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Do You Have a Post-ICD-10 Strategy?
Post-ICD-10 planning is critically important to the health of a practice, in part because ICD-10 is brand new to providers, payers and related affiliates alike.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
We Get Letters & Email
It was with great interest that I read "Trouble in the Wellness Waters?" in the May 1, 2015 issue of Dynamic Chiropractic. I heartily applaud Dr. Hayes for his insightful and informative article.
A Tribute to a True Chiropractic Leader
President of Texas Chiropractic College (alumnus, class of 1950) and the American Chiropractic Association (ACA) Board of Governors. President of the Texas Chiropractic Association and twice-appointed member of the Texas Board of Chiropractic Examiners.
Troubleshooting: Billing Multiple Fees for the Same Service
I am afraid I may doing something illegal. I have heard I cannot bill different fees for the same service.
Why More Patients Don't Come to Your Office
Every so often, something turns out to be much easier than anticipated. It's like ordering a piece of furniture or a child's toy that comes in 167 pieces.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Active Care for Ankle Sprains
An ankle sprain is a common injury, since this joint is required to perform complex movements under high forces during normal walking. In fact, 10 percent of all emergency-room visits are ankle-sprain related and an estimated 25,000 ankle sprains occur in the United States daily.
When Patients Lie (Bribe or Flatter)
Recently, a new patient told me about what I thought was a novel twist on the doctor-patient relationship. She felt she had to lie to her DC to discontinue her treatment.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Thinking About Cohen's Kappa
Let's think about some notions of reliability and validity, and about what it means for diagnostic examiners to agree in meaningful ways. Diagnostic tests must obviously be both reliable and valid.
Managed Care Subverts Chiropractic
A study published in the American Journal of Managed Care underscores why so many chiropractic patients go out of network in order to get the care they need: Managed care may be effectively locking them out.
Dietary Fat and Prostate Cancer: An Important Update and Review of Mechanisms
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
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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