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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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?
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.
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.
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.
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!
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.
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.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching 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.
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.
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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