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We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
August, 2010, Vol. 10, Issue 08
We Get Letters and E-mail
Editor's note: Massage Today received a large response to Ralph Stephens' July 2010 article, "Marching Toward Therapeutic Irrelevance", with the overwhelming majority in favor of the article. The following are some of those letters received, along with one response from Mr. Stephens.
MTBOK "Still Evolving"
We would like to respond to comments by Ralph Stephens in your July issue and correct misinformation some seem to have about the Massage Therapy Body of Knowledge (MTBOK).
The MTBOK was developed as a resource to inform and guide those within and outside the massage therapy profession including massage therapy schools, massage students, practitioners and researchers. It also is intended to inform and guide the profession in the areas of massage therapy practice, accreditation, research, certification, education and licensure. It is an evolving document and none of us should expect it to be perfect. With its publication, it is available to all--for study, comment, and improvement.
We especially want to clarify that its release does not change any massage therapy laws, regulations, curricula or legal scope of practice. The areas devoted to definitions and scope of practice are intended to speak to baseline, entry-level massage practice --taking into consideration that current entry-level standards vary widely and help define that practice. Some of the MTBOK is aspirational. The developers clearly state that massage therapists often do other things or incorporate a variety of modalities into their practices that require training and education beyond what should be expected of baseline massage therapy education.
Our profession is still evolving and so will the MTBOK. We encourage everyone connected with the profession to read the full document at www.mtbok.org and add comment and feedback at .
The eight members of the MTBOK Task Force contributed a tremendous amount of time and energy to this project; the result of which is this document. We are grateful to them for their commitment and welcome the input and guidance of the entire profession to build upon this inaugural body of knowledge for the massage therapy profession.
Massage Therapy Body of Knowledge Stewards
Medical Massage Therapist?
I agree with Mr. Stephens' comments. I live in the Tri-Cities in Washington state. There are three massage schools here that crank out multiple therapists every year. Are they well trained as medical massage therapists? They all say they are. We contacted one of the local schools a couple of years ago offering a medical massage training. We asked what that constituted and were told Soap Charting and Insurance Billing were part of the curriculum. My wife and I are both massage therapists as well as health care professionals with a college degree. We found this to be laughable. I wrote to the Department of Labor and Industries in Washington state, voicing my concerns that not everyone is qualified to see their patients.
I was told that until our professional organization comes up with a definition of what "medical massage" is, the Department of Licensing could not offer a separate license for spa and medical massage. Most of the massage therapists in town were basically taught spa massage, and they lack specific technique, clinical experience and general medical backround to be therapists. The doctors don't know the difference, the public doesn't know the difference and no one is regulating who calls themselves "medical massage therapists".
Group Health has moved in the right direction creating the "Clinical Massage Therapist" designation. Until medical massage becomes at least an associates degree it will not be taken seriously. It means nothing to the medical profession if you prove the benefit of massage therapy in one or one hundred studies. They couldn't care less. I have been a respiratory therapist since 1986. Doctors are business men with stethascopes. It's about volume, money and standardization. One day they will put you in a box, take away your individuality, narrow your scope of practice and give you a discount in the gift shop on your birthday. On that day you will have become part and parcel of the great medical system.
Disappointed and Dismayed
I just read your article in Massage Today. WOW! I've been saying that for years! I've read your articles before, (and was not offended), but this one spelled it out completely.
I have a degree in accounting, which I practiced for 20 years before becoming a massage therapist. I've been practicing for 9 years in my own massage business. I've taught in the massage schools, been a member (and officer) in my local AMTA, and sat on the massage board for my state.
This is how I see it:
When I first went to massage school, in 2001, massage therapy was just beginning to open up wide. I had great hopes and expectations for the future of massage therapy. I must say that I am disappointed and dismayed at what is happening today. The schools are charging 3 times the price for less instruction from incompetent instructors, and putting out MTs like water. Now that the FSMTB has watered down their MBLEx exam, everyone passes! Very few new MTs take the NCTMB or NCE because it is more expensive and much more difficult. I've had LMTs tell me that they could have passed the MBLEx without ever taking a massage therapy class, let alone any extensive anatomy/physiology class. So we have a lot of LMTs out there, but their abilities and education are highly questionable. It's like the box of chocolates: you never know what your gonna get!
