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Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
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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