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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.
May, 2013, Vol. 13, Issue 05
VacuTherapies and Working With the Senior Athlete
By Annie Garic
There are more than 10,000 men and women between the ages of 50 and 90+ that gather every two years to compete in the National Senior Games. These athletes train year round in their chosen sport and participate in yearly local events in order to improve their skills.As with athletes at any age, injuries occur that can sometimes sideline them. I know, because I’m one of them. No one wants to take time out due to a nagging injury. VacuTherapies can really help speed up recovery time.
Vacuum therapy, is a highly effective modality for treating most injuries at any age, even if your client is not an athlete. These techniques are a modern application for the ancient tool used in traditional cupping practices. With vacuum therapy, the practitioner uses cups as an extension of their hands to mobilize tissue and fluids. Cups are utilized in a variety of different ways in order to accomplish the desired results. An amazing aspect of this method is the speed in which results are achieved. Vacuum therapy promotes circulation, moves stagnation, reduces inflammation and loosens adhesions. It’s a technique that can be enjoyed by the injured athlete because it has a sedating effect on the nervous system. Proper use of equipment lifts and separates tissues allowing fresh blood and oxygen into dehydrated, undernourished areas.
A 59-year-old female basketball player broke a bone in her hand during practice that required surgery. Two weeks later, the swelling in her hand under the cast had not subsided. She was not able to bend her fingers, which was an intricate part of her physical therapy. She then came for a massage. I applied the VacuTherapies machine to the appropriate areas. While I monitored the machine, I was also able to work with my hands on other affected areas of her body that needed attention. The vacuum machine affords the practitioner the opportunity to achieve more results in the same amount of time. The vacuum therapy drained the lymph system and the inflammation in her hand was reduced significantly. She returned to physical therapy and her recovery time was lessoned. She was back on the court earlier than was predicted.
Vacuum therapies can also be used on site. The vast selection of equipment affords the therapist a multitude of choices to bring along to any sporting event. The cups range in size to accommodate the large muscle groups, like quadriceps and gluteus, and very small ones to fit hands, feet and the occipital region. While playing in a basketball tournament, a 56-year-old female athlete strained her gastrocnemius, forcing her to sit out the rest of the day. That evening, we used a large cup from the manual set to lift and stretch the soft tissue. I initially used suction/release technique due to the sensitivity of the lower leg. Then, gentle, long gliding movements to move out any debris using constant suction. I completed the treatment with reverse friction using a smaller cup along the anterior attachments and around the knee. The next day, the athlete was able to resume tournament play as if nothing happened...to the dismay of the opposing teams, I might add.
One of my clients is a 64-year-old avid tennis player. While playing, she experienced a pain in her shoulder. By the time she finished her match, it had transferred to neck pain. By using a technique called “rolling rotation” I was able to locate the trigger point in her rhomboids. This technique, along with a couple of other techniques called twisting and shaking enabled the release of some deep adhesions.
Senior games offer 19 different sports to participate in. One of my clients, a 67-year-old male, takes advantage of about half of them. One day, he sustained an injury to his wrist while diving for a softball. The pain was shooting up his extensor muscles. The first thing I did was park the micro magnet cups to change the polarity of the tissue. Then I applied some suction/release for deep tissue release. I finished the treatment with reverse friction on the attachments of his forearm muscles. A couple of weeks later, I ran into him at the gym, where he was playing pickle ball. I asked how his injury was doing and he said, “what injury?” One treatment had resolved it completely.
Several years ago, a female athlete came to me for a pain she felt in the attachment area of her hamstrings that was also radiating down to her foot. She had just turned 80 and was training for a half marathon. She was on a time frame that did not allow her to cut back on her work outs. At the beginning of the treatment, the client was very sensitive to palpation on her gluteus. I placed a large cup from the vacuum machine on the suction/release mode area to flush the muscles and relax the nervous system. This allowed me to have both hands free to explore the hamstrings. What I found was an adhesion in the belly of the biceps femoris and semitendinosis muscles.
The “bunching up” mid-way down her leg seemed to be causing her pain at the ischial tuberosity. I then switched the cup from her gluteus to the area over the adhesion. The gluteus area was much less sensitive and I was able to do some deep tissue work on her periforimis with the client experiencing much less pain. After taking the pulsating cup off of the hamstrings, the adhesion had softened significantly. I changed the cup size and adjusted the machine to static suction and continued to use the vacuum with different techniques over the entire muscle group. When the session was over, the client reported a reduction in her pain and a feeling of lightness in her leg. We did one more treatment a week later and she was free of pain. This therapy did not interrupt her training schedule and she successfully accomplished her goal of completing the half marathon.
As a therapist and senior athlete, the equipment provided through this modality is an invaluable part of my lifestyle. Self care is key to maintaining fitness for my career and sporting activities. After an extreme workout, I am able to apply the cups easily to flush areas of lactic acid before any soreness sets in. When traveling to competitions, I pack a set of the various sized silicone cups. This prepares me for any ailment that may arise. The “big mouth” silicone cup comes in handy to relieve congestion in the legs and hips. The smaller size cups accommodate other body parts that may be in need. My teammates benefit from them, too, and that makes for a winning combination.
Annie Garic graduated with a Bachelor's degree in Health and Physical Education from the University of New Orleans and a Masters degree in Physical Education from Southern Methodist University. She began her massage therapy career in 1987 earning certifications from the Institute of Psycho-Structural Balancing, the Atlanta School of Massage and the Upledger Institute. In 2000, she took her first ACE Massage Cupping(TM) workshop from Anita Shannon and became a Certified ACE Massage Cupping(TM) Educator in 2005. Annie practices in New Orleans and Asheville, North Carolina and teaches nationwide.
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