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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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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?
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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.
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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