resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
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
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