resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
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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