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Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
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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