resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
May, 2009, Vol. 09, Issue 05
Malpractice Claims: Sexual Misconduct
By Dixie Wall, Contributing Editor
Sexual misconduct is not a new problem among health care practitioners. Hippocrates even added to his oath, "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or men, be they free or slaves." In order to prevent this damaging conduct from happening to our clients and in our practices, we must maintain appropriate boundaries and develop open communication. It is our responsibility as the therapist to establish these boundaries, and shift them to the needs of the client.
Malpractice and/or liability claims are generally categorized into malpractice, criminal or civil. Malpractice includes acts of commission and acts of omission.1,2 Acts of commission are unintentional or intentional acts, performed by a therapist, that result in some type of harm to the client. Acts of omission is more common among primary health care physicians such as doctors, chiropractors or acupuncturists and involves a failure to refer clients out when indicated, or some type of missed problem in initial treatment of patient. Criminal suits are usually claims that involve some type of illegal implication and ramification for unprofessional illegal conduct. This month, we will further discuss these criminal acts but more specifically unprofessional sexual misconduct.
According to the Medical Council of New Zealand, sexual misconduct can be divided into three categories. The lowest level of misconduct is defined as "sexual impropriety." "This is nonphysical contact of a patient that is inappropriate jokes, crude gestures ... or demeaning comments about a patient's undergarments." The next level is "sexual transgression," which is defined as, "inappropriate touching of a patient stopping just short of an overt sexual act." This can include unnecessary contact with the breasts and inappropriate draping or lack thereof. The last and most severe is "sexual violation." This is defined as, "a sexual act between patient and doctor, there is no distinction between which party initiated the contact and whether the act was consensual." When any type of sexual misconduct takes place, the issue is no longer in the malpractice realm but becomes a criminal issue. These illegal acts are usually excluded in malpractice insurance policies.
Health care professionals are held to higher standards due to the hands-on nature of our field. The one-on-one time spent with clients creates a special personal connection between the client and therapist where the client may share personal information that would not be shared to other types of professionals. With the exception of the health care professionals, people would generally never allow another service provider to touch them. This immediately places us in a unique position of trust as separate and distinctive professionals. Unfortunately, according to the American Massage Council's claims history, sexual misconduct is the number one type of claim against massage therapists.
Sexual misconduct is not limited to sexual interaction with a client. It can be an inappropriate comment, flirtatious behavior, look or gift. This type of misconduct can harm the client in many ways and has major repercussions for us as practitioners. These repercussions may include damaged reputations, lawsuits, and ultimately losing our permits, licenses and practices. How can these issues be prevented? Most experts in practice management recommend setting adequate and appropriate boundaries.
Boundaries separate your personal space from the space of the client. Most boundaries are created by the client and maintained by the practitioner. The maintenance of these boundaries can help us maintain a thriving and professional practice. There are several types of boundaries set by in practice that can help us to prevent any misunderstandings or mistakes that could lead to sexual misconduct.
The first and most important when it comes to sexual impropriety claims are physical boundaries. What kind of touch will we accept from a client when greeting them? What type of draping techniques should we use? According to an administrator at a leading massage school in California, "draping is the number one complaint from clients receiving massage in their clinic." Massage therapists must make sure that the client is properly, consistently and conservatively draped. Always give the client sufficient time in private to change before and after the massage.
The next way to protect yourself is by maintaining verbal boundaries, keeping open all lines of communication with your client. Listen to your clients attentively and comfort them through a routine professional protocol in treatment procedures. When explaining your treatment plans for the client, make clear what you are going to do, explaining again what you are doing while doing it, and then telling the client what you just did. Set the language in conversation on the telephone in a professional level. Always avoid improper slang, language and gossip, and keep client's confidentiality a priority.
Lastly, a first impression is always made with visual boundaries. Our society is based on visual recognition and appearance. Create your own professionalism by consistently practicing routine procedures and retaining a standard dress code. Uniforms can create a comfortable atmosphere by setting a familiar tone. Keep your office clean and neat.
Through establishing, encouraging and enforcing these boundaries, you will promote your profession, as well as the safekeeping of yourself and your clients. Next time, we will discuss three additional boundaries that can help us succeed in practice.
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