resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
January, 2014, Vol. 14, Issue 01
Economic Evaluation of CAM/CIM Practices
By Massage Therapy Foundation Contributor
Contributed by MK Brennan MS, RN, LMBT; Jolie Haun, PhD EdS, LMT, April Neufeld, BS, LMT
In this month's review, the Massage Therapy Foundation's writing group selected a study done in 2012 that evaluates the economy of Complementary and Alternative Medicine (CAM), also referred to as Complementary and Integrative Medicine (CIM).This review is timely given the non-discrimination section of the Affordable Care Act is set to go into effect on January 1, 2014. Section 2706 provides a possibility for insurance reimbursement for massage therapy: "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law."
The objective of the review done by Herman et al., was to establish the value of complementary and integrative therapies within the health reform context. Numerous sources including PubMed, CINAHL, AMED, Psych Info, Web of Science and EMBASE, were searched for information published between 2001 and 2010. The Cochrane complementary and alternative medical group was used for determining the criteria for studies and all of the sources reporting economic outcomes were reviewed with the terms "integrative," "integrated" and "collaborative" medicine added to the search. Three hundred, thirty-eight (338) economic evaluations were identified and 204 of those were published between 2001 and 2010. One hundred, fourteen (114) of the 204 were full economic evaluations with 90% of those being studies of single therapies. Only one study compared usual care to usual care with access to CIM practitioners.
Surveys done in 1990, 1997 and 2007 show estimated out of pocket expenditures of $14 billion, $27 billion and $34 billion for CAM to treat principal medical conditions. This indicates an increase in the use of CAM for healthcare and the willingness of individuals to pay for it. The cost-effectiveness of CAM use, however, has not been well defined. As the authors explain, "Economic evaluations allow costs to be included, alongside data on safety and effectiveness, in healthcare policy decisions. As healthcare costs rise, the availability of these economic evaluations becomes increasingly important to the formulation of disease management strategies which are both clinically effective and financially responsible." This type of evaluation provides massage therapists and other CAM practitioners information that is valuable when meeting with conventional healthcare providers, insurance providers, policy makers, consumers and other stakeholders.
Articles were categorized as full or partial economic reviews. A full evaluation compared the costs, as well as the outcomes, of two or more therapeutic treatments for the same population. A partial evaluation was one that focused on cost-identification or cost-comparison. The authors used the 35-item British Medical Journal checklist to capture components of internal validity and transferability of information. They "also chose five quality criteria by which to identify a subset of full economic evaluations to highlight as being of most interest to policy makers." These include a comparison of CAM to usual and customary care; use of at least one recognized perspective such as hospital or third-party payer; randomized control studies or non-randomized ones that are adjusted to address baseline differences; a measured outcome unless the study was a modeling one that used the data from previously published studies; a sensitivity analysis since assumptions made can factor into uncertainties in economic evaluations.
Items reviewed from the studies that met the above criteria included: "treatment and study duration, primary clinical and economic outcome measures, the setting in which treatment took place, study design and sample size, the type and perspective (i.e., the point of view used to define costs) of the economic analysis, and incremental cost effectiveness of the CIM alternative compared to usual care."
Results of the analysis are mixed. Thirty-one of the full economic studies were considered a higher-quality than the others because they met all five of the study criteria. These indicate potential cost effectiveness and even cost savings across a number of CIM therapies and populations. "Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460)."
Other studies reviewed provide information for specific practices and/or settings. For example, cost savings were seen with acupuncture for breech presentations in pregnant women and also for low back pain. Other cost savings were found with some supplements, naturopathic care, Tai Chi and manual therapy.
The methods used in this article are comprehensive and applied multiple measures of study quality in the review of the articles. However, the authors recognize some study limitations, including: 1. The reviewers not blinded to journals and article authors; and 2. Publication bias was not assessed. However, the authors suggest for the purposes of this review, it is not clear if either of these limitations is relevant.
This report and those like it are valuable to those interested in making a case for the inclusion of CAM in healthcare settings or insurance reimbursement as well as consumer awareness. As the use of CAM increases and policies change to increase reimbursement of CAM care, economical evaluations of this type are needed to determine the use and cost effectiveness of CAM in the healthcare setting.
To learn more about the economic impact of CAM, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for CAM/CIM cost analysis studies.
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