resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
October, 2005, Vol. 05, Issue 10
Searching for Medical Massage
By Keith Eric Grant, PhD, NCTMB
I suppose I share a personality trait with a notable orange cat that once graced my life. Upon hearing a fence-top "discussion" among others of his kind, he would head toward the fray, rather than away from it.Only this trait can explain my entering into the current fray on the definition of medical massage.
If we are to call an area of massage "medical," then it seems it should have connection to those who practice medicine and the treatments they provide. To be both relevant and comprehensive, medical massage should both fall within medical interest in massage and be broad enough to span the scope of such interest. Because medicine directs its efforts toward the treatment of dysfunction, medical massage also would be expected to produce measurable outcomes within the context of such treatment. Where integrated with medical efforts aimed at preventative intervention, preventative use of massage also would be medical massage. Outcomes might be directly observable based on patient reports, or on third-party diagnostics such as laboratory blood analysis.
These thoughts gave me a sufficient focus to search the PubMed database (January 1997 through August 2005) for indexed articles with massage in the title and without the terms cardiac or carotid as a keyword; using the latter terms often retrieved massage in a medical context outside of our interest.4 Prior to 1997, the number of articles with online abstracts dropped off sharply, motivating the limit on how far back to search. What I retrieved for my efforts was 463 articles, from which I was able to visually select 172 as addressing the use of massage in the context of specific medical treatment. Of the initial 463, I first eliminated those not identifiable as relevant to massage as we mean the term. I next excluded articles simply introducing massage to another professional audience or describing the setup of a massage or CAM program. I also eliminated papers on sports recovery facilitation apart from injury treatment.
For each of the remaining articles, I attempted to identify the patient population that was targeted and the goals of the treatment. In Table 1, I've presented a summary of the populations served and in Table 2, the goals of the treatments provided. For several of the articles, either the population, treatment or both fell into multiple categories, such as children who are burn patients being treated for pain and discomfort as well as stress, anxiety and depression. Thus, my totals for treatment populations and treatment goals are both greater than 172.
While this survey of PubMed articles is far from being a complete and rigorous characterization, it clearly indicates the medical application of massage extends over a range of treatment needs and uses techniques from simple touch to highly clinical. The goals involve changes that are physical, neurochemical, emotional and behavioral. For me, a picture emerges from which I draw several conclusions.
First, the con-siderations of whether massage is medical and whether it is clinical-orthopedic are separate. Medically oriented massage draws on a diversity of skills and techniques. Similarly, orthopedic techniques can be used in a medical context or in, for example, the context of sports facilitation and maintenance. That a technique is not tissue-specific does not imply the absence of assessable outcomes. The only conclusion we can draw as to technique is that the practitioner should be working within his or her training.
A second conclusion is that those practicing medical massage will need to communicate and integrate within the medical environment, including having knowledge of terminology, privacy requirements, record-keeping and facility protocols. Dunn and Williams note, for example, changed expectations for physical privacy, uninterrupted time and presence of monitoring equipment and wires while working in hospitals compared to individual practice.2 This area of communication and protocols for medical integrations defines the single core area of training and knowledge pervasive to the medical use of massage.
Finally, a practitioner working in a medical context will need to know the needs of the specific population served on physical, emotional and social fronts. Renee Gecsedi points out, for example, the need for specific knowledge in working with cancer patients.3 "LMT's need information about a patient's cancer diagnosis, comorbidities, type of treatment and response to treatment to safely provide massage therapy. Nurses play an important role in conveying this information and [other] information LMT's [require] about any special considerations, such as the presence of neutropenia or thrombocytopenia. Safe and effective massage therapy to patients with cancer only is achieved when the patient, healthcare providers and LMT collaborate effectively."
Applications in gynecology and urology, while outside the current scope of practice in many states, were within the discussion of practice submitted for consideration to the British Columbia Health Professions Council in a relatively recent comprehensive review of health professions. In its reply, the HPC noted that norms on and availability of training are, as yet, inadequately developed.1 Lacking clearly identified areas of application and norms for the corresponding knowledge and skill requirements, likely are the greatest deficit we encounter toward medically-orient massage. We still need to work with other health care provides to create norms and guidelines for most applications.
To the extent medical massage is definable separately from massage in general, it is defined by its integration into a medical context and by its focus on treatment outcomes. We have a great diversity of opportunities for practice, and equally great opportunities to benefit our fellow inhabitants on this blue-green planet by realizing the full potential of massaging "medically."
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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