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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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%.
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.
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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).
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.
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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