resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Why More Patients Don't Come to Your Office
Every so often, something turns out to be much easier than anticipated. It's like ordering a piece of furniture or a child's toy that comes in 167 pieces.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
We Get Letters & Email
It was with great interest that I read "Trouble in the Wellness Waters?" in the May 1, 2015 issue of Dynamic Chiropractic. I heartily applaud Dr. Hayes for his insightful and informative article.
Managed Care Subverts Chiropractic
A study published in the American Journal of Managed Care underscores why so many chiropractic patients go out of network in order to get the care they need: Managed care may be effectively locking them out.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Thinking About Cohen's Kappa
Let's think about some notions of reliability and validity, and about what it means for diagnostic examiners to agree in meaningful ways. Diagnostic tests must obviously be both reliable and valid.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Troubleshooting: Billing Multiple Fees for the Same Service
I am afraid I may doing something illegal. I have heard I cannot bill different fees for the same service.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Do You Have a Post-ICD-10 Strategy?
Post-ICD-10 planning is critically important to the health of a practice, in part because ICD-10 is brand new to providers, payers and related affiliates alike.
When Patients Lie (Bribe or Flatter)
Recently, a new patient told me about what I thought was a novel twist on the doctor-patient relationship. She felt she had to lie to her DC to discontinue her treatment.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Dietary Fat and Prostate Cancer: An Important Update and Review of Mechanisms
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
A Tribute to a True Chiropractic Leader
President of Texas Chiropractic College (alumnus, class of 1950) and the American Chiropractic Association (ACA) Board of Governors. President of the Texas Chiropractic Association and twice-appointed member of the Texas Board of Chiropractic Examiners.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Active Care for Ankle Sprains
An ankle sprain is a common injury, since this joint is required to perform complex movements under high forces during normal walking. In fact, 10 percent of all emergency-room visits are ankle-sprain related and an estimated 25,000 ankle sprains occur in the United States daily.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
June 14, 2004
Teaching Unethical Business Practices Must Stop
By Ed Denning, MEd, LMT
It is time to stop teaching unethical business practices to massage therapists. Those who teach the unethical business practices outlined below do so to capitalize on the greed of massage therapists who do not think about the consequences of their behavior.Those consequences are now beginning to exact a price, which all massage therapists will pay.
Unethical Teaching of Code Selection
One of the teaching practices I am talking about is the inclusion of highly questionable Current Procedural Terminology (CPT) Codes. Many more codes than is appropriate are presented in literature and seminars. These folks carefully point out that the massage therapist is responsible for selecting the correct code (which means that the authors or seminar prenseters are not liable for what they teach), then list a large number of codes, most of which no massage therapist is qualified to use.
Those they teach are encouraged to interpret for themselves the meanings of the codes and whether they are qualified to use them. In most cases, the selection of a code is driven not by the meaning of the code and the massage therapists' qualifications, but rather by the fee that code pays.
The result of that kind of teaching is significantly higher fees and much greater income for the massage therapist, which is what drives the massage therapist to resort to questionable coding decisions. Did you know that an indentation of wording in the CPT coding manual carries with it an addition to the definition listed?
Did you know that a semicolon has a meaning, which is different than a comma when reading the codes? If you do not know those things, then you are incapable of using the American Medical Association's (AMA) CPT coding manual correctly. Stay out of it.
Certain insurances in Colorado are now restricting the number of CPT codes that a massage therapist may use to one code. They are also setting a specific maximum amount that can be claimed for that code. This is occurring because 95 different codes had been used by massage therapists making claims to their company. There are only three codes that the vast majority of massage therapists are able to use. That is not opinion, that is fact. The insurance companies are protecting themselves from unprincipled abuse on the part of the massage therapists. The massage therapists have abused those companies because of what they were taught.
Unethical Teaching of Fee Setting
Fee setting is a complicated and imprecise subject. One of the ways some teachers abuse this imprecision is to not include some very important information in their teaching. There are books that list every CPT code. They include information on usual and customary fees for service. The one I have organizes information in this way:
Except for Medicare/Medicaid, there is no set fee for 97124; each fee is for a unit of 15 minutes.
When you take into account the number of years of training, the overhead of the professional office, insurance to practice, and other miscellaneous costs of doing business, the physician has a right to charge a fee significantly higher than the massage therapist. And yet some who teach about fees would choose the $84 fee as though that ought to represent the usual and customary fee.
Realistically, a physician's usual and customary is higher than that of a massage therapists. Fifty percent of the physicians charge less than $40 for that service; therefore, a massage therapist's fee most certainly ought to be below $40.
Another small problem: If I tell you what the fee is for a service, then I have committed price fixing; that is i1llegal anywhere. We must each set our fees according to our own set of values and conditions. There is no legally correct fee. You could charge $150 per unit, and it would be legal to do so. So, why not choose the higher numbers?
Unethical Teaching of Business Practices
Consistency is the principle by which you can judge whether your business practices are within an ethical framework. Do you always charge the same fee for the same service? Please note: the amount charged is not the issue, it is the application that counts.
Which of the following should be charged a different fee than the others?
The answer, of course, is that they should all be charged the same fee. Can you make exceptions? Of course. I was a former teacher. Perhaps I wish to provide a special discount to teachers. I need only be up front regarding my prejudicial behavior toward teachers. My fee differential ought to be readily available for all to question.
What about insurances? An insurance company's client is an individual. Individuals all ought to be treated the same according to the example above. But there are additional expenses to billing insurance. Shouldn't we be able to charge a higher fee due to the higher expenses? The answer is "Yes".
However, there is no CPT Code for that expense by a massage therapist; therefore, it is not now possible to charge insurances for that work. Be patient. Such codes will be forthcoming.
There can be a large difference between legal and ethical. Helping to place that gap in perspective is the concept of "usual and customary." When trying to determine what is the usual and customary fee for a massage therapy service, you would want to know what a particular service would cost the average customer. Not the discounted price or special price, but the amount which the customer parts with before going out the door.
Earlier I asked a question: Why not choose the larger number? This had to do with the fee schedules that are published by the AMA.
The reason you don't charge the higher number is because it does not represent your "usual and customary" fee honestly and accurately. You choose a number that represents the reality of your behavior. No tricks with wording or fancy ways to sidestep an honest appraisal. If a cash customer would always pay $55 for a service then that is the "usual and customary" fee. Apply the "usual and customary" concept to the figures from the AMA and live with it.
Acceptable Ethical Models To Command Higher Fees
How can you earn a higher fee and avoid all of the previously mentioned problems? Actually for some it is quite easy.
There are many more ways to earn substantial incomes as a massage therapist. All of them require dedication, perseverance, education, good judgment, personal growth and hard work.
Ending Unethical Teaching
Ed Denning is a licensed massage therapist in Ohio. He is coordinator of the massage therapy program at Stark State College of Technology, and also serves on the Massage Therapy Advisory Committee of the Ohio State Medical Board.
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