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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
April, 2014, Vol. 14, Issue 04
Touch Programs Help Families Bring Cancer Patients Relief
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun, PhD, EdS, LMT, Ruth Werner, Immediate Past President MTF, Beth Barberree, RMT, BA
Effectively addressing the needs of patients with cancer requires a multi-faceted holistic approach in the clinical care and home setting.Innovative approaches to patient care integrate family members as informal caregivers, to help meet patients'; needs. In this month';s Massage Therapy Foundation research review, we share findings and implications from a randomized controlled trial that evaluated a multimedia instructional program for family caregivers in touch-based techniques to provide comfort to cancer patients at home. The manuscript was published by Supportive Care in Cancer in 2013.
The proposal was to teach loved ones how to massage cancer patients. Massage is a popular palliative modality for symptom relief associated with cancer and associated treatment. Research has demonstrated significant effects for patients with cancer on symptoms such as pain, nausea, stress, anxiety, mood disturbance, fatigue and sleep disturbance. Understanding the need for symptom relief and leveraging the role of informal caregivers, Collinge and colleagues developed a touch-based program for at-home caregivers. The program was designed to empower them with the ability to have an impact on patient well-being through the use of partnered massage. These authors suggest a caregiver-based program such as this can benefit the patient, the partner and the quality of their relationship.
Collinge and colleagues developed a multilingual (i.e. English, Spanish, Chinese, Vietnamese) DVD, with an illustrated, spiral bound manual to be used as a home-based instructional tool. (The program is now also available online via streaming video with an ebook manual.) The program, entitled "Touch, Caring and Cancer: Simple Instruction for Family and Friends," addresses, "attitudes and communication about touch in cancer, psychological preparation for giving and receiving touch, safety precautions, massage techniques for comfort and relaxation, acupressure for specific cancer-related symptoms and practice in the home setting." This program offers patients, their family members and loved ones an economical home-based self-paced alternative for symptom relief.
The experiment used was massage for one group and reading aloud for the other. A sample of 97 adult patient and caregiver dyads was randomized to the treatment (DVD massage program) or control groups (reading any literature of the patient';s choice such as poetry, fiction, nonfiction, religious, etc.) for four weeks. Treatment dyads received the program with instructions and were asked to practice at least three times per week. In the control dyads, caregivers were asked to read to their patients for the same frequency. To measure outcomes, self-report instruments assessed change in symptom severity, quality of life, perceived stress and caregiver attitudes.
Results indicate significant reductions in all symptoms for patients in both groups after a 20-minute session of their assigned activity: 12% to 28% reductions after being read to, and 29% to 44% reductions after massage. Though both groups showed improvements, "The average proportion of decreased symptomatology reported from pre- to post-sessions over the four weeks was significantly greater for patients in the massage condition for pain, nausea and other self-reported symptoms (i.e. less common symptoms yet those that were significant to patients)." Significant effects across time were also indicated. Symptom improvement was significantly greater for the treatment group (caregiver massage) than the control group (caregiver reading) for stress and anxiety in weeks two, three and four, pain in weeks three and four and fatigue in weeks one and four.
Massage caregivers in the treatment group reported satisfaction with their ability to help their loved one feel better. They showed significant improvements in confidence, comfort and self-efficacy. There were no significant differences within or between patient groups on the Perceived Stress Scale or the General Functional Assessment of Cancer Therapy-Version 4. However, the authors did note using the specialized statistical method, Classification Tree Analysis, statistically significant associations were found between patients'; diagnostic and massage variables with their Perceived Stress Scale score at follow-up.
No adverse events were reported during the study, which suggests that the massage taught on the DVD appears to be safe for this population.
Collinge and colleagues conclude that, "multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain, depression and other symptoms. Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress."
This study has several meaningful implications for the field of massage research and practice. First, these findings support previous research suggesting massage is an effective palliative modality for patients with cancer. Further, these findings indicate that massage, which is typically considered a clinical or spa treatment, may be re-conceptualized as a home-based treatment provided informal caregivers are given proper instruction. Practitioners of Complementary and Alternative Medicine, particularly massage therapists, can consider programs such as Touch, Caring and Cancer as an option to complement other clinical treatments, such as formal massage therapy regimens, to provide patients comfort in the home setting between clinical and massage treatments. This program is one of many that can be created for patients with diverse conditions as an alternative. For example, Collinge and colleagues are currently evaluating a similar home-based integrative therapies program called Mission Reconnect, to promote well-being and relationship resilience in veterans and their partners healing the effects of military deployment. Programs such as these will create a new economical, home-based, self-paced option for diverse patient populations to receive symptom relief at the caring hands of their family members and loved ones.
To learn more about touch and caregiving, 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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