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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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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 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.
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.
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.
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.
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.
March, 2010, Vol. 10, Issue 03
Massage Tables Are Like Elegant Desserts
By Angie Patrick
It's true, massage tables really are like elegant desserts. The best ones have the perfect balance of sumptuous and delicious layers. Go enjoy a delicious gourmet dinner. Chances are the dessert tray will be filled with items sporting layer after layer of sheer decadence. More layers really equals more luxury and more indulgence.
However, this is where the similarities with your massage table end. I have seen some therapists who will place a sheet over a table and call it complete. This can leave a client shivering and feeling more than a little exposed. I have also witnessed other therapists create the equivalent to the Leaning Tower of Pisa in an effort to make the table more comfortable. This often results in the client fussing with the table covers and struggling to keep them in place while trying to roll over, or even worse, the coverings sliding to the floor completely when the client gets off the table due to ill fitting or inappropriate coverings not created for use on a massage table.
How do you know when enough is enough? How can you be sure you have not crossed the line between cocooning comfort and overcompensation for an uncomfortable table? Often, these lines can be blurred. Let's look at some of the regularly used table coverings in order of their layering on the table, and then you can utilize the information provided to pick and choose which would be appropriate for your specific applications.
Table warmers come in many different forms. Some are washable while others are not. Some are suited for treatments where they might come in contact with water and others are not made to withstand moisture. Before you choose, decide whether or not you plan to practice treatments that require the warmer to be water-proof. For instance, if your plan is to offer herbal wraps, you will most likely opt for the water-proof option for safety's sake. If your plan doesn't include treatments utilizing moisture and free-flowing water, then a regular fabric table warmer will work fine. In all cases, check to be sure the warmer has an auto-off feature. This alleviates the age old worry in the middle of the night as you sit straight up in bed, "Did I unplug the table warmer?"
Some models can be programmed to work continuously for up to 99 minutes, and then power down. This is a great feature, and one I personally prefer. It takes the guesswork out of whether or not the warmer will remain on for the full treatment. Given the average massage is 60 to 90 minutes, it should cover most treatments. The trick is remembering to reset it between clients so it does not power down in the middle of your massage. These typically are washable on the gentle cycle, although it is preferable to hang them to dry to better prevent the warming filaments from breaking.
Ideas for Added Padding
Fleece likely is the most popular and widely utilized plush covering. This covering provides additional cushion and a degree of comfort that a sheet on bare vinyl will not provide. Look for fleece with elastic corner holds or a fitted cover to secure it to the table. You have a couple of choices in the type of fleece you utilize. Some people only want wool fleece pads. Although these are very warm and cozy, they cannot be machine washed and some clients might have allergies to wool, which won't necessarily be disclosed in the intake form. I prefer the synthetic fleece because it offers greater flexibility in washing. It can be machine washed and dried in the dryer on fluff or air dry without heat. I would suggest a therapist have a few sets of fleece so they can be changed out between clients on a busy day. Now they are more affordable than ever before, ranging from $25 to $110 depending on the material you choose.
Another popular option for added comfort is memory foam covered in vinyl. This is a fantastic way to soften a hard table or elongate the life of one that is beginning to show wear on the padding. It usually is 2 to 3 inches thick and is made of visco-elastic material which reacts to body heat, conforming to the contours of the body. These, when covered with vinyl, are easily cleaned and offer a very comfortable foundation for your client. While not inexpensive, they can truly provide a luxurious feel to your table and extend the usefulness of a table in the beginning stages of wear, allowing an additional pocket of time before you must invest in a new table.
Choosing the Right Sheets
Once your warmer and choice of pad are in place, affix your fitted sheet to the table. The next layer is your top sheet. Please be sure the sheet sets you buy are appropriate for a professional setting. I have seen the occasional therapist use cartoon-character sheets fitting a twin bed on their professional massage table. The intent is to be cute and quirky, but the reality is you come off looking ill-prepared, childish and difficult to be taken seriously. Purchasing sheets appropriate for your practice is fundamental in being considered a professional. Be sure your sheets are in good repair, not stained and do not reek of old oil. This is more than a wee bit off putting, and can ruin the whole massage experience, no matter how expertly executed.
Your choice in sheet material is one that could require some additional thought. Although we all want an attractive and inviting table, being pretty may not be enough. Look for fabrics that are durable and can withstand repeated usage and laundering. Here are a few examples of the most commonly chosen sheet types, and reasons why they may or may not be a fit for your needs.
Poly Cotton: These are a blend of cotton content and polyester. These sheets are thinner and great in warmer climates. They resist wrinkling, although they are not wrinkle-free. There is little shrinkage, and they usually hold up well during laundering.
