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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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."
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.
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.
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.
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.
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.
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.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
January, 2011, Vol. 11, Issue 01
Basic Aromatherapy: Recognize and Offer High-Quality
By Shellie Enteen, RA, BA, LMBT
I have been with Massage Today since the first year of publication in 2001. So many new readers have joined us since that first year, and many are now viewing these articles for the first time.This 10th year of publication seemed like a good time to review some of the basics of aromatherapy and begin again ... from the beginning.
It's my hope that the information and guidelines presented in this and following articles on the basics of aromatherapy, culled from more than 20 years of experience, will help propel Massage Today readers in the right direction on a journey through the wonderful, welcoming and profitable world of essential oils.
Aromatherapy is a natural adjunct to the practice of massage and one that greatly enhances the therapeutic experience. The demand for aromatherapy is booming. It has truly become a must-have modality at spas and salons, and essential oil companies are springing up everywhere.
Most schools of massage still have minimal training in aromatherapy, but massage therapists don't have the luxury of years of private research and experience to become proficient in this modality. Because of this, and my love for the essences, I became a teacher of aromatherapy CE courses for massage therapists. I then went on to develop a "Foundations in Aromatherapy" course; and after becoming a registered aromatherapist (the only recognized credential in the U.S. today in this unregulated industry), I went on to develop professional level courses that would prepare those interested in becoming registered aromatherapists, too.
Though still relatively new to the U.S., the art and practice of aromatherapy is as old as our relationship with plants. Infused oils, pomades and plant resins were used from ancient times for healing, cosmetic and ceremonial purposes. References to the properties and uses for essential oils are found in manuscripts from China, India and Egypt that date as far back as 2,800 B.C. However, since most of these substances were rare and costly, they were employed mainly in the Royal Courts and Temples, administered with ritual and invocation. Trade routes, methods of extraction and blends were closely guarded secrets.
A plant's "essential oil" is a liquid produced in small, gland-like pockets. It is called an oil, not because it has the same chemistry as non-volatile oils such as almond or olive, but because it will emulsify into fats and not water. Another term for this is "lipophilic". Essential oil producing glands appear in different parts of individual plants. Citrus oils come from the rind, flower oils from the petals and other oils from leaves, resinous bark, berries and roots.
The word "essential" refers to the fact that this liquid both contains the imprint of the plant's specific chemistry and has meaningful qualities for the plant itself.
The volatile molecules of the essential oil communicate with the plant's environment, and with mankind, through aroma and vibratory rate. Volatility refers to the ability of this liquid to change into a gas at room temperature. This is how it is conveyed into the nasal cavity and lungs. When it reaches the olfactory nerve it becomes an electrical charge which runs along the nerve pathway into the brain, activating different glands and centers. In the nasal mucosa and lungs, it passes quickly into the bloodstream.
After a long history in the Middle East, India and the Orient, the use of essential oils caught on in Europe largely as a result of contact with these precious materials during the Crusades and through increased trade routes. Although archeologists have recently uncovered a clay distilling apparatus in Egypt, the process through which we get many of our essential oils was greatly increased after glass became a more common material.
The distillation process was written about extensively in 16th century Germany. This made a large number of previously unobtainable plant essences grown in Europe, like lavender, chamomile and rosemary, available. Along with herbs and spices, essential oils were the medicines of the time and the primary ingredient of costly personal fragrances. Nineteenth century chemists, anxious to identify the active biochemical ingredients and their effects, laid the groundwork for synthetic derivatives which led to the decline of both essential oils and herbal medicine.
Modern scientific literature on essential oils began in the 1920s with the French chemist, Rene Maurice Gattefosse. He suffered a serious burn while working in his laboratory in the family's cosmetic firm and, knowing the herbal lore about healing burns, plunged his hand into an open vat of lavender (a popular ingredient in the colognes and sachets of his day.) To his relief and amazement, the burn healed without pain, blister or scarring. His subsequent investigations into the sedative and regenerative properties of lavender led to scientific exploration and testing of other essences. He coined the term "aroma therapie" to describe this medicinal aspect of the fragrant botanical component.
A great deal of medical research on the effects of essential oils now exists, leaving no doubt that when the right oil is chosen, at the right time, wonderful things can occur. It is also possible to complete medical school in France and specialize in aromatherapy.
