Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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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.
Preaching 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.
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.
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.
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.
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.
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.
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.
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.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
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.
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.
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!
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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?
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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