resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
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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