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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
November, 2008, Vol. 08, Issue 11
Economic Crisis: Be Aware, Get Prepared
By Ralph Stephens, BS, LMT, NCTMB
Many businesses and industries have run aground because they had the wrong perception of their place and purpose in the market, especially during times of economic change and crisis. For example, at one time railroad companies thought they were in the railroad business.They didn't realize until it was almost too late that they were really in the transportation business. Once they adapted to that larger paradigm, the ones that survived did much better.
The massage profession faces a similar situation. I think we, as a profession, believe we are in the massage business. This is a very narrow, focused, myopic view. We are really in the people business and the health business. We serve the public with alternative health care not available from any other source in a manner to bring about better health, wellness, movement and relief of pain. Massage is the primary tool we use to accomplish that, but we also use related techniques, education and products.
We are confused about who our customers really are. Our customers are not the allopathic medical community, not the AMA, not the insurance companies, not HMOs and not the government, but the public, people, individuals. We must reach out and promote to these individuals in such a way that they demand that our services, techniques and philosophy be accepted and included by health care on our terms, not on the allopathic system's terms. We can do this, but we have to change our focus, and we have to be ready to state what our terms are and stick to them.
We are going through a time of economic change, and the turmoil during that change looks a bit scary. Be assured, massage has survived thousands of years and many elections, disasters, economic crises, wars, global changes, etc., and it will continue to survive. Massage will continue to be in demand because there is nothing that can accomplish what massage can do as efficiently, effectively and pleasantly.
The current economic crisis will present some challenges, but I assure you the answer is not to sell out to the failed traditional medical system. The answer is to provide a cost-effective alternative. People may not be able to afford insurance or traditional health care, but they will need pain relief and wellness care. It is cheaper to stay well than to get sick. It is cheaper to prevent/eliminate carpal tunnel syndrome with massage than to have surgery for it. Both people and businesses will be looking for cost-effective alternatives to unaffordable crisis medicine, and we are sitting pretty to provide it to them. Well, at least some of us are.
The small percentage of us who have invested in ourselves beyond entry-level and learned how to assess and treat specific conditions, relieve pain and, most importantly, prevent injuries and illness are very well-positioned. The general relaxation side of the profession will likely see a more serious downturn, except possibly chair massage, the most cost-effective version of relaxation. The good news about chair massage is that when given by a properly trained therapist, chair massage can also provide specific therapeutic treatment, especially for upper-body complaints affecting the shoulders, wrists (carpal tunnel syndrome), low back and neck.
Invest in yourself by acquiring the skills, knowledge, and techniques that enable you to help people in pain. Practice them until you are really good and you will most likely do very well in the coming years. You will be able to really help people, and people are really going to need help. Wouldn't you like to have people begging you to work on them instead of you begging for work?
Canada's Health Care Ship Sinking
Have you by chance heard of Claude Castonguay, the "Father of Quebec Medicare"? In the 1960s Castonguay chaired the committee whose recommendations became the glorious Canadian health care system of which we are told. He is now the chairman of a government committee reviewing Quebec health care. He has concluded that the Canadian system is in "crisis."
"We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it," says Castonguay. This money would have to come from significantly higher taxes. But now he prescribes a radical overhaul: "We are proposing to give a greater role to the private sector so that people can exercise freedom of choice." Freedom? What a concept.
Castonguay advocates contracting out services to the private sector, even going so far as suggesting public hospitals rent space during off-hours to entrepreneurial doctors. He also supports co-pays for patients who want to see physicians. Castonguay, who once championed public health insurance in Canada, now urges for the legalization of private health insurance.
What would drive a man such as Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care. Try a system in which people in towns like Norwalk, Ontario, participate in lotteries just to win appointments with the local family doctor. Years ago, Canadians touted their health care system as the best in the world. Today, Canadian health care stands in ruinous shape, according to Canadian Dr. David Gratzer, MD.
If Castonguay is abandoning ship, why should Americans bother climbing on board a similar ship? Will we pass each other going in opposite directions? English economist Alexander Tyler documented that the downfall of democracy, usually within about 200 years, comes when voters realize they can vote themselves something for "nothing" from the public treasury. Once people become dependent on government, they are one step away from tyranny.
Someone gets the bill for free health care, and that someone is the average middle-class taxpayer. Sadly, no one is talking about getting government completely out of health care, which is too bad, since government is the problem.
Chew on This
Earlier this month in an unprecedented U-turn, the FDA dropped much of its reassuring language on amalgam (silver) fillings from its Web site, substituting: "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses." It adds that when amalgam fillings are "placed in teeth or removed they release mercury vapor," and that the same thing happens when chewing. Mercury is the sacred metal of allopathic medicine. By placing it in our bodies through vaccines and fillings, they make billions treating the resulting conditions that manifest from the damage it does to our nervous systems.
The FDA is now reviewing its rules and may end up restricting or banning the use of the poisonous heavy metal, at least in fillings. It's about time. Want to bet that the law passed by the new Democratic Congress and signed by President Bush, giving drug companies immunity from damages caused by drugs and vaccines, includes mercury? If the drug companies can get off free, the FDA can tell the truth. Who are they really protecting? Both parties and the bureaucracy of government agencies are completely controlled by the giant corporations. By definition, this is fascism. They justify human suffering in the name of profit. How does it feel?
As we are soon approaching the completion of another trip around the sun, I want to thank you, the loyal readers of this column, for your support throughout the past year. I wish a Happy Holidaze to all and remind you that this time of year is about something far bigger than shopping. See you back here in January. Bring hot (dark) chocolate. We'll talk more about a paradigm shift in health care only we can provide.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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