resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
January, 2011, Vol. 11, Issue 01
Practice Building: Getting Inside Your Patient's Head
By David Kent, LMT, NCTMB
What makes your outcall, chair, spa or clinical practice different from the others in your area? Implementing systems that make your practice standout from your competition are fundamental to insuring success.When a client experiences an appointment, there are many things that leave unique lasting impressions. However, what triggers a client to reschedule, return and refer? Let's look at a few subconscious triggers our culture and society has taught our clients to expect when visiting a health care provider. Then we will outline ways to integrate these systems into your massage therapy practice so your clients reschedule and refer new business.
Throughout life when we have pain or other symptoms we go to the appropriate health care provider. For example, we go to a dentist for a toothache, a family-care physician for the flu, and a chiropractor for a vertebral subluxation.
Patterns: Over the years, various doctor visits have taught us recognizable patterns that we now expect when we go to a health care provider. Typically, we arrive at their office and check-in, payment is confirmed, and then complete intake forms that include: health history, current symptoms, height, weight, blood pressure and so on.
Physiology: If the function or physiology of an organ system is in question, the health care provider will test and measure levels in the blood and urine. These levels are compared against established normal ranges for variations sending up "red flags".
Anatomy: Likewise when the form or anatomy of the body is suspect, they evaluate the structures utilizing an array of techniques from a palpation exam, orthopedic and neurological assessments, range-of-motion and muscle testing, to name a few.
Imaging: Some imaging such as X-ray, MRI, and ultrasound provides an internal view of the anatomy allowing us to see: a broken bone, a tumor and other abnormalities in the body. (Image 1) "Before" and "after" photos are commonly used by many medical specialties, from reconstructive to cosmetic surgery, because they document measurable change from start to finish.
Findings: The health care provider proceeds to explain the origin of your symptoms while referencing the tests, imaging and photos as supporting evidence. They often highlight or circle the high and low markers on the reports that indicate abnormalities. They often point out specific areas on the X-rays, MRIs or photos of the structures involved. (Image 2) Finally, they present the solution in the form of a treatment plan. Read "The Initial Treatment: Generating Thousands to Your Practice" (MT, July 2010).
Integrating Patient Expectations
Besides experiencing the above scenarios themselves, how many times have our clients also watched it repeatedly on TV and in the movies? The bottom line, our clients expect their health care provider to gather information with intake forms, listen to their history and evaluate their current condition (subjective component), followed by palpation, assessments, tests and imaging (objective component). All findings and tests are reviewed (assessment). Finally, we are told the treatment options (plan). Being aware of these patterns allows you to implement similar systems into your massage therapy practice. Let's look at each component and understand how it applies to you.
Subjective Component: Regardless of where you work, the acronym, OPQRST is a helpful system to efficiently guide the documentation of our client's subjective complaints. The following is a breakdown of that system:
Onset: When did the symptoms (pain, tension, restricted range-of-motion) start? What were they doing immediately before or leading up to the time the symptoms began?
Provokes: What activities or movements cause the pain and/or symptoms to start or get worse? What makes it better?
Quality: Describe (using the patient's words) the phenomena they are experiencing. Terms might include but are not limited to: pain, aching, burning, stabbing, numbing, pressure and tingling.
Radiates: Where is the pain? Does the pain radiate? If yes, where?
Severity: Have the client rate their current level of pain on a scale of 0-10, with 0 = no pain and 10 = severe pain.
Time: When did the current pain start? How long has the condition existed?
Completion of an intake form, questionnaire and pain scale is followed by the therapist reviewing OPQRST, providing a professional initial impression that is effective, thorough and customary to the client.
Objective Component: Now that we understand the client's symptoms, we can start the investigative process of determining other contributing factors. The first step is to identify what parts of the body are functioning abnormally. Orthopedic assessments are quick, easy and effective ways to test for musculoskeletal abnormalities or impairments. (Image 3)
Postural analysis photos are excellent for documenting posture, educating clients and customizing treatment plans. Keep the process simple, the camera and screen built into many cell phones can be both a powerful assessment and education tool. (Image 4) They allow you to instantly take, review and zoom-in on a picture. Showing a client their posture adds a whole new meaning to the saying "a picture is worth a thousand words". The visual impact for the client to see their high shoulder, forward head or collapsed abdominal posture is a powerful educational tool that makes a lasting impression of your ability to identify, understand and address their problems.
Assessment: Looking at the anatomical facts allows you to establish a clinical impression or assessment, so you can create a logical treatment plan.
Plan: Just like other health care providers, you must proceed to explain the origin of your client's symptoms and a solution while referencing the tests (orthopedic, range-of-motion) and postural analysis photos as supporting evidence. Read "Tools to Succeed for Massage Therapists" (MT, May 2009). It is important to "connect the dots" on a level the client can easily understand. The client must feel you understand the origin of their pain and can implement a successful, goal oriented, treatment plan. Here are a few tips:
Highlight: Highlight or circle items on the intake forms, questionnaires and pain scale of significance. Review each item with the client and take notes as appropriate.
Focus: Like doctors and other health care providers utilize X-rays, MRIs or CAT scans to educate patients, draw conclusions and design treatment plans. Make it easy for your clients to understand the stresses their musculoskeletal system is enduring by zooming-in on different postural analysis views and explain how your treatments can help. (Image 5)
Explain that muscles help to determine the location and position of bones in space, so by looking at the client's posture along with various assessments, we know which structures (muscles, ligaments, joints, nerves, etc.) are being stressed or compromised.
A lateral view photo makes it easy to show a forward head, rounded (protracted) shoulders or a collapsed abdominal posture. An anterior view photo will quickly identify the presents of a fallen arch, high shoulder, and much more. Use the photos to create measurable treatment goals. Read "Getting Comfortable With Postural Analysis" (MT, July 2008).
Correlate: Myofascial Trigger Points (TrPs) can form and be perpetuated for numerous reasons. Poor posture is one contributing factor. The formation of trigger points in the trapezius muscle is easy to understand when we cross-reference the posture photos.
Use visual aids like trigger point wall or flip charts to educate clients of referral patterns. Reviewing trigger point patterns with the client builds trust and confidence. Clients find it comforting to see their pain pattern on your charts. (Image 6) Explain how your treatments can help to address trigger points.
Reinforce: When a client asks during or after a treatment why a muscle is tight or tender, take this opportunity to briefly reinforce the connection between their posture, limited range-of-motion, trigger points and pain. Teach clients stretches, movements and offer tips that support their therapy.
Sample: A dental hygienist gives you a new toothbrush and floss at the end of a cleaning. Similarly, a medical doctor often gives patients drug samples. In similar fashion you can provide samples of topical analgesics. One company will supply to you, free of charge, brochures with a sample packet attached with you name and phone number printed on it. This is an easy and inexpensive way to promote you business. Selling topical analgesics can provide addition income.
Thank: It only takes a moment to say "thank you" or a few minutes to send a note. It is always nice to be acknowledged and feel appreciated. Read "Building Raving Fans" (MT, April 2008).
Society has taught your clients what to expect when visiting a doctor or health care provider. With this knowledge you can integrate the above systems into your practice to standout from the competition while triggering your clients to reschedule, return and refer. Ultimately, you must present the solution in the form of a treatment plan.
Click here for previous articles by David Kent, LMT, NCTMB.
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