Muslin: Very thin fabric, does not offer much coverage for client modesty. These sheets might work well when used in wraps. Not a favorite among most therapists for everyday use on their massage table.
Cotton: Natural fiber, flat-spun fiber finish, and soft to the skin. For client modesty, look for sheets with 300-350 thread count. These are a bit thicker and offer greater coverage. Buy sheets a bit larger than your table to allow for inevitable shrinkage. These will launder well although they will wrinkle substantially if left in the dryer unattended after drying.
Flannel: A tried and true staple in any therapist arsenal. This is a natural cotton fiber that has been spun to allow fibers to be "unruly" and then brushed to allow fibers to loosen and become lofty. These sheets offer superb coverage and long wear. The more they are washed, the softer they become. Flannel is not gauged in thread count, but it is rated by weight per square meter. For durable flannel that will wear well, look for flannel with weight of 150 g per square meter or greater. These weights will launder well but will wrinkle if left in a basket after washing. Again, be sure to buy sheets large enough to accommodate shrinkage.
Bamboo: A new fiber in the massage-sheet arena. This fiber is incredibly soft to the touch. It feels almost silky and can provide a very luxurious feel to your table. It is also a nice "trendy" component to say you are using greener products. Even though there are several positive reasons to choose bamboo, it also has a few setbacks. It can be price-prohibitive in many cases, and it often can have substantial shrinkage and wrinkling if laundered in any way other than described on the packaging. It also is still somewhat fragile in its longevity, allowing the stitching holes to stretch and become somewhat unsightly. If you have the budget, time and opportunity to truly care for these sheets, they might be a good fit. If you are looking for a workhorse, you might decide to opt for another material.
In all sheets, you will want to be sure the pocket is deep enough to accommodate the table warmer, and fleece or memory foam pad, as well as the table. In the top sheet, you likely will wish to find something measuring 59 to 65 inches wide and 80 to 90 inches long. Not only will this allow nicely for any shrinkage, it will continue to provide adequate coverage for the client following laundering. This is why most household sheets for twin beds do not always offer a perfect fit.
The Proper Blanket
There are many schools of thought in regards to blanket materials. Again, it is driven by your needs and usage. I will provide you with the most common offerings, although there are many more on the market than I can list here.
Cotton Thermal: Likely the most widely used blanket in massage. It is loosely woven, thicker yarn cotton that will remain breathable while retaining warmth. It is prone to shrinkage and does have a tendency to become snagged. These are affordable and come in an array of designer colors.
Fleece: Softness is the hallmark of this fabric. It harkens to days when we were children and all things we snuggled with were fluffy and soft. It evokes an instant relaxation response and is widely used in the industry. It will launder well, although it is prone to shed in the first few washes. Most will not have appreciable shrinkage. These will also wrinkle, but not much.
Bamboo: This fabric makes a lovely blanket; offering softness and luxury to any table. This is not a very durable fiber so handling and laundering of the blanket must be done with care. It is prone to pilling, so it should be handled with greater care. It will also shrink if dried in a heat setting. Tumbling on low heat or no heat is preferred to extend the life of the blanket.
Down Comforter/Duvet: Incredibly lush and totally cocooning. It's downside is the expense and the upkeep of the duvet covers between clients. For a similar feel without the expense, look for down alternative comforters. These can also alleviate the allergy reaction to down.
Making Your Table a Sanctuary
Many therapists have different ideas about the way they would like their table to look and feel to the client before they climb on. Some would opt for a clean, luxurious spa feel with a crisp, white duvet covering a plush, down comforter. Others may prefer a world-traveler look, complete with colorful saris from India or Pakistan accompanied by a decorative pillow of silk or satin. Still others may opt for a more ethereal feel, with thin gossamer fabrics covering their table, lending it a cloudlike quality.
I have seen tables with flower petals scattered on them, or simply dressed with a bundle of freshly cut rosemary sprigs tied with a piece of raffia placed in the center of the table. I have seen the table scattered with chakra stones, as well as beautiful bowls of water with a Beta Fish swimming in it on the floor beneath the headrest for a lovely view while face down. Any one of these ideas can evoke a serene feeling of calm and relaxation. The truth is, there are no real wrong ideas when it comes to the decorative part of the table. Just, as in all things, present a professional appearance.
I hope these bits of information will be able to assist you in the decision of what to use on your table. The possibilities are truly limitless, and we have only scratched the surface here. There are more beautiful massage linens coming into the market every day and there are many great suppliers bringing these to the forefront. Enjoy the search, but always remember to present yourself, your practice and the supplies you use professionally.
Click here for more information about Angie Patrick.
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