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Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
September, 2004, Vol. 04, Issue 09
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.
So, the roller coaster ride isn't over yet, just because your new day spa is open, right? In fact, a new ride has just begun.The ups and downs of the long planning stages are over, and you find yourself behind the wheel of a new enterprise with all the unforeseeable problems and challenges that are sure to arise. You're encountering one of those problems right now, in the very first month of operation. Though it's not a pretty one, it's all too typical.
After months of training and coaching, trusting and coddling, and friendship and teamwork, your lead esthetician, Marie, has shown her gratitude by not showing up for work one morning - quitting without giving notice. Isn't it amazing what goes through the minds of some people? What could she have been thinking to justify such an unfair move? Now, she's taking her newfound knowledge with her to a spa that is going to open across town in a few months - a new business, no doubt, inspired by the splash your Spa House made. The competition is going to be fierce, especially with the "insider's" knowledge that Marie will take to the other spa.
"Life is not fair!" You think, and perhaps you're right. But, as we say in the spa industry, Lou, it's no use crying over spilled milk and honey- exfoliating paste. There are a few proactive steps you can take at this interesting juncture.
Job Security - In Reverse
Usually when people talk about job security they mean the employee, not the employer. As a spa owner and employer, you are looking for the same kind of security from your employees as they're looking for from you. How can you trust them when you give them your best and they still abandon ship - like Marie? How can you know they'll be there for you in your time of need? Is there really any such thing as job security in the spa industry?
Spa employees know that their security is somewhat tenuous at times. There are a couple of spas that are unionized but, by and large, the majority is not, and employees have little recourse in instances of dismissal. Perhaps that is part of the reason why so many of them are ready to leave even a good job at the first sign of something better on the horizon. How can you get employees to be loyal?
There are some techniques that work well for some spa owners, such as offering money for continuing education, contingent upon the employee staying in the position for a certain amount of time; increasing pay scales over time often work; and giving people responsibility and a clear path toward career advancement helps, too. However (and this may be just my own overly nihilistic opinion), in the end, employees are out for themselves; they will do what they will do. It is better to go into your role as boss realizing this. It may be a mistake to put too much stock in your friendship with your employees. Doing so will often lead to disaster (emotional, as well as business-wise).
This is not to say you shouldn't be friendly with your staff - that is desirable. Remember though, that part of the relationship, no matter how friendly it gets, is also based on economics. Employees need you for the money you give them. You need them for the money they bring through the clientele. Friendships that exist within that dynamic are sometimes fragile things. That said, now what do you do? You're short an esthetician. In fact, you're short your only esthetician. You've spent months training her and thousands of dollars on the products she was going to use. Ahhhggg!
Of course, you've got to begin the search for a new esthetician. You might offer some of those incentives I mentioned earlier to your new recruit. Tell her you're going to increase her pay over time, and offer money for continuing education after a year of service. Tell her she'll make a higher commission rate as a "senior employee." And treat her like a professional first, a friend second.
In the meantime, before you find this person, you can take some immediate steps that will help you fill the gaps in your appointment book and make sure that you'll never ever again have to explain your complete lack of facial services to clients.
Face Treatment Options
You have a secret weapon on your staff when it comes to facial services. I'm talking about your massage therapists. You haven't been thinking about them offering esthetic-type treatments, but as I told you before, there is no reason to confine their scope-of-practice to the body alone. The face, in fact, is a part of the body, right? There are many face-specific services that massage therapists can perform to the satisfaction of your guests, the great support to your bottom line, and all without greatly angering the folks at the cosmetology board.
For example, I teach an Ayurvedic face massage treatment to students in my spa workshops, and they love it. The treatment consists of an application of herbs that are left to dry and then exfoliated off with the fingers. A hot towel is applied, and then herbal floral water followed by a pressure-point massage with essential oils from India. The treatment is finished up with a short massage using an emollient cream. It takes just half an hour, and it does not include extractions, diagnoses, or any of the specialties of our esthetician colleagues; however, clients report a healthy glow to their skin afterwards, induced, no doubt, by the balancing herbs and oils, plus increased circulation from the massage.
Clients also report feeling relaxed and cared for in that particular way that facials can make you feel. An esthetic treatment is different than a massage treatment. They both have their advantages, and these hybrid "face massage" treatments sometimes offer the best of both worlds. The Ayurvedic treatment can be emulated with a wide range of other products and techniques. Some of the more popular these days are Balinese, Indonesian and Thai. Getting your entire massage staff trained on these modalities is a great way to offer guests something different and assure that you won't be left without a facial service to offer if something like this ever happens again.
Of course, it's always a good idea to be aware of the laws in your state regarding face treatments. You definitely do not want to break any of them; in a few states, it is actually quite difficult to do even simple treatments, like the one I described above, if there is any chance it might impinge on cosmetologists' practice. Just be careful and do the right thing. I'm sure once your business starts to really rock, you'll have more than one esthetician on staff, and perhaps this problem will never arise again, but it's always good to be prepared, right? And don't forget about the new retail possibilities you'll be creating by adding these spa face massage treatments to your menu!
Well, Lou, I hope your second month in business is a little less traumatic than your first, and that you and your partner, Barbara, get the operation running smoothly after these initial hiccups. Always know that in the spa business there are usually more surprises than certainties. This makes for some great rewards, as well as challenges. I know you're up to them all!
Talk to you soon,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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