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Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
August, 2008, Vol. 08, Issue 08
A Definition of Medical Massage
By W.D. "Peter" Lane, LMT, CNMT, NCTMB
There is a need to define the frequently used term "medical massage." One proposed definition would require a medical massage therapist to have significantly more training to qualify for licensure.The curriculum for medical massage would include cadaver studies, chemistry and nutrition, as well as an internship. The state would provide a separate license for a medical massage therapist, which would allow the practitioner to bill insurance. The insurance component would compensate a therapist for the additional required education. A medical massage therapist would work with a patient's primary care physician to provide optimum health for the patient.
One of the most vexing issues facing the massage therapy industry today concerns the term "medical massage." All health care professionals know what it is, yet few are able to define it. Yet, when we as bodywork practitioners answer the question of what medical massage is, we will further the goal of legitimizing and establishing advanced bodywork in the health care environment.
Why is "medical massage" creating such a stir in the massage and medical community at large? Who should be allowed to practice medical massage and how? When is it indicated and when is it not? I attempt to answer these questions from the standpoint of a licensed massage therapist and a certified neuromuscular therapist who has been treating patients in New Mexico for the past 12 years. My opinions are based on practicing in both the massage and medical environments.
I have come to these opinions based on a sincere desire to see the perception, understanding and appreciation of bodywork advanced throughout the U.S. with some degree of uniformity. More importantly, the bodywork industry needs a universal definition so when a patient seeks out the services of a medical massage therapist he or she will know that therapist is licensed and properly trained to treat their pathology. It's important to define medical massage to both eliminate imposters and to protect legitimate medical massage therapists.
In my opinion, medical massage should:
These days, many other definitions of medical massage are floating around the country. Some serve the limited financial gain of a person or organization promoting a particular definition. Some definitions state medical massage should only be practiced in a doctor's office under the absolute control of an MD or DC. If practiced in a PT clinic, it must be under the domain of a PT. One organization states only students who take their "national certification examination" in medical massage should be recognized as a medical massage therapist.
From an insurance billing perspective, there has been recent litigation attempting to prevent a bodyworker from filing insurance unless they are a "medical massage therapist." Fortunately, when the judge asked for a definition of medical massage and none could be offered, he ruled in favor of the massage therapist. It has become quite clear these definitions do not have at their core the benefit of the patient.
Under the definition I propose, an LMMT (licensed medical massage therapist) should be someone who has received training requiring more than the universal 500-hour training threshold that has become the norm for massage therapists. The curriculum should require more hours in anatomy and physiology, pathology, patient assessment, kinesiology, musculoskeletal anatomy, including cadaver studies, chemistry and nutrition. The curriculum would include alternative therapy electives, a segment on business and ethics, practice management and insurance billing.
I also propose a significant clinical practicum and internship. Included in this formula is a continuing education requirement that exceeds the current eight to 16 continuing education units required biannually by many states. The extra education can be accomplished within the context of a 2,000 to 2,400-hour program similar to the structure of training programs in place in Canada where 2,200 to 3,000-hour programs are standard.
An LMMT would have the option of practicing in a controlled environment such as an HMO, working in private practice or something in between. The state would be required to adopt separate licensure for LMMTs. Furthermore, the LMMT automatically should be included in the mix of approved therapies for insurance billing.
The benefits for patients and therapists are obvious. The patient will know his or her therapist is properly trained, qualified and competent to treat the condition they have been referred for. The therapist will have the satisfaction of knowing their training will bring measurable results to the patient and they will be compensated for their work by insurance. The insurance industry benefits by knowing an LMMT is ethically and legally following a standard of treatment and documentation. By arriving at a national consensus about the definition and training of an LMMT, the U.S. will have gained a cost-effective tool in containing spiraling health care costs.
A quality-driven, credible medical massage therapy program should be predicated on proper program development and organization complimented by a competent and experienced teaching staff and utilized in an active clinical environment. Too often, education and competency have not paralleled each other and curriculum has not been problem-centered and patient-based.
The following curriculum outline is designed to assist preeminent institutes for higher education in the medical massage industry. The medical massage program can be implemented in stages as instructors are trained and certified or offered as a comprehensive second-tiered advanced program.
Medical Massage Therapy Curriculum Outline
Anatomy and Physiology:
ACI-Cell anatomy and physiology
The chemistry and physiological processes of the body.
Musculoskeletal pathology and related disease processes.
Nutrition and your patient. Pharmacological and nutritional interactions and outcomes.
Medical Massage Theory and Disciplines:
Assessment Procedures and Protocols
Advanced Musculoskeletal Palpation:
Cadaver Dissection I-V
Medical Massage Clinical Practicum
Medical Massage Externship Program
Business and Ethics:
Insurance billing for the medical massage therapist.
History of Medical Massage
W.D. "Peter" Lane is director of the NeuroMuscular Therapy Center of New Mexico in Albuquerque, N.M. He is an instructor of anatomy and physiology and maintains a private practice treating patients who present with a variety of soft-tissue dysfunctions. For more information about the NeuroMuscular Therapy Center of New Mexico visit www.salubria.org.
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