resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
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.
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.
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.
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.
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?
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.
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%.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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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