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State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
February, 2013, Vol. 13, Issue 02
Massage Therapists and the Detection of Skin Cancer in Clients
By Massage Therapy Foundation Contributor
Contributed By April Neufeld, BS, LMT, NCTMB; Sandra K. Anderson, BA, LMT, ABT
Have you ever noticed strange moles or lesions on your patient's back? This is important because skin cancer is the most common cancer in the United States, with more than 3.5 million cases diagnosed annually. Since massage therapists see a great deal of client skin on a daily basis, they have a unique opportunity to recognize potential skin cancers.
This month, we at the Massage Therapy Foundation (MTF) are reporting on a study by lead author Shannon M. Campbell and colleagues called "Skin Cancer Education among Massage Therapists: A Survey at the 2010 Meeting of the American Massage Therapy Association." It was published online on August 23, 2012 by the Journal of Cancer Education, August 23, 2012.
"While non-melanoma skin cancer (NMSC) accounts for the majority of cases, melanoma is responsible for more than 75% of skin cancer deaths. Between 1992 and 2004, melanoma incidence increased 45%. In the United States, one in 52 men and women can expect to be diagnosed with melanoma in his or her lifetime. The back is the most common location of melanoma in men, while the lower legs are the most common location in women. Prognosis of melanomas is related to anatomic location. The 10-year survival rate for melanomas on the back is around 68% while the 10-year survival rate for the lower legs is 82%," write the investigators.
These statistics indicate that early detection of skin cancer is an important public health initiative. While the majority of interventions have been through detection by medical professionals, recently attention has been turned toward the ability of non-medical professionals, such as hair dressers and massage therapists, to assist with skin cancer detection. These professional massage therapists see and palpate large areas of clients' skin, including the back and legs. In addition, massage therapists may also frequently observe areas of the skin not examined by healthcare providers, such as the scalp and soles of the feet, in addition to backs and legs.
The purpose of this study was twofold. The first was to describe the skin cancer education massage therapists receive during training and second, to evaluate massage therapists' comfort levels in identifying suspicious lesions and communication with their clients about them.
The research method involved surveying two separate groups of attendees at the American Massage Therapy Association (AMTA) annual convention in 2010, in Minneapolis. One group of 179 completed the survey at a booth in the exhibit hall; the other group of 114 were participants who attended a skin cancer education workshop at the convention. Thirty-one surveys were excluded because the respondents were either from Canada or had not completed their entry-level training. Therefore, the final sample was 262.
The survey consisted of demographic questions such as gender, age and ethnicity. Participants were also asked the number of years the subject worked as a massage therapist, the state in which they practice, age range of clients, number of clients they treat per year, average number of visits per client annually, how many clients the massage therapists have recommended see a healthcare provider over the past year for a suspicious lesion, and if they ever detected a lesion on a client's skin that was confirmed to be skin cancer.
Participants were also asked to give detailed descriptions of their skin cancer education both during entry-level training and through continuing education. Descriptions included the name of continuing education courses, numbers of hours, textbooks used, academic credentials of the course instructor, types of skin cancer covered, testing and education about how and when to discuss a suspicious lesion with a client. Additionally, participants were asked to describe their comfort level recognizing and discussing a suspicious lesion with a client, as well as recommending a client see a healthcare provider for a suspicious lesion. All comfort level questions were assessed using a scale of "not at all," "a little," "somewhat," "quite" and "extremely." Frequency questions were assessed using a scale of "never," "sometimes," "usually," "often" and "always." The observed frequencies and percentages were calculated using Statistical Analysis System (SAS) version 9.2.
Results of the survey indicated that 60% of massage therapists received skin cancer education during their entry-level training, 25% received it afterwards and 16% received both during and afterwards. The majority of participants stated that melanoma and non-melanoma skin cancers were reviewed during both entry-level and continuing education courses and that when and how to discuss a suspicious lesion was also included.
Whereas 12% of participants reported a personal history of skin cancer, 72% reported knowing a friend or family member with a skin cancer diagnosis. Of those surveyed, 43% reported wearing sunscreen usually or often on sun-exposed skin and 83% reported performing self-skin exams (SSEs) at least every 1 to 2 months. Participants also reported examining their client's skin regularly, with 44% reporting that they always do so. Massage therapists who examine their own skin at least once a year were more likely to examine a client's skin. Most of those surveyed recommended at least one client see a health care provider for a suspicious lesion over the past year.
Most participants reported being quite or somewhat comfortable recognizing a suspicious lesion, being quite comfortable discussing it with the client, and being quite or extremely comfortable sharing medical knowledge and recommending the client see a healthcare provider about the lesion. Additionally, massage therapists who perform SSEs, had detected a lesion on a client that was confirmed to be skin cancer, and who examine their clients' skin on a regular basis, and who referred clients to be seen by a healthcare professional are more likely to be comfortable recognizing a suspicious lesion.
"This study has several limitations," write the researchers. "It is an observational study that does not allow for cause and effect relationships to be identified. The sample population was from a select group at a national convention and the results may not be indicative of all massage therapists. Additionally, 114 of the 293 participants completed the survey prior to participating in a workshop on skin cancer," which means they may have a greater interest in skin cancer prevention and detection. "Further studies on a larger scale with a more representative sample are needed to confirm the data. Because many years may have elapsed between training and completion of the survey, participants may have incorrectly recalled details about their education and practice. However, this study serves as a valuable introduction to skin cancer education efforts within the massage therapy community. Additional studies should focus on improving massage therapists ability to recognize suspicious lesions and collecting data directly from massage therapy schools regarding their skin cancer education."
So what does this mean? It means that massage therapists who are already checking their clients' skin for suspicious lesions are providing a valuable and necessary service, one that can potentially save a client's patient's life. Massage therapists who are unsure of their ability to detect a suspicious change on a client's skin, and are unsure of how to discuss it with the client, would definitely benefit from a course that covers this information. It could make all the difference in the world to someone they know.
Editor's Note: Want to hear more great research all in one place? Attend the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation April 25-27, 2013, in Boston, Massachusetts. Registration is now open. Learn more at www.imtrc.org.
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