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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."
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?"
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
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.
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.
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."
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.
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.
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.
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.
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.
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."
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.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
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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