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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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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?
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.
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.
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.
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.
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.
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.
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.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
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!
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching 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.
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.
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.
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.
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.
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.
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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