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