fascial webs as networks of communication.4
While it is true that 'everything is connected to everything else,' some bits are more connected than others. An extension of the pioneering work of Dr. Ida Rolf and her system of Structural Integration, these 'myofascial meridians' provide a map for postural compensation, which, when grasped, provide a model for 'tensegrity' balance of the myofasciae around the skeleton. Using this scheme, unexpected linkages lead to new 'whole body' strategies for manual and movement therapists.
The interconnectivity that Myers implies adds the perspective to our work that we are never, in truth, just engaging a local area but initiating a chain of communication and compensations that will spread over a client's entire body. As our fingers ply the ancient trade routes of our physical embodiment, we bring goods of comfort and relief that reach back to our beginnings as human beings and beyond. We are linked by many webs of connection.
Everything touches everything. - Argentinean author Jorge Luis Borges
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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