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Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
December, 2004, Vol. 04, Issue 12
By Keith Eric Grant, PhD, NCTMB
Staring into crystal balls to discern future trends is more often than not like starting Monday morning without downing a stiff swig of fresh brewed coffee after a fiercely active weekend - mostly an experience of perceiving fog.Still, every now and again, the clouds shift and a few shapes become perceptible. As the nights become longer and cooler (yes, even in central California), and the streetlights glow through the dark and mist, it seems a suitable time to ponder shapes faintly seen ahead.
Massage is rapidly paddling into the mainstream of culture, but few appear to have looked far downstream. It's not so much that there are rapids ahead, as the character of the river is changing as we emerge from the secluded canyon in which we've been both hidden and sheltered. I've recently been looking at massage education statistics for California. One such statistic shows that since the beginning of 2002, there have been half as many career colleges adding massage training to their programs, as there have been startups of dedicated massage schools. Career college programs were only about one-third of all non-degree programs prior to 2002 and have increased by 75 percent since the beginning of 2002. From the hour-distribution of new entry programs (Table 1), it also seems that new massage schools and new career college programs are targeting different student populations.
Relatively few stand-alone massage schools in California are accredited and tapping into federally sponsored financial aid. Instead, the vast majority of such schools in California glean their financial solvency by targeting pay-as-you-go students - students often making mid-career transitions.4 One reason for this is simple: many programs are shorter than the federal financial aid minimums of 600 hours for loans 2 and 720 hours for Pell grants.2,3
The U.S. Department of Education approves agencies that accredit schools because accreditation is a big part of the gate-keeping on financial aid. To assure their stability, schools applying for accreditation must have been in existence for more than two years. Stand-alone massage schools tend to be accredited by program, while colleges tend to be school accredited. Because of the two-year rule, accreditation by school rather than by program can be a significant competitive advantage, particularly if graduation from an accredited school is required for licensing. Career colleges tend to be veteran players in the financial aid and accreditation end of the marketplace, and have now spotted massage training as an attractive market. As Ralph Stephens exclaimed in his July column, "We've made it!"
The academic college community, both public and private, is another new training provider with growth potential. Both career and educational colleges can leverage support for courses over multiple health care professions. They can provide a broader choice of electives, including courses in small business management, communications, and psychology that are synergist to successful practice. Colleges often have media departments to help with developing presentation materials and with moving parts of traditionally lecture-based courses online. Colleges can also wrap associate degree programs around certificate programs, providing greater educational portability and more career flexibility.
Community colleges often benefit from state support motivated by effective workforce development. Here in central California, the program at De Anza Community College, initiated in the early 1990s by Jeffrey Forman, provides an example of two-certificate programs leading potentially into an associate's degree.5
The competitive exclusion principle of ecology states that two species that compete for the same resources cannot stably coexist. One of the two competitors will always have an ever so slight advantage that eventually leads to extinction of the other. Survival strategies for both species and businesses include finding a niche that avoids head-on competition, gaining the upper hand via internal efficiencies8 and making use of spatial heterogeneities to find a local advantage.6
In California, a large diversity of massage schools (over 200) has managed to survive together via these strategies. Local regulations have differed from place to place, even within the same region, and schools have found different training niches and targeted different student markets with different length programs.
One aspect of most licensing legislation and something many of us in California are trying to avoid, has been to force all schools, stand-alone, career, and college, uniformly into the same educational hour-requirement niche.
Texas, one of the holdouts in this rush, seems about to join the crowd, judging by last month's article in Massage Today (www.massagetoday.com/archives/2004/11/04.html). The Texas Association of Massage Therapists (TAMT) seems not to discern the difference between state regulation that does not require a program to be more than 300 hours, and regulation that forbids it to be longer. Massage schools in Texas could get more change than they anticipate.
Ultimately, the career schools and community colleges, now that they have found the market, will seem likely to grow to dominate the market from 600 hours upward. Just as Southwest and Jet Blue have redefined profitability for airlines, careers schools and colleges may do so for massage training. Nature has a path of ecological succession after a forest fire, with initial grasses and herbs giving way to shrubs, giving way to different stages of trees.9
Stand-alone massage schools and the Commission on Massage Therapy Accreditation's (COMTA) focus on them may be part of the "shrub phase" of succession in massage education. Current massage-only schools, could well need to either broaden their offerings or create partnerships with colleges, teaching under the latter's school-accredited umbrellas.
For the individual practitioner, heavy reliance on financial aid implies that most will enter practice with a significant debt burden. Needing to pay down loans will likely impel recent graduates into jobs at spas and health clubs rather than the riskier entrepreneurship of trying to start a sole practice. Over the next decade, it's likely that massage training will become much more like any other career training, partly from new competitors and partly from uniformity created by legislation.
The challenge comes in guiding this natural succession to give students full worth. The emphasis should be on outcomes carried into practice rather than simply hours on the meter.7 Such outcomes are not just limited to technique, but include the interpersonal relationship facets of our massage profession.10
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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