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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.
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.
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.
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?
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
June, 2010, Vol. 10, Issue 06
Heating Up Your Practice Safely: Feedback From Readers
By Dixie Wall, Contributing Editor
After receiving many compelling comments to the two-part series, "Heating Up Your Practice Safely," I was inspired to publish some of the common questions and insightful comments I received. As always, I appreciate your questions and comments and am always open to being educated by my readers.
"Thank you for the much-needed article on safety while using heat during massage therapy. I would just add multiple sclerosis to your list of conditions in which to avoid heat. Though it is considered to be an auto-immune condition, some may not know that and cause great harm. Thank you so much."
Thank you for your response to my article. Multiple sclerosis is an important addition to the list of diseases contraindicated for heat therapies. Multiple sclerosis is a chronic, often disabling auto-immune disease that attacks the central nervous system, which is made up of the brain, spinal cord and optic nerves. More specifically, the body's own defense system attacks the myelin sheath (the fatty substance that surrounds and protects the nerve fibers in the central nervous system) leading nerve fibers vulnerable to damage. The injured myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is interrupted by scar tissue, nerve impulses traveling to and from the brain and spinal cord are distorted or incomplete, producing the variety of symptoms that raise a red flag for heat therapies. Among these are numbness, tingling, weakness, spasticity and unsteadiness of a limb. Fever, hot baths, sun exposure, and stress have all been associated with triggering or exacerbating an attack. Thanks for your contribution.
"I enjoyed your article in this month's Massage Today on hot stone therapy. I practice in Florida and as of March of this year my liability carrier (International Massage Association) announced that due to the increase in claims due to burns, they will no longer cover hot stone therapy. I have talked to other massage therapist with different carriers and they have had the same response. I've also noticed in various spa advertisements that they have dropped hot stone therapy from their ads as well, and one has changed from hot stone to warm stone.
"I have wanted to take a course for some time now but am shying away from doing so because of the change in policy. My question to you is, if the client signs a consent form and ends up with a burn and the therapist is not covered, what the legal ramifications would be. Of course this would have to happen now! Thanks for your input and I look forward to your forthcoming articles."
It appears as though your current massage malpractice insurance policy no longer meets your individual needs. I don't give legal advice, but I do know it's never wise to gamble with one's livelihood by carrying a policy that does not cover all the modalities you practice. It may be time to switch insurance carriers.
"I think you have pointed out a lot of great things in your article about hot stones. I would have liked to have seen something about the hygiene, i.e., how to care for the stones, cleaning and sanitation, since the stones are kept in the perfect environment for bacteria to flourish."
Thank you for your response. You bring up a crucial issue. Due to the increase in bacterial and virus outbreaks over the last decade, the Centers for Disease Control & Prevention (CDC) has put a major emphasis on hand washing and routine sanitary procedures, especially in health care settings. Hospital and clinical settings are a major cause of the spread of many of these "super bugs." Unlike the common cold or a flu virus, these new super bugs spread by direct skin-to-skin contact or with contaminated objects. Carelessness or lack of proper sanitation procedures may make the massage therapist a perfect route for transmission of infection.
According to the South Carolina MRSA Infection Protection Act: "Methicillin-resistant Staphylococcus aureus (MRSA) is a common staph infection which is resistant to many antibiotics and which is increasingly prevalent in health care settings. A study published in the 2007 issue of the Journal of the American Medical Association, found that MRSA infections occur in approximately 94,000 persons each year and are associated with approximately 19,000 deaths; approximately eighty-six percent are health care associated."
In our practices, we have an obligation to ensure each client is protected from these "super bugs" with the safest routine clinical procedures. Different practitioners have their own unique way of sanitizing and/or cleaning their stones and massage tools. Some boil their stones in salt water or wipe with alcohol, others scrub the tool with soap and hot water. I've even heard of therapists using the dishwasher to sanitize the stones. With all the different methods of sanitation what is the safest standard procedure?
One of my teachers, Jenny Ray at Sacred Stone Therapy, has provided me with the latest information on sanitary procedures from the Geothermal Therapy Association (GTA). According to Ray, "The CDC has recently approved GTA recommendations as sufficient for protecting the client from H1N1, HIV AIDS, MRSA and other staph infections. The recommendations are as follows:
Stones should be washed as soon as possible after treatment, as the longer the oils and bacteria stay on, the harder they may be to remove. The critical issue is that the antiseptic routine must be done between each individual client. For more information, refer to the GTA Web site at www.stonewalkersassociation.com which will soon be moving to www.geothermaltherapy.com.
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