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Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
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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