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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
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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