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Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Fish Oil: A Key Component of 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?
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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