resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
June, 2009, Vol. 09, Issue 06
Thinking in Practice
By Keith Eric Grant, PhD, NCTMB
"Experts see the world differently. They see things the rest of us cannot. Often experts do not realize that the rest of us are unable to detect what seems obvious to them." Gary Klien, author of Sources of Power: How People Make Decisions.
The world of learning has long fascinated me. I've taken the opportunity to walk it from a number of different perspectives: a physics graduate student; a research scientist; a massage student, practitioner and instructor; a martial arts student and teacher; a music student; and a folk dancer. My experience has thus spanned both the academic and experiential realms; both the conceptual and the kinesthetic. And out of all these experiences, one lesson has become clear (and applied in multiple realms): You cannot just pour information into a student and expect it to become magically useful.
Creating useful skills requires skill practice in context, and requires changing the manner in which the student uses their mind and senses to perceive the world. Without this context, information lies dormant, unconnected and unusable outside of the academic realm. I've had the opportunity to verify in my own experience that "experts see the world differently,"1 just as Gary Klein, senior scientist at Applied Research Assoicates, concluded from his field research. This change in perception is not a result of classroom lectures, but a result of guided participation. If we want to create skilled massage practitioners, we cannot just talk at students or be satisfied when they have memorized definitions and phrases from books. We must encourage and guide them in gaining patterns of tactile memory coupled with active awareness of what they are encountering.
From his research, Klein summarizes what differentiates the novice from the expert into three aspects: a history of experienced patterns; the ability to project the effects of an intervention; and a tuning of sensory discrimination. "These aspects of learning can be tied to the two primary sources of power we have been examining: pattern matching and mental simulation. Pattern matching (intuition) refers to the ability of the expert to detect typicality and to notice events that did not happen and other anomalies that violate the pattern. Mental simulation covers the ability to see events that happened previously and events that are likely to happen in the future. We also encounter some additional sources of power. The ability to make fine discriminations must involve some sort of perceptual learning."1
In a recent book, Think Again,2 authors Sidney Finkelstein, Jo Whitehead, and Andrew Campbell drew on Klein's research and other sources of neurological and cognitive research to better understand failures of decision. One of the things they noted is that experts rarely compare alternative actions. Instead, an expert will move directly to what experience indicates to be a viable solution. This can be both a strength and a weakness: a strength in that it generally produces a correct action quickly, and a weakness because it can also be the cause of occasionally missing alternatives or misidentifying a situation. One interesting aspect of this process is that most of the cognition happens at an unconscious level, as in the following quote taken from Think Again:
"Klein discovered that people with experience do most of their decision making unconsciously. They assess the situation by drawing on similar experiences from their memory, but much of this assessment process happens unconsciously. They then select a course of action from their memories of past actions. Finally, they test the practicality of this course of action by imagining what will happen if the action is taken. The imagining activity is the main conscious work that happens during a decision. What Klein had discovered is that we mostly make decisions unconsciously using experience, intuition, and imagination. We do not normally do much conscious analysis, such as identifying and comparing options or challenging assumptions and initial assessments."2
The conscious level of processing is primarily used only in unfamiliar situations and, for decisions where there is time, for consciously cross-checking the faster, unconscious process. It's fair to ask if this really is the case in health care. The answer provided for nursing, from over a decade of study by Patricia Benner and colleagues is a definite yes. The following is an excerpt from a book written by Benner, et al Expertise in Nursing Practice3:
"As a process, the diagnosis-treatment model was simply not apparent in the narrative accounts provided by nurses at any level, but clearly not in those by nurses practicing at the expert level. The judgments were rather characterized by immediate apprehension of the clinical situation, progressive understanding of the patient's story through his narrative accounts, and the capacity to notice qualitative changes by knowing the patient's pattern of responses; nursing actions were typically response-based, relying on whole intuitions of what had worked in past similar situations, and modified in accordance with this particular patient's responses to it. In this kind of fluid, skillful response, there was virtually no evidence of 'treatment' based on explicit nursing diagnoses."3
The above in no way diminishes the usefulness of anatomical information and abstract knowledge of techniques. What it does indicate is that, like pouring the molten bronze for a cast statue, the usefulness and integrity of the end result is only as good as the containing mold created by practice and experience. Without such a mold, all that is obtained for either statue or learning is a puddle of slag.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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