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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.
January, 2008, Vol. 08, Issue 01
Things to Consider Before You Buy
By Angie Patrick
In massage therapy, one of the biggest purchases you will make is your massage table. Choosing the proper table and accessories to buy can be a daunting task. There are so many choices, so many manufacturers, a multitude of table names, varied widths, specialized uses and a rainbow of colors. Whether I am on a trade show floor, speaking at a school or in our call center, the same concerns seem to be global in the industry. How can I possibly make an informed choice with so many decisions to make?
I would like to share with you some bits of information I hope may help you sort through some of the options and enable you to make the right choice for your needs, your body type and your budget. In this article, you will find some of the more frequently asked questions answered in a non-biased and informative manner. By taking the time to consider some of the points to follow, you can be confident you have made the best possible buying decision for you and your unique needs.
How do I plan on using my table?
You may be a spa company, student, seasoned professional, homemaker or a grandparent buying a gift for a loved one. What are your specific reasons for purchasing a massage table? Will you have a brick-and-mortar business? Or will you be on the road? Are you specializing in mobile therapy at sports events or will you be seeing individual clients? Once you have firmly established your needs for a table then making some of the other choices gets a bit easier.
How much can I afford to spend?
Believe it or not, this decision is not driven by budget alone. Once you have decided your intended use, you can weigh out the benefits of an open-end model as opposed to a more professiona-grade table. For instance, an average consumer wanting a massage table in their home will not have the same requirements a professional massage therapist will have. The needs are different.
Some will tell you to buy the most expensive table you can find because they equate cost with quality. Others will tell you to spend as little as possible because they are penny-wise and pound-foolish. The truth is, high cost does not always indicate quality and a less expensive table is not always a lesser quality table. The most important thing to remember is to buy professional-grade equipment for your practice.
You do not have to spend a great deal to spend wisely. The most economical purchase a massage therapist can make is an informed purchase. Investing in a product that can withstand repeated usage day after day, is far more economical than replacing a table every three years. Over the long haul, what features will withstand the ravages of time and usage? Comparing woods, vinyl, hinges, face rests, joints and support cables can help you decide what will best fit your needs.
What width table do I need?
This often is the biggest reason for buyer's remorse among therapists. The old adage "bigger is better" does not always apply to massage tables. Your own body style has a great deal to do with the width of the table that you will find most comfortable day after day.
If you choose a table too wide for your body type, you can begin using improper body mechanics and cause yourself discomfort and stress to your lower back. In most cases, if your height is approximately 5'4" to 6'5", I suggest the use of a table from 29" to 31". The most popular and widely recognized standard size table is 30" in width. This table accommodates most therapists, and a large percentage of clients will fit comfortably on this size table. If you are more petite, you may need to consider a table 28" - 29" wide. If you are taller in stature, you may want to consider tables 32" and up.
What height range should I look for?
Table height is determined by practitioner stature and the modality they practice. The majority of portable tables on the market today can adjust to a varied height of 24" to 34" or higher. This can accommodate most needs and is widely accepted as the average. Some modalities require the table to adjust lower or even lie flat on the floor. For example, shiatsu and Feldenkrais both require lower adjustment. Look at your needs to determine if this is a feature you will require in your regular practice. Keep in mind proper body mechanics when you are considering a table. You do not want to lean over too far and cause stress on your back; conversely, you do not want to stand on your toes to reach the mid-back of a client. Protecting your own health is paramount because an injured therapist is an unemployed therapist.
Is table weight really important?
Most wooden portable tables weigh in ranges of 30 lbs to 38 lbs. You also can purchase some well-made aluminum models that are 21 lbs to 29 lbs. You should think about how often you will be transporting your table. If you are planning to work outcalls, then weight is a factor. Keep in mind your carry case, face cradle, sheets, fleece pad, table warmers, oils, tools and bolsters will add weight to your transport. It's important to choose a quality carry case with cross-body, carry straps to minimize the wear and tear on your body.
One amazing little miracle designed to save the therapist's back was the invention of the table cart. These fabulous little devices are fantastic for a mobile therapist and can alleviate much of the transport woes for your table and peripheral products. Thanks to the genius of this cart, you can consider a heavier table and know that you will only be lifting it in and out of the car, rather than carrying it from the car to the client's door.
