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Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
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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