Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
October, 2004, Vol. 04, Issue 10
Understanding Domestic Violence: What Massage Therapists Should Know
By Rebecca J. Razo
Author's note: Since the majority of domestic violence victims are female, the pronoun "she" is used continuously throughout this article; this is not, however, intended to diminish incidences of abuse suffered by male victims.This article is for informational purposes and not a substitute for professional training or continuing education.
October is a magical time of year: Shorter days yield to cooler nights while the leaves turn color and fall gracefully from the trees, forming yellow, orange and red sidewalk mosaics. We buy bags of candy for the invasion of trick-or-treaters (hoping we don't eat it all ourselves before the big day arrives) and generally prepare for what is sure to be another busy holiday season.
What many people don't know, however, is that October also marks a less celebrated -- but no less relevant -- occasion: Domestic Violence Awareness Month, an event first organized in October 1987 by the National Coalition Against Domestic Violence for the purpose of focusing awareness on the crisis of domestic violence.1
Definition and Background
In Improving the Health Care Response to Domestic Violence: A Resource Manual for Health Care Providers, Warshaw and Ganley define domestic violence -- also known as intimate partner violence -- as "...a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, that adults or adolescents use against their intimate partners."2
As hard as it is to contemplate the implications of violence in the home, it is even harder for those whose reality includes living in constant fear of abuse by spouses or partners. Consider these startling statistics from the Family Violence Prevention Fund (FVPF):
As these statistics show, domestic violence is prevalent in the U.S.; moreover, its victims are both male and female, and it can be found in every race, ethnicity, culture, social structure and income bracket, as well as within heterosexual, homosexual and transgender relationships. There is no "typical" victim of domestic violence, and "... no causative link has been found between the characteristics of battered women and their victimization ... Being a victim of domestic violence is due to behaviors of the perpetrator, rather than the personal characteristics of the victim."2
In their book, , Ben Benjamin, PhD, and Cherie Sohnen-Moe write, "On the average, one of every five clients a [massage] practitioner sees has a history of some kind of trauma or abuse."
Although not every victim of abuse has necessarily been a victim of intimate partner violence, it is likely a massage therapist will, at some point, come into contact with a client who either is or has been subjected to domestic violence. And according to the FVPF, "A recent study found that 44 percent of victims of domestic violence talked to someone about the abuse; 37 percent of those women talked to their health care provider."5
Although massage therapists are not considered health care providers , the demand for massage therapy as an adjunctive health care treatment has been increasing. Thus, massage therapists might very well see the signs of abuse before these signs are visible to others.
Sheryl Heron, MD, MPH, is an associate professor and associate residency director at Emory University School of Medicine's Department of Emergency Medicine in Atlanta, Ga. She was appointed to the Georgia Commission on Family Violence in 2002, and has dedicated much of her career to domestic violence education and awareness.
When it comes to domestic violence, Dr. Heron believes in a coordinated community response -- that every facet of the community, including religious institutions, health care providers and service-oriented businesses (like massage) must address the issue in order for victims to have easy access to help. Dr. Heron believes that massage therapists are in a unique position to help victims, since many may seek massage as a way to heal.6
The Role of the Massage Therapist
There are a number of signs a massage therapist can look for to determine if a client is a victim of intimate partner violence, most notably, the presence of bruises, cuts and lacerations on the face, head and body, or in areas usually covered by clothing, including the back, chest, breasts, abdomen and extremities. Soft-tissue injuries, sprains, fractures, eye or ear trauma, complaints of injuries lacking visible evidence, chronic illness, injuries that do not appear to heal over time (suggesting repeated abuse), or injuries that do not coincide with a client's explanation of how the injury occurred, are also key indicators of violence.2,6
Unlike medical doctors and other health care professionals, massage therapists are not typically bound by mandatory reporting laws when abuse is discovered (check the laws in your state); however, Dr. Heron says there is nothing wrong with a massage therapist asking pointedly, but gently, if a client is a victim of intimate partner abuse.
"[Therapists] can tell their clients that they are not asking to probe or pry but that they are in line in the fight against domestic violence in their community," she suggests.6
The National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings suggests the following framing questions to help clients feel safe and comfortable about disclosing whether they are victims of intimate partner violence:
More direct questions include:
Should a client disclose that she is indeed a victim, massage therapists must listen and validate their client's experience without judging, laying blame, or pressuring the client to do something she is not ready for. Emphasize that the information the client shares is strictly confidential; however, try to negotiate with the client to document the disclosure of abuse in her patient chart.
Documentation of the victim's abuse could help her in court if her perpetrator is prosecuted; however, for safety reasons, it is important to chart only what the client wants documented about her injuries and/or experience. If a victim indicates she does not want the experience documented, Dr. Heron emphasizes the practitioner must respect her wishes."Say: 'I understand and respect that [choice].'"6
"Domestic violence is about power and control," Dr. Heron adds. She cautions therapists not to "exhibit another power/control situation. Victims must feel empowered." Dr. Heron affirms that listening without judgment "gives women a chance to make decisions about [their] lives without re-victimization."
Although Dr. Heron concedes that it can be frustrating for practitioners when victims decline help, she notes that if clients know their massage therapist has access to resources, they will know it is safe to return for help in the future. "You meet your clients where they are and give them autonomy with your knowledge of domestic violence," she says.6
So, what steps can massage therapists take to help victims of abuse?
For one, therapists can hang posters and display informational brochures in their rooms or offices (Educational resources are available for a nominal fee through the FVPF.) This conveys the message that the therapist is socially responsible and sensitive to the issue of domestic violence, which also opens the door for victims to confide in their therapist and/or seek help. Therapists should also have referral numbers to local or national violence hotlines, such as the National Domestic Violence Hotline (800-799-SAFE).
Focus on Education and Awareness
Although Dr. Heron believes that massage therapists and health care practitioners in general could benefit from more education in the area of domestic violence, she affirms there is more to education than practitioner awareness -- there is public awareness.
Tanya Brown, youngest sister of the late Nicole Brown Simpson, and a certified domestic violence counselor and co-founder of the Nicole Brown Charitable Foundation, agrees; moreover, Brown believes that education and awareness begin in the home.8
"Violence starts at home with shouting, yelling, screaming," she asserts. "We need to bring respect, trust and honesty back to our kitchen tables. How about getting to really know your kids? Have them sit with you...ask them, 'How was your day?' Have conversations. By doing this you are promoting a healthy environment for children."
Though Brown advocates awareness, she notes that outsiders should exercise caution when trying to help victims.
"Domestic violence is the most dangerous call for [police] officers to go on. I strongly suggest that you don't get involved directly with wanting to 'save' the victim. You, too, could be in danger. Have those hotline numbers ready. Ultimately, it is up to the [victim] to get themselves help. You just lead them to the resources."
Irrespective of whether victims have access to resources through their massage therapists, Dr. Heron makes one point clear: "Abuse is a crime. We all need to be informed, educated and committed."
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