Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
July, 2013, Vol. 13, Issue 07
Ethical Considerations for Pediatric Massage
By Tina Allen, LMT, CPMMT, CPMT, CIMT
The practice of massage therapy is generally regulated throughout the U.S. with many states having standard guidelines and a method of licensing/registering massage therapists and practitioners.As a therapist, you must always adhere to the guidelines mandated within the area (geographic location) you are practicing. When working with pediatric populations, it is especially important to have a solid grasp of legal mandate, as well as ethical considerations due to the fact that not everyone has a clear understanding of pediatric massage therapy. Clarity and consistency will help develop a professional understanding of nurturing touch as an important part of every child's life.
Within a pediatric healthcare practice, privacy, safety and care is of the utmost importance. While these same qualities are important for all clients, children require a practice of extra special care. By learning and following a professional code of ethics, you will not only be able to better assist clients, their families and other healthcare providers through interactions, but will also ensure you are received as a professional service.
What are Ethics?
As healthcare providers, we are judged on our technical competence in our profession and the ability to build trust in others. In order to project this allure of pride and confidence in our field, we must have it within ourselves; when you practice ethically not only do you have more pride in yourself, but also your profession. Traditionally, ethics is defined as a philosophy which seeks to address questions about morality; concepts of good and bad, right and wrong. Ethics encompasses our moral principles that govern a person's or group's behavior, the correctness of specified conduct and the discipline of dealing with what is good and bad and with moral duty and obligation.
Is It Legal?
Understanding the legality of your actions is an important factor in the decision-making process. With child clients, we face another layer of legality due to requirements of consent from not only the pediatric client, but also their parents/guardians, and in some cases, their healthcare provider.
Is It Ethical?
Professional ethical behavior relates to your actions and being sure they are consistent with the standards established or practiced by others in the same profession. It is best to adopt a standard of ethics that serves your practice and clients well and stick to it.
Is It Fair?
This is an area that is subjective and many people have a different understanding of what they feel is fair. We base our beliefs and understanding on what we feel is fair, while another may feel differently or may have chosen to do something in another way. Always reflect on whether the decision you are making may result in harm or an arbitrary benefit. If this is the case, then it is not considered "fair." With each child and family we must practice the same care and regard to safety, boundaries and scope of practice, no matter what.
Children need clear boundaries, as do health providers. It is imperative that we understand and follow good professional and personal boundaries to establish the best care.
Within the guidelines of informed consent, a client/patient must be fully informed of the care you wish to provide so they may make an educated choice in receiving hands-on care. This is the client's legal and ethical right to direct what happens with their care plan, their body and to consent to, or refuse therapy. For children, this may involve their parents or healthcare provider's request for you to provide massage therapy. Typically, a child is not calling you to schedule an appointment, but when a child says no to any part of the massage, or wishes to have it change, this is to be respected, whether the massage is medically ordered or not.
Many children don't understand what massage is or how it might be beneficial. Having a good explanation of massage therapy in terms they understand, along with why massage might be beneficial, will help you to inform and receive an appropriate consent to begin or continue your session.
Always respect cultural, ethnic and religious beliefs of the patient and family and do not impose your own beliefs or values. "The United States is becoming increasingly culturally diverse and this trend is expected to continue throughout the 21st century. One does not have to look far to see this reality, especially in metropolitan areas. In some cities (e.g., Miami, Los Angeles) persons in business and others must be bilingual to communicate. With the increase in cultural diversity comes a responsibility for ethical thoughtfulness on how this diversity affects health care practice." (Ludwick & Silva, August 14, 2000)
Working with children in hospice and palliative care can be emotionally different than working with other pediatric patients/clients. Not only are you dealing with your own belief system, but you may be challenged with the question, "What will happen when I die?" Children of all ages may pose this question. First, recognize your beliefs may not mirror those of the child or their family, and it is not your place to "fix it" or even answer it directly. You might try using a reflective response of, "What do you think will happen?" Listen to their response with open ears and mind. Do not judge, do not place your beliefs onto them and do not try changing their mind to your beliefs. You can always respond with an answer of, "That is definitely possible," or "That sounds lovely." The reality is whatever your beliefs may be, we do not know what will happen if the child is to pass, but being present is essential for the child.
Other Situations to Consider
Navigating the waters of massage can be tricky when you are working with children. The question of who is the client may be raised during the session. While it may seem obvious, when you work with children with special healthcare needs, you are often interacting with tired and stressed parents or healthcare providers who may need a shoulder massage. It is crucial to ask yourself if this seems appropriate, should a second appointment be scheduled for the caregivers or is it ethical to provide massage for the parents when referred to work with pediatric patient?
To Drink or Not to Drink
Should I offer my client a drink of water at the end of the session? In this question, we are reflecting on a typical practice of many massage practitioners. Offering a drink of water at the end of the session is almost industry standard, but not when dealing with children. Children can have many different healthcare concerns and may not be in a position to make this decision on their own. If they are undergoing medical treatment or have a special healthcare plan, having a drink of water could be harmful. Anything taken by mouth needs to be done under proper advisement, which is not your decision to make. Accordingly, it is out of your scope to determine if water is appropriate before, during or after your hands-on session.
What if I see signs of abuse or neglect, or if my pediatric client tells me they are experiencing abuse or are feeling suicidal? These type of events need to be reported as soon as possible. By working with the public as a healthcare provider we are mandated to report these situations. Some children have no one else they can speak with, or feel comfortable to talk to, so you may be it. If you have concerns that are real and legitimate, making an anonymous call or reporting it to your supervisor in a healthcare setting is required. First, do no harm, which means you should report when you feel harm has come or will come to your client.
How do I assess appropriate boundaries if my client is not able to communicate with me? Often times, communication is largely non-verbal. Always look at your client's body language and recognize their unique engagement and disengagement cues. If you feel you are not able to read your client's cues, or if communication is difficult, than speak with the client/patient's immediate care providers to seek guidance on communication. Parents and healthcare staff communicate with the child under their care on a daily basis and it is not safe to assume that you will already know how to recognize each child's cues. Taking the time to meet them at their level and communicate with those around them is extremely important.
Is it alright for me to accept gifts from my clients or their family members? Generally speaking no, this is not acceptable. Think carefully about why you are being given the gift and how this will impact the relationship. Remember, clients and family members sometimes struggle with receiving the generous gift you are offering, but it is simply what we do as massage therapists. Children may color you a picture or card as a thank you for their massage and this is generally acceptable to receive. However, if they offer you their favorite stuffed animal, it is best for you to ask them to keep it safe until you return another time.
Working with pediatric patients and clients is rewarding and different than working with any adult population. Knowing how best to communicate, maintain boundaries and practice ethically makes all of the difference to the child, their family and their healthcare team.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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