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Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
January, 2005, Vol. 05, Issue 01
"Peek-a-Boo, I See You": Obstetric Ultrasound
By Elaine Stillerman, LMT
Expectant mothers ask for it by name. They often can't wait to get to their obstetricians to "see" how their babies are growing. A remarkable diagnostic tool called ultrasound enables mothers and doctors to peak into the mysterious world of the life and growth of the fetus in-utero.But is it safe and accurate? Are women being protected, or are they being offered a false sense of security about the health of their babies? And what about this burgeoning business of keepsake images and videos of unborn babies? Are eager mothers courting danger with this unnecessary exposure to ultrasound radiation?
Originally developed during WWII to help the military detect enemy submarines, this technology wasn't used in clinical obstetrics until the early 1960s. The use of ultrasound has now become a routine practice in prenatal care in most industrialized countries. Ultrasound uses ultra-high frequency sound waves that bounce off internal structures to produce images (sonograms) of organs, tissues, blood flow, or, in obstetric instances, the developing fetus. According to the Food and Drug Administration (FDA), there are legitimate medical reasons to use this prenatal test: to confirm pregnancy, assess fetal age, diagnose any fetal abnormalities or birth defects, evaluate the position of the placenta, and determine whether there are multiple pregnancies. Generally speaking, when a trained professional administers the test, it is assumed that its benefits outweigh any risks; however, some experts feel that even medical application of obstetric ultrasound has not been fully tested and is not without risks.
There is a lack of epidemiological studies on the risk of ultrasound on human fetuses, although animal studies have shown altered growth, low birth weight, diminished immune response and a deviation in genetic material from high doses of ultrasound. Studies on humans exposed to ultrasound have shown some serious side-effects, including pre-term labor or miscarriage, low birth weight, delayed speech, and fewer instances of right-handedness, which is viewed as brain damage to the developing brain. According to some doctors, ultrasound has its place in clinical diagnosis but not during pregnancy. Many physicians are losing their ability to confirm gestational age through a bimanual examination because they rely so heavily on technology, and medical schools rarely teach this palpatory skill.
Other concerns about the medical use of ultrasound include different powers of energy emanating from the equipment itself (the machines are becoming more powerful and there is inadequate data or control on levels of output) and the misreading of these tests by technicians or doctors. A study conducted on the accuracy of ultrasound at a major women's hospital in Brisbane, Australia, showed that ultrasound missed almost 40 percent of fetal abnormalities. Many genetic and physical disabilities, such as Down Syndrome, or heart and kidney disease, cannot be picked up from an ultrasound. False positives (an abnormality is detected when it does not exist) may occur, and uncertain interpretations can be extremely stressful for the expectant couple.
There are other serious considerations. The number of elective scans is increasing as doctor's routinely use the test at many prenatal visits, sometimes exposing their patients - and fetuses - to periods as long as one hour. The traditional transabdominal scan is now being replaced with the transvaginal scan, which probes even closer to the growing fetus. New developments, including the Doppler ultrasound, 3-D ultrasound and even 4-D (moving or dynamic 3-D) scanners are currently available to women.
The 3-D ultrasounds are also referred to as "entertainment scans" and provide clearer pictures of the fetal face and movements. What is of greater concern is that the technicians who perform these entertainment ultrasounds are neither regulated nor certified by the states where they do business. Appealing to their emotions, expectant parents are being courted by a number of new companies who claim that this 3-D technology is safe and can offer them the chance of a lifetime to photograph and video their unborn child (doctors use 2-D imaging.) They claim that these pictures help couples bond early with their babies. For a fee of about $80 for a short session, couples can learn the baby's gender. For $300, a half-hour session (exposure) will record fetal movements on a videocassette or DVD; color photos are included in this package. The recommended gestational age is between 28 and 32 weeks for the "cutest" images.
The FDA strongly cautions against the use of ultrasound for these keepsake memories. They insist that nonmedical use of ultrasound is not a wise idea. The FDA also regulates medical equipment and is trying to crack down on the "entertainment" use of ultrasounds. Along with the FDA, the American Institute of Ultrasound in Medicine and the European Committee for Medical Ultrasound agree that the nonmedical use of ultrasound must be discouraged and that the use of 3-D ultrasound for psychosocial or entertainment purposes is inappropriate and contrary to responsible medical care.
The use of a diagnostic ultrasound during pregnancy may provide some valuable information about the well-being of the fetus. It can also be emotionally comforting to see the fetus' heart beat. But the advance of technology needs to be kept in perspective and in the safe hands of those qualified to use it.
Click here for previous articles by Elaine Stillerman, LMT.
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