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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
April, 2008, Vol. 08, Issue 04
The Structural Component of Soft-Tissue Rehabilitation
By Don McCann, MA, LMT, LMHC, CSETT
One of the most important factors in understanding and treating clients in pain who need therapeutic massage is evaluating the cause of the discomfort. We often look directly to the area of discomfort and find inflammation, swelling, ischemia, trigger points, buildup of fiber, scar tissue and adhesions, and think treating this is the key factor in our client's recovery. However, when we treat only the symptomatic areas, we are doing our clients a major disservice. There always is a reason for any area of the body to be in distress. One factor that is ever-present is the relationship of structural imbalance to the area of pain.
Structural balance allows the body and its musculature to function with strength and flexibility. When there is an imbalance in the structure, specific areas of the structure will overwork or be weakened to the point of injury or distress. This can be understood when looking at muscles moving bones in a lever relationship. When the structure is balanced, the lever and fulcrum are in an optimal performance relationship. With structural imbalance, the fulcrum/lever relationship is, at worst, totally dysfunctional and subject to breakdown or, at best, weakened and in need of additional support from surrounding soft tissue. This is inefficient and, in essence, the muscle that is supposed to be doing the work only has a third to half of its strength. This leaves that muscle very susceptible to strain or injury. In addition, the joint or spine is unstable and weakened and subject to strain or injury.
Thus, in therapeutic massage, a major treatment goal is to release the structural imbalance. Let's look at what happens when this is not factored into the treatment protocol. One of the easiest ways to understand this is to look at an area where most clients experience pain - the top of the shoulder, which includes the trapezius, levator scapula, supraspinatus and rhomboids. When this area is hot, inflamed, spasmed or strained, clients will present wanting relief ASAP. If the massage treatment is focused only within this area, there might be short-term relief; however, in the long run the condition could worsen. If the soft tissue in the top of the shoulder is released without balancing the shoulder, the muscles in the front of the chest will have less resistance and pull the shoulder farther forward into additional imbalance. The long-term result is that the client will most likely have more pain, discomfort and dysfunction in the area due to the increased distortion. To make matters worse, the soft tissue in the top and back of the shoulder actually are counterbalancing and actively working to hold against the stress in the soft tissue in the front of the shoulder.
So, when therapeutic massage techniques are applied first to the spasmed tissue on the top and back of the shoulder, which is invested in maintaining its holding pattern, the area will be resistant to the technique being applied. The sensation for the client is intensified and the client will experience greater discomfort because of the difficulty in relaxing that musculature. Plus, it will take two to three times the amount of work and pressure by the massage therapist to achieve results in the area. This obviously is a lose-lose proposition.
If the theory of releasing the shoulder into structural balance is applied, the muscles in the front of the shoulder are treated first, releasing the shoulder back into structural balance, and allowing the muscles in the back and top of the shoulder to release their compensation holding pattern that was counteracting the tension from the muscles in the front of the shoulder. The massage therapist will achieve greater results with much less work. In addition, the client will experience less discomfort and will be able to maintain structural balance and long term homeostasis.
Neck problems. Most clients will complain of pain in the back of the neck and at the base of the cranium. The majority of them will be holding the head forward, resulting in a reverse curvature of the cervical spine. In order to achieve structural balance, you will need to first release the soft tissue that is responsible for pulling the head and neck forward before releasing or treating the tissues at the back of the neck where the pain is located.
Low back. When clients present with low back pain, there is an imbalance in the pelvis that includes the legs and feet. This imbalance is not only front to back, but also involves torsion where one ilium rotates anteriorly, and the other rotates posteriorly. The most effective way to move the client into structural balance to relieve the pain is to release the leg and ilium that is rotated anteriorly first, and then the posteriorly rotated ilium/leg side.This concept of structural balancing to achieve long-term results, while working within client comfort levels, can be applied to any musculoskeletal imbalance found in the body.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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