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Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
September, 2008, Vol. 08, Issue 09
Questions With Direction
By David Kent, LMT, NCTMB
One of the most challenging aspects of being a massage therapist is trying to build a thriving practice with repeat clients. So, it's no surprise that many therapists have felt the crunch with the recent downturn in the economy.Unfortunately, services like massage therapy often are among the first to be cut from one's budget in times of economic crisis.
Therefore, it is now more important than ever to convince your clients to stay the course with their massage therapy sessions. This article will show you how asking some simple questions can ultimately lead to repeat clients, whether you work in a spa, outcall, seated or clinical massage setting. Soliciting a client's feedback by way of asking thorough questions will better help you understand your client's needs and deliver results. Even more important than asking questions, however, is listening and responding to the information your client provides.
One way to organize your questions is to make use of the wide range of forms available for these purposes. In fact, your questions will, to a degree, be directed by the information you obtain using forms. I have my clients complete intake forms prior to therapy. These help me develop targeted questions to clarify my knowledge about their health history, specific areas of pain, stresses in their life, ergonomics of their activities of daily living, medications they are taking, and to identify any precautions or contraindications before the session begins. Using intake forms helps me develop goals for the client's current and future sessions, which also is useful in persuading my clients to commit to ongoing treatment.
There are various types of questions. However, this article will focus on two primary categories: general and those related to a client's pain. General questions are great for helping you understand your client's expectations no matter what kind of practice you have.
Question: What are your goals for today's session?
Reasoning: If you don't ask this question, you won't know if a client wants a relaxing Swedish massage or a vigorous sports massage that integrates stretching. This also is important so you're responding to your client's needs and not responding to your perception of your client's needs.
Question: What areas would you like me to focus on today?
Reasoning: This question also relates to the previous question. At one time or another, we've all probably had an experience with a therapist who seemingly ignored the very thing that brought us to therapy in the first place. When you ask this question, it's very important to listen closely to the answer. When you listen to the client and deliver results, it increases the odds your client will reschedule and/or refer others.
Question: Have you received massage therapy before?
Reasoning: Regardless of the client's answer, this is the ideal time to communicate to the client how you will perform the session. For new clients, you might advise the client to disrobe to their level of comfort and then discuss draping techniques. For veteran clients, you might ask if they'd like you to do something extra special, such as incorporate essential oils into the session.
Question: If you have received massage therapy previously, please tell me where you received it, by whom, and which treatments were the most beneficial?
Reasoning:This information can help you understand how to adapt the session to the types of massage therapy that have produced positive responses for the client in the past. You might also ask the client what they think makes a great massage - and then do what you can to meet the client's expectation.
Question: What type of pressure do you prefer?
Reasoning: Keep in mind that levels of pressure are subjective for each client. What you perceive as light pressure and what the client perceives as light pressure could be entirely different. It's important you check in with the client at the start of and during the session.
Question: Have you ever had any negative effects and/or experiences from receiving massage in the past?
Reasoning: People respond to massage in different ways. Some get ill or are sore for several days after they receive a deep massage. This is where intake forms and questions can be very useful. Some questions might include what medications the client is on, if they bruise easily, what the client's diet is like, as well as questions related to general health and exercise.
Question: Is there anything else I should know?
Reasoning: I intentionally keep this question open-ended so the client can add additional information at their discretion. It's up to me to connect the dots. I am frequently amazed by how many clients will tell me about a traumatic accident and/or major surgery in the past that they didn't mention previously.
Questions About Pain
Question:What other health care providers have you seen recently and for what?
Reasoning: This question immediately informs you if your client has seen a doctor or if the client has self-diagnosed. I can then quickly perform a postural analysis (See "Getting Comfortable with Postural Analysis" in the July issue), check range of motion and perform relevant muscle tests and orthopedic assessments to determine if it's appropriate to proceed or if the client needs to first follow up with a physician.
Question: Have you tried different health care practitioners over time? If so, which one(s) provided the most relief? What did they do and how long did the results last?
Reasoning: Understanding more about the treatments a client has sought for pain relief will give you insight into how you can best help them. For example, if the client sees a chiropractor on a regular basis, you might suggest they schedule an appointment with you immediately before the appointment with their chiropractor for maximum results.
Question: What do you do for pain relief?
Reasoning: I am always surprised by how many people buy topical pain relievers at a drug store. Why should the drug store get the money? Consider selling topical ointments in your practice. Integrate a topical into the therapy session, then send the client home with a sample. The next time the client buys a topical ointment, it might just be from you.
Question: What aggravates your condition?
Reasoning: If the client reports increased back pain when standing or straightening after bending down, it might indicate lumbar and hip flexor or extensor involvement. A muscle movement chart can help you determine exactly which muscles to assess. Trigger-point charts are useful for educating clients about referred pain. Additionally, using the postural analysis information combined with photos helps show the client how stressed or shortened muscles have contributed to the formation of trigger points. This further leads into a discussion of how a series of treatments can be beneficial.
Asking the right questions can help your practice tremendously. I am looking forward to learning how the questions in this article worked for you. I encourage you to read my other articles that can help during these challenging economic times.
Click here for more information about David Kent, LMT, NCTMB.
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