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The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
June, 2008, Vol. 08, Issue 06
Contemplating Thai Massage Regulation
By Nephyr Jacobsen, LMT
I've done deep-tissue Swedish massage for 17 years. I mean really deep; no fluff-and-buff stuff here. But it doesn't come close to Thai massage, and nothing I've seen does. It's yoga and Rolfing and acupressure and tapotment and chiropractic and reiki and deep compression work and myofacial release and hydrotherapy with herbs and the power of spirit, all rolled into one.At the same time, it's none of those things because those aren't Thai and the truth is, Thai massage really is Thai. It's not a new brand of ayurvedic medicine or a twist on Chinese meridians, it's seriously Thai and it's serious medicine.
And here in the U.S., you can practice it after watching a do-it-yourself video, taking a two-day workshop or reading a book. And you can teach it after going to Thailand and taking a five-week course, a two-week course or a one-week course, never having actually had a working practice of it in your life. And people do. So long as you meet the regulatory professional massage laws of your state (which are all written with Swedish massage in mind), you can practice and teach Thai massage without a day of training if you so choose. And in some states, you don't even have to be a licensed massage therapist because you can claim this extremely physically intensive bodywork modality is technically energy work.
There is no regulation of Thai massage outside of the Swedish massage laws in the U.S., and I'm not even sure if there should be. Regulation is a sticky subject and with Thai massage, it gets complicated very quickly. At this time, the majority of states have some sort of regulatory agency that establishes the specific requirements to practice bodywork professionally and governs all massage modalities. A few states have no massage oversight at all and little to no requirements concerning practice. In those states with explicit oversight, all massage modalities are grouped together and have the same requirements. There are no specific laws for specific modalities. At this time, no organization in the U.S. has the authority to specifically regulate, certify, register or accredit Thai massage practitioners, therapists, bodyworkers, instructors or schools.
A Case for Thai Massage Regulation
Thai massage has the potential to cause injury if not done correctly. This applies both to the therapist and the receiver. Thai massage is a far more dangerous modality than Swedish massage could ever be. With proper training, it's amazingly therapeutic. And knowing effleurage, petrissage, cross-fiber friction and the diaper drape doesn't prepare anyone for practicing Thai massage. That's like saying if you're a highly trained golfer, it follows that you are qualified to play professional basketball. It's apples and oranges.
What this means is that states requiring that Thai massage practitioners be licensed massage therapists have really not done anything to protect the public safety in regard to Thai techniques. Because none of the required massage training (I'm not talking about the sciences of anatomy/physiology here) has anything to do with what you must know to practice Thai massage. It is left up to the practitioner to voluntarily seek out quality instruction.
This is why the regulation of Thai massage by a body of professional practitioners can be seen as necessary. In this case, oversight must come from within the community of Thai massage practitioners, because these are the individuals who truly understand the techniques and the proper methods of training. Of course, these individuals also would have to be professional licensed massage therapists, in order to comply with state laws.
A Case Against Regulation
And here is where I start to sound a bit inconsistent, because a part of me believes the way one trains should be voluntary. I have always felt that massage, as with herbalism and midwifery, belongs in the layperson's hands, where some of the best teachers are quietly hidden and carry no state-governed credentials. I am deeply suspicious of massage regulation, with its pandering to large corporate schools and its focus on written exams for a field that involves the unmeasurable ability to touch and feel with intuition and competence.
In the world of Thai massage, regulation is nearly impossible. While schools and practitioners have begun to be regulated by the Ministries of Education and Public Health in Thailand, it remains a fact that some of the most proficient therapists in Thailand are unlicensed, unrecognized and unofficial. Some of these practitioners are masters of hereditary methods; some live in the far-out villages where licensure is not possible.
Maintaining the Status Quo
There are some who suggest Thai massage practitioners should not have to be licensed massage therapists at all, meaning they should not have to meet any existing state requirements in order to practice their profession. This position holds that Thai massage is not the same as other bodywork modalities and should have either no requirements or only those of our own regulatory agencies. They propose that we should not even call it Thai massage, suggesting instead names such as Thai Yoga Therapy or Thai Intensive Stretching. It's as if a change in semantics will change the fact we are "manipulating soft tissue," the common definition of massage in most states. While I agree Swedish massage licensure does not qualify one to practice Thai massage, I do not think it hurts.
Another factor in this issue of creating regulatory agencies specifically for Thai massage is the need to be wary of self-absorption - to the point of forgetting the public we serve. So, how do we regulate Thai massage? We set the standards not by creating more regulatory agencies and attempting to separate ourselves from the rest of the massage world, but by creating classes and schools with a high bar and by being practitioners who don't balk at training. What if, instead of using our energies to fight the existing system and create new regulating agencies, we were to work together within the system? This could be the best of both worlds. Thai massage does not become regulated unto itself (hopefully avoiding homogenization), and by following state requirements of licensure, at least in states that have requirements, the people who can practice will by default be those who are willing to put in a little extra work.
I have looked through both lenses and agreed with what I saw. In the end, I have come to a place at which I accept things the way they are. It's not perfect, but I know the things that bother me most about the present and likely future of Thai massage are not actually going to be fixed by less or more regulation. They are not being fixed by the states that don't require Thai massage therapists be licensed in massage and they are not being fixed in Thailand, where there is very specific government regulation of Thai massage. What bothers me are things like gaps in integrity and the need for better understanding. Things like the tendency to call Thai medicine ayurvedic or Chinese because we don't understand it enough or respect it enough to grant it its own standing. Things like infighting among practitioners and teachers. More importantly, I am bothered by the actual danger of an ancient art becoming watered down and distorted until it no longer exists in its true form.
Luckily, these are things we can change without having to restructure the system. These are things we change through personal commitment. As we teach our students and teach each other, we set the bar higher and encourage quality in the Thai massage community. I believe it's up to us as individuals, not laws, to keep Thai massage safe and authentic. Those who do will shine brightly.
Nephyr Jacobsen is the founder and director of The Naga Center School of Traditional Thai Medicine in Portland Ore. She has been a massage therapist for 17 years and has spent extensive time studying Thai massage, both domestically and in Thailand.
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