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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
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.
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.
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.
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.
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?
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
April, 2014, Vol. 14, Issue 04
Finding a Bridge to Somewhere
By Ralph Stephens, BS, LMT, NCTMB
In this, the third column in what I am calling the Policy Wonk Trilogy, we will look at the best solution on the block to uplift our profession, elevate our educational system and improve the quality of massage delivered to the public.If you have not read the two previous columns, they are in the November 2013 and February 2014 issues of Massage Today. And please note the therapy tip at the end of this column.
It's time to get out the shovels and dig deep enough to find a real solution to the primary problem plaguing the profession of massage therapy. First, high-profile projects like the MTBOK or the ELAP can have no real impact because there is no way to compel implementation of their recommendations. That is probably a good thing considering their recommendations miss the mark. However, if we go down to the foundational structure, it becomes apparent to the careful observer that the real problem is how we regulate our massage schools. Most state departments of education and boards of massage do little to regulate free-standing massage schools and massage programs in other institutions. Some basic forms are filed, maybe a bond posted and that's it. In most jurisdictions, it is just a business tax and permit.
When we started passing licensing laws for massage therapists, there needed to be qualifications to obtain a massage license. Since at that time there was no accreditation agency functioning in our profession, most state licensing laws specified education hours and curriculum, and gave the Massage Board some authority to oversee massage schools. This pattern has continued over the past 15 years. However, almost universally, these boards are understaffed, have little inspection ability and neither board members nor professional staff have the requisite experience with educational administration.
No other profession tries to define and enforce its educational standards through licensing statues and state board rules. Ours does because we did not understand the proper structure of professional regulation as we passed our patchwork of lousy massage regulations, with a few good ones here and there. By contrast, licensure in most professions requires that an applicant has graduated from a school accredited by the accrediting agency that is dedicated to that profession. Done. You won't find specifics on the number of clock hours of classroom training in other profession's licensing laws, or any mention of the required courses in the training curriculum. THAT IS ALL HANDLED AT THE ACCREDITATION LEVEL. The system of state occupational licensing boards was created to regulate practitioners – not educational institutions. This is a fundamental flaw that must be changed. Until it is, this "achilles heel" will maintain the current inconsistencies and inefficiencies of educational regulation and will prevent massage therapy from becoming a true profession.
It is time we change our statues to require institutional or programmatic accreditation for all massage schools from one specialized accrediting agency. It's a simple solution with ample precedent in other professions. However, the path to getting there is complex and fraught with obstacles. First of all, there are seven different agencies recognized by the U.S. Department of Education (DOE) that accredit massage schools and programs. On top of that, only about half of all massage programs are offered in an accredited institution. And only four states that license massage therapy require accreditation of massage schools.
The Commission on Massage Therapy Accreditation (COMTA) is the only one of the seven accrediting agencies that is considered by the DOE to be a specialized accreditor for massage therapy and it is the only one that has developed and implemented competency-based curriculum standards. They're the home team here, but they've been under supported by the major organizations in our field and are struggling to attract and keep enough schools under their wing to remain viable.
We already have the vehicle to bring about the needed improvements in massage education – and DOE has given COMTA the blessing to do so. As the common accrediting agency for all massage institutions, COMTA could implement the teacher education standards developed by the Alliance for Massage Therapy Education. As well, its competency-based curriculum standards would create greater consistency in entry-level training programs; something that the MTBOK and ELAP are incapable of doing on their own.
As the FSMTB develops its Model Practice Act as a guide for state massage regulation, it should specify that an applicant for licensure has graduated from a COMTA-accredited institution. State massage boards do not have the expertise, the staff or the authority to bring about the educational changes we need to deliver competent professional massage to the public. Trying to integrate the findings of the ELAP and MTBOK projects into our laws will be an expensive and time-consuming effort. Even if that were to be accomplished, it would still have little effect as licensing boards cannot effectively enforce standards on massage schools.
Needless to say, this will require a huge paradigm shift, which is seldom easy and often painful. Several obstacles must be worked out and it will take time, maybe a decade. Schools that have institutional accreditation from one of the six general vocational accrediting agencies must have a way to add programmatic accreditation from COMTA in addition to their existing status. These schools cannot and will not leave their existing accrediting agency that provides the gateway for students in all of their various programs to receive Federal Student Aid.
Then there is the issue of the other half of all massage schools that are not currently accredited. Most have stayed away from this process because they do not want the headaches of administering Federal Student Aid – or simply lack the financial resources to be able to meet the DOE's eligibility requirements. For these schools, COMTA must be able to create (again with the DOE's permission), a kind of "lite" accreditation process that is not a gateway to financial aid. For those who may remember, the original acronym for this agency in the early 1990's was COMTAA, which stood for the Commission on Massage Therapy Accreditation and Approval. It's time to bring back an approval-level function to be able to bring all massage educational institutions under one regulatory roof.
I am asking for a lot here, but massage therapy has emerged in a very different way than other regulated professions. While we desperately need to move the oversight of schools to COMTA, we must do it in a way that does not unduly punish schools or cause them to perish. Instead of funding more "Bridges to Nowhere" projects like MTBOK and ELAP, our stakeholders should be funding COMTA and the lobbying necessary to accommodate our profession's transition to a properly regulated entry-level education industry.
Stimulus - Response
While some believe that we "relax" muscles by physical pressure and stretch forces applied by the common massage techniques, there is another possibility. Maybe all we are doing is some form of stimulus response. Are we merely providing a stimulus to the nervous system and that stimulus causes the nervous system to "relax" a muscle and/or vasodilate blood vessels? Do you know how the nervous system "perceives" the touch you apply? Do you know how the stimulus of a particular massage stroke is perceived by the nervous system? If not, you are working blind. Each massage stroke is perceived by the nervous system as a specific stimulus and it elicits a specific response. To get the desired response you better be applying the correct stimulus.
Might it be that we are stimulating mechanoreceptors which elicit a relaxation or inhibition response? Might there a better way to manually elicit an inhibition response than the tried and true method of sustained pressure and deep stripping effleurage causing at least discomfort to the patient and over time injury to most therapist? Stay tuned for the answer. You will be surprised.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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