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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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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."
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.
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.
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.
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.
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.
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."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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.
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.
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.
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.
September, 2009, Vol. 9, Issue 09
By Elaine Stillerman, LMT
I always felt that the case of Meador v Stahler and Gheridian would have made a terrific case for the award-winning television show "Boston Legal." I could just picture Alan Shore (brilliantly portrayed by James Spader) eloquently and passionately representing his client while educating the rest of us about our legal rights as patients.
Not familiar with this case? Let me explain. In 2005, a Massachusetts woman, Mary Meador, sued and won a $1.5 million award against her obstetricians for performing a C-section she made clear she didn't want. She didn't claim that the procedure was negligently performed or that her postsurgical complications (which left her bedridden and unable to work for a number of years) were foreseeable. The merits of her claim were that the doctors had misrepresented the risks and dangers of her birth choice -- a vaginal birth after a prior C-section (VBAC) -- and that they ignored her repeated pleas and requests for a vaginal birth.
The doctors were brought up on charges that they failed to obtain Meador's informed consent, which constituted substandard, negligent medical care. The forensic psychiatrist who testified at the trial established a link between the lack of informed consent and the physical and emotional toll it took on the patient and her family by forcing her to undergo a procedure she did not want and did not medically need.
When it comes to labor and childbirth, a woman's emotional vulnerability and physical discomfort makes it difficult for her to stand up for her rights. She needs to focus on her labor and not be engaged in an argument about what she is entitled to. According to the Childbirth Connection's "Rights of Childbearing Women" brochure2 (www.childbirthconnection.org), "Every woman has a right to accept or refuse procedures, drugs, tests, and treatments and to have her choices honored." (For a free copy of this important pamphlet, send a SASE to Childbirth Connection, 281 Park Avenue South, 5th Floor, New York, NY, 10010.)
Fifteen years before the Meador case, Congress passed the Patient Self-Determination Act (PSDA) as an amendment to the Omnibus Budget Reconciliation Act of 1990. It became effective in December 1991. Basically, the PSDA requires that Medicare and Medicaid providers (hospitals, nursing homes, hospice programs, home health agencies, and HMOs) give competent adult individuals, at the time they are admitted or enrolled in the program, information about their rights under state laws governing advance directives. These rights include:
The PSDA also prohibits institutions from discriminating against a patient who does not have an advance directive or a plan of care.
All hospitals that receive federal funding (nearly 80 percent of hospitals in the United States) must conform to the Center for Medicare and Medicaid Services (CMS) Conditions of Participation (CoP) which requires that hospitals honor patient rights as expressed by the PSDA, the Consumer Bill of Rights and the EMTALA (Emergency Medical Treatment and Advanced Labor Act) law to be fully informed of the risks, benefits and alternatives of any proposed treatment and to participate in all treatment decisions. Hospitals that fail to uphold this practice run the risk of receiving stiff fines and/or losing their right to qualify for Medicare or Medicaid funding.
In New York, we have the Public Health Law, Section 2503, passed in 1978 (see my March 2006 column "The Truth About Pitocin" ), that requires all doctors and midwives to fully disclose and require informed consent from laboring women, regarding the use of all drugs during labor and delivery. The Joint Commission on Accreditation of Hospitals (JCAHO) accredits 80 to 85 percent of American hospitals, and one of their standards for accreditation is patient rights. Complaints about patient rights violations can be made to them at www.jacho.org or (630)792-5800.
In my May 2005 column "'V-Back' to the Dark Ages," I addressed the political environment surrounding VBACs and the increased medical denial of this choice, so I am not going to go into the benefits and risks of VBAC again. Instead, I want readers to know that we and our clients have choices and responsibilities when it comes to our health care. Informed consent can only be provided if the patient is truly informed, and by regularly conceding this right to our care providers, it proves how rare and improbable this practice is. The onus of education, the burden of learning the facts, options, alternatives and side effects of procedures and drugs must be the responsibility of the patient. That is the only way, regrettably, that the patient will learn all the facts. Patients don't have to be powerless about their rights.
This is neither a war against individual doctors, or hospitals and their care, nor a diatribe against the medical community at large. It is a wake-up call to those patients who have remained passive about their own health decisions for too long and who have merely accepted the choices that are made for them by others. Only when patients and their care providers can openly discuss, debate and compare options based on shared evidence-based information can we really have a partnership, a team, dedicated to a person's total health care. Alan Shore would have fought -- and won -- for these rights. We can too.
Click here for previous articles by Elaine Stillerman, LMT.
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