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Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
October, 2005, Vol. 05, Issue 10
The Labors of Legislation
Pennsylvania, New Jersey Bills Raise Different Issues
By Editorial Staff
Pennsylvania and New Jersey are two of several states in which massage therapists are seeing legislation introduced regarding licensure and certification.As we go to press, New Jersey Assembly Bill A4034 has been approved in committee, while Pennsylvania's House Bill 1643 has been sent to the House Committee on Professional Licensure.
New Jersey - A4034
New Jersey State Assemblymen Peter Barnes and Patrick Diegnan (both D-Middlesex) and Assemblyman Gordon Johnson (D-Englewood), proposed the bill, which would require certification for anyone performing "massage, bodywork or somatic therapy services." It is believed that this bill will be amended on the floor of the Assembly and then voted on as early as November 2005, when the New Jersey legislature returns from its recess. If the bill is not voted on by both houses by the end of the year, it will be reintroduced in 2006.
The bill stems from a title act approved by the New Jersey legislature in 1999 for massage, bodywork and somatic therapists. The act provided for optional certification, meaning no one was prohibited from practicing; it was just an issue of whether someone wanted to use a specific professional title affiliated with massage and bodywork, such as "Certified Massage Therapist." The act does prohibit state-certified therapists from providing treatment: "Massage, bodywork and somatic therapies do not include the diagnosis or treatment of illness, disease, impairment or disability."
As with most cases of licensure/regulation, there are potential concerns with A4034. In its current form, the bill would make existing voluntary state certification mandatory. Thus, the limited scope of practice in the title act would become the scope of practice for therapists.
Specifically, in the current draft of the New Jersey bill, anyone practicing bodywork who is not state certified is considered to be guilty of prostitution. The following text is taken directly from A4034: "Proof that any premises, place or resort which holds itself out as rendering massage, bodywork or somatic therapy services employs or utilizes a person who is not certified to render these services as required by section 1 of P.L. c. shall give rise to a permissive inference that the premises, place or resort was conducted or maintained as a house of prostitution."
According to the legislative update on the AMTA-NJ chapter's Web site, members are informed that "it is important for AMTA-NJ Chapter Members to remember the State Certification Law is a Title Protection Law, and therefore Professionals choosing to use any of the Titles identified in the Law are obliged to become State Certified. Consequently, for Practitioners in our profession who offer services which are not becoming State Certified this could potentially create a challenge should the State Examining Committee interpret that they fall under the NJ Title Act for Massage Therapy, Bodywork or Somatic Therapies. It is the hope of the leadership of the AMTA that our members and all Professionals in the State will want to become State Certified and be proud to hold their title as defined by our law."
New Jersey has been accepting applications for state certification since November 2004, and as of August 2005, only 60 therapists have been officially state certified, and 170 applications are pending. The current timeline for completing the certification process is at least three months.
Rena Margulis, NCTMB, Dipl. ABT (NCCAOM), a practitioner in Haddenfield, N.J., notes several potential problems with the latest version of A4034. (Under the current title act, the New Jersey Massage, Bodywork and Somatic Therapy Examining Committee, which is within the N.J. Division of Consumer Affairs, is responsible for certifying massage therapists who wish to utilize titles affiliated with massage and bodywork in a professional capacity.)
According to Margulis, A4034 "allows state-licensed, state-certified or state-registered professionals to perform massage and bodywork if it is within their scope of practice. But no one else. In an obvious error, there is no exception for students performing massage in a clinic or for anyone else receiving training in touch, even medical students. There is no exception for out-of-state continuing education instructors or for bodywork offered without reimbursement. Under A4034, anyone who performs bodywork without state certification faces the 'permissive inference' that he or she is operating a 'house of prostitution.'"
Margulis urges massage therapists in other states to watch this debate carefully, as there are fears other legislative bodies could make similar decisions in other states - making a title act a practice act with very little warning. "Compare the differences between the New Jersey statue and the New Jersey regulations. In many cases, what legislators did not prohibit, the regulations did. Many New Jersey therapists who backed the title act several years ago are now very, very, sorry they did," Margulis said.
For more information about A4034, visit www.njleg.state.nj.us.
Pennsylvania - HB 1643
Meanwhile, in neighboring Pennsylvania, House Bill 1643 finally has been sent to committee and is awaiting a vote by both houses as of press time. Currently, 66 state representatives have signed on in support of this bill and the Pennsylvania chapter of the American Massage Therapy Association (AMTA-PA) has distributed 14,000 cards across the state, requesting that HB 1643 be moved from committee to the House for a vote.
However, as with the New Jersey legislation, this bill has its critics - albeit in this case (as far as we can tell), from outside the massage profession. In its most recent legislative update, the AMTA-PA said physical therapists in Pennsylvania have publicly stated they are against the bill. The attorney for the Pennsylvania Physical Therapists Association, F. Stephenson Matthew, was quoted in the Eastern Pennsylvania Business Journal as saying, "The group believes massage therapists are not qualified to treat disabilities or impairments, that licensure is neither necessary nor appropriate and that it has concerns with the grandfathering of existing massage therapists." However, after repeated requests, the PPTA leadership has yet to contact the Pennsylvania Chapter to discuss their issues with the bill.
Despite this criticism, in the same legislative update, Pennsylvania Chapter President, Nancy Porambo, MS, NCTMB, offered her support of the bill: "[The bill] sets parameters from which we can build higher standards for the future of the profession of massage therapy, a position every profession seeking licensure had to take in the beginning of their growth."
She also said: "We are proud to state that many of our schools have redesigned their massage therapy programs to become an associate degree program. Many other programs across the state are above the proposed 600 hour minimum and our standards in the bill are currently higher than the national average of 500 hours."
To track the status of HB 1643, visit the AMTA Pennsylvania Chapter Web site at www.amtapa.org/gov/updates.php.
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