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Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
June, 2006, Vol. 06, Issue 06
Truth: The Golden Thread, Part One
By John Upledger, DO, OMM
One element shared by all effective healing methods is the process of leading the patient through honest and truthful self-discovery. In my experience, this "Golden Thread" is necessary for the initiation and continuation of self-healing, because it is only through self-healing (as opposed to curing) that patients can experience both permanent recovery and spiritual growth.
Before exploring the issues of self-discovery and self-healing, let's examine the differences between healing and curing.Surprisingly, both words share essentially the same dictionary definitions: that of being a method or course of treatment that aims to restore health. Yet the definitions don't capture the implications the two words have in today's health care world.
Healing often refers to what is done by the patient or the patient's body to resolve a problem of the body, mind or spirit. Curing usually refers to what a physician or therapist does to the patient. Thus, we frequently speak of patients needing to heal themselves after a disease has been cured. Surgically removing the gallbladder, for instance, might cure the gallbladder disease. But the patient must then heal the wound and adapt to the organ's absence in order to achieve full digestive-system function.
The reason we need to clarify the difference between healing and curing is quite simple: Effective therapy, whatever its outer form, initiates, facilitates and supports the patient's own healing efforts; whereas the curing process provides a more temporary and perhaps only palliative effect. Although curing might remove the symptoms of a disease from the outside, so to speak, it usually leaves the underlying causes of the symptoms untouched.
For example, a physician might cure hemorrhoids by surgically removing them. However, if the hemorrhoids are secondary to liver congestion due to chronic alcohol abuse, the problem will not be healed until the patient resolves the underlying reason for the alcohol abuse. Perhaps it would even be better for the surgeon to leave the hemorrhoids intact to remind and motivate the patient to pay attention to the alcohol abuse. In this way, the real cause of the problem might be eradicated.
One of my friends, a general surgeon with more than 30 years of experience once confided to me that, in retrospect, he felt most of the surgeries he had performed might better be classified as excisions of the vocal apparatuses of his patients' inner selves. By removing certain organs or tissues, he believed he was eliminating the bodily voices that were trying to focus attention on the source problem.
Going back to our patient with the hemorrhoids, if they are removed, yet the alcohol abuse continues, the inner self has no choice but to select another organ as an attention-getter. The next target might be the gallbladder, which the surgeon might then need to remove because it becomes full of stones.
So, now we have a heavily drinking patient without hemorrhoids or a gallbladder who still has little or no idea why he's abusing alcohol. Perhaps he's using it to escape feelings of guilt one of his parents instilled in him when he was a child. Whatever the case, if the issue is left unexplored and the abuse continues, eventually the liver function will once again falter.
When such a case of deterioration continues, the inner voice of the body's wisdom will feel an increasingly urgent need to contact the patient's conscious mind. You might even see varicose veins develop in the esophagus. Now the situation is life-threatening, requiring internal medicine specialists and surgeons to co-manage the process. Once the veins are surgically dealt with, there might be little remaining that can be removed except the liver itself, in which case a transplant would be necessary. Usually, though, the internist must support the abused liver until death takes over.
Now, let's backtrack a bit. Somewhere along the line, a psychiatrist might have been called in to deal with the alcohol abuse. Or perhaps by now the patient is believed to be suicidal. In either case, most of the drugs prescribed by the psychiatrist will probably have both mind-altering and hepato-toxic (liver-poisoning) qualities. So the inner voice has even less of a chance to communicate with the drug-compromised mind about the reason for the alcohol abuse. And the liver function will be further impaired due to the toxic nature of the drugs.
What might we expect from such a scenario? Most likely, premature death. The cause would probably be recorded as liver failure due to alcohol abuse. But from our perspective, it might be just as accurate to say the patient died from a hemorrhoidectomy thoughtlessly performed without having searched for an underlying message. Or, we might consider the death due to the second excision of the inner voice that was attempting to speak through the gallbladder.
Becoming aware of this inner voice is what I mean by self-discovery that leads to self-healing. In the case I just outlined, treatment not only failed to make the patient aware of the inner voice, it ultimately suppressed it. This led to a self-perpetuating cycle of deterioration.
Short of a miracle, the process probably was irreversible once the varicose veins developed in the esophagus and the brain was numbed with mind-altering drugs. After all, what chance does the inner voice have against an onslaught of modern surgical technology and psychopharmacology?
Of course, a myriad of health approaches and philosophies have been created in response to the failure of traditional curative methods. Therapeutic massage, meditation, exercise, nutritional therapy, herbal therapy, homeopathy, acupuncture, manual medicine, rebirthing, counseling, primal scream, CranioSacral Therapy, SomatoEmotional Release and biofeedback, to name a few. Although outwardly different, each of these systems facilitates the self-discovery that leads to self-healing.
When considering how the process of self-discovery works, it's important to remember our self-image constantly is changing. It seems the closer our perception of self approaches the truth, the deeper becomes our capacity for self-healing. When there is a close correspondence between self-image and trust, our self-healing power may be virtually unlimited, capable of producing the "miracle cure."
That's why, as a therapist, your main responsibility is to help the patient develop a truer (more accurate) self-image. You must become an accurate reflecting mirror - a medium through which the patient's real self can be perceived more clearly. You must be an unbiased facilitator, understanding the patient's true self-image might not be compatible with your preconceived notion of the problem.
When you release any ego-based tendency you might have to engage in dogmatic symptom classification, you can become a clear, reflecting medium that ultimately permits no illusion, delusion, camouflage or facade. Then, and only then, can you and your patient both discover the truth.
As a facilitator, you also must not force too much perception of truth at one time. Otherwise, you run the risk that the patient will turn away from his own reflections. You must be a very sensitive mirror, reflecting only as much as the patient is able to deal with at any given moment. Still, you must reflect enough to prevent stagnation and keep the self-discovery process moving forward.
The art of therapy is in sensing how rapidly the process can move without turning the patient away, and in allowing the patient to make his own discoveries. This requires you to avoid suggestion and leading. It also involves connecting with the patient at a nonconscious level. The process of self-discovery might continue with or without words. I wish you well as you continue to weave the Golden Thread throughout your therapy.
Editor's Note: Part Two of "Truth: The Golden Thread" will appear in the July issue of Massage Today.
Click here for previous articles by John Upledger, DO, OMM.
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