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Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
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.
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.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
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.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
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.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
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.
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.)
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
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.
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.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
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.
May, 2007, Vol. 07, Issue 05
Scope It Out
By Ralph Stephens, BS, LMT, NCTMB
Ignorance is only bliss until reality smacks you in the face. As promised last time, the discussion of regulation (licensure) continues. This month's subject is scope of practice, an area in which we really are punishing ourselves and decreasing our ability to help the public, due to the poorly written laws we are passing.
Another purpose of licensure is to define the scope of practice of a particular profession.To use more accurate terms, scope of practice defines the extent of the monopoly granted by the state. Of course, the MDs who were first to the trough have a virtually unlimited scope of practice. That was their goal in creating licensure: a complete monopoly, along with the elimination or complete control of all competing forms of health care. It still is their goal, and universal access to health care may give it to them if we are not diligent. Every other profession has their scope limited by their licensing law.
Most professions desire as much extension of a scope of practice as they can get and always are working to expand it. Sadly, ours is not this way nationally. Our national leadership has given up huge aspects of our scope for no apparent reason, other than to just pass something. For example, any muscle-bound meathead at a health club can do specific stretches on anyone who walks in the door, but we pass laws for ourselves that prohibit us from doing specific stretches or joint mobilization. This has got to stop and should be reversed.
Our profession has failed miserably when it comes to defending our scope. I have watched it shrink to a shadow of what we should be able to do. In most licensed states, we no longer can do what massage therapists of the 1950s and 1960s did very well - without licensure. Our national leadership's willingness to restrict our scope of practice actually is endangering the public and limiting the care the public can receive. If alternative disciplines give up scope of practice, where can the public receive it? The public frantically is searching for alternatives to the current health care system, which is the single biggest killer of Americans. That's right. According to their own figures, allopaths kill more than 250,000 people each year; yet allopaths call alternative practitioners "quacks." By passing laws that end our ability to perform what historically has been the scope of massage therapy, we are forcing the public back into the hands of the allopaths - to face cuts, burns, poisons and even death. "Sorry, we used to be able to treat the soft-tissue conditions of scoliosis, but our new law won't allow us to manipulate the spine. So, I guess you will have to go get rods installed." How does it feel, Indiana?
By not having a logical, aggressive plan to pass uniform legislation for massage in every state to protect and expand our scope, our national leadership is depriving the public of the soft-tissue care it seeks, needs and deserves. In the process, our leadership slowly is killing the therapeutic side of our profession. It's the first-door-provider, therapeutic massage practice that the public needs and that allows massage therapists to make a comfortable income. Every massage licensing law should give us first-door access to the public, along with the right to assess, examine, manipulate and otherwise treat connective tissue with whatever means, techniques and equipment we are trained in. Training should be able to come from school or post-school sources. Stretching, movement and alignment techniques are necessary for proper and complete soft-tissue care, and should be included in our scope. While we might have to do it subtly, language-wise, this is the outcome we should achieve. Anything less is merely a self-imposed tax on our practice with no resulting benefit, except maybe to our egos - "I'm licensed."
If the massage profession is going to impose licensing, it should benefit from it, not suffer from it. Remember, the purpose of licensure is to benefit the profession and to protect it from the public and other professions. Don't say that when you are trying to pass a bill, but it is the reality of the situation and needs to be kept in mind. Every professional benefits from good legislation and suffers from poorly written laws.
At one time, I was a huge proponent of licensure. However, in the past few years I have been on the opposing side of several laws, because the laws were so poorly written that, had they passed, they would have been more of a burden than a benefit. Be alert as to what is being proposed in your state. Don't let a law restrict what you can do more than if you didn't have the law. Wakeup out there! A bad law is worse than no law.
Speaking of bad laws, Indiana is in the process of passing one. It will be another patch in the quilt of completely incompatible laws we have imposed on ourselves. It will be nothing but a burden on practicing therapists, but the schools are going to love it. Allowing schools to do whatever they want is all that is important, right? Indiana therapists, if there still is time when you read this, I encourage you to fight the legislation. If it's already passed, read this and weep.
So, what is the point of all this licensing discussion, other than just the educational aspect of it? Well, colleagues, it's about paradigms and what our profession once was, could be, but instead is becoming. Not enough ink to write on that until next time.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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