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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.
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."
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.
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.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
December, 2008, Vol. 08, Issue 12
Your Clients’ Winter Skin
By Rita Woods, LMT
What can I do about it? In the winter months, this is the question most often asked by my clients. They are talking about their dry and sometimes cracked skin. The skin is the first barrier of defense against millions of bacteria, viruses, molds and fungus. The skin is like the walls of a fortress that protect the interior from invading armies. Intact, healthy skin is vital to our overall health. As a therapist, I always keep extra lotion on hand during the winter because the client's skin will suck it up like a sponge.
Skin is our domain. We see it and touch it on every client. We use it to get to muscles, ligaments, fascia and all that lies underneath it. Just think about it - we work muscles and soft tissue, but never actually get to touch it. We make contact with our target muscles by using the skin. It's important that we offer advice, suggestions and services that will assist our clients, as they depend on us for information. Let's face it, we probably see more skin on a person than their spouse or partner.
Let's first look at why the skin becomes dryer in the winter months. Low humidity is the main cause. The air around us is more dry, so the moisture is wicked out of our body and we receive virtually no moisture from our environment. Other factors contribute to dry skin but dry air will exacerbate an existing problem. When you think about dry skin, you should have two objectives in mind: first, getting moisture into the cells, and second, keeping it there.
One thing you can do is to work with the air around you. Add some moisture to it. When I was a kid I remember my mom putting containers of water on the vents in the floor. She was adding moisture back into the air. That was our humidifier. Grandma had a wood stove and always had a cast-iron tea kettle simmering on the stove. Again, moisture back into the air. In addition to keeping our skin moist and cutting down on static electricity, moist air retains heat better.
If you are dehydrated, drinking more water can help. However, recent studies suggest people who are adequately hydrated do not receive any additional skin benefit from drinking more water.
Now let's look at topical applications. We call these moisturizers, with hand and body lotions being the most commonly used products. There are three types of basic moisturizers. One puts moisture in, one prevents moisture from escaping, and one makes the skin feel smoother. Individual skin varies, so trial and error may be necessary to find the right combination. It's chemistry that make these work, so I'll give you ingredients to look for. There are many substances in each category, but these most often appear in over-the-counter lotions.
Humectants. This is a classification of moisturizer that penetrates the stratum corneum, the top layer of skin, and helps absorb moisture. Humectants are popular in anti-aging products since skin dries out more as we age. The common ingredients in this category include glycerin, hyaluronic acid, panthenol, propylene glycol and sorbitol.
Occlusives. This category works by coating the top layer of the skin to decrease evaporation. Common substances with occlusive properties include lanolin, stearic acid, cetyl alcohol, caprylic/capric triglyceride, mineral oil and petrolatum. I can already hear the moans about using mineral oil or petrolatum. But keep in mind that for many people, their hands, fingers and feet will actually crack and bleed. This is a most unhealthy condition and can be quite painful as well. In this case, they may want to use grandma's beauty secret of smearing a white petroleum product, like Vaseline, on their hands and then donning a pair of white gloves before going to bed.
Emollients. Emollients soften and smooth skin texture. Common substances with emollient properties include cyclomethicone, dimethicone, isopropyl myristate, octyl extenuate, isopropyl palmitate, isopropyl isostearate and jojoba oil.
By knowing the action of different ingredients, you and your client will have the ability to make better decisions about winter skin care. But there is still more that can be done. The skin has a layer of lipids that is vital to healthy skin. This natural lipid component can be stripped away with soaps, harsh cleansers and even hot water. At the very least, try using warm rather than hot water for showering. After showering, pat dry and while the skin is moist, but not wet, apply your lotion; especially a moisturizer or lotion with humectant properties. This can draw moisture from the surface into the skin.
Exfoliates. A lotion or moisturizer works more effectively when the skin is free from dead surface cells. For best results in the winter, use a good nonabrasive exfoliator that contains its own moisturizing properties. A salt scrub may be helpful but can also be drying to winter skin.
The skin is the largest organ of the body and deserves quality care. For many people, winter care may require measures that go beyond their normal routine. Skin care problems should be viewed as any other acute or chronic health issue and be addressed accordingly. The use of products or ingredients that you may normally avoid could be your best defense. I had a friend tell me that when her hands start to crack, she uses grandma's Vasoline-and-gloves regime. She sees it as medicine: It's not to be taken all the time, but she is grateful for it when there is a problem.
Click here for previous articles by Rita Woods, LMT.
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