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We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
October, 2003, Vol. 03, Issue 10
We Get Letters & E-Mail
By Editorial Staff
Editor's Note: Some letters have been edited for space and clarity.
The Breast Massage Controversy Continues
Dear Massage Today:
I have been a New York state licensed massage therapist for nearly 5 years.This is the first time I have felt compelled to respond to something I have read regarding our profession. I read Mr. Korn's July editorial (www.massagetoday.com/archives/2003/07/10.html), together with his responses to questions he received regarding that editorial in the August issue (We Get Letters and E-Mail, www.massagetoday.com/archives/2003/08/17.html). I am appalled by his comments that "female massage therapists regularly get massage from therapists specifically trained in breast massage to enhance their breast health."
First of all, I receive regular massages from colleagues, and NEVER have I received a breast massage from them. Second, please show me some statistics that indicate breast massage "enhances breast health." (This sounds very much like a male chauvinistic statement.) Third, since when is breast tissue considered "muscle" and therefore subject to massage? Naturally, there is underlying muscle tissue and I have, in fact, utilized massage in this area for female clients following mastectomy. But, the breast tissue itself is NOT muscle. And lastly, NYS law prohibits breast massage - period. I have never performed massage on breast tissue and would not even suggest it to anyone - even with a "specific informed consent." I don't want to lose my license.
I might agree, slightly, if Mr. Korn were suggesting that female massage therapists, who do regular self-breast examination, have heightened palpation skills and notice irregularities more readily than the lay person, but even this statement is suspect, as any woman who practices regular self-examination knows when there is an irregularity in her own breast tissue.
Your Mr. Korn is full of bad advice and bad knowledge. I think his advice is dangerous, and I hope he doesn't practice massage in NYS.
Jody Learned, LMT
Cliff Korn responds:
This writer's concerns are exactly the type of undereducated thought processes that stimulated me to suggest that people need to avail themselves of skilled touch in the first place. I will respond point-by-point:
This writer proves a point I have always believed: A quality massage education is not tied to hours. New York has a 1,000-hour licensing requirement, and I daresay that most massage therapists with far fewer hours of schooling are well versed in this writer's shortcomings.
Lastly, the writer should go back and reread her NYS regulations where she'll find the following statement: "When massage of breast tissue is therapeutically indicated, the female patient/client must be fully informed and give consent before the therapist undrapes the breast for treatment (www.op.nysed.gov/mtguide.htm)."
So, I don't think that I am "full of bad advice and bad knowledge," and I stand by my initial recommendations.
Cliff Korn, LMT
"Have you had problems with the NCBTMB?"
Dear Massage Today Readers:
We are seeking the pros and cons of those who certify through the NCBTMB. Our experience has shown us no difference in competency or quality between those who do and do not certify; moreover, we have found NCBTMB's testing process to be untimely and not cost-efficient. We are compiling a record of problematic experiences candidates have had, and would appreciate any experiences candidates would like to share. Our hope is to one day have an examination process that will indeed credential a therapist of higher competency, whether it be through improving NCE or creating another [test]. We look forward to your feedback.
Selena Belisle, President
The following letters were not published in the print version of Massage Today.
In Support of Breast Massage
I am not a massage therapist, but I am married to one. I just read the letters to editor in the August issue (www.massagetoday.com/archives/2003/08/17.html), and I felt that I had to respond.
The breast is made up of tissue, nerves, lymph glands and the other good things that make up the rest of the body. For years I have suffered from breast congestion -- that is, tender breasts caused by lymph blockage. The breast is part of the body. Men have them too and they get theirs massaged! Women's are just a bit larger. We are told to check our breasts every month for changes; however, the breast changes day to day.
We can massage our own breasts, but the leverage acheived by someone standing over is much better. When my breasts are tender, a good breast massage relieves any lymph blockage and takes the tenderness away. As long as the touching of breasts is limited to sexual connotation, a woman will never get a good body massage. A breast is an extension of the female body -- nothing more. The mind needs to be open and trained to think of it in that matter. When a massage therapist gives a massage, he or she should maintain a professional state of mind and should be able to touch any part of a woman's body.
