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How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
November, 2005, Vol. 05, Issue 11
Questions From Readers
By Shellie Enteen, RA, BA, LMBT
In a previous column, I invited questions from readers. Fortunately, I received some important questions and felt everyone might benefit from the information in the answers. I have received permission to use the names and questions that appear below.Again, please do contact me with any comments and questions you might have and I will answer you directly and, where appropriate, might ask to use your question as part of an Aromatic Message column.
My first question came from Angela Barker:
Question: "I just read your very interesting article on essential oils. Can any essential oils be used during pregnancy?"
Answer: Yes, essential oils can safely be used during pregnancy within certain parameters. There is some controversy over how cautious one has to be during this time. Some Aromatherapists are very conservative, while others are more liberal in this respect. Most would agree that if you don't have problems with bleeding during the first trimester, Lavender is safe to use throughout. One of the safety concerns is that essential oils pass through the placental walls into the fetus. Another is that essential oils affect the hormonal system and also stimulate processes in the digestive, elimination and reproductive systems.
If you decide to use essential oils, it's best to remember that and use less of the oils considered safe than you would in a regular massage blend (up to four or five drops as opposed to seven or eight drops of all combined oils in one ounce carrier oil). You safely can inhale Peppermint for morning sickness (however, best not to use Peppermint if you are nursing, as it can stop the milk flow). Floral waters (also called 'hydrolats' and 'hydrosols') can be used with more confidence as they are more dilute.
Later in the pregnancy, other essential oils considered safe on the body and in the bath are Rose, Neroli and Chamomile. In small doses, Geranium, Jasmine, Petitgrain, Patchouli, Mandarin, Sandalwood and Ylang Ylang also can be used. I have had great success with a highly diluted blend of Rosemary and Lemon (1 drop each per one ounce carrier oil) used only on the feet and legs of a woman in her ninth month, suffering from decreased circulation and swelling. During labor, Clary Sage, Jasmine and Lavender help relieve pain, anxiety and assist delivery. Much of this information comes from "The Aromatherapy Practitioner Manual" by Sylla Sheppard-Hanger. You also might like to read some other authors on the subject, Patricia Davis and Valerie Worwood for example.
Several questions came from David Ponsonby:
Question: "You have an interesting overview of aromatherapy in the current MT. However, I still find it difficult to make choices or blends. We see a lot of 'failed back syndrome' patients...everything hurts, all the time. They often have surgical scars and retained hardware. They can be 10 years post-surgery. We tend to feel there is a psychosomatic component. There might be aches, sprains and spasms as well. They might be unemployed and surviving on insurance and security payments. Women tend to be more sensitive to scents than men. Do we combine approaches so that the patient smells the scent (e.g. cotton ball in bra for females), as well as having it on their lumbo-sacral region? Or have it on their pillow, clothes closet...for longer term exposure? Some essences are quite expensive."
Answer: I would like to refer you to an article I compiled on treating Fibromyalgia with Aromatherapy on the NAHA Web site www.naha.org, as you say you feel there is a psychosomatic component and an overall chronic pain issue, and we explore this in the article on Fibromyalgia. Another suggestion is to combine Bach Flower remedies with essential oils, as they treat the mind. You can read more about Bach Flowers on my Web site at www.astralessence.com. Bach Flowers can be put into a treatment blend that your client applies themselves and might use in a bath. You would shift the vibration of the Bach Flowers if you apply this type of blend to someone else, so they need to do it themselves. You also can suggest Bach Flowers they can take orally.
As for blending, I believe you do need to learn the properties, but there is no substitute for your own sense of smell. In my classes, I teach blending with the nose as the final judge. Make a list of what you think you should be using based on the properties you either know or have found in a reference book. Before you add the essence, smell it and allow yourself to come up with a quick 'yes' or 'no' answer. Don't linger over the smell, if in doubt, 'no' is the answer. What is happening is that the limbic region of the brain is registering all the properties and the 'yes' or 'no' is the response you have to indicate if those properties are the ones needed, for yourself and for others. Smell each proposed addition along with the blend you have going before you put it in. You will know if you should add it and also how much of it you should add. If you get some 'no' answers, another essential oil, not on your list, might come to mind and even if you don't know why, if it smells right, put it in. It might be that you will discover the reason you chose it, either through a communication the client makes during the session or something you read about that essence later. Trust yourself. I highly recommend having books that address the psychological/spiritual aspect of essences such as "Aromatherapy for Healing the Spirit" by Gabriel Mojay and "Subtle Aromatherapy" by Patricia Davis.
It's fine to fragrance a cotton ball if you are working on the psychological levels, stress, etc., but I would highly recommend using the essences in the treatment oil (you will notice I don't say lotion because you would need one that will totally absorb the essences and many won't do that). There is a powerful therapeutic effect when essential oils touch the skin, due both to their physical and vibratory effect. You certainly can give the client some of the blend to use at home.
You say some essential oils are very expensive and that is true, but when you figure the cost per drop, you will discover that even the most expensive essence is very affordable. A regular massage blend in one ounce carrier oil would contain up to seven drops of essential oils. The cost per drop is calculated by taking the price and dividing that by the number of millimeters (price divided by quantity) and then dividing that figure by 25 drops (the approximate number of drops in a ml). For example, if you bought 10 ml of Lavender for $14, you would divide $14 by 10 and have a price of $1.40 per ml. Then, divide $1.40 by 25 and you find that good quality therapeutic Lavender is a bit less than six cents a drop. You might use three or four in the blend, which would be 18 to 20 cents. Suppose you bought Rose at retail for $45 a ml. No need to divide by the number of ml, it's $45. If you divide this by 25, you get $1.80 per drop. Rose is a strong scent so you might add only one drop. When you realize your blend is now costing you $2, even using one of the most expensive essential oils, you find that this definitely is do-able.
I always would charge at least $5 or even $10 more for adding Aromatherapy to massage for both your material cost and your expertise. Even if you do an expensive blend occasionally, much of the time your blends would cost you a lot less than $5, even with the carrier oil figured into the price.
Question: "I still wonder about trusting my selection. Should the client select his/her own?"
Answer: No, the client should not select their own essences. Every inhalation is a treatment, so if the client is inhaling a lot of essences, they already are being treated and even over-treated. Try spending a little time blending for yourself or for friends first, and you will feel more confident. If you absolutely don't feel comfortable with blending after this, then you can opt for purchasing premixed blends for pain relief, relaxation, circulation or detoxification. You can ask the client to select one of those by the name and not by the smell. This is not my favorite way of treatment because there are more levels to each of those areas and each client is an individual, but a generic blend will do if necessary!
Click here for more information about Shellie Enteen, RA, BA, LMBT.
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