resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
January, 2006, Vol. 06, Issue 01
"Incident To" Issues
By Cliff Korn, BS, LMT, NCTMB
Are we professional, or not? Should those who choose to practice under the term "massage therapist" have the option of being considered a health care provider? Are we part of a "profession" that can benefit or be harmed by the actions of outside organizations/professions? Can, or should, we politicize the work we do by letting regulators know our opinions?
Your answers to these questions likely will determine your comfort level with this monthly editorial.For the record, I answer all of them affirmatively. I'm hoping enough of you do, too, and will let your feelings be known about something that has insidious downside implications for segments of our profession.
I am speaking about the ruling the Centers for Medicare and Medicaid Services (CMS) issued to prohibit Medicare reimbursement for therapy services provided "incident to" a physician's office visit. As of July 25, Medicare will pay physicians for physical, occupational and speech pathology therapy performed in their office as an incident to service only if it's done by a licensed therapist (or an assistant therapist supervised by a licensed therapist). When CMS uses the term "therapist," they now mean only physical therapists, occupational therapists or speech and language/hearing pathologists. Previously, Medicare paid physicians for incident to therapy services even when other providers, such as massage therapists, athletic trainers or physical therapy aides, performed it. However, Medicare no longer considers physician supervision of these auxiliary providers to be sufficient. Under the new rule, physicians are not permitted to bill Medicare for therapy services performed by athletic trainers, kinesiologists, therapy aides, therapist assistants, massage therapists, or any other non-therapist professionals.
It appears to me that we, and many other professions, were out-lobbied by other groups. The December 2004 issue of PT Magazine had an article entitled, "Physical Therapists Win Change in Medicare 'Incident To' Rules." The PTs of the world seem happy with the law changes. It seems like such a simple thing on the surface - a ruling that says physical therapy must be performed by a physical therapist. That makes sense, doesn't it? I think massage therapy should be performed by a massage therapist, too! As they say, though, the devil is in the details, and the definition of what constitutes "incident to" therapy adversely affects many massage therapists. As you well know, there is a significant difference between the performance of "physical therapy" and the delivery of "physical medicine."
This issue has been on the radar screen for several years, but the "blip" was not a bright one because CMS was reporting that the proposed changes merely were a clarification of existing CMS policy, and it was required by a 1997 statute. A quick Web search brings much information suggesting this hardly was accurate. My own reading indicates a significant change in policy, as opposed to just a clarification.
Massage Today columnist Vivian Madison-Mahoney writes, "I attended the recent press event in Washington, D.C., where Coalition members spoke out and expressed their concerns on how the recent Medicare ruling has affected them. This ruling limits only PTs, OTs and SLPs to provide therapy to physician patients where Medicare is reimbursing for the treatment." She goes on to state, "Doctors everywhere are feeling the sting of this ruling in that they are not allowed to decide what treatment, and who is best to provide it, for their patients. Therapists and other qualified providers who have been allowed to provide treatment 'incident to' physician's services for the past seven years are now out of work across the nation due to this ruling.This includes nearly 1,200 lymphedema therapists who are mainly massage therapists, in addition to thousands of other qualified providers and massage therapists who treat other conditions for the Medicare patient such as musculoskeletal conditions."
So, how did this ruling occur? Was there a great expression of concern from physicians and patients? Apparently not, since many physician groups, including the American Medical Association, joined a coalition to try to stop the ruling! The AMA formally stated, "The AMA urges CMS to withdraw its proposed changes for incident to physical therapy services and re-issue a new proposal in a later proposed rule after consulting with all affected physician and other health professional organizations"
The National Athletic Trainers Association went so far as to file suit to stop the proposed change, but their suit was set aside. There are some 23 different professional groups who have formed The Coalition to Preserve Patient Access to Physical Medicine and Rehabilitation Services (www.coalitiontopreservepatientaccess.org/).
My concern, and the primary reason I am bringing this to your attention, is not because so many massage therapists get reimbursed by Medicare; they don't. I find this issue important because so much of what happens with Medicare filters down to the private segment. I am very concerned that the commercial insurance carriers will find this an attractive way to limit payment for currently covered services. This increases profits for the three select therapy groups, as well as the insurance carriers, to the detriment of the public and all other care groups who otherwise are qualified to perform the services. It also undermines the patient/physician contract, as neither will be able to choose the best provider for a specific service. Make this a personal issue - see yourself, a parent or another loved one as a Medicare recipient in need of postsurgical lymphedema treatment. Now, decide if you'd rather have the treatment performed by any PT (because it could be reimbursed), or by a massage therapist specifically trained in lymphatic drainage. Medicare patients who seek "therapy-incident to" services from anyone other than a physical therapist, occupational therapist or speech/language pathologist might be denied coverage.
I strongly urge you to visit the Web site listed above and read the links listed under "Coalition Information." Then contact your professional associations to see what they are doing about this. Follow up by getting involved personally, and make calls to your congressional offices and let them know what actions you'd like taken. It's my opinion that CMS should revise its current ill-conceived "incident to" policy and revert to the one that since 2001 has stated that "any individual" can provide therapy services. What do you think?
Thanks for listening!
Massage Today encourages letters to the editor to discuss matters related to the publication's content. Letters may be published in a future issue or online. Please send all correspondence by e-mail to , or by regular mail to:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.