resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
July, 2003, Vol. 03, Issue 07
We Get Letters & E-Mail
By Editorial Staff
Editor's Note: Some letters have been edited for space and clarity.
Controversy Over Fees
I would like to thank Alice Belusko for her letter to Massage Today (March 2003, www.massagetoday.com/archives/2003/03/15.html) in reference to my article, "Fees" (October 2002, www.massagetoday.com/archives/2002/10/10.html).
In response to Alice's statement, "I'm not sure if [Vivian] has personally done 25 hours of massage, week in and week out, for any substantial period of time.If she possessed this type of experience, I'm sure her article would have defended the billing fees of LMTs": In my defense, I did not begin to perform massage therapy until I was 45 years old. I worked seven days a week, every week, on seven to eight patients a day. I worked this way for over a year from 8 a.m. until sometimes as late as midnight, often going home in tears with sheer exhaustion. I charged $25-$40 per massage, each being one hour or more, mostly deep-tissue. I opened my own office after a year.
During this time, many of these clients became medical and insurance-related cases. Alice misquoted or misunderstood me in her letter by saying I had charged $95 per massage in 1984-85. I first charged $35 to $40 until I began the prescribed therapy. I then raised the medical-case fees to $56 for years, until I got the nerve to raise prescribed fees to $65. I finally raised the basic rate to $75 in late 1997 for hands-on services, and added $20 for a modality if prescribed (whether or not it was for one or four modalities).
I also served for nine years as the insurance committee chair for the Florida State Massage Therapy Association (FSMTA). We worked very hard to get laws passed that required insurance companies to reimburse massage therapists for massage when prescribed by physicians. We were successful partly because we showed that we provided the same services as other providers, but at a savings to insurers. At the time, workers' compensation was paying a maximum of $58.50 per treatment, which was my average, since most of my cases were from workers' compensation. Now, worker's comp payments average about $96.
Why did I have a successful business? Because I built a reputation providing quality services at reasonable prices people and insurance companies could afford.
Florida law states in essence, "If a policy covers massage then it shall cover the services of one licensed to perform massage."
Make no mistake. All the insurance companies have to do is write massage out of the policies, and WE ARE DONE! Insurers are looking to save money. If we provide the best for less - I didn't say for nothing, only less - then, we will be searched out, not written out.
P.S. At age 63, I still carry my table and give as good a massage as anyone. The client or insurers will still get what they pay for even though I do not charge upwards of $150 or more for the therapy. Luckily, I was able to retire on the measly low rates I charged, so now I do not have to do that. I sincerely wish that for all of you!
I just had to respond to the ludicrous letter from Alice Belusko. I do not dispute the title "My hands are just as important as a surgeon's hands," but all goes downhill from there; the rest of the letter is basically bereft of reasoning.
To the whine: "Do you know how many years the therapist can work? When was the last time you saw a 60-year-old massage therapist dragging his or her table through someone's front door?" I am almost 60 years old, and I can still perform this "heroic" work. I had the basic common sense to purchase a light weight table and a carrying case, so I can actually carry, rather than drag the table. Why would someone who has 25 hours of massage every week, year after year, avoid the common sense to rent an office and avoid all this pathetic dragging?
I agree with Vivian that billing $145 to $175 an hour is excessive. I bill according to Medicare limits, all of my fees, whether private insurance or Medicare. The amount allowed in this area for manual treatment is $25.34 for a 15-minute increment. An hour would be $101.36. This is what anyone would get for this treatment, including occupational or physical therapists who have much lengthier education requirements.
If it's worth it to you, pay it out of your pocket, but spare the rest of us the rapidly accelerating insurance rates by gouging insurance companies and giving responsible LMTs a bad rep.
I am writing in response to Vivian Madison-Mahoney's article, "Fees" (October 2002). With all due respect for Vivian's areas of knowledge and expertise, I feel that the massage practitioners who have invested in specialized training, and have committed to doing the work that results in the resolution of repetitive strain injuries; whiplash; frozen shoulder; failed back surgeries, etc., are well able to command rates other than those commanded by massage therapists with "minimal training." These techniques produce real results.
It's a big world out there, and while traditional forms of bodywork certainly have their place in the scheme of things, perhaps a broadening of perspective would refresh not only Ms. Madison-Mahoney's frame of reference, but also acquaint her with new vistas of paradigm in our wonderful profession - ones that the medical profession are only now beginning to turn to.
The average case of carpal tunnel syndrome costs around $100,000 between lost productivity, worker's compensation and medical costs. A few treatments with a massage therapist highly skilled in the techniques which resolve soft-tissue dysfunction and syndromes (which end in "itis") is a sure bargain.
C. Carow, NCLMT
"A Fully Trained Massage Therapist is a Medical Professional"
This is a commentary to Vivian Madison-Mahoney's view on the "Medical Massage Controversy" (April 2003, www.massagetoday.com/archives/2003/04/07.html).
I am not really sure when "massage" became nonmedical and started to be linked to pleasure, mischief and more. It is not accidental that a massage therapist is called a therapist - a therapist being a medical professional, according to my terminology.
In my opinion, a fully trained massage therapist is a medical professional. I would like someone to explain the difference between a regular massage and a medical massage. If I visit my massage therapist, I will tell him/her where it hurts, which area to concentrate on and which ones to avoid; he or she will do their best to comply. I am usually relieved of pain (if sometimes only temporarily) and feel de-stressed and relaxed - an added benefit.
This I do, because I would rather eliminate aches and pains the natural way than to pop any kind of pain medication, even if it is "only an aspirin or Tylenol", or similar. For those kinds of ailments, I do not need a doctor's prescription, but would recommend that insurance companies provide reimbursement for visits to a massage therapist just as they would for visits to any medical professional; this, along with other complementary medical modalities, should be addressed by the insurance companies, as they will be saving money in the long run by investing in preventative and natural health care from the start. If we would all ban together to make this happen, then we would make progress in all of our fields.
I wholeheartedly agree with Ms. Madison-Mahoney that schools should devote much more time to the medical side of how massage can relieve a number of conditions, and when to refer a client to a doctor; agreed that many years of experience will give a massage therapist more confidence and expanded knowledge, but the base education should be more solid than what is being taught in massage schools today. If like in the medical profession, the massage profession could implement various degrees of LMT to assure clients of the courses and CEDs a therapist has studied and earned, or the specialty of an individual therapist, this would elevate the level of the massage profession and hopefully, one day, will eliminate associating the profession with escort services.
Hannelore R. Leavy
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