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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.
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.
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.
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."
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.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
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.
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.
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.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
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.
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.
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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