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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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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."
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
December, 2011, Vol. 11, Issue 12
Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials
By Massage Therapy Foundation Contributor
Energy-based healing practices have been part of various cultures throughout history. Use of these complementary therapies, referred to as biofield therapies, is gaining popularity in the U.S.The theory behind energy-based healing practices is that humans have an energetic dimension necessary for sustaining life. A healthy person's energy field is symmetrical and balanced, allowing optimal energy flow. Imbalances in the energy field might result in pathological physical and psychological symptoms.
Scientific study of the biological mechanisms, effectiveness and safety of biofield therapists is limited. However, this month's Massage Therapy Foundation research column reviews an interesting, systematic, evidence-based approach study of the biofield therapy Healing Touch that was conducted at the University of Virginia, Charlottesville, and recently published in the Journal of Holistic Nursing.
Healing Touch is a "hand-mediated" therapy involving the practitioner using his or her hands, either on or above the client's body, to restore, energize and equilibrate imbalances in the client's energy field, with the goal of health, well-being or to alleviate specific conditions. Healing Touch originated in the nursing field in the late 1980s as a patient-centered modality in which the practitioner and client both participate in the healing process. Reported benefits include reducing stress, anxiety, pain and depression symptoms, while increasing relaxation and an overall sense of well-being.
This published systematic review evaluated data from randomized clinical trials (RCTs). The systematic review examined the clinical effectiveness of Healing Touch as supportive care for medical conditions. Electronic databases (MEDLINE, CINAHL, and ClinicalTrials.gov) were searched for peer-reviewed articles about Healing Touch. Of the 332 potentially relevant articles, five were included in the review (327 articles were excluded). The five articles selected, involved studies which used random assignment to the treatment condition. Some of the five articles were selected because they employed a blinded study design, which means the studies had data collectors or participants who did not know what type of treatment the participants received (e.g. treatment or control).
The five selected studies involve the use of imagery, stress-relaxation therapy, prayer, therapeutic massage, Healing Touch, mock Healing Touch and presence (as in the presence of someone with the participant, but who did not perform any type of treatment). The sample sizes ranged from 62 to 237 participants. The participants included both men and women who had a mean age between 50 and 65 years old. The studies included multiple conditions including cancer, coronary artery bypass surgery or surgery to enlarge coronary arteries blocked by plaque (percutaneous coronary intervention).
While one study had no significant results with Healing Touch alone, the other four studies show significant findings. One study showed that recipients had significant improvements in respiratory rate, heart rate, blood pressure, pain and mood disturbance after receiving Healing Touch. Two of the studies showed that recipients who received Healing Touch had a significant increase in overall functioning, satisfaction, emotional role functioning, mental health and health transition and a decrease in worry. And the fifth study showed that Healing Touch recipients had a significant decrease in anxiety and the length of their hospital stay.
More studies about the clinical effectiveness of Healing Touch for improving health-related quality of life are required, given the inconclusive findings and limitations of the studies reviewed. Limitations included one study which did not include a "usual care alone" group, i.e. a control group, which is a group of participants that received only the usual medical care and no biofield therapy or other type of therapies. Usual care alone groups are essential when making comparisons with the standard of care. One study used a standardized Healing Touch method involving a "modified" chakra connection, but the modification was not explained. This makes replicating the study difficult. In another study, music was played during Healing Touch treatments; in this case, theoretically the music could have been the reason recipients felt more relaxed. Also, a standard Healing Touch protocol was not used and recipients had different types of cancer. Both of these factors could have potentially contributed to some of the variability in the results. Further, one of the studies used Healing Touch involving different lengths of treatment without the use of a standard protocol, again making replication of the study difficult.
None of the studies justified the protocol or length of time chosen for the Healing Touch treatments. Additionally, because there are several levels of training, the experience of the Healing Touch practitioners should have been described.
Additionally, a limitation of systematic reviews is that studies with positive results are more often published than those with negative results which can lead to a bias toward the publication of studies that are more positive rather than representing all RCT findings.
Research in biofield therapies is difficult because there is a question about whether it can be analyzed using conventional scientific approaches, such as RCTs. Few clinical trials use adequate research methods, including the use of blinding and control treatments; which can result in exaggerated treatment effects. Sometimes trials do not have large enough sample sizes. Another issue is that biofield therapy practitioners are not always involved in developing research protocols and researchers might be unfamiliar with the language used in complementary therapies. Yet another potential problem is that many different types of subjective assessments can be used to determine treatment outcomes; this makes it difficult to compare studies. An approach using mixed-methods including both quantitative and qualitative data, might prove vital to understanding the effects of Healing Touch.
How exactly Healing Touch has an effect is currently unclear. The biofield has only recently begun to be measured. Future research in biofield therapies such as Healing Touch should continue to improve in rigor and detail, as well as investigate whether the effects of these therapies are comparable to the effects of other complementary modalities such as massage therapy.
In closing, though inconclusive, the results of the effects of Healing Touch are promising. It is encouraging that research is increasingly being done to address the effectiveness of therapies based on ancient healing practices involving the human energy field. The current challenge in this field of inquiry is to develop rigorous and replicable scientific research protocols that will demonstrate both the effectiveness and therapeutic capabilities of biofield therapies such as Healing Touch.
Source: Anderson, Joel G., Taylor, Ann Gill. Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials. Journal of Holistic Nursing. Published online 12 January 2011; DOI: 10.1177/0898010110393353
Click here for more information about Massage Therapy Foundation Contributor.
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