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Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
May, 2004, Vol. 04, Issue 05
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.
Well, the opening of your new day spa is just two months out now, and you're going crazy trying to get everything together.Don't worry; that crazed feeling you have is natural. It wouldn't be a true spa opening if you didn't feel like you were juggling at least a hundred balls in the air at once.
I must admit - you really "take the bull by the horns" when you need to get things accomplished. The job descriptions you've created for The Spa House are exactly what you needed to keep things on track as the business gets up and running. Without a clear understanding of what's expected, employees have a tendency to make their own rules, regardless of your best, albeit unstated, intentions.
Job descriptions are usually most effective in spas when they are included in a manual that you hand out to each employee. That means each employee benefits from reading the job description of every other employee, as well as his or her own. It is most important for you to include a job description for yourself and your partner/co-owner Barbara, as well as the people who will work for you. That way, you'll be perfectly clear about your role regarding authority, boundaries, and responsibilities.
There are just a couple little things I would change with the job description you created for Jeanie, your lead therapist.
When writing job descriptions, it's important to remember that employees will often take them literally. So, it's important to include a level of detail that cannot be argued with or interpreted in different ways. For example, in Jeanie's description you say: "The lead therapist shall be responsible for the conduct, demeanor and appearance of the other therapists and estheticians." This can be taken several ways. Does that mean Jeanie can then reprimand the other therapists on these issues? Does she have the authority to send them home if one of the guidelines is broken? Does she have to come to you or Barbara first before making any disciplinary decisions? Is there some kind of logbook into which she can record infractions?
Each job description needs to list specific actions that employees can perform to satisfy their duties. For that, you will need to spend a little more time fleshing out the details. Then, when you have finished, you can insert all of the descriptions into the manual, which will include a list of general guidelines that all employees can refer to.
One other item in the job description that I thought could use some clarification was this: "The lead therapist shall be available to fill in for other therapists if they are sick or otherwise unable to perform their normal functions." First of all, this seems a little onerous to me, as it should really be your own responsibility, ultimately, to make sure the customers are happy and that somebody is available to perform their treatments. Passing this off to your lead therapist gives her a little too much power. This might make her resentful of the imposition on her time, and that resentment might lead to an abuse of the power you've given her.
I would suggest you strike this part of the description entirely and instead say: "The lead therapist shall be responsible for creating and monitoring the weekly work schedule for the massage therapists or estheticians, according to the guidelines written in this manual. He or she will report illnesses, requests for time off scheduling conflicts and potential uncovered shifts to the owner/director in a written report on the first day of the pay period every two weeks."
I think you get the idea. So, it's back to the drawing board on those. Sorry to load you with more work! But guess what? There is yet another form you'll need before opening The Spa House. It's called the "client intake" form.
It's very important that you safeguard yourself against potential lawsuits. Regardless of how professional your staff is and how closely you monitor every aspect of your spa's operations, problems can still occur. Remember when you were working in the medical day spa and that client complained that she'd been injured by one of the mechanical massage techniques you performed? It turned out to not be your fault, but it sure felt good to have that liability insurance provided by the professional massage association you're a member of, didn't it?
To that end, it's important to include in your guidelines that each and every one of your therapists and estheticians carries his or her own liability insurance, usually via an association. And it's a must for all clients to fill out an intake form before anyone on your staff touches them. The intake form should give you an idea of each client's general health and any specific problems that you may have to look out for when your therapists and estheticians apply products and procedures to them. Thus, it must be customized to complement your particular offerings.
For example, I've been working with Biotone lately, and have developed an intake form that addresses the specific concerns related to treatments performed with their line of spa products. (View this form at www.royaltreatment.com/Intake_Form.htm.)
In other news, I was happy to hear that the hotel down the street has approached you asking to form a strategic alliance. It has customers in need of a spa; you have a spa (or will have in two months) in need of customers. It seems like a marriage made in Heaven. But how will it work?
I recently counseled another friend opening a spa, on the same issue, and I recommended that she get a written agreement from the hotel stating exactly how they would promote her spa. (Will they have brochures or table tents in the rooms, for instance?) In return, she agreed to offer each guest coming from the hotel a 10-percent discount. The guest receives the benefit, and you receive the business. It's "win-win-win." This, I believe, is a more effective strategy than charging full price and then giving the hotel a percentage of your income.
Keep on charging forward, Lou. You'll have your spa up and running sooner than you think!
Until next time,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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