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How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
September, 2004, Vol. 04, Issue 09
Safety While Working Alone
By Colleen (Steigerwald) Holloway, LMT
During massage school, never once did it occur to me that I was preparing for a career that would leave me isolated for the majority of my workday. After all, my technique classes were full of other students chatting and learning.Even the student clinic was brightly lit and somewhat noisy.
It wasn't until about a month into my career, when I was waiting for an unknown male client to arrive for a six o'clock appointment, that it dawned on me that I was going to be alone in the office - and in a room for an hour - with someone I did not know. Not only was this client a stranger, he was a stranger who was about to be completely "in the buff," covered only with a sheet. "If I'm going to be vulnerable, I should at least have a plan for my safety," I thought, while awaiting his arrival.
We've all been in this situation. Even male therapists experience the occasional female client who makes a suggestive or inappropriate comment that leaves the therapist wondering what kind of services the client is seeking in addition to professional massage. As massage therapists, it is essential to create a safe environment and plan your exit in advance so you will know what to do if your safety is ever at risk.
Screening Clients on the Telephone. Safety begins when the client calls for an appointment. A caller should not hesitate to give you a last name and telephone number. If the caller refuses, I would question the reason why and, in turn, refuse to grant the caller an appointment. Likewise, if a client refuses this information on the health intake form, I would refuse the appointment.
If the caller asks if you accept "tips," nine times out of 10, you are being asked if you will include sex in your treatment for extra money. My response would be, "Gratuities are accepted for exceptional professional services; however, sex is never a part of our service."
When the Client Arrives. Just prior to the arrival of your client, close any doors to other rooms so the client will not know if other people are present in your office or home. Keep several lights on outside the treatment room, as well.
During the Appointment. Make sure someone knows where you are, with whom, and when your appointment will be finished. If you have a cell phone, bring it into the treatment room with you and keep it within reach, or place it in your pocket. Of course, you will turn the ringer off, but keep the telephone turned on. If the client makes an inappropriate comment or gesture during the appointment, it is best to end the appointment and leave the room.
Whether you collect the fees for the appointment is not important; what is more important is your safety. I have known many therapists who tolerated an inappropriate client because they needed the money. It is never worth the money to risk your safety. If you let a client act inappropriately, the client will think the behavior is acceptable and continue.
On-Site Appointments. Your safety is most at risk if you are going to a client's home or hotel room because you will be unfamiliar with the location. Make it a point to survey the location inside and out, taking note of all exits when you arrive. This will prepare you for a quick exit should it become necessary.
After you arrive and greet the client, use your cell phone to call someone (or your answering machine) while in the client's presence. State where you are, including the address and/or room number, who you are with, and that you will call back when the appointment is finished. This will deter anyone with preconceived ideas from taking action. Keep your cell phone in your pocket or apron as a backup.
In my career of 10 years, I am thankful to say I have had only two mishaps with clients who acted inappropriately, although I've warded off many potential problem clients on the telephone. The first client was a nudist and thought I should adhere to his belief system. The second squirmed for 10 minutes on the table before flipping over without my prompting. Instead of accusing the clients of acting inappropriately, I simply told them that I was uncomfortable and left the room.
If you have a safety plan in place, you will be less vulnerable. Unfortunately, sometimes we come across those in our profession that abuse or misunderstand what massage is all about. Plan for your safety and enjoy your career.
Click here for previous articles by Colleen (Steigerwald) Holloway, LMT.
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