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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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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."
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
August, 2003, Vol. 03, Issue 08
The "Secret" of Chinese Pulse Assessment, Part II
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
Editor's note: This series of articles is based on information from Barbra Esher's forthcoming textbook, Shiatsu and Chinese Medicine.
Last time, I gave an introduction to taking the pulses using the information gathered within the context of Chinese assessment principles.In this article, you will find the method for taking the pulse and the correlations to the whole body.
Method for Taking the Pulse
If you want accurate readings, it is essential to decrease your variables as much as possible. I can't emphasize this enough! There are so many things that will affect your readings. Being consistent each time you take a pulse will enable you to better evaluate the information.
The best time to take the pulse is at the crack of dawn, which is considered a neutral time between yin and yang when you can get the most accurate reading. I don't know about you, but I am not ready to restructure my practice so that my clients line up at 6 a.m. to have their pulses taken! Instead, I give my clients a few minutes to settle down from the yang of rushing to get to their appointment (between the yang of the outside world and the relative yin of my office) and take their pulses at that time. Most of my questions are guided by what I feel in their pulses.
To start, make sure you are grounded: both feet on the floor if you are sitting, shoulders relaxed and your breath regular and natural. Traditionally, the pulse is compared to that of the healthy practitioner. You could always use a clock if you aren't in optimal shape! Likewise, the client needs to be relaxed: shoulders dropped, with nothing even slightly occluding the arteries. The hands need to be below their hearts, resting naturally on a pillow or their bodies. The client can be sitting or lying down, but be consistent with whatever way you do it.
Use your first three fingers to rest on the radial artery at the styloid process, with your right hand on the left wrist and your left hand on the right wrist. The first position is sometimes referred to as cun, or inch, and is on the wrist crease, just distal to the styloid process. The second position is called guan, or bar, and is right over the process; the third position, chi, or cubit, is just proximal to it. The pressure is fairly light at the superficial level, slightly deeper at the middle level, and just before the bone for the deepest level.
Pulse Position Correlations
It is common for the superficial and deep positions to be each associated with a meridian; there are three superficial and deep pulse positions on each hand, making a total of twelve pulse positions. Interestingly, the positions were described in the Nan Jing (Classic of Difficulties, written around the 2nd century CE) using six meridian terminology, such as Hand Taiyang and Hand Shaoyin for Small Intestine and Heart. This specifically relates to the meridians more than the organs - a distinction not normally made in English. That's why ABTs often use this pulse map, compared to later ones commonly used by herbalists.
The Nan Jing used and developed the Five Element theory more than other Chinese medicine texts, and you may notice those correlations within the positions. The elements associated with the positions on the left hand control or act on the positions on the right. Fire (SI/H) controls Metal (LI/Lu); Wood (GB/Li) controls Earth (St/Sp); and Water (Bl/Ki) controls Fire (TH/Pc). Thus, it is thought that the pulses on the left hand are stronger than the right, though often with people that are Blood-deficient, this is not the case.
Start taking the pulses using this map and write down how strong or weak the pulses are in each position. Group the pulses into the upper part of the body for the first position; the middle part of the body for the second position; and the lower part of the body for the third position. You will notice that the part of the body in which your client feels the most discomfort is the pulse that stands out as the most weak or strong, in relationship to the other pulses. You will refine this technique the more you practice!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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