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Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
March, 2008, Vol. 08, Issue 03
Relying on Intuition
By Keith Eric Grant, PhD, NCTMB
"When we classify an aptitude as intuitive, it conveniently serves to remove it from the list of things we need to teach or confront. Perhaps, however, this accepted map does not match the territory it supposedly represents. Could it be that achieving mastery beyond technical competence is less innate than we customarily believe? My answer to this question is that I believe that implicit skills both underlie and transcend what we typically think of and teach as massage skills. Following a common terminology from psychology, I refer to these as metaskills. My second premise is that more is known about the structure and communication of these metaskills than we usually believe. A major reason for this disconnection is that much of the knowledge we seek is scattered across the boundaries of several disciplines. The good news is that it is exactly such knowledge, from regions where different disciplines cross and intermingle, that often newly inspires creativity and invention. My third and final thesis in writing this article is that what we learn about our metaskills can fundamentally influence how we conceptualize and teach the practice of massage therapy."3
A little more than a decade ago, I started several years of pondering and slowly piecing together an article on intuition and metaskills. Apart from a few preceding lines, the paragraph above was the opening statement of that article. The passage of a few more years has only strengthened my conviction that much of intuition is, in reality, a simple expression of experience-based expertise operating at an unconscious level of the mind. Those years also have added more supporting resources.
My starting point this round is Malcolm Gladwell's book Blink, a lay introduction to our use of tacit knowledge and unconscious decision-making. In the book, Gladwell ties into the field research on decision-making done by Gary Klein.4 What Klein had expected to see, based on theories and laboratory studies, was experts making rational comparisons of two or more alternatives. What he discovered, however, was this wasn't how the real world worked. The great majority of the time, people unconsciously recognized a situation as "prototypical" of something in their experience and moved directly into action. Klein termed this process recognition-primed decision-making (RPD), something Klein also noted as being a model of intuitive response. When the situation was even more novel and a single response wasn't obvious, people would engage in "satisficing"- mentally simulating possible responses one by one and picking the first one that would likely work. The mental simulation allowed experts to spot weaknesses in a potential response without trying it. The process was rapid, generally occurring in less than a minute. Logical comparison was used only in learning situations outside of prior experience. It resulted in far slower responses and less certainty of achieving desired effects.
Klein recounts research done by co-worker Beth Crandall, who studied how nurses in the neonatal intensive care unit (NICU) of a large hospital judged when a baby was developing a life-threatening infection. Often these premature infants only weighed about 2 pounds each, sometimes less. Crandall saw that the nurses could react to the start of sepsis even when objective tests were still coming back negative. Rather than starting from objective knowledge and developing methods by which nurses could detect the onset of infections, Crandall's research delved into what expert nurses were doing unconsciously. She catalogued that into cues that could be used to more quickly train expertise. In short, Crandall was discovering how to train nursing intuition. This process of eliciting how naturalistic decision-making works is the subject of cognitive task analysis, a domain to which Crandall, Klein and Robert Hoffman have contributed their own field manual.1
In his book,4 Klein provides us with a statement about training that's as applicable to massage as to the professions he specifically studied:
Klein's observations don't say that information is unimportant, but they do emphasize the need for teaching anatomical and other didactic information within the framework provided by hands-on experience. The conclusions Klein makes from research thus run counter to what I've observed as a trend in massage training: delaying hands-on experience while stressing the purely didactic. While Klein focused on challenging situations - those that would place the most stress on expertise - he is also explicit that the results are even more applicable to commonplace situations. He found the same responses in design engineers who had weeks on a project as those who had to make life-or-death decisions within seconds.
With experience, we most often act without conscious consideration of the exact sensory input to which we are responding. Our unconscious minds recognize the patterns of sensory information and our hands "tell" us what to do. When we achieve this ability, we join a wide interdisciplinary corps of experts. It's part of the power of "knowing" just the point that invokes a change.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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