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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%.
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.
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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).
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.
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.
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.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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