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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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%.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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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