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News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
October, 2003, Vol. 03, Issue 10
Massage in the States: An Updated Look at the Data
By John Fred Spack, LMT
I have recalculated massage therapist densities based on new census and circulation data. My report on data last year appeared as a letter to the editor several months ago in Massage Today (www.massagetoday.com/archives/2002/11/16.html).The new figures show a continuation of last year's trend. These data are drawn from the July 1, 2002, United States Census Estimate for Total State Populations, and the June 2003 circulation reported by state for massage therapists in Massage Today, a publication of MPA Media.
Use caution when quoting these statistics. In conducting this research, it was unknown how Massage Today obtains its circulation mailing addresses, and whether the state-by-state breakdown bears a fair resemblance to the actual number of practitioners in a given state. Moreover, there is a small discrepancy in comparing 2002 estimates of population with 2003 circulation figures, which have been changing almost monthly. The census data used here did not account for state-to-state variations, which may occur in prospective massage therapy numbers. For instance, the data do not eliminate prisoners, members of the armed services abroad, or infants. Neither do the figures used show variations in concentrations of ethnic minorities, which may represent new opportunities for market penetration.
Density was determined by finding the ratio of total state population to total circulation of Massage Today in that state. A low figure may be interpreted as beneficial, meaning there are fewer members of the public apportioned to the services of one massage therapist. Per capita was determined as the reciprocal ratio: A high figure here equates to a low density, meaning there are more massage therapists as a portion of the population.
A nonregulating state was defined as a state that does not yet issue certificates for title use or licenses for practice. Twenty-one states were counted as nonregulating, including Kentucky; Illinois; New Jersey; and Arizona, where laws have passed, but are not yet implemented. Thirty jurisdictions were classified as regulating states, almost all of which are licensing states in the traditional sense of that term. Of the 14 states with the lowest density, all are licensing states. Many of these administer the oldest regulatory programs in the country. Of the 14 states with the highest density, eight are nonregulating states.
The overall per-capita availability of massage therapists in the U.S. is 2.9 times greater in regulating states than in nonregulating states. The mean density of 51 jurisdictions (50 states and the District of Columbia) is 3,428 persons per massage therapist. For regulating states, the average density is 2,497 persons per massage therapist; nonregulating states have an average density of 7,529 persons per massage therapist. The range of densities runs from Utah (low with 990) to Maryland (high with 16,053). South Carolina has the median density of 4,426. (Note: Massage schools may want to use the average density figure of 3,428 persons per massage therapist to encourage enrollment by those who welcome the challenge of developing a market, which is still fairly untapped.)
Massage Today reports that 68 percent of massage therapists are readers of its publication, according to an independent random survey of U.S. massage therapists (www.massagetoday.com/readershipsurvey). This may mean that Massage Today's circulation figures only represent 68 percent of U.S. practitioners; even so, there are no data that say this can be applied proportionately state by state. Nevertheless, even at 68 percent, it is unlikely that the corrected variation, state by state, would make a significant dent in the advantage of regulating states, having a magnitude of nearly triple that of non regulating states.
Some states present data extremely outside the trend. The three states with the highest densities are all regulating: Maryland (16,053); North Carolina (11,989); and Mississippi (13,675). However, most case comparisons show compliance with the overall trend. The per-capita occurrence of massage therapists in Florida (regulating density 1,119) is five-and-a-half times that of California (nonregulating density 6,331), if these data are to be believed.
Nonregulating Georgia (9,750) is nearly surrounded by regulating states with more favorable densities: South Carolina (4,426); Tennessee (3,762); and Alabama (5,608). Even so, all of these Southern states have densities above the national average, which may lead to some speculation about the nature of the market for massage therapy in this region.
Nonregulating states Massachusetts (3,367) and Vermont (3,178), while below the national average, are in the regional company of regulating states, most of which have even more therapists per capita, according to these data: Maine (1,941); Connecticut (2,544); New Hampshire (1,555); "anti-trend" Rhode Island (4,212); and diverse New York (6,738). The New York statistic is large enough to flip this region from a below-average density of 2,718 without inclusion, to an unfavorably high average of 4,138 persons per practitioner when New York is included. Nonetheless, seven of the 11 states with higher densities than New York are non-regulating states.
The case of Minnesota is also interesting; Minnesota is the pioneer Freedom of Access state, which makes it semi-regulated, but still subject to a patchwork of local laws. Being the 17th most dense (5,750), it falls into the pattern of nonregulating states when compared with regulating neighbors Iowa (2,919); North Dakota (2,114); and Wisconsin (3,016). With the implementation of Illinois' new law, it will be telling how this 14th highest state (6,667) changes. Another state that will bear comparison with Minnesota is Arizona, if only because it, too, has a new law to be implemented and has a comparable density (5,732), as well as total population (about 5 million people).
Another aspect of these data is correlation to longevity of licensure. At first glance, it appears that the longer state licensure has been in place, the more therapists - as a portion of the population - are available to the public. It is a challenge to explain the differences between regulating and non-regulating states. The trend is frequent, large, logical and comprehensive; however, certain assumptions may be challenged (like, for instance, that MPA Media is as aggressive at searching out subscriber addresses in nonregulating states as in regulating states, or that access to an address by MPA Media is comparable to access by the public to a corresponding massage therapist).
At minimum, these data cannot be used to support the Friedmanite Theory often presented to legislators, which argues that implementation of state licensure will reduce competition among therapists by lowering overall rates of entry into the profession.
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