Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
September, 2003, Vol. 03, Issue 09
What Memories Can Bring
By Keith Eric Grant, PhD, NCTMB
Teaching massage has many rewards.One of these comes from simply enjoying the interplay of individual personalities working together closely, as we do in massage classes. An even deeper satisfaction comes in watching how students' skills develop and their confidence increases over periods as small as several weeks. These developments imply that our teaching is making it into our students' sensory input through the filters of awareness and practice, and into their multiple types of long-term memory. Without memory, we would begin anew each week and never get far. Understanding more about the structure of memory gives us a hint of how learning occurs.
Neurologists have broken the structure of memory into sensory working and long-term memory.6 The first stage, sensory memory, receives the river of input from our senses. It has a large capacity, but only holds information for about one second. The next stage, working memory, has a more limited capacity (seven items, plus or minus two) and holds information for 20 to 30 seconds. Neurologists believe working memory can be divided into a central executive controlling attention, an auditory (phonological) input loop, and a visual input sketchpad.1 The final memory stage is long-term memory, which handles anything we remember longer than working memory can hold. Long-term memory has a near-infinite capacity and seems to be broken up neurologically to process different types of input and content. Long-term memory is thought to divide into declarative memory (conscious memory for events and facts) and implicit memory (unconscious memory for skills; habits; repeated recognition; emotional responses; skeletal musculature; and reflex pathways).9
What neurologists and psychologists have learned about the structure of long-term memory functioning has often come from examining the effects of brain injuries. More recently, functional magnetic resonance imaging (fMRI), which measures oxygen flow to different areas of the brain, has been used to display activity in different structures of the brain while doing specific mental tasks. Foster and Jelicic discuss research with amnesia from brain injury in introducing a recent compendium of articles on the structure of memory:5
The term 'memory' can refer to numerous different kinds of remembering and types of knowledge. We will be dealing with information, which is retained in long-term or secondary memory, also referred to by some authors as the permanent memory store. This memory store spans a period from a few minutes to a lifetime. Within this system, evidence from amnesic subjects has proven particularly informative in determining the organization and operating principles of memory. Thus, amnesic individuals have profound memory loss for events which occurred after their brain damage (i.e. they manifest a severe anterograde amnesia), but relatively better preserved memory for events which took place before the occurrence of the brain damage (i.e. their retrograde amnesia is typically less severe). Amnesiacs also typically have preserved functions in other psychological domains; for example intelligence, perception, language and motor functions. Importantly for the theoretical view of long-term memory organization, amnesiacs continue to be able to learn specific types of new information, such as perceptual and motor skills.
It's striking that motor skills can be learned by amnesiacs when they no longer have the ability to memorize facts or remember events for more than a few seconds. This "dissociation" between brain functions indicates to neurologists that conscious (declarative) memory and (procedural) memory for motor skills are physically separated in our brains. Even more intriguing, amnesiacs presented with a word, such as "reason," tend to complete the word fragment "rea" as "reason," rather than other alternatives, such as "reader " or "reality."3 Although conscious memory was lost, some previous experiences remained at an unconscious level.
There is a profound implication in this research that the touch we provide in massage will interact with both conscious and unconscious memories. This provides a pathway for working with life experiences our clients may have consciously forgotten but still recall in their body usage. Such research also adds direct neurological support for pediatrician Mel Levine's observation that neurologically based memory deficits can be very specific, compromising performance; for example, in the massive detail recall used on tests while allowing near normal processing in the less memory-intensive activities of everyday life.7
The physical separation of different facets of memory helps explain the observation that the activity in which facts are presented is an integral part of what is learned. Situations co-produce knowledge through activity. Learning, and the ability to use what is learned, is fundamentally linked to the situation in which it occurred. There is a strong indication that competence can only be measured in situations approximating actual usage. Even the medical profession is becoming aware that objective knowledge and competence are not equivalent, leading to a proposal that "professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served."4
Working with the memory we each have been given, there remain ways in which we can prompt our memories. Elizabeth Phelps describes ways that emotional content may improve recall, perhaps explaining Elizabeth Bowen's observation in my opening quote:8
For instance, although we know that there are several different types of memory in humans, the predominant one is the ability to recollect information at will. These memories for emotional events seem to have a persistence and vividness that other memories lack. There are several possible ways emotion may alter this explicit, hippocampal-dependent form of memory. Emotion may alter the rate of forgetting for emotional stimuli. Emotion may also provide an organizing theme to aid in later recall. Emotion may influence attention or perceptual encoding, which may effect later recollection. Emotion could also add a component of distinctiveness. All these variables may act independently to influence our ability to recollect emotional information.
Before the printing press was invented, techniques for memorization held greater importance for maintaining and passing on knowledge in an oral tradition.10 People used mnemonic strategies that grouped information using acronyms for easier recollection. We still do this today, using the acronym SITS, to help remember the muscles of the rotator cuff, the Supraspinatus, Infraspinatus, Teres minor and Subscapularis. We still use acrostics, in which the first letter of each word in a sentence is the first letter of a bone or muscle. Thus, the phrase, "Some Lovers Try Positions That They Can't Handle" helps us to remember the eight carpal bones: Scaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapezoid, Capitate, and Hamate.
A more involved visual format of mnemonic, the Method of Loci or "Memory Palace", dates back to the Greek orator Simonides in the 5th century BC. Supposedly, Simonides was at a banquet, but had left the room just before the roof collapsed. He helped identify the bodies by visualizing a walk through the room, as it was when he left it, noting where different people were in the room. Later, remembering would be visually associated with specific settings in visualized buildings, or so-called "memory palaces." To remember the material, one simply walked mentally through the buildings, often to recalling sequences of items that numbered in the thousands.
Memory brings us much in our senses of self and embodiment. Living within our bodies, sensory input - touch; texture; odors; and light - acts as a direct pathway into accessing memories held below our conscious recollection. In touching our clients' skin, we touch their entire lives - history, present, and future. It's something to remember.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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