resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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?
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.
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.
November, 2004, Vol. 04, Issue 11
We Get Letters and E-Mail
By Editorial Staff
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be published in a future issue of Massage Today or online, and may be edited for space and clarity.Please send all correspondence by e-mail to or via regular mail to:
Responding to Ralph Stephens
I appreciated Ralph Stephens' article, "We've Made It!" (www.massagetoday.com/archives/2004/07/13.html) describing the reality that health care in our country is controlled by a system whose primary goal seems to be economic and political advantage rather than effective healing. I'm glad Ralph continues to write on this topic. As I see it, the origin of this situation is shared among the allopathic community, the pharmaceutical and insurance companies, medical schools, and government policies. We are facing a systemic problem that is not localized to one group of practitioners. It is my hope that the massage community will work toward bringing positive changes to this system. I think respect by the massage community toward allopaths, insurance companies, etc., is only due to those people and institutions who actually work for the best interest of the patients. Unfortunately, as Ralph points out, this is not always the case.
I am presently collaborating with Walt Stoll, MD, on a book titled Recapturing Health, which we hope will encourage health care freedom and bring about positive change in the system. Walt is a holistic medical doctor who long ago awakened to using a wide range of healing modalities, including massage, chiropractic, energy healing and other methods. We hope our book will inspire individuals and practitioners to see the truth and begin an informal grassroots movement to improve how health care is provided in our country. It will be a wonderful day when the health care system itself is healed so that people may be healed. You can read more at http://lifespring.netfirms.com or www.askwaltstollmd.com.
Ralph Stephens' article "We've Made It!" points out how far massage has come now that the medical profession is criticizing us in order to control our scope of practice. He discusses how rehabilitation specialist Dr. Robert Gotlin attacks our profession by pointing out the possible dangers of massage. This is behavior Stephens feels is motivated by allopathic physicians wanting to control and profit from our growing profession as they tried to do with chiropractic. Stephens also states that doctors should tend to their own houses before coming in to clean up ours, emphasizing how many people die and suffer each year from mistakes made in the medical profession.
Although there is probably some truth in Stephens' point-of-view, there is another way to look at this issue. Perhaps Dr. Gotlin truly cares for his patients' welfare and is just giving them his honest professional opinion about massage. Many massage practitioners provide competent, skilled, therapeutic treatments. Still, I have experienced (and know enough people who have also experienced) minor injuries and pain after receiving contraindicated massage techniques. A number of my clients and colleagues have shared similar experiences. As a result, I am reluctant to receive anything but a relaxation massage with a trusted practitioner who will not try to fix or change me in some manner.
After practicing as a professional massage therapist for 23 years, I recognize the value of a good massage for relaxation, relief from muscular tension and chronic pain, and even injury rehabilitation. Unfortunately, our field has grown much faster than our standards. Massage training has become heavy on neuromuscular and orthopedic techniques, but light on teaching practitioners why, how, when and where to use these techniques.
Plus, techniques are a dime a dozen. Knowing when to apply them appropriately with skill requires in-depth, specialized training. If we, as massage therapists, are going to use manual therapies in a physical therapy context, we need to be well trained in their application. Granted, our mistakes will probably never result in the number of fatalities caused by physician error. Still, consumers receiving neuromuscular and orthopedic massage techniques have a right to be educated about the contraindications of these types of modalities, and treated by competent, appropriately trained practitioners.
Mary Ann Foster, CMT
Questioning CranioSacral Therapy
Dr. Upledger speculates that cerebral spinal fluid (CSF) moves in a pulse, and that cranial bones move in relationship to this pulse (www.massagetoday.com/archives/2004/08/12.html). Medical imaging is a technique to validate these speculations. Medical imaging is sensitive enough to detect extremely minute changes in bone position and in the detection of a moving fluid. Let's start with cranial bone motion first.
A standard imaging technique for people with brain tumors or other cranial space occupying lesions is to utilize repeat head computer tomography (CT) scans. In this technique, a series of CT scans are compared with each other to determine if a lesion is microscopically growing or shrinking. For this technique to work, the sequential scans must have a common reference for which to measure change. The common points of reference used are cranial bones. If these bones moved, as is speculated, comparing serial CT scans would not be possible, since the reference would be moving along with any lesion change. Since the cranial bones are fused, comparing repeat scans provides accurate, detailed information about the change in a tumor's size.
Magnetoresonance (MR) imaging cannot record motion. Blood flow, including venous blood flow does not image using the MR technique; however, CSF does image with MR, indicating that CSF moves very, very slowly. If CSF were to move in a pulse, it would not image using MR. Of note, MR can be used to image bone; cranial bones image quite well, indicating that they do not move relative to one another. Dr. Upledger's article speculates that CSF moves in a pulse and the cranial bones move in relationship to this pulse. These speculations are refuted by the results of medical imaging.
Bruce Klein, ND
"There is no way to succeed against a large, profit-driven insurance company"
I have been practicing massage therapy for 17 years and billing insurance for about six. I am also in it for the long haul. In California, if you're billing insurance, it's not only long, but also uphill and into the wind. The latest legislation has slashed care for injured workers and denied claims from many professionals. I applaud Donald Schiff's letter and clear thinking about what is really involved in working with insurance companies (We Get Letters and E-mail, Sept. 2004. www.massagetoday.com/archives/2004/09/16.html).
The articles by Vivian Madison-Mahoney are hogwash, indeed. Her views may have been appropriate 10 years ago, but there is no way to succeed against a large, profit-driven insurance company. Ms. Madison-Mahoney would have us take what we can get and not assert ourselves as the professional, heath care providers that we are. We will not gain any ground by rolling over to insurance companies. Keeping fees low will only drive therapists out of business and allow the insurance companies to win.
Don Schiff is right on about the level of service that medical massage provides versus relaxation massage. The last workers' compensation client that I saw required six long-distance phone calls, resubmission of billing and a three-month wait for payment. How could I stay in business giving this level of service for artificially low fees? Massage therapists are not the only ones who are fighting this battle. The doctors, chiropractors, PTs and acupuncturists are in it, too. In California, many insurance companies are making huge profits by denying care to injured workers. The battle is just starting. If we don't stand up for ourselves, who will? I think Schiff's view speaks for the majority of massage professionals in the modern world.
Jody C. Hutchinson, BA, NCTMB
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.