resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
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.
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.
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.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
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.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
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.
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.
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.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
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?
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
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.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
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.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
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.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
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.
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.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
June, 2005, Vol. 05, Issue 06
We Get Letters and E-Mail
By Editorial Staff
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be edited for space and clarity, and published in a future issue or online.Please send all correspondence by e-mail to or regular mail to:
Regarding the National Certification Board
It's been said that criticism is free advice offered by people who truly care. So on behalf of the NCBTMB, thank you for caring about national certification and for the chance to share an insider's view ("Lots of Stuff," May 2005, www.massagetoday.com/archives/2005/05/07.html).
Things are not always as they appear. Tempting as it may be to point fingers when the going gets tough, the board is sensitive to the recent controversy and takes personal responsibility for the decisions and leadership of the NCBTMB. That said, the nomination process was flawed and required intervention. The board made changes to the process and continues to review policies that ensure propriety, and help us practice what we preach.
Losing two executive directors, a board chair and chair-elect, has been extraordinary. While others may view them as detrimental, these events have helped the board reconnect with the principles of consensus and accountability and thus made it possible for us to let go of an 11-year relationship with our management company. Quite simply, the NCBTMB is transitioning from adolescence to young adulthood, and growing up. We appreciate that a mature organization values its stakeholders, understands its purpose, recognizes its strengths, identifies how it needs to grow, and implements strategies to that end. By electing Elizabeth McIntyre - an experienced and qualified board member - as chair-elect, seeking an executive director whose loyalty is to certificants, and hiring personnel who value the industry, we hope to demonstrate our learning and that we're listening to those we serve.
Cliff, please continue to voice your concerns as you see them and join us as we begin a new era for the NCBTMB. Together we can discover the good that is yet to come.
Garnet Adair, chair NCBTMB
I appreciated your article in the April 2005 issue that puts some serious questions to representatives of the National Certification Board ("Winds of Change Blowing at NCBTMB," www.massagetoday.com/archives/2005/04/01.html). One point that I would like to highlight and would like to see addressed further is the following quote from Garnet Adair:
This statement makes it sound as though the candidates who take the test actually get to discuss any concerns they have over difficult or unclear questions with someone who can do something about it; this is decidedly not so. When I took my exam back in December 2000, I was not even allowed to see which questions I missed - just that I passed the exam. And as I understand it, candidates are also not allowed to remove test questions from the test site. How are they supposed to remember the unclear questions after answering 160 test questions? And to whom could they even address these concerns?
Real "beta testing" in the computer software world involves users who actively test a new piece or component of software and offer feedback to the programmers and designers about how it can work better. As I see it, there is no feedback mechanism to the NCB. I am beginning to agree with those who feel that the NCB's power is getting out of control.
Andrea Porter, LMT
I had the opportunity to read the article and interviews regarding the NCBTMB and just had to e-mail you. I certainly had to chuckle when I read the reply to Massage Today's question regarding the monopolization of the massage therapy profession by the NCBTMB and AMTA. The response was: "They are another professional related organization. One is a membership organization; one is a voluntary certification."
Voluntary? It has been my experience in dealing with states that use the NCBTMB as their certifying exam that it is anything but voluntary. I just needed to voice my opinion.
Marie A. Ruberto, Managing Director
"Rather than reinvent the wheel, let's clarify our use of already defined terms"
Since every profession needs a clear scope of practice, it was refreshing to read Ralph Stephens' March 2005 editorial titled "What Scope of Practice?" (www.massagetoday.com/archives/2005/03/11.html). While I agree with Mr. Stephens regarding our need for a well-defined, cohesive scope of practice, any massage legislation must be inclusive of our entire profession to represent more than special interests. As a 25-year practitioner and massage educator, I am often dismayed with the widespread impression of many massage graduates that they are medical practitioners able to treat condition Y with technique Z. How did a "medical" scope of practice - that a massage therapist can evaluate, diagnose and treat soft-tissue disorders - seep into so many massage training programs?
This approach creates several problems. First of all, massage therapists generally lack training in a preliminary step of this cause-effect equation - evaluation X. Before being qualified to evaluate soft-tissue disorders, physical therapists undergo four to six years of education and training. Also, they are often required to gain some years of clinical experience before being allowed to practice evaluation on their own. Although competent and well-trained manual massage therapists help many people with soft tissue problems, it is doubtful that evaluation skills could ever be adequately taught in 500-1,000 hour massage therapy programs.
Second, evaluation is prohibited by the scope of massage practice defined in many state laws. Both the American Medical Massage Association (AMMA) and the American Medical Massage Therapy Association (AMMTA) recommend and/or require specific continuing education classes to standardize evaluation and treatment skills in medical massage (Mr. Stephens' classes are on both lists).
Yet 24 states with licensing laws include statements to this effect: Massage is defined as excluding the diagnosis or treatment of illness or disease or any service or procedure for which a license to practice medicine, nursing, chiropractic therapy, physical therapy, occupational therapy, acupuncture, or podiatry is required by law. Since many of the manual therapy techniques advocated as medical massage arose within the practice of medicine and physical therapy, conflict is inherent if we practice them within an X-Y-Z medical protocol.
While my preference is for the more personal, holistic approach to manual therapy offered by "medical" massage therapists, as both a client and practitioner I will continue to rely on medical professionals for evaluation and diagnosis.
Consulting with them about the medical conditions of our clients builds bridges between our professions. Furthermore, given the history of costly legislative battles between chiropractors, physical therapists, occupational therapists, and others squabbling over "turf," it is highly unlikely that even a well-organized massage coalition will ever be able to afford the lobbying clout to change the laws already on the books. And do we want to?
Rather than be PT wannabes, let us own and promote what massage already offers: effective methods that promote deep, profound relaxation; pain, muscle tension and stress reduction; and the enhancement of health and well-being. Practitioners can still practice "medical/orthopedic massage" within a remedial / holistic context (already written into many state laws) to alleviate symptoms and improve the structural balance of a client.
Rather than reinvent the wheel, let's clarify our use of already defined terms. Since "medical" is defined as relating to the science or practice of medicine or treatment of disease, "medical massage" should be inclusive of all massage methods applied to people with medical conditions. Many agree that what the AMMA and AMMTA call medical massage is better described as orthopedic massage. Why not call it what it actually is?
Third, advocates of the medical/orthopedic massage would separate the profession into relaxation and therapeutic modalities. Why? Relaxation massage is therapeutic. It just may be the truest application of medical massage for the injured, ill and dying today. Medically based relaxation massage deserves more acknowledgment than it receives.
Since I may be ill and for sure will be dying some day (as will you), I take great comfort in knowing that many massage therapists today practice in hospitals and hospices. Read the state laws and it becomes apparent that massage does have a defined scope of practice that is fundamentally holistic. We simply need to hone it and then collectively and proudly own it.
Mary Ann Foster, BA, CMT
I completely agree with Mr. Stephens that a simple scope of practice is easy to sell politically. The scope of practice he describes is essentially diagnosing and treating minor myofascial conditions using manual manipulation, mechanical and electrical devices, and nonprescription medication. This scope of practice is proven to be successful, as it is the scope of practice of the chiropractic and/or physical therapy profession.
Allowing a massage therapist to use electricity, manual manipulation or to diagnose is a difficult political sell. First, it infringes on the chiropractic and PT professions. More importantly, it is difficult convince most people that a vocationally trained massage therapist is capable of diagnosing problems. At present, diagnosis of myofascial problems is limited to college-educated people. If you strip out the controversial language, the scope of practice becomes the treatment of minor myofascial conditions. This may work.
Bruce Klein, ND
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