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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?
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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?
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.
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 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.
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.
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.
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.
December, 2009, Vol. 9, Issue 12
Heating Up Your Practice Safely, Part 1
By Dixie Wall, Contributing Editor
Over the last decade, many bodyworkers have begun using stones, not to replace human touch but as an additional relaxing and leveraging technique. Traditionally used by Egyptians, Shamans and American Indians, stones have a long history of therapeutic use and spiritual healing.Today, incorporating stones in one's practice offers this ancient tool, to not only relax clients but also give our hands a rest. Hot stones are a form of thermal and magnetic therapy, requiring a unique trust between the client and practitioner. A respect for the trust bestowed in us by our clients need to be developed by a safe and meticulous protocol to perform this primal technique.
After attending a hot stone seminar this summer, I was immediately reminded how splendid hot stone massage is, not only for the client but also for the therapist. Throughout my years of practice, I was always hesitant to use any type of tool, I never cared for the way the tools felt on my skin, either giving or receiving. Yet with rocks, especially smooth and warm ones, the feeling is different. There is an instant primal connection to a real rock from the ocean or a riverbed, which is relaxing to the spirit and nurturing to the soul.
Hot stone massage is usually done with basalt lava stones, which contain high levels of calcium, magnesium and iron. These minerals can facilitate balance within our energy centers or chakras, and they can move stagnation within our channels and meridians. Many therapists use cold stones as well. These may be smaller marble stones or quartzite crystals. Cold stones are commonly used on the face.
Stones and heat are both very powerful. When not treated with respect and vigilance, they can actually injure the client. Other types of heat therapy to keep in mind include hydroculator wet packs, water bottles, herbal compress bags and infra-red heat lamps.
Last fall, I published a three-part series on malpractice and liability claims. Many of these claims frequently involve burns from hot stones, cupping and hydroculator packs.
And while we are well aware of all the benefits of hot stones and other heat therapies. Over the winter months, we will discuss several treatment procedures, contraindications and cautions of which we should be aware as we provide therapeutic heat, especially hot stones to our clients. This month, we will discuss treatment procedures, skin typing and informed consent.
It is of utmost importance to have set procedures. We must follow a methodical, yet simple, protocol in our treatment rooms to ensure the safety of ourselves and our clients. Sloppy procedures and little or no training are the number one causes of burns in the treatment room. Why do client's get burned? Usually because stones are too hot.
According to Michael Schroeder, vice president of the American Massage Council, "The most common problem with hot stones is the method therapists are using to cool down the stones. If they are too hot, therapists often use cold water to cool them down, but this only cools the external layer of the rock.
"After placing them on a client, the superficial layer of the stone quickly becomes hot again, sometimes burning the client. The therapist doesn't realize they have only temporarily cooled the external layer. This means if the stones are too hot, the only way to cool them down is time. We can put them on a washcloth next to the heater, turn down the temperature and wait for them to cool."
Additionally, always test stones on your own forearm before placing them on the client. Our own hands may not be a safe temperature gauge because they are less sensitive to heat than the rest of our bodies.
Never give a hot stone massage using silicon gloves. If you use a glove rather than tongs or a skimmer to remove the stones out of the water, never put them straight onto client. If the palm of your hand cannot hold the stone, most likely the client will not tolerate the heat. Again, test the temperature on your own forearm first.
Always use a temperature gauge in the water while heating up the stones. Warm stones (90 F - 110 F) are used for those with sensitivity to heat or for large stones that are going to compress the body without a sheet or towel. Hot stones (110 F - 125 F) are used for active massage. Temperatures will vary according to client, always test your equipment, set the heater at low without a cover and go from there.
It's better to start on tougher (yang) areas first (back and lateral portions of the body), then work toward medial and anterior portion (yin).
In general, "stones do not care for bones". We should avoid all bony clefts and spinal processes. No stones should be placed on the eyes if the client wears contact lenses.
Fitzpatrick Classification Scale
Another tool we can use to keep our clients and ourselves protected is becoming familiar with skin typing. The Fitzpatrick Classification Scale (developed in 1975 by Thomas Fitzpatrick, a Harvard Medical School dermatologist) classifies a person's complexion and tolerance of sunlight. The scale is used by several different health practitioners to determine how their patients will respond to heat therapies.
We can educate our clients by including a skin typing chart in our initial examination documents or by incorporating it into our informed consent documents.
Another important facet of a long-term successful practice using heat therapies is always having the client sign an informed consent document, specifically for hot stone therapy, before receiving treatment. This document may explain benefits and risks of hot stones therapy, contraindications and cautions, and explain the skin-typing procedures.
By enlightening our clients through a professional intake procedure, we further establish a foundation of love and trust that facilitates their healing.
In the chilly months ahead, heat therapies may be suitable to offer your clients as a seasonal special or a holiday gift. When incorporated into practice with a healthy respect and awareness, we can securely integrate these healing modalities into our current practices. In the coming months, we will discuss contraindicated diseases, conditions and medications for heat therapies.
I would love to hear your experiences or comments. Please feel free to contact me at .
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