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Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
March, 2004, Vol. 04, Issue 03
Clinical Reasoning Skills
By Whitney Lowe, LMT
In the health care arena, assessment is commonly defined as the systematic process of gathering information in order to make informed decisions about treatment. We all do this any time we make a decision about how much pressure to use, which technique to employ, or how to address a particular problem presented by a client.What is different is the degree to which we use these assessment skills. As massage therapists become more involved in treating people, the process of assessment becomes increasingly important. You must be able to distinguish between conditions with similar symptoms and make vital decisions about how to approach a client's condition, or determine whether to treat the condition at all.
There are numerous systems of assessment for pain and injury conditions that share common elements, including the use of specialized orthopedic tests. These tests are used by different types of health care professionals to identify various pathological problems. Since different health professionals utilize the same tests, communication between multiple practitioners regarding the condition of a client/patient is easier. However, while these tests are a valuable part of the assessment process, a common trap can occur when using them. The trap occurs when too much emphasis is placed on using tests over other methods of assessment and evaluation. For example, if a client complains of shoulder pain, and you know about special orthopedic tests for shoulder disorders, it is a common fallacy to run through these tests to see if you can find the nature of the client's problem. This is still a shotgun approach. What is missing is an essential element of the assessment process: clinical reasoning.
When first learning about a subject, the information is often divided into separate facts or concepts. It is only after achieving a greater degree of mastery in the subject that people organize this information into usable patterns. Studies that have investigated the difference between the way experts and novices present information have found that experts put together more patterns of information, while novices tend to gather more separate details, many of which may be irrelevant to accomplishing the final task or skill they are learning. This aspect of learning and processing information is essential in assessment and clinical reasoning processes, and can be well-illustrated in the following example.
When a client complains of shoulder pain and describes the common symptoms, the practitioner must determine what information is relevant and how to proceed in the evaluation process. If the statements are considered separately, they may not lead to essential clues about the nature of the condition. This is often where the practitioner jumps to the use of several tests to see if he or she can hit on the "right condition"; however, the more skillful practitioner will pick up on statements during the initial intake and begin to form patterns. This practitioner will see connections between various signs and symptoms, and the further line of inquiry will almost lead itself in many cases. The art of reasoning is the ability to see these patterns of connection; therefore, the challenge is learning how to perfect those skills and see the patterns.
Consider the job of a detective. When investigating a crime, the detective must pick up on clues and determine which ones are important (and which ones are not). The ability to discriminate between the two can be difficult. The best way to make this choice is through a combination of subject-matter knowledge and experience.
For clinical practitioners, the more we know about various pathological problems, the wider the base of information we can draw from when searching for relevant clues. At the beginning, it will be difficult to know which clues are relevant - this is where experience comes into play. After seeing similar conditions a number of times, we develop an experiential background against which we can see similar patterns and recognize which cases are similar to others we have worked with before. As we combine our knowledge and experience, we are able to more accurately and quickly find the nature of a client's complaint.
The more skilled you become in clinical reasoning, the easier and faster the assessment process will be. Therefore, as you learn about assessment and range of motion evaluations, muscle tests, or specialized orthopedic tests, always think about why you are using a particular procedure, instead of just going through the motions. The more you understand why you are doing what you are doing, the more you will contribute to your ability to see these patterns within the clinical evaluation process, and significantly improve your skills.
Click here for more information about Whitney Lowe, LMT.
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