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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%.
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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
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.
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.
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.
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.
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.
June, 2003, Vol. 03, Issue 06
The World of the Injured Worker
By Vivian Madison-Mahoney, LMT
Author's note: This revised article was originally prepared by myself and Sherry Smith, LMT; it was presented to a three-member panel of the Florida Workers' Compensation Division, which included Insurance Commissioner, Bill Nelson.The panel was in the process of revising its 1997 "Florida Workers' Compensation Health Care Provider Fee For Service Reimbursement Manual" during a time when the workers' compensation system was trying to eliminate massage therapists from the original draft for changes in the system; needless to say, workers' compensation carriers in Florida are still reimbursing us. It pays to fight for your rights!
This article is directed toward those interested in working with injured workers. If you have not considered working with these types of patients, this article may help you understand why accepting some insurance for reimbursement is necessary.
I originally wrote this article with the Florida worker in mind, so some references may not fit the circumstances in every state; still, it is generally the same everywhere. Keep in mind that not all cases or conditions are the same, and this article focuses on cases involving the more serious or catastrophically injured worker. Health-care providers who specialize in work injury cases generally agree that the following summarizes the experiences of a typical injured worker.
The Typical Injured Worker Scenario
The Employee's Continuing Nightmare
At this point, the employee can experience any of the following:
Surveillance of Injured Workers
The insurance carrier's surveillance officer begins to film the employee engaging in activities such as attending a child's baseball game; walking with a cane through a fairground; or swimming.
Consider the following examples:
Injured employees may experience fear knowing that their every move may be filmed. They can't tell whether they are being stalked; are about to be robbed or beaten; if their children are in danger; or if it is just the carrier's surveillance crew filming their activities. This causes undue stress and fear for innocent employees who, through no fault of their own, were injured.
These stories go on and on. Surveillance films (paid for by the carrier) often present a distorted or incomplete report of the employee's activities, or are not even of the patient.
Searching for Normalcy
The employee will try to find some semblance of normalcy by trying to engage in daily activities as best as possible, even though these minor activities can cause undue pain. Unfortunately, the surveillance crew is not present to film this pain or disability. The employee's injury may allow him or her to engage in certain activities for short intervals when there is time available to recuperate. These activities may not allow for repetitive motion but may be necessary to begin the improvement process; however, the employee may not be able to perform on the job without ample rest time between activities. Once again, the insurance carrier's spot surveillance is taken out of context, and the employee is punished for trying to rise above his or her injury by beginning to participate in short and varied activities.
The Employee's Changed World
By now, the employee's world has changed - maybe forever - because of this injury. The employee's disability income does not meet financial obligations; disability checks that were initially on time become delinquent or are cut out completely at the whim of the insurance carrier or adjuster.
The employee's once-good credit rating is lost as bills are turned over for collection. Collectors call the home daily. The employee's spouse works, but can no longer carry the financial or emotional load alone. Family emotions and financial pressures continue to escalate. The employee receives the disability check late, or it is reduced or stopped completely. The utilities are shut off. The adjuster refuses the prescribed treatment plan, including medications, and the employee cannot purchase the prescribed medicines. The employee's spouse is leaving him or her, or contemplating doing so. The employee has no choice except to seek legal counsel. The children suffer from experiencing the discouragement, depression and other sorrows created by the situation.
Employee Seeks Self-Medication
To obtain some relief, the employee begins self-medicating with prescribed medications (if he or she can get them through workers' compensation coverage); over-the-counter medications, alcohol; or all of the above, to cope with the physical and emotional pain. Some employees become addicts.
To keep sane, the employee seeks the help of a mental-health counselor or is referred to one by the attending physician. The employee feels emotionally strung out, despondent, and sometimes suicidal. The system has created the need for these additional services.
And They Wonder Why?
Many months (frequently, more than a year) have elapsed since the employee's injury, and the employee feels as if the world is crashing down. Despite many forms of treatment, the employee's condition has not improved and has often intensified. The employee has begged for something to help him or her deal with the pain and get back to a life that includes work and normalcy. Despite what the employer or insurance carrier may think, the majority of employees do not like watching soap operas, feeling incompetent, and being out of the work atmosphere: It has been forced upon them by the system.
It is my belief that the majority of injured employees would rather work than be supported or made to feel the effects of despair, inadequacy, and self-doubt created by the system and this situation. And they wonder why they can't get an injured worker off of temporary or permanent disability to return to work.
No two cases are alike: Not all carriers defer treatment, and not all employees are completely honest; but there are a few exceptions, and it is those exceptions that get the most publicity. It is my opinion, from my years of observation, that employers and insurance carriers pay a much greater price to avoid paying for the catastrophic legitimate cases, than they lose on those who try to elude the system now and then.
I will be attending the annual Workers' Compensation Educational Conference again for the 19th year. (Incidentally, there are more surveillance exhibits there than other types of services.)
The Employee Finally Receives a Prescription for Massage Therapy
Watch for the continuation of this article in the August issue.
Click here for more information about Vivian Madison-Mahoney, LMT.
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