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Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
April, 2005, Vol. 05, Issue 04
By Keith Eric Grant, PhD, NCTMB
Last time, we explored factors that lead to business survival in the practice of massage ("Meaning Business," Feb.2005, www.massagetoday.com/archives/2005/02/07.html). What I emphasized were the skills of attitude, business, presentation, niche identification that provide a focus for work, and a stream of clients to work with. This time, I'm focusing on factors that allow you to physically stay in practice. Some of these are mostly within your control and planning; others - like the direction of the wind - can only be known and contended with.
To survive physically, respect massage as a body-based endeavor. Our bodies have their rules as to training and accommodating to new stresses. One of the cardinal rules of increasing sports training is to increase activities by no more than 10 percent per week.3
Physiologically, the ability to increase use is partly due to the effects of super-compensation on muscle strength and endurance discussed in my article, "Training Effects." (June 2003, www.massagetoday.com/archives/2003/06/08.html).
The structural accommodation of bone and connective tissues to stress, over time, is conceptually captured in Wolf's and Davis's laws, respectively. Increase your use of a given body area too fast and it can't accommodate before it breaks down. Respect your body, and its time for adjusting in your enthusiasm for doing the work.
Apart from controlling the rate of ramping up the total amount of massage you do, it's important to control both how the massage is done and the cumulative after-effects. Less stress is placed on your body when you vary the means of applying pressure, alternating the work you are doing between different body surfaces - fingers, palms, open fists, knuckles and forearms. Just as important, is learning to work equally with both sides of your body rather than always using a dominant side.
As your work becomes deeper, the additional pressure should come more from your weight and stance rather than your hand and arm muscles. Having a table that is about fingertip high is one measure of height I use for sports or deep-tissue massage. Another measure is having a table at a height that allows me to place a flexed knee on its surface with my other foot flat on the flow, while still being able to freely lean forward to apply weight. Using a stance with one foot in front of the other will allow you to push your body forward and back from your legs in a rocking motion, rather than pushing from your shoulders. Movement training from tai ji or qigong can help in getting the feel of moving your body with intent. Squeezing petrissage that intensely uses hand and forearm muscles can be supplemented or replaced with rolling the tissue as you rock forward. Finally, both getting massage for yourself and using body-care techniques, such as those given by Sharon Butler and Lauriann Greene, can increase your professional longevity.4,7
Staying in the massage business goes beyond just doing the work. In the United States, provision of health insurance is largely gained through employer plans (or by marriage to an employed person). Distinctions are made between individual plans, small-business plans covering two to 50 persons, and larger employer plans. Planning for health care can be vital to both your family and business finances. A recent review of 1,771 bankruptcy filings revealed that 52 percent of them resulted from medical costs.9 The study showed that involuntary lapses in health coverage can be financially devastating. Even when people had medical insurance coverage, the co-payments and deductibles for serious health crises coupled with loss of income accumulated overwhelming debt.
While there is little you can do outside of politics to change the structure of health insurance provisions, there are a number of resources you can use to learn about small business health insurance, including coordination with the new, pre-tax, health savings accounts (HSAs).1,2,8,11,12
In looking through the state health insurance guides by Georgetown University8 and the coverage offered by organizations, such as the National Association of Female Executives (NAFE),10 I noticed much of the provision was done through a single Internet broker.5 May the days of your practice be long and fulfilling.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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