resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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?'
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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?
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.
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).
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.
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.
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.
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.
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.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
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.
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.
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.
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.
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.
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.
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.
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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