resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
March, 2005, Vol. 05, Issue 03
What Scope of Practice?
By Ralph Stephens, BS, LMT, NCTMB
Most professions clearly stake out a scope of practice and then work to expand it. They work to plant it into law in each state and then grow it at every opportunity. Not the massage profession.We have consistently avoided defining our scope of practice. Our national leadership has consistently refused to draft model legislation and work to pass a standard law in every state so practitioners can have mobility, and the public can depend on a massage professional to meet consistent competency standards. Instead, volunteer therapists in each state have written their own laws from scratch, with minimal, if any, guidance. In the last two years, both the AMTA and ABMP have published some models, but they are suggestions - more guidelines than goals to accomplish.
Most massage therapists do not understand the legislative process and the nuances of drafting practice legislation where words mean something and a lack of words means something; mistakes have been made, not learned from, and made over and over, wasting years, thousands of dollars, and countless hours of effort. For proof of this, consider the hodgepodge of inconsistent licensing laws that have been passed, some of which are more of an impediment than benefit to practicing professionals.
In some states, teaching a seminar entitled "Medical Massage" is against licensing regulations. Due to poorly written laws, in some states, massage therapists cannot practice CranialSacral Therapy; in other states, stretching and exercises have been removed from our scope of practice. Some of our best educators cannot teach in some states because the way they practice the strokes (the same used by all forms of touch therapy) is not described or titled "correctly." Quite honestly, this is an embarrassment.
Whenever we have been challenged, we have given up scope of practice. Our scope is now more restrictive than it was 20 years ago. Some of our licensing efforts have become nothing more than a tax to practice, in some cases a voluntary tax. Want a license? Here you go. Don't want one? Fine - do your thing. The few good state licensing laws are constantly under attack, and there appears to be little effort by the professional associations to defend what we have, much less go for more.
Unfortunately, we are so politically correct that we dare not offend anyone. Since any time a group takes a stand on something - right or wrong - it offends someone or some other group, the massage profession has been very careful not to declare a meaningful scope of practice, a meaningful definition of our profession, or a meaningful piece of model legislation. The absence of leadership is not due to incompetence. Consciously or unconsciously, it is driven by money.
Nothing had better get in the way of the cash flow. The cash flow comes from anyone and everyone getting in easily and quickly. Zip them through school, sign them up in some association, sell them an insurance policy and maybe a license. In a few years most fail because of a lack of skills in both technique and business management; however, they are replaced by even more, quickly trained therapists.
The legal environment does not really matter; in fact, better for it to be muddled. As long as we can push some oil around and use the word "therapeutic," the system works very well for the system. "The mill" grinds up therapists, while the regulators, insurance vendors and associations fleece them. The 500-hour standard is a joke - it's not even long enough to be recognized as a profession by the government, which always sets the lowest possible standards for everything (well, except for taxes). Yet, a significant number of people in this profession feel 500 hours is too high.
The only thing saving this profession is the incredible power of caring touch, the good hearts and intentions of the majority of the people entering this profession, and the far too few excellent schools, whose owners really are dedicated to quality training and to the profession. Sadly, most of these owners have been therapist/educators for a long time and they are nearing retirement. When that generation hangs up their towels, I wonder who will carry on? Oh well, the cash flow won't go down without a fight. Corporations and bureaucracies are very good at maintaining the status quo. That said, may I suggest what I think our scope of practice should be? (Since it is my column, of course I can!)
The scope of the medical massage therapist or any massage therapist/bodyworker is simple. We should have the scope of practice to assess and treat - yes, treat - minor myofascial complaints. "Minor" meaning surgery is not required. (So the complaint can be major to the person with it! But surgical intervention is elective, not required.) Myofascial - meaning muscles, tendons, ligaments and fascia.
To do this we treat (there's that "T" word again) the soft tissues and the tonus mechanism (system) of the body using manual manipulation methods; stretching and movement; hydrotherapy; mechanical/electrical devices, which effect muscle tonus; nonprescription medications (homeopathy, herbals, supplements, etc.); and nonprescription topical applications. This is clear, simple, concise, and very open. If you think about this, you will realize what an incredible scope this would give us. I'll bet we could get that (and more) in every state with well-written legislation and the support of our patient base. Of course, to get it, we may have to increase training and competency. (Uh-oh. That will threaten cash flow. Sigh.)
Yes, this would probably mean a split in the profession to separate the amateurs from the professionals at both the school and therapist levels. The professionals might have to be divided into relaxation and therapeutic levels. Not necessarily, but probably. More training coupled to competencies, not just hours, will likely be required.
Obviously, this is an editorial / philosophy column. It is not intended to impose anything on anyone but to create awareness, plant seeds and encourage you to think. Keep thinking. I'll be back with more for May Day.
Try This: When faced with a complicated or seemingly difficult patient complaint with an intimidating diagnosis, approach the patient lovingly and respectfully, giving him/her your undivided attention. Respecting all applicable contraindications without causing pain (discomfort is ok, but pain is not), work to reduce muscle tone, ischemia and trigger points, increase circulation, and restore range of motion. By normalizing soft-tissue and movement, it is amazing how many complaints quickly lessen or go away.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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