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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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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."
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
June, 2009, Vol. 09, Issue 06
The Importance of Scar Tissue Release Therapy
By Marjorie Brook, LMT, CIMI
Scar tissue therapy is generally overlooked by health professionals because the extent of physiological effects scars can have on the body have never really been acknowledged. As massage therapists, we know that the slightest restriction in the elaborate matrix of fascia can have major repercussions from one end of the body to the other.A simple scar from a childhood accident to major surgery can have a lifelong effect both physically and mentally for your client. Scar tissue has the potential to spread in any direction including internally throughout the body. It can also restrict movement or function anywhere in the body from a joint to an organ.
Scar tissue release therapy is extraordinarily simple to learn, easy to apply and yields powerful results that can prevent a lifetime of compensation, complications and pain. I have been a licensed massage therapist for more than 12 years and in all that time, a reoccurring theme seems to have prevailed. The presence of scar tissue can have a lifelong physiological effect on the body -- a fact that seems to have eluded traditional health care professionals. This realization combined with my clinical experience, education, teaching and research, has led to developing methods that improve upon existing fascial techniques for scar tissue release.
During the course of my career I've treated many patients whose problems could be traced back to a scar they had forgotten they even had. Almost everyone has a scar. While not every scar presents a problem, often they can. This is due to the fact that the body is one large, three-dimensional piece of fascia that envelops us like an intricate spider web. Any kink, pull or restriction in one area affects the whole matrix.
Scar Tissue & Adhesions
Scar tissue and adhesions are the result of our body's natural healing process and it occurs both internally and externally. The process, if working correctly, is supposed to eliminate the scars and adhesions once the wound is healed. In some cases, a person's body does not breakdown the scar tissue. The adhered tissue continues to spread which can trigger a cascading effect of compensations throughout the body.
Scars are areas of fibrous tissue that have replaced normal skin, or other tissue, after injury. A scar results from the biologic process of wound repair (protective, useful barrier) in the skin and other tissues of the body. Scar tissue is never as functional as the original tissue it has replaced. With the exception of very minor lesions, every wound (both internal and external) results in some degree of scarring.
Adhesions are bands of scar tissue that anchor and support the wound. It binds together all tissue it comes into contact with. Adhesions may be thought of as internal scar tissue. Although adhesions can occur anywhere, the most common locations are within the stomach, pelvis and heart. (For a comprehensive list of specific types of scar tissue and adhesions go to www.brookseminars.com/resources.)
Cases of Scar Tissue Treatment
Scar tissue release therapy is extraordinarily simple to learn, easy to apply and yields powerful results that can prevent a lifetime of compensation, complications and pain. The therapy is a series of fascial techniques that release and realign the restrictive tissue from the starting point (visible scar) to the end point (where the line of frozen fascia stops). This release system differs from traditional methods because it approaches the multi-faceted matrix of fascia three dimensionally.
I have used this therapy with success for clients who range in age (from children to seniors) and who have experienced a broad scope of problems. In many cases, the results have been achieved within one to three sessions. Below are the stories of three clients who have experienced dramatic results (client names have been changed to protect their identities):
Another client for general relaxation massage referred "Laura" to me. Prior to starting our first session she forewarned me (out of being embarrassed) that her leg was "scary" looking due to vein removal surgery she'd had several years prior. I've seen and helped many clients with scar tissue resulting from vein removal surgery but was stunned at hers. Starting about two inches above her knee all the way down to the middle of the foreleg was a scar every inch and a half - with skin puffing up in between. It looked as though she had been bitten by a shark. In addition to the physical scarring, she experienced pain in her knee and down her leg (which made it difficult to keep up with her four boys). As you would imagine these scars not only affected her physically, but emotionally as well. She was very self-conscious of their appearance, so uneasy that she had not worn shorts since the surgery. She was frustrated that she couldn't keep up with her mother's walking pace while out shopping. And she was angry because her doctor told her nothing could be done, "it just healed that way." But after just one scar treatment session Laura experienced relief physically. By the end of three sessions the swelling was gone, the scars were reduced and Laura was thrilled. Laura's scars have faded by 85 percent. She now wears shorts and was able to actually go skiing with the boys for the first time in four years!
"Debbie," 35, came to me several years ago for help with what she thought was carpal tunnel syndrome. After observing a large scar on Debbie's wrist I inquired as to its origin. When she was nine years old she had put her hand through a window chasing her brother. After working on her hand for two sessions, scars from the glass cuts were reduced visibly by about 80 percent, she obtained range of motion back in her hand/wrist and the numbness was gone.
Another regular massage client one day inquired about my services for his 10-year-old son "Bobby." Bobby, who is very active in sports, was born with a clubfoot and was experiencing a lot of pain in the Achilles tendon of his good leg. After three surgeries his foot was locked in an inverted position causing him to walk on the outside edge of the foot. He was also scheduled for a fourth in a series of seven surgeries. After a thorough evaluation it was clear that it was not the deformity of Bobby's club foot that was holding his foot in this position - but the scar tissue and adhesions from the past surgeries which was wrapped around the ankle into the arch of the foot and up the back of the Achilles tendon. Due to the inversion of the foot, Bobby was using his hip flexors to move his leg forward. After working on Bobby's good leg, I asked his parents if it would be all right if I worked on the other foot. Much to the parent's shock after the first session of treatment, Bobby's foot released about 90 degrees. Upon seeing her son stand with his foot almost flat on the ground Bobby's mom said half in shock and half in anger, "Why didn't the doctors tell us to work on the scars? We would have done it everyday!" I continued to work with Bobby for almost two years. Along with continued work on removing the extensive scar tissue, he needed stretching and strengthening sessions to retrain the muscles in the atrophied leg and throughout his hip. While his foot will always be stunted from his deformity he never did have that fourth surgery.
It is my hope that with modern science starting to recognize the importance of fascia and the effects of scar tissue on the body that scar tissue release will be brought to the forefront of therapy. Massage therapists can make significant and long-lasting changes in the health and well-being of their clients by incorporating scar tissue release therapy into their treatments. It is my experience that this therapy can play a major supportive and therapeutic role in helping anyone living with the physical, emotional and mental effects of scar tissue and adhesion restrictions.
Marjorie Brook has been a nationally certified, New York State LMT since 1997. She is an advanced AIS practitioner/instructor who teaches nationwide, as well as in Canada and Europe. Marjorie offers continuing education courses in Active Isolated Stretching and Strengthening, Scar Tissue Release, and Body Mechanics through her company at www.brookseminars.com.
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