However, there are also contraindications for essences, as well as possible sensitivities and dosage guidelines. Therapists who choose to use aromatherapy in conjunction with work on mind/body - whether in spas or private practice, as room diffusion or in massage - need to be well-educated with regard to properties and effects and to treat essential oils with the respect they deserve as a powerful healing modality. Simply adding lavender to a massage oil or using the same commercially prepared blend for every client isn't the way to go if you want to use these substances professionally and responsibly.
Many books and classes on aromatherapy are available, some for continuing education credit. As in massage practice, opinions about therapeutic applications of essential oils can vary, so try to read and hear from as many leaders in the field as possible with principles of safety in mind, so that you can form your own opinions.
And, because an individual's response to essences can differ from time to time, a good "sense" of which essence to choose can be as valuable as all the literature on properties. In order to develop this, become familiar with essences and the information directly conveyed through their aroma. Pay attention to "likes and dislikes" because it is thought that these responses, occurring in the limbic region of the brain, communicate desirability of effects.
It is also important to realize that the most powerful aromatherapy treatment is simple inhalation. Realize that through breath, you and your client receive the treatment at the same time. The greater your repertoire of essences, the more you can moderate your own exposure to certain oils. And it is advisable to use only high-quality essential oils, which means a substance manufactured and grown with integrity and without adulteration or harmful additives.
Remember, good quality essences will cost more than fragrance grade, but it is definitely worth buying them, even for room diffusion.
True essential oils range in price from extremely expensive (like melissa, rose, jasmine,) expensive (like chamomile, helichrysum, and the endangered oils of frankincense and sandalwood) moderate (like ginger, peppermint, basil) to fairly inexpensive (like lavender, rosemary, orange).
"Bargains" are not always what they seem to be in this field. You should question whether therapeutic quality is present when a wide variety of essences are displayed in the same amount (usually 10 milliliters) for the same price. Think twice when an essence you know to be very expensive is offered in large quantity at a low price. Also think twice if oils are more expensive than the usual retail price and claims are made for certain grades or exclusivity. And finally, since light affects essential oil chemistry, avoid essences sold in clear glass bottles or those that are kept in a sunny window in a store or salon.
Many factors influence quality: the method and expertise of extraction, the region of growth, a particular species of the same plant and/or extraction from certain parts of the plant may be considered better quality and therefore more costly. (Quality standards may reflect both fragrance and levels of desired biochemical components.) For example, wild rose geranium from China may be almost twice the price of the farmed variety from Morocco. Orange blossom extracted from the flower and leaf can cost almost a third the price of that from the petal alone. And you'll pay more for silver fir (Abies alba) than for Douglas fir (Pseudotsuga menziesii). As with other crops, a shortage will push the price up.
In these, and other ways, the essential oil business shares many characteristics with the wine industry. Many of the manufacturers of fine essential oils have been in business for centuries. Since plants are living organisms, they are affected by their environment and climate. Therefore, the same manufacturer can produce an essence that varies in aroma from year to year, so you can expect the same variance with true essential oils that you would from different vintages of wine.
Most distributors shop the manufacturers and repackage the essences, either singly or in blends, under their own label. It is for this reason (and because of the vast amounts of plants required to produce essential oils) that one should be wary if a distributor claims exclusivity on quality. But when distributors shop well, the results are good products that deliver fine fragrance and top therapeutic effect.
As a consumer, try essences from distributors that are recommended by lecturers or referenced by authors of books on aromatherapy or who advertise in professional journals such as the one produced by the National Association for Holistic Aromatherapy (NAHA). Compare online or in-store prices and samples. Experience will help you zero-in on the products you want to use in your practice.
The NAHA is a non-profit educational organization of peers. The organization promotes public and professional awareness of true aromatherapy and standards for practice, education and products. They can be reached by e-mail at or online at www.naha.org.
Getting the information you need and finding the right products isn't really hard work. Attending lectures and sampling essences is both interesting and pleasurable - and it will bring tangible results. No matter how you choose to use essential oils in your practice, they will add a wonderful dimension to the therapeutic experience. Understanding the world of essential oils will no doubt provide you with a growing respect and appreciation for the beauty, individuality and healing presence of our helpful neighbors in the Plant Kingdom.
Click here for more information about Shellie Enteen, RA, BA, LMBT.
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