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Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
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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