resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
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 more information about David Kent, LMT, NCTMB.
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