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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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."
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
April, 2010, Vol. 10, Issue 04
Releasing the Pain of an Old Story
By Sharon Desjarlais, CC
I love a touching story. As a business coach for CranioSacral therapists, I'm blessed to hear plenty about the transformations that take place on the treatment table. And once in awhile, I run across one that stirs something deep inside of me.
That's what happened when I received the following essay by Jeannine Wiest, a CranioSacral therapist in Southern California. It's a poignant example of the freedom that comes when we release the old, outworn stories that take up residence in the tissues. Enjoy!
"Sparkle Hip" by Jeannine Wiest, LMT, CST
An ache is getting my attention. I need fresh eyes for the nagging feeling that's been surfacing as a catch-click pain in my right hip. I decide to see Abigail, a CranioSacral therapist I've heard good things about. She works out of her townhouse by the beach.
I find her place easily. I'm early so I drive around and see a Big Lots store. I wonder what leftover retail items I need. I find mugs that say "Official Society of Sarcasm: Like We Care What You Drink." In an existential mood, I buy two.
My stomach flutters as I drive back to Abigail's house and park. With 10 minutes to kill, I turn on the radio. "You know that I could use somebody..." Kings of Leon. Love them.
That's three minutes gone. Maybe I can just sit here for a little while longer. A gardener starts his blower two houses up. A man shuffles by with a poodle that reminds me of my childhood pet. Okay, let's ring the bell.
I enter a small brick courtyard with one cactus, wind chimes and three sets of shoes. Abigail appears wearing an Esalen T-shirt and drawstring trousers. We walk downstairs to her treatment room.
She leaves me to settle in, face up on her table. The blue room has shelves of crystals and books. The lights are low. I clear my mind of Big Lots, childhood pets and expectations.
Abigail comes in. I feel the heat of her hands as she connects with the dorsa of my feet and my cranial rhythm. It feels like sonic electricity humming. She palpates her way up my body, asking me about surgeries as her hands move to my ASIS hip bones. I tell her I've had two laparotomies.
"How long ago," she asks.
"Long ago," I answer. Her hands sandwich my abdomen.
All of a sudden I'm in 6th grade. A memory floods my awareness as I shift into a SomatoEmotional state. I see my 10-year-old self in a New York City school bathroom with Pam Maher. We're both looking in the mirror.
Pam has strawberry blond hair she wears long and straight with a center part, like Joni Mitchell. Her features are angular. She's painting her small mouth with Yardley Pot O' Gloss. A child model, she wears things I've never seen at the Long Island Green Acres Mall.
Today she's wearing a suede two-piece outfit, the exact russet shade as her hair. The front and back are attached with tortoise-shell rings, so there's a 2-inch separation on both sides. It's not X-rated because of the brown-ribbed unitard underneath. This picture has been hiding in my right hip.
"Where are you, Jeannine?" Abigail asks.
I tell her I'm in the bathroom with Pam. Tears form. My spine shudders from neck to hips.
"What are you aware of?" she asks quietly.
"She's putting makeup on," I say. "I'm pretending I left my makeup at home, but I don't really have any."
A wave of nausea comes over me as I watch little Jeannine feeling less than Pam. A tear slides down the side of my eye and pools in my ear.
"Tell me more," Abigail says neutrally.
"She's a model. She was just in the New York Times magazine section. I ask her how it feels to be in a full-page ad by herself."
My hip screams a raw arthritic pain, but I don't have arthritis. Now Abigail is sandwiching my hip.
"You're asking her a question." she continues.
"I ask questions. I want to imagine what it's like to be in the center of a magazine. I feel so stupid, like she knows things I'll never know."
I fall silent. My fascia shifts to accommodate this focused attention. Abigail stays where she is. Tears fill my face.
The observer part of me is pleased and curious about what's transpiring. Being neutral on the table allows me to be present to witness trauma unraveling. It's the coolest way to explore.
I'm still in the bathroom with Pam. She tousles her hair, which is weird because it just falls straight again. It would never occur to me to tousle my hair.
"How does it feel to have them choose you?" I venture.
"I don't know," Pam replies.
Answering me is obviously a pain. I ignore it. After all, she's my friend, and I want to know.
"How come you don't know, Pam?"
"Because I don't ask stupid questions," she says.
All at once I think, "Did I hear that correctly? What does that mean?"
Then it dawns on me. Oh. Oh no. Grown-up Jeannine, watching from a therapy table 40 years away, sees what 6th-grade Jeannine does in that instant: She leaves her body to protect herself. She makes decisions about herself that day that are stuck in my 50-year-old hip.
Abigail notices. "Huge heat release just now," she says. "Feel that?"
"I'm invisible," my 6th-grader cries.
At that moment I confirmed something for myself. I am stupid. Pam wouldn't say it if it wasn't true. I walk into one of the bathroom stalls and close the door.
Abigail murmurs, but I can't hear her. Louder she says, "Tell me more about invisible." Her voice pierces the stall where I'm frozen in 6th-grade discovery.
"My heart," I say.
"Your heart," Abigail repeats gently. "What about your heart?"
"She stabbed me with words in my heart."
"Yeah. Pam, my perfect friend." I sniff.
"What about your heart?"
"My heart is huge and sloppy and not cool."
"Huge, sloppy and not cool," Abigail mirrors. "Is that right?"
"Mmmhmm," I whisper. "I have to hide it."
"Hide it. Why is that?" Abigail says.
"I have to hide it to make it fit into this body."
I fall silent as a lighter feeling begins to flow into my hip. Minutes pass. My body shifts to take in the awareness.
I've told that story over the years to shrinks and to lovers, pointing in an analytical way to the moment I decided I must be stupid. None of them gave my body relief from Pam's words, which had been stuck in my hip for 40 years. Now that trapped energy has moved.
Abigail asks me if I want to reframe the scene. She has one hand on my hip, the other near my heart.
"I'd like to play hooky, take my 6th-grader to the park and get her out of that bathroom before she has to hide in a stall and pretend it's okay," I say.
"Do you need help with that?" Abigail asks.
"No. I'm going to dance out of the building and up to Central Park and 59th."
And I do that in my head. I feel viscerally how freeing it is to change that story and run to the green trees with my big sloppy heart.
"What are you aware of in your hip now?" Abigail asks.
"It feels empty," I say, "like a vast art gallery in the Village waiting to be filled with art."
It's not any analogy I ever imagined, but that's what bubbles up.
"What would you like to fill it with?" she asks.
"Sparkles," I say. "Lots of sparkly art."
My left brain kicks in. Jeez, what kind of Village gallery has sparkles? Then I laugh, because it's my sparkle art. My hip needs sparkles. The hip has spoken. I don't know what my inner wisdom will show me next, but I'll meet it with a sparkly hip.
Click here for more information about Sharon Desjarlais, CC.
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