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The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
July, 2010, Vol. 10, Issue 07
The Initial Treatment: Generating Thousands to Your Practice
By David Kent, LMT, NCTMB
After nearly two decades of owning a clinic, managing therapists and treating patients to this day, I have learned to never underestimate the potential income of a new client, when their initial treatment includes the appropriate education.A client who is well-educated on the tremendous benefits of consistent massage will more than likely become a regular client. And potentially, after an initial treatment, one client can generate tens of thousands of dollars to your practice.
In the early 1990s, a client was referred to my clinic with symptoms of pain and restricted range-of-motion (ROM) in their neck and low back. During that initial treatment, I provided pain relief along with education to help the client understand why he was in pain and how continued treatments would help improve his quality of life. To this day, that same patient spends hundreds of dollars in monthly self-care treatments when he visits Florida. This adds up to thousands of dollars annually, and tens of thousands of dollars since his initial visit.
Whether you work for yourself or someone else, the initial treatment often determines the number of future appointments scheduled, the purchases of other products or services, future referrals and possibly the amount of your gratuity or bonus. This article will cover various ways to educate patients during their initial treatment to build your practice and attract patients who will spend tens of thousands of dollars.
During the initial treatment the patient is evaluating whether they should invest future time and money on more treatments. Since you only get one chance to make a good first impression, make it count. Start by being thorough and have clients complete health intake and pain intensity scale forms to document their past and current conditions. On a diagram of the body have the patient shade the areas that hurt, indicate the pain type (e.g. aching, dull) and intensity (0 = no pain / 10 = excruciating pain) they are experiencing. (Fig. 1)
These essential forms will help the patient to clarify and the therapist to quickly understand: When the pain started and what may have caused it? What has been tried in the past for relief and the results? Do they believe the condition is temporary or permanent? What movements aggravate the pain? If there has been a medical diagnosis: when, by whom, and what tests or imaging were performed? What activities of daily living (ADL) is this pain effecting and how has the pain modified those activities? What are their goals for today's treatment? (Read "Questions with Direction" MT, September 2008.)
Clients should feel confident that you understand the origin of their pain and have the information needed to implement an effective treatment. It only takes a few minutes to ask clarifying questions regarding information on their intake forms, check range-of-motion, perform prudent orthopedic assessments and take postural analysis photos.
Postural analysis grid charts make it easy for clients to see asymmetries of the body. While large charts are appropriate to hang on a wall, digital versions of charts are perfect for when wall space is limited or when you perform outcalls. And along with the digital age we live comes various digital applications to choose from. I show patients the correlation between their posture and their pain by using the screen on my cell phone. (Fig. 2) (Read "Getting Comfortable With Posture Analysis" MT, July 2008.)
A muscle movement chart allows you to immediately identify the muscles causing their postural distortions, limited range-of-motion and pain. This chart lists the muscles that shorten and contract producing movement in every joint of the body so you can breakdown any postural pattern. It also allows you to confirm the normal degrees of range-of-motion for each joint.
Review the trigger point (TrP) referral patterns that mimic their symptoms. If a client reports they have headaches that start in the temple or behind the eye, which then radiates behind the ear and into the neck, they are describing the referral pain pattern for TrP #1 in the trapezius muscle. This is one of the most common TrPs found in the body. Showing clients their pattern on a trigger point chart lets them know you understand the pain and have a plan to help. (Fig. 3)
Portable trigger point flip charts provide a professional presentation in any environment and are easily moved from one location and/or treatment room to another. The best flip charts on the market have laminated pages to prevent oils and lotions from damaging them. Note: Look for chart systems that are logically designed, easy to use and includes a muscle movement chart. (Fig. 4) (Read "Tools to Succeed for Massage Therapists" MT, May 2009.)
Training and Treatment
A solid knowledge of anatomy is key to delivering effective hands-on treatment techniques. Dissection seminars are the ultimate learning experience allowing you to see, touch and understand every tissue of the body. Attending this level of education sets you apart from other therapists. Physicians and other health care providers in your area will respect this level of study and be more willing to refer. Your therapist bio should be updated to reflect your advanced trainings. Certificates should be placed in your reception area, treatment room and/or your Web site.
Homestudy DVD programs are excellent support tools. The best dollar valued programs cost more; however, they come with accompanying photo manuals. This allows you to watch the DVD while reviewing your manual. Some systems include cross-referencing to trigger point, muscle movement and other charts.
Review and Recommend
Upon completion of the treatment, explain that it makes sense to you that they felt the aches, pains and symptoms that caused them to seek your services. Share that during the treatment you palpated the muscles, assessing and confirming your other objective findings. Review very briefly their postural analysis photos, correlating the photos to their pain intensity scale and trigger points that were identified during the treatment. Conclude your treatment with a few tips and recommendations to help them avoid this pain from returning. Show them stretches, the proper use of ice, and the ergonomic modification to be integrated into their daily routine. Now that they feel the relief of one treatment, explain that a series of four, six or more would provide much greater benefit. This is the time to explain the specials or packages that would be best for them.
Clients also realize we have extensive experience using various creams, lotions and topical analgesics. They respect our judgment and purchase the same products we use during their treatment as gifts for themselves, family or friends. Most products have a 50 percent markup and can add significantly to your annual bottom line without requiring you to perform any additional hours of therapy.
Never underestimate the future potential income a new client can generate. Be proactive and prepared by investing today for the tools and knowledge you need to educate yourself and your clients. Before you can expect clients to make a large long-term financial investment in your treatments, you must show and tell them all the reasons this is a wise and worthwhile investment. Integrating the proper patient education into your initial treatment can reap patients that spend tens of thousands of dollars with you over the years.
Good luck and please let me know about your experiences in the treatment room.
Click here for more information about David Kent, LMT, NCTMB.
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