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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.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
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.
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.
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
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
March, 2011, Vol. 11, Issue 03
Desexualizing the Touch Experience: A Proactive Approach
By Cherie Sohnen-Moe
Sexuality is a natural part of the human experience. We are born as sexual beings with a need for touch and intimacy. We require a healthy environment that supports our natural development in these areas to thrive as organisms.By definition, sex, touch and intimacy are three distinct behaviors and experiences. The fact that they overlap at times is what creates confusion.
In the September issue of Massage Today, I wrote about what to do when a client crosses the line. The focus of that article was on the specific steps to take when your boundaries are ignored. This is the first part of a two-part series where we explore the importance of desexualizing the touch experience and steps you can take to help prevent clients from crossing your boundaries.
Sexuality and the Touch Experience
The general public, clients and practitioners all share in the confusion about how massage therapy and sexuality are inter-related. The intentional misuse of language (e.g., massage as a euphemism for prostitution) has had a profound impact on the public's understanding of massage therapy. The misuse of words is not just a semantic problem; it is a personal and cultural issue about how people relate to certain parts of the body and human experience.
Unfortunately, we have been forced to spend the past three decades defending our profession and proving to the world that massage therapists are not prostitutes. One of the repercussions of this has been a dissociation with the sensual aspect of our work. Too many people attempt to ignore the elephant in the corner. This denial can lead to problems. Pretending that something doesn't exist is generally ineffective. Every client and every practitioner brings their sexual nature and background with them into the therapeutic setting. The key is to create an environment that demonstrates professionalism, sets healthy boundaries, and allows sexuality while desexualizing the touch experience.
The term desexualize is best defined by examining its opposite: sexualize. In the book, Behind Closed Doors: Gender, Sexuality & Touch in the Doctor/Patient Relationship by Angelica Redleaf, DC, she defines sexualizing as: "Making an event, procedure, conversation, or experience into something that is sexual or could be interpreted as sexual." Desexualizing, then, means ensuring that the treatment is not in any way turned into a sexual experience for either the massage therapist or the client. Keep in mind that while correct intentions and acting professionally does not guarantee the absence of inappropriate expressions of sexuality in treatment sessions, they can mitigate those expressions.
Proactive Steps to Desexualize Massage
You set the tone for professionalism by your marketing materials, how you answer the telephone, your personal appearance, your office location and ambience, treatment interactions, communications, and documentation. The first part of this series covers how to desexualize your marketing materials and to screen telephone calls--steps to take before someone becomes your client.
Marketing materials (e.g., brochures, business cards, Web site, business name, e-mail address) need to be professional and project the desired image. Use appropriate language and terminology. Avoid phrases like "full-body massage". Even words such as "release" can be taken out of context. Be sure your photos and artwork are not provocative: view pictures from all angles because sometimes images look fine from one direction, but suggestive from others. Ideally, have your picture taken by a professional photographer, but refrain from using "glamour" shots.
Now let's discuss your business name. Many massage therapists use their personal name as their company name. This is a fine option; although, if you go this route, I suggest you use your full name and include a title. For instance a business name that says "Terry Smith, LMT" sounds much more professional than "Massage by Terry." Use caution if you decide to have a separate business identity: avoid anything gimmicky or that could have a double meaning. Also, verify that your business name doesn't mean something derogatory in another language.
Set up a separate business e-mail account from your personal account. Either use your name, company name, or the type of work you do as the first part of your e-mail address. I have seen way too many examples of therapists with business e-mails like or . I'm a rock-and-roll gal who has a healing touch, but I wouldn't use either of the above examples as my business e-mail address.
Recently, I discussed this topic in a marketing class that I teach and had people critique each other's e-mail addresses. One woman's e-mail was . As soon as she said it out loud there was a lot of snickering in the room. She didn't get it; the year 1969 was very important to her. She failed to realize how the number 69 has a sexual connotation and that using that e-mail address for business could send the wrong message. Ideally, you would have a business Web site and your e-mail address would reflect that (e.g., ).
