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Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
March, 2016, Vol. 16, Issue 03
Telling the Truth About Massage Therapy
By Tracy Walton, LMT, MS
Google "benefits of massage therapy," and you'll bring up 3.5 million web pages. Spend an afternoon checking out a bunch of them, and you'll find a few dozen benefits of massage therapy, along with a hundred or so conditions that massage is expected to help.
Among the many beneficial effects of massage, you might pick out a few focused on common cancer symptoms and side effects of treatment. In particular, you'll see references to the "Big Five" in cancer care: pain, nausea, fatigue, anxiety, and depression. These are compelling problems, familiar to oncology massage therapists and clients alike. Research has found growing support for effects on these symptoms and the strongest support is for easing pain and improving mood in people with cancer.
These claims are simple and fairly well documented. If we stopped there, with that last humble sentence about "growing support," we'd be on solid ground. But in the massage profession, we haven't stopped there, and some of our other claims are not so humble, and not solid at all. Go to some web sites, and you'll see long laundry lists of massage benefits. These don't apply to a specific population or problem. Instead, they are more generic. As we will see below, many of these generic claims are downright problematic.
All of us in massage therapy, not just those working with people with cancer, could do with a closer look at the generic list. I've whittled that list down to a short list of a few supposed massage benefits: claims of massage improving circulation, immunity, and endorphin levels. The likelihood of massage clearing out toxins or lowering cortisol levels.
You might have heard some of these claims repeated for years, starting with your first class in Swedish massage. They are mainstays in the massage therapy profession. Unfortunately, there are at least two problems with this short list.
Clients Don't Ask for These Benefits: Many of our claims about massage are focused on physiological effects, rather than clinical improvements. How many of your clients ask for an increase in circulation or endorphins? How many ask for detoxification or a smaller supply of cortisol coursing through their bloodstream? My guess is that, aside from an occasional request, most clients aren't focusing on these benefits. Our lists of benefits sound good, but they don't really address the primary reasons people come to us. People come to us in order to feel better.
Look back at the big five in cancer care vs. the generic lists of benefits and you'll find an important distinction: The Big Five focus on feeling better, improvements in pain, anxiety, and so on. In contrast, massage claims about endorphins and cortisol focus on complicated physiological explanations of how we might feel better. The former are clinical outcomes of massage therapy, the latter are mechanistic outcomes. Clinical outcomes are direct and relevant to the client. Mechanistic outcomes may not matter to a client at all. Many people take medications without questioning the way they work. In fact, many medications bring about positive clinical outcomes, while their mechanisms of action remain a mystery to consumers and medical providers alike.
This means that when our oncology clients (or really, any of our clients, regardless of health history) look for information about feeling better from massage, they are often met with a distracting list of mechanisms, focused mostly on cells or molecules in the blood going up, going down, or moving more swiftly through the body. These mechanistic claims might sound appealing, but they aren't usually related to the client's problem. And they come with other problems, too.
Our Claims Are Not Accurate: Many of the claims we've been making with such certainty are not at all certain. In most cases, we have no decent research to back what we are saying. For example, the claim about massage upping endorphins can be traced to only two tiny, primitive studies. Only one of those studies, fraught with design issues, reports an endorphin boost. Yet a Google search for "massage" and "endorphin" brings up tens of thousands of websites claiming massage will raise your endorphin levels.
Likewise, claims about improved circulation and immunity — mainstays of massage literature — have only a handful of studies behind them, with conflicting results. A body of research on cortisol has been analyzed and reported that massage does not lower cortisol. And there is no good evidence that I know of, anywhere in the English language, on the massage and toxin question at all.
The weakness in our claims about massage raises serious ethical issues for our profession. Health care providers have a recognized duty to tell the truth about their treatments. Even outside of health care, truth in advertising is a responsibility of anyone promoting a service or product.
When we offer massage therapy, people with cancer, health care providers and the public assume we are telling the truth about our services. In cancer care, patients may be especially vulnerable to false claims and oversold promises. They need to hear reasonable expectations about what massage will do for them. That's why the humble statement above, about "growing research support," for massage and cancer symptom relief is so important.
In particular, at least five of the generic claims we make about massage — effects on endorphins, circulation, immunity, cortisol, and detoxification — should be phased out of our literature, our websites, and our massage classrooms. Any time we tell someone, "massage does this," or "massage will help you with that," without good backing, we are making a false claim. Even with a few million websites repeating the same thing, we have a professional responsibility to question what we are told and what we tell our clients.
Telling the Truth, Discarding the Myths
To help MTs in this regard, the Massage Therapy Foundation has just released a free e-book, 5 Myths and Truths about Massage Therapy: Letting Go without Losing Heart (http://info.massagetherapyfoundation.org/5-myths-and-truths-about-massage-therapy).
In partnership with the Foundation, I wrote the e-book to help straighten out our stories about massage. I offer up a research summary of each claim about endorphins, immunity, cortisol, circulation, and detoxification. I also reference many of the small research studies behind each claim, such as the two tiny studies about endorphins, mentioned above. The results may be surprising, but will help all of us make fair, accurate, more defensible claims about our work.
Reporting the true benefits of massage therapy is just as important as discarding untrue claims. The Foundation offers free e-books on massage and pain research, pediatric massage, connecting with researchers, and even an e-book on connecting with physicians. These and other resources are referenced on the Foundation website www.massagetherapyfoundation.org/resources/general/. The e-books are just a sample of the many resources available at the Massage Therapy Foundation, which has funded research, education, and community service projects for 25 years.
In addition to the free e-book through the Foundation, I have listed 20+ highest-level massage research papers in a recent blog post, "One Massage Study Does Not Prove a Point, www.tracywalton.com/one-massage-study-does-not-prove-a-point/. Three of the papers listed are on massage and cancer. In that post, I also explain why a research review typically provides more useful and accurate information than the single massage studies we are told to promote.
All of our client populations deserve clear, accurate information about the benefits of massage therapy. Massage therapy is a wonderful intervention that is becoming more and more welcome in health care circles, and especially in cancer care. When we keep our claims true, humble and thoughtful, we strengthen the foundation of massage therapy for years to come.
Click here for more information about Tracy Walton, LMT, MS.
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