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Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
November, 2011, Vol. 11, Issue 11
Challenging Sacred Cows
By Ralph Stephens, BS, LMT, NCTMB
Some big changes are coming in the regulatory and professional development areas of our profession. While we are making these changes, it is time to have an open discussion about several "sacred cows" that tend to come along with regulation.
The first is continuing education. I am a huge believer in continuing education, especially for a profession that has such an abysmally low entry-level education standard. However, there are two ways to go about it, forced and voluntary. Which is best?
In a series of columns some years back (November 2006, January, March, and May 2007 issues of Massage Today), I explained that professional regulation of healthcare professions (licensing) hides under the mantra "to protect the public." The "safety of the public" is supposed to be the reason for licensing. This is utter nonsense and typical government-bureaucrat double-speak. Never has the public gone to the legislature demanding protection from a healthcare profession, or probably from any other profession. It is always the profession(s) going to the legislature begging for a government-granted monopoly to practice their discipline without competition. The "public safety" line justifies regulation and allows government to expand (revenue and staff) and the profession to control entry into the field while mandating professional development (cash flow). Never believe what bureaucrats and politicians say. Carefully observe what they do and its effects. There lies the truth – it's a form of outcome-based education.
The classic and most obvious example of this is the fact that medical doctors and their system, regulated by the state's medical boards, are allowed to kill more than 250,000 people a year through mistakes. This is by their own figures. That's more people killed by doctors than by guns, drunk drivers and wars combined each year. The public isn't being protected at all, the profession is. Try to discipline an MD. You have to go through the medical board. Same for all licensed healthcare providers. Regulation is really to protect the profession from the public. However, if for the sake of discussion we accept the public safety premise, is there ANY evidence out there that mandatory continuing education hours have any positive effect on public safety? The Pew Foundation did a study sometime ago and could find no evidence.
Are some people being injured by massage therapists? Of course. However, there is virtually no documentation of massage related injuries. Many experienced therapists, including this author, report anecdotally helping people recover from injuries received at the hands of other therapists. It is happening. The question becomes, is there any reason to believe that mandatory continuing education will prevent or lessen any of these injuries? If there is no documentation of injuries from massage, no documentation that continuing education would prevent injuries that might be occurring, and no documentation that continuing education protects the public, why is it mandated in our statutes?
The obvious answer is professional development. We have such a low entry level we need further training some say. But do we really "need" it? If a massage school graduate wants to function at entry level and just give nice soothing, general, non-specific massages for the length of their career, do they really "need" continuing education mandated for license renewal? If they cannot do that safely without forced CE Hours, maybe we need to raise our entry-level standard. It is time to have this discussion, factually, and make the decision based on evidence. While I am not a fan of evidence-based medicine, for decisions like this, I am a believer in no more government regulation than necessary. This is a discussion we must have and now is the time.
Why now you ask? Because the Federation of State Massage Therapy Boards (FSMTB) along with other stakeholders in our profession are about to create a new continuing education provider approval process and FSMTB is also writing a model massage law. Also, the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) is currently revising their continuing education provider approval process. Now is the time to review our concepts of regulation before these documents are written, as it will be very difficult to change them once implementation starts.
How much continuing education do we really need to renew a license to practice massage? Is there any public safety reason for mandatory CE Hours? Maybe mandatory CE hours should only be for true public safety issues like CPR-First Aid, abuse reporting, etc.? However, do those courses really improve public safety? Prove it!
How many LMTs have used CPR-First Aid on a patient in their practice? How many people have been "saved"? Is the time and money invested giving any return other than to the providers of the classes? Do we really need CE provider approval at all? If so, why? Virtually every provider that applies gets approved. All that is required is paperwork filled in correctly and money, so what's the point?
While we are at it, do approval processes for continuing education providers in any way protect the public? Where is the evidence one way or the other? Provider approval has become a cash cow for the NCBTMB and some state boards. More and more state boards are getting into the act. It is merely a tax. This time consuming and expensive tax gets passed along to those who take continuing education courses. Is a continuing education class any better at protecting the public or promoting professional development because some instructor or quite commonly a school administrator can fill in a bunch of paper work and submit a fee? Once approved, the worst provider and the best are equal.
Please note, I have not advocated any position on these issues. I will do that in my next column. In this article I want to stimulate your thoughts, your input and your involvement. We can talk about it here in the pages of Massage Today, and I am sure we will, but it will be best, and most influential, if you send your input to: the FSMTB ( ), ABMP ( ), AFMTE ( ), and AMTA ( ) as well as other stakeholder organizations. This is your chance to be heard, to have real input on the future of this, your profession. A stakeholders meeting is coming up soon, in October I believe. Seize the moment and let somebody know your ideas and concerns. If you don't, you have no grounds to complain later. If you are not at the table, you are on the menu.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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