And, we can thank the State Boards for watering down their tests, also. They love the MBLEx, because since more pass, they get more licensing fees. I don't even want to get into the politics and power struggles involved with boards and associations. It's all about money!
So, we have an influx of many LMTs, but the only ones who are making money is the schools and the State Boards. The massage therapists certainly aren't making a ton of money.
I have quite a turnover in my therapists. They don't want to work; they don't want to work when the clients can schedule (after 5 p.m. or Saturdays), they don't want to spend any money on hands-on classes so they can hone their skills or learn new ones...
I'm not sure what the answer is, but you are right! Where are all the professional LMTs who should be screaming at the tops of their lungs to make a difference? Chances are, they are afraid of the powers that be, and don't want to stir up the waters. The more mediocre LMTs, the less other medical professionals respect us. I don't blame them!
Well, I've said my piece. I wish I could say that I feel better. But, I'm glad I'm not the only one out there who sees! Keep writing your articles about the truth! Sometimes it is painful, but needs to be said.
Tina Elwood, LMT, NCTMB
Misrepresentation of MTBOK
In his July 2010 column, Ralph Stephens misrepresents the Massage Therapy Body of Knowledge (MTBOK). He says, "[The MTBOK] has become an instrument to effectively suppress clinical massage." Excuse me? Since he doesn't give the reasons why he believes that, where do I even begin to clear up his confusion? I'll simply give a counterexample: me. My practice is primarily clinical massage, everything I do is in the scope defined by the MTBOK, and my clients get spectacular results. So his claim is clearly false.
He states that, "Any therapeutic scope of practice that is left in our massage laws is being defined out of our scope by MTBOK," and, "The less we can do, the less valuable we will become in the health care system of the future." To think that defining our massage therapy scope of practice will limit what we can do in our practice is a common misconception, one that would have been clarified for Mr. Stephens if he had attended the MTBOK webinar on June 23. (Find the recording here: http://www.mtbok.org/mtbok_project_webinar.html. I highly recommend it.) In fact, you are free to combine massage therapy with other types of treatment, provided you have the training and skill to do so. So you're free to incorporate aromatherapy into your practice, or herbology, or selling fish for that matter. As long as we're clear that selling fish is not massage therapy.
He says, "'Evidence-based massage' ... will support orthodoxy, stifle innovation, and force providers to treat conditions, not people." To the contrary, the MTBOK expects massage therapists to "develop an inquiring mind and question current massage therapy practice," and encourages them to "participate in massage therapy and/or related research," so that we all contribute to an advancing body of knowledge. Which raises the question: Did Mr. Stephens even read the document?
I totally agree with him that the public needs "skilled, specific, therapeutic touch from well-trained professionals." The MTBOK is a giant step forward in raising the standards of our profession. If enough of us get behind it, it can have a major influence on massage therapy training, licensure, regulations, portability across state lines, professionalism, and acceptance by the medical community -- to the benefit of us and those we serve.
If Mr. Stephens has any informed complaints about the MTBOK, he can participate in revising it for the next version, as it is intended to be a living, evolving document. So can any of us, and I encourage everyone to do so.
Terry Kahn, BA, CMT, NCTMB
I enjoyed reading your article in the July issue of Massage Today.
I definetely agree with you!
Louise Leguizamon, LMT
Love your article! I am the last person to be considered PC which is probably why I can't keep a teaching job. Students love me, but administrators have turned education into a lifestyle preservation venture. I have even ben told "I would rather work with someone I like than someone competent"!
I applaud your efforts,
I wrote to you about a month ago through your website regarding your article. I couldn't agree more!!! The strangling of our potential to offer true healing therapeutic work is absurd and serves no one. I have been educating the general public and corporate america in fitness and health for over 30 years as a trainer, coach, administrator, and massage therapist. I have seen a dramatic decline in the willingness to explore our craft to its true value. The fear surrounding this myopic mindset is obvious and the MTBOK just adds to it. How can I help support your stance and get massage therapy where it needs to be??
Michael Alan, LMT, CPT (1996 -2010)
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