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It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
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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