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How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
September, 2012, Vol. 12, Issue 09
Navigating Ethical Boundaries
By Suzanne Scurlock-Durana
In the next decade, as a profession we would be wise to cultivate the deeper level of ethical action that occurs when we are more embodied. Most of us currently have a good basic knowledge of ethics that clearly delineates both what we do and don't do, in and out of the treatment room.I want to explore the territory beyond that – what we find when we move into the integrity of the navigational system of the body as the ground of our knowing about what is ethical in any given situation. This means knowing when someone has crossed a line even if we cannot put it in words at that moment. It is also what tells us when something is "spot on" in terms of our confidence and creativity.
What I am referring to here is the process of embodiment as a primary tool for navigating ethical boundaries and establishing and maintaining ethical therapeutic relationships. This requires that we have the basic skills to be connected to our environment, our clients, etc. And that we connect in a healthy manner, that we know how to connect with, but not invade another person's personal space and that we know how to hold our own boundaries firm when needed so that others respect and honor our personal and professional space.
Building from this foundation is the deeper level of integrity and ethical behavior that emerges as we ourselves become more grounded in our own bodies and in our own inner wisdom as practitioners. In my three decades in bodywork and teaching, my experience is that we all have access to this innate wisdom, but many have never consciously recognized it. Let's explore how to bring this inner wisdom to conscious awareness, and to engage with it.
STEP 1: Dropping In
To engage this inner wisdom, first allow yourself to drop your awareness down into your body, doing so with an openness to discovery and a willingness to meet whatever you find inside with as little judgment at possible. Any meditative system that helps you explore your inner landscape will work here. Not a guided visualization, which tells you what to find inside, but a system that helps you ask questions of your internal landscape and then encourages you to notice what sensations, visual hits or inner knowing show up. So questions like, "What is the temperature of the air as it enters my nostrils; and is it effortless to breathe today, or is there a catch anywhere in my inhale or exhale? And, what sensation would feel most nourishing to my lungs right now?"
When you ask yourself these "sensation questions," you are engaging parts of the brain that Dr. Daniel Siegel names as the cutting edge of conscious awareness. Our neurons fire in a more integrated, full-brained manner when we open up to bodily sensations and drop in to explore what is there.
Step 2: Expand Your Internal Awareness
Next, allow yourself to expand to a more full body awareness. If the container of who I am – in my body and mind – is fully present, it means that I am actually conscious of my boundaries. I am "at home" at the border where who I am ends and the rest of the world begins. If someone tries to cross my boundary, I am a lot more likely to sense it immediately. If, on the other hand, I live primarily in my head or only by the dictates of external sources and rules, then I am not as available for the wisdom my boundaries may be signaling to me. I am not able to self-reference.
Another example of this is when we fail to do the basic self-care that keeps us full and energized as therapists. When we are "running on empty," it is easy to miss signals from our deep wisdom (or any other part of us for that matter). Most of us intuitively know this, but the stressors of life can cause us to forget these important facts.
Step 3: Own Your Inner Wisdom Places
So what does this deep wisdom of the body have to teach us about integrity and ethics and how can we tap into it more regularly? First of all, we now know that every cell in the body has its own intelligence that when healthy, operates in conjunction with all the other cells in our bodies. In this dynamic process, I have found that certain areas of who we are seem to have certain kinds of wisdom. Let me give you a few simple examples.
There has been lots of research recently on the "gut brain" or the intelligence of the lower torso area of our bodies. Think of how powerfully it signals you when something is really "off" in your world. "My gut sense is that this is a bad idea." Or alternately, "I don't know why, but this feels really right!" The pelvis/gut area of the body has it's own wisdom and when you listen to it, it can keep you safe and move you in more life enhancing directions.
How about our hearts? This area is the center of our cardiovascular system and also what makes us human. Deep inspiration often emerges from our hearts. We fall in love through our hearts. Our hearts register our inner world and how we are feeling in any given moment. When something in our life touches us deeply, you hear the expression, "Oh, my heart!" "Or, "My heart aches for you."
Our feet and legs seem to have wisdom about how to move through life's thorny issues if we engage them. When I am mulling over a problem or wondering how to resolve something, if I can take a walk (engaging my feet and legs), I often come back with the issue resolved even if I didn't think about it on my walk!
And so, we have three examples of different general areas of the body, each with their own flavor of wisdom. If you can learn to engage them, you are on your way to having the integrity of full body presence, and navigating in your world from the wisdom of your inner landscape. How can we do this?
First, by engaging the heart. Allow yourself to relax and breathe naturally into your heart area. Notice what whispers of wisdom are there, without judgment. The signals can be quiet initially. Do not let your linear mind over rule what you are hearing. Best used in conjunction with the wisdom of the gut.
Second, engage the gut. When you enter the treatment room, notice what your gut is signaling to you about this person's situation. Do they need you to approach them firmly or gently? Do they need you to engage verbally or remain silent? It is often as clear and simple as that. Again, do not let your linear mind automatically override what you are hearing. Once you have a clear hit from your gut, you can assess the facts of the situation as you know them and decide on the wisest actions to take in that session.
And third, engage your feet and legs. As you enter the treatment room, feel the sensation of your legs supporting your upper body. Feel your feet under you. Wiggle your toes if you need to feel more sensation. As you go through the session, return your awareness to your legs and feet and to the ground under you for support and steadiness.
The key here is to remember that optimally all our cells - and thus all parts of us - should be connecting with each other. My heart may tell me what is going on inside of me emotionally, but my gut will tell me the truth of the situation, and my feet and legs will help me "walk in the world" in a more powerful, clear manner. Think about falling in love with the wrong person - your heart may feel so full in the moment, but when you ask your gut it gives you a big internal "no – this person is a schmuck." Your feet and legs can help you take action with our inner wisdom fully manifesting. So if engaged, we can take an action and walk away from that circumstance that was bad for us.
When we are more fully embodied, it means that there is more communication between all the parts of who we are. In that, there is a synchronicity that is far greater than the sum of the parts. Navigating from within ourselves – mind, body and spirit – only makes sense with what we do for a living. Ethical actions follow naturally when we are fully present. Isn't it time you stepped into the integrity of your full body presence?
Suzanne Scurlock-Durana is a 20-year veteran in the field of conscious awareness and its relationship to the healing process. An expert at integrating right- and left-brain understanding, she teaches therapists around the world how to develop their therapeutic presence through her Healing From the Core training series offered by The Upledger Institute.
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