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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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
June, 2013, Vol. 13, Issue 06
Help in Understanding Parkinson's, Part 2
By Ann Catlin, LMT, NCTMB, OTR
In part one of this series from the April issue, I presented an understanding of Parkinson's disease (PD), its symptoms and current medical treatment.Now we'll take a look at how massage and other bodywork may play an important role in managing symptoms and offering those with PD a better quality of life.
I'd like to challenge you to ponder what it means for a person living with PD to have "quality of life." Most massage therapists immediately think of tremors and muscle stiffness when asked to name a symptom of Parkinson's disease (PD). What about symptoms that can't be seen but only experienced by the people living with this progressive neurological disease? The Parkinson's Outcomes Project reports that negative mood and depression have the greatest impact on health status and that 40% of people with PD experience depression and/or anxiety disorder.
These symptoms seem to have even greater impact on quality of life than motor symptoms. There's constant frustration from struggling to get through daily activities. But I've observed another invisible symptom – feeling isolated. One symptom of PD is a mask-like expression that comes from poor motor control of facial muscles. The subtleties we rely on for communication and social connection are gone. Imagine a man with PD at a social gathering, say a neighborhood picnic. Here's a man who can't move or walk well so will stay in one place and has a blank and staring expression on his face. Is this a person who will likely be approached by others? I suspect not. Strangers will misread the expression as boredom and withdrawal. Acquaintances may feel uneasy about what to say as they notice the changes that have occurred and avoid him. Closer friends may overcompensate for their uneasiness and dote or be overly helpful. Children may even be a little frightened of him. The end result is that few people will treat this man as they would have before PD. Satisfying social relationships must be hard to come by for many people living with the symptoms of PD.
I have a client who has, for many years, been an active board member of a community music guild. In his early seventies, he developed PD, however he continued to be involved on the board. During a recent session, he told me about the board meeting he attended last week. He said that hardly anyone spoke to him directly and he felt ignored. "I'm the same person," he told me. "Do I smell? I'll never go back." The more I think about this, the more I realize the full impact of his statements. He's been cut out of a community and he knows it. Now, he's left to wrestle with the loss and anger along with feelings of low self-worth. I don't think his situation is unique at all. So how can we, as massage therapists, make a positive difference?
Which modalities are most effective?
It's reported that up to 40% of individuals who have PD use at least one type of complementary therapy with herbal supplements, vitamins, massage and acupuncture most commonly used. I was curious about which bodywork modalities have proven most effective. The following is a survey of the literature along with my personal experience.
Alexander Technique: This educational method teaches the client how to change faulty postural habits to improve mobility, performance and alertness along with relief of chronic stiffness, tension and stress. Main benefits are coordination of the musculoskeletal system, improved breathing, vocal production and speed and accuracy of movement. One study demonstrated that following 24 lessons in Alexander Technique, people with PD had less depression and greater self-concept. These results were sustained for six months. Alexander Technique may have the greatest impact on these PD symptoms: bradykinesia, which means slow, deliberate movements and difficulty performing rapid alternating movements such as combing one's hair or clapping. Because Alexander Technique uses a cognitive approach to re-learning movement patterns it may also help develop new neural pathways in the brain to compensate for those no longer functioning properly. The client may also feel empowered by being actively involved in learning new movement patterns resulting in improved mood and feelings of confidence and self-worth.
Neuromuscular Therapy: This approach is described as soft tissue manipulation techniques including myofascial release, positional release and trigger point techniques. One study examined the effects of neuromuscular therapy on motor and non-motor symptoms of PD. Following treatments twice a week for four weeks, clients had significant decreased tremor and improved rapid alternating movements (finger tapping). However, clients did not have substantial changes in mood. It appears that neuromuscular therapy may be most beneficial for motor symptoms of PD, which would contribute to improved ability to perform activities of daily living.
Swedish Massage: In my experience, rocking broad compression and moderate pressure effleurage seem especially effective for PD symptoms. Rocking stimulates the vestibular system as well as the proprioceptor nerves in the skin, joints and muscles which may improve postural tone while promoting an overall relaxation response. Gentle, sustained compression applied to muscles that are rigid or hypertonic encourages "letting go" or relaxation of the muscle and increases range of motion at least temporarily allowing greater postural comfort for those who have advanced PD. Broad, slow-stroke effleurage on the full back seems especially helpful. Studies have shown that three minutes of slow-stroke back massage decreases blood pressure and heart rate while skin temperature increases. Slow-stroke back massage has been used as a common nursing intervention to help patients sleep. We've long understood the link between massage and improved mood. One study showed that Swedish massage increased serotonin and dopamine levels by 28% and 31% respectively while decreasing cortisol levels by 31%. This is important in understanding that massage changes the biochemistry of the body and decreasing stress reactions.
It's clear that touch therapies can be effective in easing the physical symptoms of PD which goes a long way in improving function and alleviating physical discomfort. But I'd like to go back to those hidden symptoms I described earlier, the frustration, isolation and feelings of low self-worth. Let's look beyond bodywork to the power of compassionate human touch to heal in ways we are only beginning to fully understand. The man I described who felt shunned by his peers looks forward to our sessions which take place in his home. Following the massage, he reports decreased pain and appears physically comfortable and is able to move his arms a little smoother. But what shines through the physical benefit is a shift in his demeanor. The other day he told me how much our sessions mean to him. "You treat me like I still matter." I believe his statement had nothing to do with bodywork but rather by reaching past the disease to serve the human being inside of the body impacted by PD.
Acceptance and compassionate presence comes through caring human touch. I'll close with a quote from one of the sources for this article, "While complementary treatment modalities are used widely by patients with PD, only use of various massage techniques seems to improve subjective well-being and quality of life," from Rehabilitation Interventions in Parkinson Disease by Alex Moroz, MD, et.al.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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