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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
April, 2012, Vol. 12, Issue 04
Treatment Decisions for Peripheral Neuropathy
By Rita Woods, LMT
First, the physiology and chain of events involved in a glucose-related neuropathy, as with diabetes, is more clearly understood than in some other neuropathies. This makes it easy to see how and why the protocol can be effective. Second, we know from experience that chemotherapy-induced peripheral neuropathy responds well to the massage protocol and is used today in some oncology massage clinics. Both of these conditions require that the underlying cause be eliminated for complete recovery. The glucose levels must be stable to prevent further damage and the chemotherapy must be completed or changed to achieve optimal results. Our work is to return the tissue back to normal (as much as is possible) through increased circulation and the condition will improve or go away. Peripheral neuropathies (PN) come with a variety of causes and in some cases, the cause is not known. Let's take a look at some of them.
About 30% of all PNs are a direct result of diabetes. Another 30% are considered idiopathic, meaning the cause is unknown. The rest fall into several groups and are either acquired (most of them are) or inherited. Presently, there are more than 100 known causes of peripheral neuropathy. The Mayo Clinic provides this list of known causes:
What I found missing from this list was that some medications are known to cause PN in some patients. In particular are the statins – cholesterol lowering drugs. This prompts me to remind you to get a complete medical history that includes a list of medication. Drugs are easy to look up online in order to identify possible side effects. (Please review two articles on this subject, "Chasing the Pain" from the October 2010 and February 2011 issues of Massage Today). To see how this happens, let's remember that a nerve is surrounded by a myelin sheath. Myelin is an insulating layer that forms around nerves and is made up of protein and fatty substances including cholesterol. The purpose of the myelin sheath is to allow impulses to transmit quickly and efficiently along the nerve cells. If myelin is damaged, for whatever reason, the impulses slow down or send imperfect signals that can be interrupted as pain. Stain drugs are developed to reduce cholesterol and in some patients, it prevents the myelin sheath from repairing itself. This reduces its ability to protect the nerve resulting in pain, tingling and numbness of the nerves. This can also affect nerves to internal organs. Do you see how our ability to help that client may be limited because the neuropathy is caused by nerve damage and is not the result of blocked or impaired circulation?
The neuropathies caused by physical trauma or pressure on nerves is really our area of expertise and an area in which can have a positive impact on the client. Repetitive stress often leads to entrapment neuropathies, a special category of compression injury. Cumulative damage can result from repetitive, forceful, awkward activities that require flexing of any group of joints for prolonged periods. The resulting irritation may cause ligaments, tendons and muscles to become inflamed and swollen, constricting the narrow passageways through which some nerves pass. Carpal tunnel syndrome is a good example of this kind of neuropathy. Remember to think it through. If the underlying cause falls within our scope of practice, then you may be able to have a positive outcome. If not, give what supportive care you can but be careful not to give false hope to the client. Help them to understand their condition and develop a treatment plan that you will both be happy with.
Click here for more information about Rita Woods, LMT.
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