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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.
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.
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."
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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.
April, 2010, Vol. 10, Issue 04
Does Your Staff Support You or Weigh You Down?
By Jenn Sommermann, LCMT
One of the most challenging aspects of being a business owner is managing staff. Interviewing, hiring, training, overseeing, motivating and sometimes firing staff, can take countless hours.Some wonder if it is even worth it. It can be a very lucrative part of any practice, if handled correctly. But it can also be a nightmare, especially if the staff member doesn't work out well and puts a burden on the practice. Getting the right staff member in the first place is the key to success. In the scheme of things, most of the energy should be spent on the hiring. It isn't about a warm body to fill the therapist's spot; it's about the right person. The concept of team is critical when you are looking to bring on a therapist. There are many things to consider.
As I mentioned, hiring is step one and where a good part of your energy should be spent. I used to conduct a verbal interview with a candidate first. This was level one and in the interest of not wasting anyone's time, a verbal interview weeded out most folks. If I was impressed by the verbal interview, a second hands-on interview was conducted. The interviewee had to perform a 40-minute massage on me and teach one exercise. If there was a tie between candidates, a third massage interview was performed on one of my staff members so they could have a voice in the decision process. I was never trying to replace or duplicate my hands. Moreover, I was looking for someone to "complete" the existing practice; a team member who would fit with the model I had established. To me, the team concept was far more important than finding someone who could perform an identical massage to me.
Another criterion important in my hiring process was the candidate's business etiquette and professionalism. Dress code, hygiene, timeliness and speaking voice all played a roll. Manicured hands tell a lot about how someone cares for their "tools." It was also an indication of how they would care for my equipment. My office was run in a very specific way and it was very successful. I needed a therapist who was willing and able to follow my format, accurately and with pleasure. Notice again, the focus was not on technique. I trusted the technique was there and short of giving a lousy massage, I opened myself to the possibility that there are enough clients for everyone's style.
Once hired, training started right away. It has been my experience that therapists want a fair wage and as much autonomy as possible. Even though they were working under the umbrella of my practice, I allowed them to feel like they were running their own business as independent contractors. The training that occurred was largely based on how I ran the office, what the expectations were, how to chart client notes, and shared marketing efforts. Again, there was not much emphasis on technique because I wanted the therapist to feel as if they could do their own thing.
After a certain amount of time and once I had gained confidence in the therapist, I let them fly solo. I stopped reviewing their notes and allowed them to schedule their own appointments. This gave them freedom and flexibility, creating a further sense of autonomy. With this vote of confidence came years of loyalty, as my therapists often commented that working for me was the best of both worlds.
Weekly staff meetings kept motivation high. However, there were times when one therapist could bring the entire staff down with negativity. You know what it is like sometimes. The phone doesn't ring so you obsess about it. The more you obsess, the more the phone doesn't ring. It is a vicious cycle. Basically, what you focus upon expands. If the negativity is left to perpetuate, it can grow and spiral out of control. One person can have a large effect on an entire practice. Nip this in the bud. If necessary, single that therapist out and train them to stay positive. Remember, this is a team sport, and if that person cannot commit to a positive attitude, they may not be the right fit for the practice. In this case, do what you have to do. That might mean this therapist needs to find employment elsewhere. It may sound harsh but, remember, this is your business. Your income depends on it.
Most of my staff worked out well and stayed with me the entire time I had my group practice. Some even remained after I sold my business, because the new owner followed my business model. I am proud that I was able to provide an environment that warranted loyalty and dedication. It was my greatest business success.
That being said, I did have to terminate someone once. It was one of the hardest things I had to do, but it was absolutely necessary to the success of my practice and the success of my therapists. If you find yourself in this case, talk to someone. Rehearse what you will say so you feel confident going in. Be kind but be firm. Remember, this is for the team.
A good staff can make your life much easier. If you put the time in to find the right people, you will feel supported and can be quite successful. If you find you have made a poor decision or the therapist is not the candidate you anticipated, cut your losses early. Don't linger with this decision, as it can affect the entire team and business model. Ultimately, you want a staff that can support you, lift you up and, when appropriate, fly solo. A staff that weighs you down is bad for everyone.
Click here for previous articles by Jenn Sommermann, LCMT.
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