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How to Market to the Medical Profession
The world of health care is changing dramatically. When situations occur that cause expenses to increase, it is time for you to develop strategies that maintain and grow revenue.
Detoxification Demystified and the Crucifers that Help
"Let food be your medicine and medicine be your food," is a quote often attributed to Hippocrates, a philosopher of the 5th century BC.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Create Community and Grow Your Practice
Many healthcare providers are fortunate to enjoy the freedom and independence of owning their own businesses. However, the constant demands can lead to a lonely and isolating experience unless you make an effort to get out of your office.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
When I started to think about what I wanted to do, I toured different schools to choose where to pursue my original chiropractic education.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Are You a Stakeholder?
In today's world many new things are occurring, especially in the world of information technology. With these changes, comes an entire new set of vocabulary words and definitions.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Breech Baby: A Scientific Approach
You learned a classic cookbook style treatment strategy in college for treating breech baby presentation. I'm sure you've used it. The main ingredient: moxa at Urinary Bladder 67.
Suffering Makes Us Human
It is possible that suffering, instead of being something negative, can be one of the greatest gifts to bring out one's humanity — if we allow it to be.
Yo San University Receives $1 Million Gift
Long-time Yo San University supporter Thomas S. Blount recently gave a $1 million dollar gift to the University, it's largest charitable gift to date. Mr. Blount was a retired naval officer, aerospace consultant and philanthropist.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
The 2015 Nobel Prize Shines a Spotlight on TCM Research
Traditional Chinese Medicine continues to make it's presence felt on the world stage as the 2015 Nobel Prize in Physiology or Medicine was jointly awarded to William C. Campbell and Satoshi Omura for their work on combating parasites and YouYou Tu for her discoveries in combating Malaria.
Cold and Flu Season: Expanding the Repertoire
As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Building Community: A New Way to Socialize Your Practice
Social Media can seem like a slippery slope when, in fact, it is fairly easy to understand. With social media platforms, you can connect with current and potential new clients, build strong customer loyalty and increase brand awareness.
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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