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Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
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!
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.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
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.
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.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
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.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
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.
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.
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.
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.
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.
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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