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Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
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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