If we trust our doctors to touch our breasts and be professional, then a professional massage therapist should also be allowed to touch breasts in a therapeutic setting. Massage is for the wellness of the body, and the breasts are part of the body!
A Difference of Opinion
Cim Roesener of Kansas should relax (We Get Letters and E-mail Online, www.massagetoday.com/archives/2003/09/12.html).
Roesener wrote about the "mistake" that "excessive limitations on massage therapy's scope-of-practice [was] being imposed by the state legislature," charging that SB 225 passed in Kansas with ineffectual monitoring and opposition from massage therapy associations.
I'm guessing Roesener has misread the bill and is unaware of the legal context for massage in Kansas that prevailed before the bill was even written, and continues today. The purpose of SB 225 as far as massage therapy is concerned was to liberalize the law, not make it more strict. The bill merely takes the words of the existing Kansas exemption, now in the healing arts licensing law (§65-2872), and applies it to physical therapy. Here is the exemption language in Kansas' healing arts legislation, which matches the quote Roesener lifted from SB 225:
"(f) Persons who massage for the purpose of relaxation, muscle conditioning, or figure improvement, provided no drugs are used and such persons do not hold themselves out to be physicians or healers."
There's nothing new in it, regardless of how limited one might think the imputed scope of practice is. Instead of wondering about professional associations not lobbying against this exemption, massage therapists should actually see this as a small step forward.
For quite a long time, Kansas has been the original "freedom-of-access" state, at least as far as exempting massage therapy goes. Still, SB 225 reminds us that freedom-of-access laws as passed in Minnesota and California are not doing enough of a favor for massage therapy if they only provide exemption from one or two laws that require physicians to be licensed.
Massage therapy needs to be exempted from physical therapy; chiropractic; naturopathic; acupuncture; and even cosmetology laws. None of that will handle the problem of exemption from local county and city parlor laws, however. So in the end, perhaps Roesener and I do think favorably about state licensure. Most massage therapists see it is the cleanest means of providing freedom of access to a broad scope of massage therapy, for both levels of government.
John Fred Spack
"A 'regulated profession' is the basis for the public's assurance of quality-of-practice"
I am a Registered Massage Therapist licensed in British Columbia and Ontario, Canada, and am American. I read with concern the clause in the new Arizona legislation that refers to sexual impropriety (July issue, www.massagetoday.com/archives/2003/07/01.html), which [prohibits] massage therapists [from committing such acts], then continues on to detail inappropriate sexual behavior. I understand both sides of the concern.
On the one hand, it should not need mentioning because of the ethics [massage therapists] uphold; on the other hand, there is a need to let the public know they are protected and when the line has been crossed. However, there is a sneaky insinuation in the law that massage therapists are really NOT safe or at least not to be fully trusted. In Canada, we went through this, too.
When I entered the profession in 1983, I would get a telephone call every couple of weeks asking, "how the girls are." After all my training and the difficulties of starting up a new practice, it made me disgusted and frustrated. It is different now, twenty years later. We have a College of Massage Therapists (board of massage therapy) in British Columbia and Ontario legislated by the government, whose mandate is to protect the public. The very fact we are a "regulated profession" is the basis for the public's assurance of quality-of-practice and legal recourse for malpractice of any kind. The bylaws mention "sexual abuse" by name, along with a list of other potential legal and ethical violations. In other words, this is just one of many ways in which the public is protected.
Such wording and legislation exists in other regulated professions as well. In BC, there is no "dirty laundry list" of illegal sexual acts needed to define sexual abuse. There is zero tolerance for sexual abuse; however, there is a way of phrasing the law that is sufficient to protect the public without being an embarrassment to the profession. And, bottom line: it works.
A regulated college or board is a necessary growing stage in any health profession. Self-regulation that is monitored by the government (not to be self-serving) can be a benefit to both the profession and the public. Being American, I understand the distaste for "over-regulation." On the whole, I would say that there can be balance between freedom and discipline, as there always must be.
May you find your balance unique to your American situation.
David Dressler, BA, RMT
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