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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
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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