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Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
September, 2010, Vol. 10, Issue 09
Take It From Your Peers: You CAN Get Paid to Work in Eldercare and Hospice
By Ann Catlin, LMT, NCTMB, OTR
My last article focused on keys to opening doors to eldercare and hospice. If you desire to work in these settings, my guess is you have wondered: 1) How do I get my foot in the door? 2) How do I generate a clientele? 3) How can I get paid? All very valid questions! A few months ago, Massage Today conducted a poll asking two questions: "Do you provide massage to people in eldercare or hospice? If so, do you provide this service as an employee, independent contractor or volunteer?" Here is what we learned from the 249 people who responded:
The good news is that long-term care and hospice organizations are including massage therapy services more than ever before. I'm honored to be a part of this trend and to assist folks like you along your path of service. I thought you might like to hear about therapists who are doing this rewarding work - and getting paid for it either as independent contractors or employees. I interviewed several massage therapists to find out how they are being compensated. Read on and learn from your peers what you might expect when working in this field. (To respect privacy, I have changed the names of the therapists and have not named the organizations.)
Jill, LMT, contracts part-time with a hospice. Hospices are structured as either for-profit or non-profit and this particular hospice is a non-profit organization. Funding for massage services come from grants and endowments. Jill receives referrals from either the nurse or social worker who obtains a doctor's order for massage therapy. Each patient is initially referred for an assessment session plus four visits. Jill can recommend continuation of services beyond the four visits. She has a consistent caseload of six clients and typically sees each client weekly; however, some are seen more often based on needs. Sessions last usually 30-40 minutes. Jill is paid $40/session, plus mileage. She educates the staff about her services by regularly presenting at staff meetings as well as sharing printed information. She reports that this has helped generate appropriate referrals and build relationships with other caregivers.
Doreen contracts with a 100-bed skilled nursing facility for 12 hours per month. The facility administrator acknowledges the value added by providing this amenity for her residents. The funds for massage come from a combination of general operations and marketing budgets. Doreen has permission to work with any elder in the facility. The medical director must approve of all resident activities and massage therapy is considered a resident activity in this facility. When Doreen arrives at the facility she checks in with the social services or nursing director who make referrals. Elders are selected based on needs such as pain, agitated behavior, social isolation, or newly admitted to long-term care. Sessions range from 15-45 minutes. Session documentation is kept in the activities department records. Doreen is compensated at a rate of $60/hour. She occasionally provides seated massage for staff upon request of the administrator for the same hourly rate.
Mary, LMT, contracts with a 60-bed skilled nursing facility. She has taken a creative approach. Like many facilities this one has a number of elders living there whose care is paid for by Medicaid. (Medicaid is the state-operated public assistance program that pays for health care for people with low income. Some states may have another name for it.) People who receive Medicaid benefits get a monthly personal needs allowance, which is a set amount of money each month for things like clothing, toiletries, recreation, snacks, etc. (For example, Missouri's allowance is $30/month.) Many people who receive this allowance don't use much of it and it builds up in an account. An individual must use the money or the benefit is reduced or discontinued. Mary is paid with money in the client's personal needs allowance account. The nursing home administrator refers residents who have money in their account. But the referral is not just based on the funds being available. People are referred based on needs. Mary has educated the administrator about the benefits of massage for frail elders and, together, they determine a plan of care. Reasons for referral include anxiety, depression, pain, dementia, social isolation because of lack of family. Massage sessions are scheduled either weekly, bi-weekly or monthly. Mary reports that sessions range from 15-45 minutes and she is paid a set fee per session. She consistently has a caseload of six clients.
Rita is a massage therapist employed by a for-profit hospice working part-time 20-25 hours/week. She is expected to actively participate in interdisciplinary team meetings where patient care plans are discussed. Her involvement in these meetings results in referrals. All patients and/or families are informed about complementary services and they often request massage upon admission. Rita's current caseload is about 23 sessions/week and each session lasts 40-50 minutes including documentation time. This hospice organization pays for massage services from the Medicare funds it receives to care for patient needs. Rita earns $24/hour plus mileage for travel. She also receives benefits for paid time off including vacation and holidays. She found this position through an online job search service at SimplyHired.com. She reports that because she had specialized training in massage for people in later-life stages was what secured the job. The massage program has been so successful that they have recently hired a second massage therapist!
Cindy, LMT, is employed full-time at a continuing care community that offers multiple levels of care including independent living, assisted living and skilled nursing. Cindy is considered a part of the rehabilitation/wellness department. She has a massage room within this department where she sees clients consisting of independent older adults and facility staff, as well as people from the community. Elders who are admitted to the facility for rehabilitation following an injury or illness benefit from massage therapy during recovery. She also sees elders in the assisted and skilled nursing facilities where clients are referred by staff and families. Clients pay the facility for massage which creates a revenue source for the organization. Cindy receives a salary of $45,000 plus paid time off and health insurance benefits.
A New Age of Care
In the last decade, massage therapy has gained recognition and acceptance. Hospice and long-term care facilities are recognizing the value of adding massage therapy services. Therapeutic massage is growing as a form of wellness care for older adults. Organizations that incorporate massage therapy as an ancillary service are on the leading edge of what will become standard in the future of care services and will meet customer expectations. Perhaps you will join me in ushering in this "new age" of care!
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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