resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
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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