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The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
November, 2010, Vol. 10, Issue 11
Hospice Massage: Ethical Considerations
By Ann Catlin, LMT, NCTMB, OTR
As a massage therapist, like other health care professionals, you are expected to adopt and uphold standards of practice that serve as "guiding principles" in scope of practice, client relationships, clinical decisions, and business practices.If you choose to work in hospice you enter a complex field of service that exposes you to ethical issues and dilemmas unique to end-of-life care. Of course, the standards of practice for massage therapy apply, but you will also need to be familiar with the ethical principles and guidelines found in hospice care to have a foundation from which to act. Some principles act as guidelines but many are highly individual, steeped in your own personal moral compass, providing a touchstone in situations where you search for the "right thing to do".
As massage therapy takes its rightful place in hospice care it is possible, if not likely, that you will be exposed to some ethical dilemmas of modern-day health care. Medical treatments and technology have changed the way we die in our culture. For many patients, their families as well as the professional caregiver, the experience becomes laden with conflict and moral choice.
Dr. Richard Fife,3 an ethicist, states: "In hospice care, staff members are constantly faced with the possibilities and realities of ethical dilemmas." He reports findings from a two-year study of ethical dilemmas faced by hospice staff. Some of the most common issues included:
Granted, as a massage therapist, you may not directly be involved in resolving these issues. But it's possible that you may be exposed to them. By anticipating these issues you will be more prepared and resilient when they do come up.
I will compare one area of standards of practice--the roles and boundaries as put forth by the National Certification Board for Therapeutic Massage & Bodywork6 and related ethical principle from the National Hospice and Palliative Care Organization (NHPCO)2 and how they impact day-to-day activities of providing massage services in hospice care.
Roles, Boundaries & Principle
Roles and boundaries: Adhere to ethical boundaries and perform the professional roles designed to protect both the client and the practitioner, and safeguard the therapeutic value of the relationship.
Related principle: Provide patients and their families with the highest possible level of quality end-of-life care and services, while maintaining professional boundaries that respect their rights and privacy.
Considerations for the massage therapist:
Case example: I know of a massage therapist, "Kim", who was working as an independent contractor for a local hospice organization. She was asked by the hospice nurse to see a woman with advanced Parkinson's disease. The massage therapist saw the patient for weekly sessions. I learned that Kim had, in addition, been hired by the family as a personal care attendant and was essentially "on-call" to run errands, drive the patient to doctor's appointments and stay with her in the home when the family needed to be away. Kim complained to me that the hospice had let her go because they saw her actions as inappropriate. She also complained that the family was calling on her more and more and hadn't paid her in some time. She stated that she couldn't bring herself to discontinue her service because the patient "needs me so much".
Reflection question: What is the ethical dilemma here? What would have been an appropriate course of action for Kim?
Anyone who chooses to serve those in hospice care recognizes that it is a privilege to do this profound work. Caring for the dying through the medium of touch can be an experience that forever alters your worldview of death and dying. You will be forced to examine your thoughts, feelings and behavior in this profoundly personal, yet professional work. By accepting the responsibility to explore the personal nature and impact of end-of-life care you will be more equipped to uphold the highest ethical standards of your professional role.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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