resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
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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