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Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
7 Reasons You Want a Beacon in Your Office
Have you heard about how "beacons" are transforming the way businesses interact with their customers? Beacons are low-energy Bluetooth devices that have the ability to send information to a smartphone app.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Research: Know What You're Talking About
Have you ever seen a patient in your office with multiple serious health problems you weren't sure exactly how to address?
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Chiropractic Care and Risk of Stroke: The Shoe Moves to the Other Foot
For decades, numerous papers have linked upper cervical chiropractic care to the incidence of vertebral artery dissections and stroke.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Looking Back: Abstracts From Chiropractic History (Summer 2015 Issue)
The following abstracts are reprinted with permission from Chiropractic History, the official journal of the Association for the History of Chiropractic. Chiropractic History is the leading scholarly journal of the chiropractic profession dedicated to the preservation and dissemination of the profession's credible history.
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.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Reverse Digit Span: A Useful Assessment Tool for Patients With and Without Concussion
Reverse digit span is an easily administered test of attention span. It is a component of the SCAT3 test, which is frequently used to assess concussion. It has been part of the armamentarium of cognitive assessment for many years.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Winter of Life: A Personal and Chiropractic Practice Perspective
Last November, my wife and I invited an elderly relative, Uncle Josh, to spend the winter with us. He was 82 years old at the time and turned 83 during his stay. As soon as he accepted our invitation, we began preparing.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
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.
Are You Making the Wrong Impression?
Taking a page from Stacy and Clinton of The Learning Channel's hit television program, "What Not to Wear," we recently published an article in the summer issue of Chiropractic History: The Archives and Journal of the Association for the History of Chiropractic, that explores the evolution of physician attire from prehistoric times to the present.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
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.
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