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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
October, 2004, Vol. 04, Issue 10
By Keith Eric Grant, PhD, NCTMB
At the 1968 Summer Olympics in Mexico City, John Stephen Akhwari of Tanzania was the last man to finish the marathon. Akhwari could run, and then some. He was Africa's marathon champion and had been expected to do well in Mexico; however, his training at sea level had not sufficiently prepared him for the altitude of Mexico City, and he fell during an attack of cramps.His legs bloodied and bandaged, Akhwari continued to run as best he could, limping into the Olympic stadium, with darkness falling, more than an hour after others had finished.
Sports cinematographer Bud Greenspan had been packing up his camera when a reporter alerted him to Akhwari's arrival. Pulling out his equipment, Greenspan captured Akhwari's final lap and later asked him why he didn't just stop along the way. Greenspan's film and Akhwari's reply became a classic example of Olympic spirit: "You don't understand," he said. "My country did not send me 7,000 miles away to start the race. They sent me 7,000 miles to finish it."2
Years later, at the Sydney Olympics, the Australian attach‚ for the Tanzanian athletes, brought John Stephen Akhwari to Sydney to receive an award at the closing ceremony as a living symbol of the Olympic ideal. Following the Sydney games, a foundation was created to foster the potential of Tanzanian athletes.5
Although the effect took years to incubate, Akhwari's determination to keep a commitment and face his barriers brought results beyond what even a winning run might have produced.
There are many different kinds of barriers faced in successfully entering the practice of massage, from learning to execute techniques smoothly, to marketing our services, to using good business practices, to jumping the regulatory hurdles imposed by various localities and states - sometimes with little objective basis behind them. While the process may not be pleasant, with commitment and determination to "reach the finish," we can do far more than we might have believed.
One of the opportunities we gain for ourselves by entering the practice of massage is that of helping our clients deal with another kind of barrier: injury or overuse-initiated barriers that limit normal range of motion (ROM). There are several different movement barriers that are used in discussing range of motion: anatomical, elastic, physiological, and pathological or restrictive. Greenman provides an entire chapter on barrier concepts within the larger framework of the diagnostic triad of Asymmetry, Range of motion, and tissue Texture abnormality (ART).3
The outermost limit is the anatomical barrier. When the anatomical barrier is exceeded, the integrity of the joint is compromised by fracture, dislocation or tearing of ligaments. In the interest of having return clients, I strongly advocate staying within the anatomical limits, whatever the facilitation used. Just short of the anatomical barrier, lies the elastic barrier, where the joint tissues offer considerable resistance but still have some slight ability to lengthen. This limit is generally reached using passive assistance. The range of normal active movement ends at the physiological barrier. The barrier resulting from loss of ROM due to dysfunction is the pathological or restrictive barrier. The positional relationships between these different barriers are shown schematically in
Associated with a loss of range is also a shift in the neutral or mid-point of the movement away from the limitation. Our therapeutic goal is to normalize hypertonicity and free adhesive restrictions so that we move the client's pathological barrier outward toward the appropriate physiological barrier.4
This also returns their neutral point to the correct midrange location. Our methods might include direct work to free adhesions between layers of tissue and neurological reflex-based techniques to reduce muscle hypertonicity, the latter including techniques of post-isometric relaxation6 and positional release (strain-counterstrain).1
Whatever the barrier, in facing it for ourselves and for our clients, we may achieve far more than we anticipate. At times, the road may seem long but, for each of us, there are those along the way who have believed in our abilities and helped us along our paths, not so that we could start our race but so that we could finish it.
Editor's note: Due to the transient nature of the Internet, some links may not be operational.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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