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Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
November, 2013, Vol. 13, Issue 11
The Evolution of Massage: PRN Massage
By Velvete Womack, PhD, LMT, CE, MI
In the past few articles, we've been discussing how to take massage therapy to the next level of professionalism, which also included a technique to use to ensure that YOU were ready to accept yourself as a full-blown professional.
There are many different reasons individuals become massage therapists, but no matter what your reason for becoming a therapist may be, you are still responsible for maintaining the integrity of the profession. And,it is also our responsibility to be "the light" and hold ourselves to a higher standard of practice to help inspire and motivate other therapist to do the same.
But how do we take our profession to the next level of professionalism as a team; as trusted and cooperative therapists? If you've been exposed to the medical world or studied medical terminology, then you are aware of the abbreviation PRN [Latin: pro re nata], which means whenever necessary or needed. As a therapist, we are missing out on this valuable practice that will evolve our practices and FREEDOM.
Operating a PRN massage practice has so much potential and endless possibilities that you are absolutely limitless in creative ideas and energy. One of my greatest adventures was the day I opened my very own PRN massage practice. My mind was blown by the number of physicians, therapists, chiropractors and even businesses that offered massage and that called for my services on a regular basis. There is no greater feeling in the world than when you fill your schedule book and are turning down three to four clients a day. That's when you realize just how you can be of service to mankind. So you find another therapist and offer them the same possibilities you have.
I have enjoyed all the therapists who have worked for (no, with) me! Together, we have promoted and built an even bigger and stronger foundation for the profession. Some moved on to do the same as I did and hired therapists that now work with them, paying it forward.
In most states, massage therapy has its own governing body and it is a must that you contact yours before you start so you can learn the rules and regulations that will be important to running a successful PRN practice. In texas, as it might be in your state, if you are a solo practitioner without an establishment license, then NO ONE can substitute for you. If you are not an establishment in Texas, you are not welcomed to even offer a room to another therapist to rent or have someone come in on the weekends. This rule might seem a bit harsh at first, but once you realize the importance of the paperwork, the responsibility of protecting your clients and their privacy, you get it. We are professionals, folks!
In Texas, you are able to hire or work for another as a PRN therapist if they hold a medical or professional license that is medically related, such as chiropractors or physical therapists; or if the person you are working for holds an establishment license. This does not mean you can hold an establishment license and run a PRN practice and work for another therapist while they are on vacation; they must hold the establishment license. However, if you have multiply therapists working for you in your PRN practice in Texas, you are required to have an establishment license for your business.
Records are extremely important in any profession and massage therapy is no different. It's upsetting when a therapist knows they need to do SOAP notes, but refuses on the premise relaxation isn't something that needs to be documented. It's extremely important to understand many therapists are the only folks witnessing changes that occur on their clients' backs, necks, head, feet, skin and a whole list of others areas. Such events and occurrences are extremely important, and the therapist needs to be aware and make sure it's well-documented.
Regarding records, it's also important to understand who is responsible for client records. If you are working PRN, then it needs to be within your contract that you are making sure the owner or the business you are working for is responsible for the client records, and that you are released of any liability for such records, outside of making sure you do your SOAP notes. It needs to be well-documented who owns the client records so there is no confusion in the future.
To establish yourself as a professional offering PRN services, it is a must that you communicate with your local physicians, physical therapists, nurses, other therapists and businesses to let them know you are ready to provide them with relief. At first, you'll just want to make sure people know you are available and build a reputation with them. They'll want to know what kind of work you currently do and will want some kind of references. It helps to have established yourself with a booming chiropractic or rehab businesses; they'll be your best marketers.
In order to better assist you in building your own PRN practice, I provide the following guidelines:
Also be sure to add to the contract that if your pay exceeds $500 in services, they must supply a receipt for services rendered.
If you have multiple therapists working with you, then you'll want to be sure you are also keeping excellent records because the business will only need to provide the "PRN business" with documentation, not each therapist. The contract should be signed and placed in a secure filing system so you will not have to repeat the procedure. Once a therapist or business signs a contract with you then you'll just need to do business with them until the life of the agreement is over or renewed.
If you are contracting with another therapist, you are responsible for all records, payroll and 1099s. Make sure you have a solid contract that clearly covers:
Maintain accurate records for tax purposes; this will be your responsibility because you are contracted with the company. It's important to stress here that all successful therapists must market themselves. If you are not strong in this, then PRN might not be for you. However, if you love working on different people each day and meeting new people every day, then this will be a win/win for you.
When I first started my PRN practice, I was concerned about the money and whether it would really pay the bills. The first thing I discovered was that my expenses only consisted of lotions and auto; they supplied everything else I needed. They were my receptionist, they did the laundry; they were my office manager and took care of all my client records; and they had to bill insurance and pay me the day of service ... no waiting for the money. I quickly discovered I could offer my services at a wonderful win/win rate because I had no expenses, and I wanted to be completely fair and honor that part of the deal as well.
But that's not all. Not only did many of the physicians / chiropractors pay me for what they said they would, but they also tipped me. And this didn't even include the tips the clients/patients would offer me, depending on the situation I was working in. If I worked for the chiropractor, patients were used to tipping; working for the physicians or PT, not so much. These clients were completely medical-based (insurance pays, not me), not service minded (I'm responsible for my own health and wellness).
It is with great joy and happiness that I provide this gift to other therapists to be the success they were born to be. You are all so very important to the evolutionary process of our profession. May life be just as good to you as you are to life.
Dr. Velvete H. Womack, PhD, LMT, CE, MI, is a published author, inventor, licensed massage therapist and wellness coach. With more than 35 years in corporate American, and in the medical and holistic field of health and wellness, Dr. Womack strives to provide individuals tools that will aid in balance and stress reduction. For more information, visit www.massagebyvelvete.com.
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