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The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
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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