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Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
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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