Should I invest in an adjustable face rest?
In all things, a positive first impression is key. When it comes to the comfort of your client, nothing should be left to chance. There are a wide variety of manufacturers producing adjustable headrests and most are well worth the investment. A few things to look for are quiet release knobs, easy adjustment and overall strength. Your clients will feel you have provided a more personalized treatment if you can adjust the headrest to fit their comfort level. To go one step beyond the adjustable cradle, perhaps you should consider a memory- foam face rest. This table additive can enhance the overall massage experience by reducing facial pressure points and preventing sinus pain. This also can make the best of a standard non-adjustable platform if budgetary restraints are an issue. In most cases, manufacturers offer their tables in packages and often include a carry case and adjustable face rest.
Endplates? What are endplates?
You often will have an option of choosing standard or Reiki endplates. The differences are subtle but important. Many modalities, including varied types of energy work, require you to position your knees under the table while seated. If you practice one of these modalities or like the idea of enjoying that capability, then you will want to ask for Reiki endplates. These are the support beams on the ends of the tables and can be built to allow easy access for your legs. If your planned modality will not require you to work in a seated position, you will do well with standard endplates that cross the lower portion of the table.
I have no idea what color to choose! So many choices!
Individual tastes vary, but ultimately there are a few colors that have been proven to be tried and true favorites: teal, agate, black, burgundy, green, tan and purple. But even though these are the most commonly stocked and readily available does not mean they are the only options. In fact, there are so many colors on the market the choices are virtually endless. Ultimately, your table rarely will be seen by anyone, given you have properly layered it with a body warmer, fleece pad, fitted sheet, top sheet and blanket. Perhaps you will leave your table stationary for the most part and have décor to consider, or you may want to be bold and make a personal statement. In either case, manufacturers have a wide array of colors to suit your needs. Some colors may require special ordering and may take a bit longer to ship. So just have fun, and do what makes YOU feel good!
I have seen tables at discount/wholesale clubs with a great price. They look OK, so why should I continue to look?
Have you ever heard that beauty is only skin deep? It can be especially true of discount or bargain store tables. Here are a few things to consider when you are comparing tables.
Wood: You should look for well-made construction of hardwoods such as oak, birch, bamboo or maple. Avoid soft woods your fingernail can sink into. Soft wood means low weight support, and can result in table warping and bowed legs.
Hinges: Additionally, you should pay attention to the hinges used to join the two halves of your table. A full-length hinge is best in avoiding table torque and twist. The center of your table is its weakest point. You should be sure the hinges are built to withstand weight and repeated usage.
Foam Density: "Discount" tables often have a 2" - 2.5" single layer of foam or less. This will not withstand repeated usage on a professional level. These are better suited for the consumer who is looking for a table for home use. For better comfort over the life span of your table, I recommend tables with double- or triple-layered 2.5" foam systems or higher. Most professional-grade tables have a multi-layered 2.5" - 3" or higher foam system, built to withstand the needs of the professional user. Multiple layers of foam in varied densities help to prevent the client from eventually "bottoming out" on the platform of the table. The single- layer, single-density foams have a distinct habit of wearing out and breaking down with repeated use.
Noise Reduction: After time, some discount membership club tables can begin to squeak and creak, leaving the client uncomfortable and concerned about the table integrity and ability to support their weight. Tables built with the professional in mind will have squeak-resistant legs and joints, built to withstand continuous use.
Some Basic Maintenance Tips to Extend the Life of Your Table
Just as with your car, truck, lawnmower, or any other equipment you depend on, your table requires maintenance. I suggest going over your table once a month to make sure the wheel knobs are securely tightened. Check your table legs to inspect for any fractures or cracks that may have developed. If you have screws or bolts, check them to make certain they are tight and secure. If you take the time to make sure your table is performing up to par, you will lessen the likelihood of mishaps and table failures.
There are many manufacturers and retailers that provide professional products. Most have very informative Web sites you can peruse and see images of the tables before you buy. Do your research online and make the comparisons. You are now armed with a bit of knowledge that should make choosing the right table much easier.
Click here for more information about Angie Patrick.
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