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Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
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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