Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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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!
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?
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.
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.
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.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
April, 2005, Vol. 05, Issue 04
How Should We Teach Assessment?
By Whitney Lowe, LMT
Musculoskeletal disorders (MSDs) are some of the most commonly occurring causes of pain and disability in this country. They are treated by a wide variety of practitioners, and many people with them seek the care of someone other than a physician.Consequently, massage therapy is frequently used to address this wide array of pain and injury problems.
Proper treatment of any MSD begins with identifying the underlying problem. It is only then that we can determine if we should even be working on this client. If the practitioner has determined that a MSD exists for which massage treatment would be helpful, s/he must then determine which techniques or approaches to use with the client that should be helpful. The way to make this determination is through proper and accurate assessment.
Information may be gathered in many different forms, systems or structures yet they all have several elements in common. A thorough assessment includes detailed information from the client history, observable characteristics of the client and his/her condition, as well as specific methods of physical examination.
Some practitioners shy away from any organized framework for their assessment process, stating instead that intuition guides them. Others may state they do assessment solely through what they feel in their hands. While these are very important skills and may work well for basic relaxation massage approaches, they don't provide information necessary to make appropriate clinical decisions about treating MSDs. If I had an illness or injury and went to see a physician, I wouldn't want that doctor to evaluate me based on intuition or palpation alone. Likewise, many MSDs are complex and we must engage in a more comprehensive process when evaluating them.
There are some misconceptions about what assessment entails. Some feel it is just evaluating a client's range of motion. Evaluating range of motion is important, but you must know more than your client has a limitation in a certain motion, such as abduction of the shoulder. You must do what you can to find out why that limitation exists. Others state that assessment is mainly the use of special orthopedic tests like the Phalen's test for evaluating carpal tunnel syndrome. Memorization and use of various orthopedic tests is helpful, but only when used in their proper contexts. Simply memorizing these tests does not make you effective at assessment any more than memorizing the alphabet makes you a writer.
Assessment and Learning Theory
Learning theorists have developed classifications of how we learn that describe increasing levels of complexity. One of the most common classifications still used today is Bloom's Taxonomy of Educational Objectives, first published in the mid-1950s. In this classification, Bloom and his colleagues described six levels of increasing cognitive complexity: knowledge, comprehension, application, analysis, synthesis and evaluation.
The lowest levels, knowledge and comprehension, involve rote memorization. While memorization has its usefulness, it should not be the primary goal of our educational objectives. Unfortunately, most educational environments do not go past this level and assume that "learning" has occurred because an individual is able to achieve a specific score on a test that emphasizes rote memorization and, too often, little else.
The problem with this approach is that it doesn't reflect clinical reality at all. In the clinic room, the practitioner is faced with situations where memorization of facts still leaves you pondering as to what your client's primary complaint really is. In order to get past this point you must use the higher levels of the taxonomy - analysis, synthesis and evaluation. These abilities are developed through practical application of clinical reasoning activities in the learning process. Assessment is a complex procedure of clinical reasoning that has to use these higher cognitive functions in order to be even minimally effective.
Consequently, if we want to teach assessment skills in the way they will be eventually used in practice, we have to radically alter the way they are initially presented. In order to do this we have to get away from trying to have students find the "right" answer all the time. In many cases there isn't one "right" answer. There are several different paths and they each take us in different directions that may produce a good clinical reasoning process. Therefore, to accomplish this goal we must create educational activities that encourage a degree of cognitive uncertainty and encourage the practitioner to go through the reasoning process to figure a problem out. It is only through this kind of practice that these skills are developed.
So, when learning assessment, don't get stuck on trying to memorize a large group of special orthopedic tests or performing range-of-motion evaluations and call that your assessment. You must look at the entire picture of gathering information from the client's story and physical examination, process the importance of what you have found out, and construct a model for explaining your findings. When you can do this, you have moved into the higher levels of cognitive complexity, used advanced assessment strategies, and performed a much more thorough service in seeking care for your clients.
Click here for more information about Whitney Lowe, LMT.
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