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Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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.
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.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
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."
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
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.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
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.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
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.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
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.
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.
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.
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!
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.
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.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
July, 2007, Vol. 07, Issue 07
Why Should I Learn Assessment?
By Whitney Lowe, LMT
Musculoskeletal disorders (MSDs) are one of the most pervasive health care issues in the United States. These conditions include a wide array of soft-tissue problems such as strains, tendinosis, sprains, myofascial trigger points, nerve entrapment, and the ever-present host of biomechanical problems resulting from chronic muscle tightness.MSDs are the second most common reason for seeing a family practice physician, with infectious conditions like the common cold being first.1 It's interesting that even with the high incidence of MSDs in our medical system, their importance as a health care concern seems undervalued.
Many different medical disciplines are involved in the treatment of MSDs. Orthopedists are the specialists whose primary focus is on disorders of the musculoskeletal system. However, most orthopedists' practices are limited to more serious conditions, such as those that might require surgical intervention. Consequently, the large majority of physician visits for MSDs are handled by family practice physicians.
MSDs account for millions of office visits with physicians each year. Yet most people would be astonished to realize that medical school training for most physicians does not prepare them to address these disorders at all. In fact, almost half of the medical schools in the U.S. do not require any clinical or basic musculoskeletal course prior to graduation.2
The lack of training in musculoskeletal medicine has been reflected in physician knowledge in several other studies as well. Dr. Elizabeth Matzkin and her colleagues administered a basic cognitive examination on musculoskeletal medicine to 334 medical students, residents and staff physicians.3 Seventy-nine percent of the participants failed the exam. The most common reason given for the lack of confidence in performance by the participants was that their training in musculoskeletal medicine was inadequate.
Adding to the problem of training deficiencies in musculoskeletal medicine, traditional Western medical care has not had a great track record when it comes to effectiveness in treating the plethora of MSDs. The ineffectiveness of many treatments could result from the deficiencies in training and preparation. However, it's more likely due to the fact that these conditions are largely functional, soft-tissue disorders that do not respond well to drugs or surgery, the two primary treatment tools of most physicians.
Ineffective results in traditional medical treatment for MSDs have driven millions of Americans to seek better care through complementary and alternative medicine (CAM) approaches, such as massage therapy. In their comprehensive 1998 study on alternative medicine use in the U.S., Eisenberg noted that there were an estimated 114 million visits to massage therapists each year.4 This number is likely to be higher in the coming years with the increasing popularity of massage. A study on the practice patterns of massage therapists in 2005 found that about 60 percent of visits to massage therapists each year were for musculoskeletal symptoms.5 That means a conservative estimate would suggest more than 68 million office visits to massage therapists each year to address MSDs! This number is likely to increase significantly with the aging of the baby boomer population.
Like our physician counterparts, we have gaps and deficiencies in our basic training related to MSDs. While there are a host of continuing education opportunities available for massage therapists that teach advanced skills and techniques, the large majority of these courses focus on treatment techniques. Consequently, we have all kinds of opportunities to learn how to manipulate the soft tissues in various ways to improve our outcomes. Yet, there are few training opportunities that help us develop the cognitive evaluation and reasoning skills that help us figure out the nature of our client's complaint. Wouldn't it make sense to expend appropriate effort properly identifying the nature of these MSDs?
Assessment is the systematic process of gathering information in order to make informed decisions about treatment. We must be able to tell if the client's condition is something that should be referred to another health professional or if it's something we can address. If we decide the client's condition is something that can be treated with massage, our use of all those treatment techniques we have learned will be far more effective if we understand why we are doing what we are doing. That is what assessment is all about. With more than 68 million office visits to massage therapists each year to address MSDs, shouldn't we also be looking at what we can do to best serve our clients? Massage therapy has tremendous potential to fill this critical gap of care for MSDs in the U.S. health care system, but as responsible health care providers, we really must know what we are doing. Learning and practicing effective client assessment is a key step in this process.
Click here for more information about Whitney Lowe, LMT.
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