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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
November, 2003, Vol. 03, Issue 11
By Steve Capellini, LMT
Author's Note: The Spa Letters column features news, personality profiles, trends, and plenty of professional possibilities for LMTs in the spa industry. The style is epistolary, meaning the articles are letters to a fictional massage therapist friend of the author.
Building a spa is like remodeling a house.There's a snowball effect and before you know it, you're making purchases you never dreamed would be necessary when you started. This is true even if you've put together a solid business plan with budget projections, cost analyses, timelines and "plethora proforma." In every case, reality steps in rudely and changes things. In your case, there were a number of factors you didn't count on: While changing some of the exterior siding, you found a horde of carpenter ants, which necessitated some rebuilding; the ancient plumbing needed upgrading; and choosing the best fabrics and carpeting shot the budget up another few thousand dollars. You needed some help managing this expensive, unwieldy project, so you hired a spa consultant - another expense in and of itself!
Don't worry; this consultant will save you money in the long run. You've negotiated a good fee structure with a $2,500 monthly retainer guaranteed for six months - enough to inspire your consultant to work on the project 50 hours a month and bring the expertise of her colleagues to the table. Considering the scope of your project, I think you've made the right decision.
It's time for you and your consultant to roll up your sleeves and get to work. But what first? You're in the middle of this huge project, and she came on board just last week. How can she catch up to you? First, understand that she's done all this before. She's run into the same roadblocks, solved the same problems, and dealt with similar personality conflicts. Your job is to get out of the way and let her help you. I like some of the design suggestions she's offered; and now is the time, while you're still under construction, to implement these ideas.
Idea Number One: Slightly expand the waiting room and use a large ceramic bowl for spa foot treatments there. This might never have occurred to you because it is such an offbeat idea, but I've seen it work well in other spas. Think of it this way: How much will your customers pay for waiting? That's right - zero dollars; nada; nothing. Does that have to be the case? No! While sitting in a cozy room surrounded by other robe-clad "ladies-in-waiting," your customers can be treated to a fantastic foot treatment that will not only up the square footage of your revenue-generating space (RGS), but also entice other clients to follow suit and do the same thing next time they are waiting.
Using an ornate ceramic basin, one of your therapists can soak the client's feet in aromatic water sprinkled with rose petals; apply a warm-towel-wrap, reflexology and a peppermint sea salt scrub; then trim the nails. The application of polish is optional, but only if it is a noncaustic, odorless product. This treatment not only soothes and relaxes the guest before their spa service, it acts as a live billboard for your therapists' skills. It is a way to spread goodwill and create a holistic caring environment.
Idea Number Two: Create a "river wall." I saw this concept at the Nemacolin Woodlands Spa in Pennsylvania by renowned spa designer, Clodagh (www.clodagh.com). Your consultant has suggested turning the wall between your waiting room and your treatment rooms into a "waterfall" by inserting natural rock outcroppings and a small trough along the wall/floor joint. This doesn't need to be hugely expensive; with a small, inexpensive pump and a little creativity, you'll achieve something important: bringing the outdoors in and giving your clients a little touch of nature. At the Nemacolin Woodlands Spa, this feature extended into the hallways, turning them into "stream banks" in a forest. You can create this effect on a smaller scale by imbedding smooth river rocks along the floor near the wall and letting the water lap up naturally onto a lipless edge. I've also seen this done well at the Avalon Hotel & Spa in Portland, Ore.
Idea Number Three: Use multipurpose tables for your treatment rooms to do facials. You knew about multi-use tables already, didn't you? But you didn't think about using them in your two facial rooms. It makes sense, doesn't it? Why not have two more rooms you can use to do massage, wraps or scrubs in when they are not in use by your estheticians? Golden Ratio makes some good multi-use tables that I've used before; check them out.
Your consultant's ideas about hiring spa staff are good, too. As someone who has helped assemble teams of spa professionals before, you can rely on her to give an informed opinion about potential candidates. It helps that she does not live in your community, too - she doesn't have to worry about stepping on any toes or creating political enemies and can voice her opinion without qualms.
Let your consultant conduct the initial screening of job applicants. You should step in during the next level of interviews, concentrating on the higher hiring values of camaraderie, rapport, "energy" and so on. After that, schedule yourself to receive a test massage or facial from each of the most promising recruits. Maybe I'll talk more about receiving test massages in my next letter - believe it or not, there's an art and a skill to it.
Don't focus all of your attention on hiring the "hands-on" staff. Though you are a therapist and your inclinations may lead you to focus exclusively on the massage department, remember that other staff will make a profound impact on your guests' experience. Your receptionist, for example, will most likely speak to every guest who comes through the door. Doesn't it make sense to proceed slowly and wisely when it comes to choosing this key figure in your operation? Almost anyone can answer a phone and write an appointment in a book. A good number of people may be quick at entering information into a computer. But how many of them will have your customers' best interests at heart?
While it's important to find qualified people, I think you'll do better across the board - from janitors to front-desk staff to therapists - if you look at the person first and the skill set last. Skills can be taught. The intrinsic person remains, and no amount of training, scolding or rewarding is going to change the underlying character much at all. Ask yourself one question: Would you want this prospective receptionist working in your own home? Now it's time to start assembling a great team!
Until next time,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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