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Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
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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