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Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
August, 2011, Vol. 11, Issue 08
Protect Your Business: Certification & Permits
By Michael R. W. Houston, Esq.
The trend is clear — as massage therapy becomes more popular with consumers and health care professionals, more and more states are regulating massage therapy. Currently, legislation requiring massage therapy licensing or certification has been adopted or is pending in 43 states and the District of Columbia.1 Nearly two years ago, California adopted legislation providing for the voluntary certification of massage practitioners and massage therapists by the non-profit California Massage Therapy Council (CAMTC).Designed to enable consumers to easily identify credible massage therapists and ensure that certified massage therapists have sufficient training from approved schools, California's statewide standards and certification program has been a success, with more than 22,000 applications received and nearly 16,000 certifications approved by the CAMTC as of October 2010.2 For therapists, perhaps the most significant aspect of California's legislation is that it limits the type of restrictions that cities and counties can impose on certified therapists — a significant help to your business.
As a massage therapist or practitioner, you may have already received your state-level certification; a vote of confidence in your training, expertise and professionalism. However you might be unaware that many cities and counties also have laws affecting massage businesses that must be complied with, in addition to state requirements. For instance, you also must confirm that your preferred location is actually zoned for the use, and you might need to obtain a local business license and potentially, a use permit . Local zoning and permitting requirements should not be overlooked, because operating without proper local permits could lead to closure, assessment of fines and even criminal penalties. A business proceeds at its peril if it operates without first determining what local permits are required.
State And Local Regulations
Regulations for therapists vary by state, ranging from licensure to certification or registration. States also usually allow for local regulation of massage businesses. (In California, cities and counties may regulate massage businesses under California Government Code 51030. However, as discussed below, Senate Bill 731 limits the type of regulations that cities and counties can place on certified therapists.) Cities frequently handle business permits differently, creating unique local requirements under which owners of massage therapy businesses must operate.
Cities have broad power to restrict most types of businesses and might even entirely prohibit certain types of businesses. Historically, cities can heavily regulate businesses that have a tendency for criminal activity or social ills, such as bars, gaming establishments and "massage parlors." While licensed and certified massage businesses are usually good corporate citizens, cities usually have common (and often legitimate) concerns with respect to massage businesses (as they do for any other type of business), including:
Understand Permit Requirements
With that in mind, massage therapy businesses must adhere to local zoning and business licensing laws, while ensuring that a city does not take advantage by regulating them too strictly.
Therefore, as a business owner, you need to:
Do Your Homework — Investigate what city permits are needed before signing a lease or buying property. Importantly, don't take a city employee's word about local restrictions. Do the research yourself.
Get Your Permits — Obtain proper approvals before operating. In California, having state certification will facilitate this process. If you need help navigating the myriad of regulations, consider hiring an attorney. Look for a lawyer who specializes in land use and one who is familiar with both state and local requirements.
Know Your State Laws — Don't let the city "over-regulate" your business by making you get unnecessary permits. For example, in California, Senate Bill 731 (adopted in 2008) establishes a state massage therapist certification that, if obtained, protects business owners by prohibiting cities from imposing unique permit requirements on the practice of massage by certificate holders.3 (Cities can still heavily regulate non-certified businesses.) This means that if a massage therapy business is composed of fully certified massage therapists, California cities cannot impose additional permit requirements just because the business provides massage therapy.
Despite your rights in a state like California, prepare for the city to "push back" (either due to ignorance of state law or in hopes that you are ignorant of state law). Consider retaining legal counsel to help educate city officials about state law. A small investment on the front end may save you thousands of dollars on the back end by avoiding delays in opening your business.
Know Your Rights — Know how to respond if a city tries to close you down once you have opened the doors. A permit is a "property right" that a city cannot take from you without following certain rules.
More and more states are passing massage license or certification laws. Generally, such laws help legitimize massage therapy businesses by giving them credibility both with consumers and cities. However, it is unwise to overlook local business licensing and zoning laws. It is imperative that you research local massage therapy and business permit requirements. With the proper paperwork in place, you will be able to focus on your customers and your business.
Additional information can be found at:
Michael R.W. Houston is a partner at Cummins & White, LLP, a business and insurance law firm based in Newport Beach, Calif. Mr. Houston has a practice that involves advising private parties and public agencies on the nuances of developing property in California's complex regulatory environment. He has served as counsel to numerous public agencies and private parties in connection with processing permits for various types of businesses and projects.
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