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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.
June, 2011, Vol. 11, Issue 06
Caring too Much
By Ann Catlin, LMT, NCTMB, OTR
Years ago, while sitting in a restaurant with a colleague, I learned something about myself. We each worked as massage therapists in eldercare facilities and it was really nice to talk to someone who "got it." Our conversation took an unexpected turn.We candidly admitted seemingly unhealthy responses to our work — and they were quite similar: distancing more than we thought we should and feeling irritated with other caregivers. There was one thing that stands out. We each were avoiding our work by putting off seeing clients and rushing through sessions. This caught our attention because we both love our work. So, why were we avoiding it? It just didn't make sense. We had a good laugh at ourselves, got some relief and I'm grateful for it even years later (thanks, Jeff).
I now realize that we might each have experienced compassion fatigue. As it turns out, we aren't alone. Anyone in a "helping profession" is vulnerable. Nurses, doctors, counselors, veterinarians, social workers, chaplains, emergency response workers and people caring for aging parents can also experience this. Massage therapists are on the list, too. I think those of us who specialize in working with frail elders and people living with terminal illness are especially vulnerable. Choosing to serve this special population means we are sensitive people to begin with — not a bad quality to have, but maybe it means we need to check in with ourselves from time to time to avoid the toll of compassion fatigue.
Compassion fatigue is a relatively new term. Dr. Charles Figley, an expert on the subject, describes it as, "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper." He goes on to say that, "the capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work."
Compassion fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse or severe conditions. It's different than job burnout, which is dissatisfaction with our employment situation, not necessarily the work itself.
Wanting Others To Be Happy
Compassion is our feelings and thoughts when we witness the suffering of another and the unconditional desire to alleviate that suffering. The Dalai Lama describes compassion as the "wish for another being to be free from suffering and wanting them to be happy." He also tells us that sometimes we confuse compassion with attachment, which is our own personal investment in the outcome of the situation. In other words, when we think we are feeling compassion, we actually are wrapped up in our own emotional needs rather than simply being open to the needs of the other person. Perhaps it's attachment that leads to compassion fatigue, not compassion itself. In my experience, when I truly feel compassion, I'm uplifted and it does my heart good. I feel love.
A perfect illustration of this happened just yesterday to a massage therapist named Jane in a workshop taking place in a long-term care facility. When Jane walked into the elder's room, she was stunned when she took in what she saw — an extremely thin, emaciated woman with severe bruising and discoloration on her arms and legs sitting in her wheelchair, alone. Jane described her first reaction as fear, which turned to sadness for this woman's condition and knowing that she really couldn't do anything to change it. But she conjured up the courage to stay present and focused her attention on this woman rather than the outer condition. The fear softened. She gently massaged the woman's shoulders and neck and she told Jane, "that feels good." Jane shared that following the session, instead of fear she felt good knowing she had made a difference by connecting with this woman. She was able to drop the attachment to the fear and sadness which allowed her to be present and both she and the elder were uplifted in the process.
Knowing the Signs
How can you recognize compassionate fatigue? Some of the symptoms might seem like "normal" stress responses and you might associate them with your work. After all, we live in a pretty stressful world these days. Some characteristics of compassion fatigue include:
Recognizing our vulnerability to these symptoms is important. How can we avoid this reaction or ease them when they happen? The answer lies in holistic self-care. Advice about self care typically includes physical support like regular exercise, getting enough sleep and good nutrition. However, we shouldn't stop there. Nancy Jo Bush, an oncology nurse, says that holistic self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one's spirituality and finding hope. The experts agree that reaching out to others and developing a support system is critical. Who would you turn to if you needed the support of an understanding friend? I personally like the advice from a practitioner working in hospice who says, "lighten up and don't forget to laugh."
That reminds me of an old Joni Mitchell lyric, "laughing and crying, you know it's the same release." Thanks, Joni. We'll all try to remember that!
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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