Brochures and Business Cards
The main ethical concerns are that the language and images convey professionalism (as described in the section on Marketing Materials). Before choosing images for your brochures or business cards, have other people look at them and tell you what they think they are. I've seen many photos that I've had to turn sideways or read through several paragraphs of accompanying information before I could figure out what the photo was depicting.
In addition to the cautions covered in the above section regarding professional images, you need to be careful with the links you include on your site. Besides the links no longer being active, sometimes a link that originally went to one site, all of a sudden takes you to a totally different site. This can be a purposeful act of misdirection by an outside source or I suppose something just went haywire (to use a technical term). For instance, there was a legitimate massage school that we had been dealing with for years, and one day while looking up their site, my staff noticed it linked to a porn site. We contacted the school and they were horrified! They fixed the problem, but were left uneasy not knowing how long it was linking to that site. So, in addition to periodically checking the links you list on your site, make sure that you check your own internal links.
Every time you answer the telephone, you create an impression. The question remains what that impression will be. Within the first few seconds of a conversation you convey how you feel about yourself, your practice and the caller. Just because the caller can't see you doesn't mean that s/he can't sense the attitudes you convey through the tone of your voice and the words you use.
Develop a script for how you answer your phone so that you always portray professionalism. Avoid fumbling. During an initial conversation with a potential client, you have an opportunity to gather essential information that can save a lot of time and trouble down the road. Always ask about their massage history, and briefly describe your protocol, the type of benefits they can expect, and a bit about your education, experience and/or philosophy. Know how to concisely describe what you do and your policies in a professional tone.
Handling Inappropriate Calls
Receiving inappropriate calls can be a source of immense discomfort. Unfortunately, many massage therapists still get calls from people who are ill-informed about the nature and scope of this work. Sometimes people are indirect about wanting sexual services. You can often determine inappropriate callers by their tone of voice, awkward periods of silence, calls placed late at night and if they request late-night appointments (unless it's a situation such as you are providing after-performance massage for a dance troupe). A common tip-off for massage therapists is when a caller requests "full-body massage" or the direct request for a "happy ending." Beware of callers that are reluctant to give their full names or phone numbers.
You have three main options of how to respond when someone calls requesting sexual services: you can get upset and hang up the phone; you can calmly state that you do not provide sexual services and end the call; or you can use it as an opportunity to educate the caller. Trust your instinct as to which option to choose, as it might vary with each caller.
If you receive this type of call, it works well to stay centered in your professionalism. If people want sexual services, that's their prerogative, but they don't have the right to expect it from you or any other massage therapist. Tell them that isn't what you do, give a brief description of the services you do provide, and let them know that a legitimate massage therapist does not perform that kind of work. This type of statement usually results in the caller hanging up if they are truly interested in sexual services or simply get their kicks from making the equivalent of prank phone calls.
You might want to develop an additional script for how you handle these inquiries, thus avoiding any misunderstandings or unwanted clients appearing at your doorstep.
For instance, if you feel that they might not be a true sexual predator, you could suggest they visit your Web site for more information and then if they want a non-sexual massage they can call back. This gives the callers the opportunity to learn more about massage or gracefully remove themselves from the conversation. Who knows--just because they want something you don't offer doesn't mean they might not want a legitimate massage in the future or don't have friends who want a professional massage. Remember, these are the people we really need to educate. They are the ones perpetuating the myths about massage and the entire healing arts field.
You can transform a potentially negative experience into a positive one by responding professionally and keeping perspective. Still, you must put your safety first. It's best NOT to set up an appointment with this type of caller if you are the only person in your office or do outcalls.
The information I shared in this article sets the foundation for understanding the concept of desexualizing massage and steps you can take to project a non-sexual image in your marketing materials and telephone conversations. Part two explores the steps you can take to create a safe space and desexualize the massage experience with clients. This includes topics such as personal appearance, your office location and ambience, treatment interactions, communications, and documentation. In the meantime, if you have any questions or comments please contact me at www.sohnen-moe.com.
Click here for previous articles by Cherie Sohnen-Moe.
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