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5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
June, 2006, Vol. 06, Issue 06
When Are Symptoms Not Symptoms?
By Leon Chaitow, ND, DO
Have you noticed how buzz words and key phrases are emerging from the powers that be in the increasingly regulated application of health care? Evidence-based medicine is one of these and there's a lot to be said about this topic - but not in this article.Another phrase that is emerging is informed consent. At its heart, this phrase, and what it entails, simply tells us that patients need to know what a particular form of treatment involves, as well as the drawbacks, possible side effects, success rates, etc.
How could anyone take exception to this you might ask? Surely it's everyone's right to know if there is a risk attached to a treatment method, so they can make an informed decision to accept or decline? The risk-benefit ratio can only be considered once the relative benefits, as well as potential risks, are made available to the patient/client in the form of objective information.
I would say the answer to this question is not as clear-cut as it may seem. Let's look at this in relation to manual forms of treatment. The most invasive form of manual therapy is arguably the high velocity, low amplitude (HVLA) thrust technique, as used by chiropractors, osteopaths and increasingly by physical therapists, to manipulate (adjust) joints.
Many experts have suggested there are risks attached to this form of treatment,1 particularly when applied in the cervical region. The most serious possible negative effect is stated as being a risk of stroke (vertebral artery dissection). The problem with the statistics used to demonstrate damage from manipulation of this sort is that they seldom make clear just what type of manipulation is involved, and they seldom describe the competence of the individuals applying the manipulation.
Gibbon and Tehan,2 in regards to this very issue, report that in a study of Australian Manipulative Physiotherapists, who are required to undertake specific postgraduate study in manipulative therapy, there were no major complications in 4,601 physiotherapist years of manipulative practice. Despite allegations3 the evidence actually is that a causal connection between cervical HVLT manipulation and subsequent stroke is unproven, and when applied carefully the risk is virtually nil.4,5
To be absolutely clear, there are risks in all treatment (even massage), but these risks reduce to the point where they become statistically invisible when the methods are used safely, by well-trained people, in the correct situation (for the patient)! But in the informed consent model, every patient about to receive such treatment would need to be informed that there is a defined and explained risk (and in some countries would be required to sign a form saying they had been informed, and have consented to the treatment).6 Ask yourself whether such a protocol is likely to be conducive to the individual staying calm and relaxed during the procedure? In many instances is it not likely to result in a refusal of extremely effective modes of treatment?
Despite these reservations, I am bound (in the U.K.), by a legal requirement to obtain such informed consent before manipulating any part of the body. This also is true of application of soft tissue manipulation methods, including muscle energy techniques and neuromuscular techniques. And all this takes valuable (to the patient and to me) time, and creates (I believe) unnecessary bureaucratic management burdens, as well as anxiety for the patient.
This preamble brings me to what I really wanted to discuss in this article - the meaning of symptoms, including "reactions" to treatment (such as soft tissue manipulation). I would imagine there is very little disagreement with the basic premise that all healing is endogenous (i.e., the body is self-regulating and treatment, of whatever sort, is designed to either enhance that process or to remove obstacles to it). All treatment of the body demands an adaptive response.
Whether the response is helpful and health-enhancing or not, depends on whether it's appropriate for that particular individual/condition, at that particular time.
If a "therapeutic response" is forthcoming following treatment - manual or otherwise - there is bound to be some degree of a sense of change, as homeostatic modifications work their way through the systems, and these likely are to be reported as "symptoms," or "reactions."
In many therapeutic traditions, a "therapeutic response" is regarded as desirable, as evidence of self-regulating processes in action. It's easy enough to recognize that without inflammation, we would not recover from injury (and also that excessive or inappropriate inflammation is harmful). It's also not hard to grasp the idea that if you have ingested contaminated food, the rather undignified and unpleasant symptoms of vomiting and diarrhea are life-savers (or that excessive elimination of these types can be dangerous).
Understanding that effects of (or reactions to) treatment might fall into the category of "good symptoms" should be something that can easily be explained to patients. In homeopathy, the "law of cure" suggests that recovery of health occurs in a reverse order, so the most recent symptoms are likely to be the first to go. Reactions and response to homeopathic remedies are therefore keenly assessed and are seen as positive indications of healing in process. In naturopathy, the self-regulating responses looked for as treatment is initiated (e.g., fasting, nutritional reform or supplementation, botanical medicine, hydrotherapy, physical medicine) are thought of as being representative of the "healing power of nature." These changes are commonly eliminative, and are not considered to be "side effects" but are evidence of healing in action.
In chiropractic and osteopathy, similar processes to those mentioned in the homeopathy discussion may occur, as symptoms reappear and are then normalized by the body itself, in reverse order to their original appearance. In many forms of psychotherapy, and in somatic branches of those methods such as somatic experiencing, reintegration of dysfunctional adaptive states might well involve the reappearance of symptoms as part of the process of normalization, discharge of the effects of trauma, and restoration of health. These "side effects" are not side effects at all but signify change, part of the body/mind's adaptation towards a more balanced state.
In the "informed consent" model, we likely are to spend a great deal of time having to explain these concepts. My main concern is that people might not grasp the concept of "symptoms being good for you" or "symptoms as evidence of healing in action," and might decline what they need most once they have been "informed." Even worse, having been informed there is a risk of stroke following manipulation of the neck, what will go through a person's mind when normal responses to treatment such as deep tissue massage, or neuro-muscular technique, or trigger point deactivation, or muscle energy stretching (a degree of discomfort for 24 hours for example, or a slight degree of light-headedness perhaps) are experienced? A phone call to me (or you) at 2 a.m. might be the patient's reaction. I'm not sure what mine will be when that happens though. What do you think?
Click here for more information about Leon Chaitow, ND, DO.
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