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Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
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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