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How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
October, 2010, Vol. 10, Issue 10
Managing Irritable Bowel Syndrome
By Leon Chaitow, ND, DO
This brief review of irritable bowel syndrome (IBS) management suggests that there are possible biomechanical, behavioural, as well as dietary strategies, that can commonly be helpful. IBS has been defined as abdominal pain, experienced more than once a month, associated with bloating and altered bowel habits.(Moore & Kennedy 2000) By definition, IBS is functional, that is, there is no infection or pathology associated with it. (Abrams et al 2002) It is more common in women than men, and is often associated with other chronic pelvic pain (CPP) symptoms. When IBS is chronic, core muscles (e.g. pelvic muscles) may become hyperalgesic with multiple trigger points. (Fall et al 2010)
Tak & Rosmalan (2010) discuss the role of the body's "stress responsive systems" in what has been termed functional somatic syndromes, such as IBS, as involving a "multifactorial interplay between psychological, biological, and social factors." Therefore, there is a need to move beyond a search for single causes of most conditions such as IBS, since, like many other complex and difficult-to-treat conditions, they commonly have multi-factorial aetiological features - possibly interacting with predispositions and altered stress-coping functions.
Beales (2004) has described a scenario that highlights multiple contributory factors to functional somatic syndromes: "Too much sustained, [stress] leads to the loss of internal balance, and results in reduced performance and a mind-body system in overdrive. In this state, the metabolism is struggling and cholesterol, blood sugar and blood pressure are often raised, resulting in ill health ... for instance, sufferers from irritable bowel syndrome may also commonly experience back pain, fatigue and loss of libido. Negative emotions, such as frustration and despair, can trigger exhaustion, which in turn can trigger breathing pattern disorders, as a consequence of the perceived threat to survival eliciting fight, flight or freeze reactions."
Massage offers a highly suitable stress modulating approach. (Moraska et al 2008)
Overbreathing & Colon Constriction
Ford et al (1995) have reported on the high incidence of increased colonic tone and dysfunction in hyperventilating individuals. Hypocapnic hyperventilation (low CO2 blood levels) produces an increase in colonic tone, and phasic contractility in the transverse and sigmoid regions. These findings are consistent with either inhibition of sympathetic innervation to the colon, or the direct effects of over-breathing on colonic smooth muscle contractility, or both.(Chaitow 2007)
Prather et al (2009) expand on these relationships, in review of the anatomy, evaluation, and treatment of musculoskeletal pelvic floor muscle (PFM) pain in women.
They note that persistent muscle contraction of the pelvic floor, related to noxious visceral stimulation, such as that deriving from endometriosis or irritable bowel syndrome, can lead to splinting and pain, with reduction of normal PFM function. Specifically, they report that viscerosomatic reflex activity may be responsible for increased resting tone of the pelvic floor with reduced ability to fully relax the muscle group as a whole. As a result, they suggest, adaptation occurs via recruitment of global muscles in the region (e.g. psoas and iliacus) leading to symptoms such as posterior pelvic and low back pain. Prather et al also point out that: "Proper breathing techniques, while performing exercises and activities, are essential for pelvic floor relaxation ... pelvic floor contraction during exhalation allows for synergy between the pelvic and respiratory diaphragms."
This is also a key to assisting IBS dysfunction.
In a comprehensive review of the subject Heizer et al (2009) suggest that dietary changes are worth attempting in an effort to relieve irritable bowel syndrome (IBS) symptoms. It is recommended that dietary restrictions should be introduced one at a time, beginning with any food or food group that appears to cause symptoms based on a careful patient history or review of a patient's food diary. The most effective duration for dietary trials has not been well studied, however 2 to 3 weeks is commonly suggested. A modified exclusion diet, followed by stepwise reintroduction of foods is likely to be more effective in finding problem foods, but it is more time-consuming.
General dietary recommendations for patients with IBS, based on clinical experience and anecdotal reports (Heizer et al 2009) include:
Research suggests that use of peppermint oil, particularly in cases of relatively mild IBS is likely to be of benefit in symptomatic treatment of IBS. (Capello et al 2007)
While some studies have shown potential benefit for use of turmeric (curcumin) in treatment of IBS (a member of the ginger family of plants), no placebo-controlled studies have been conducted. (Heizer et al 2009)
The conclusion of a review of the evidence for use of probiotics in both IBS and inflammatory bowel disease are cautiously positive.(Iannitti & Palmieri 2010) Two meta-analyses (Nifkar et al 2008, McFarland & Dublin 2008)) and two comprehensive narrative reviews (Wilhelm et al 2008, Spiller 2008) on the use of probiotics in the treatment of IBS. All concluded that probiotics may be useful but there are many variables affecting the results such as the type, dose, and formulation of bacteria comprising the probiotic preparation, the outcome measured, as well as size and characteristics of the IBS population studied.
IBS is common. Patients with this condition may respond well to stress reduction, better breathing patterns, biomechanical normalisation (pelvic structures) and trigger point deactivation. For more on the topic of pelvic pain in general, enhanced breathing strategies, and manual therapy, go to: www.leonchaitow.com, or blog: http://chaitowschat-leon.blogspot.com.
Click here for more information about Leon Chaitow, ND, DO.
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