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Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
March, 2016, Vol. 16, Issue 03
Becoming an Informed Consumer of Research: Basic Considerations
By Martha Brown Menard, PhD, LMT
Research is a fundamental aspect of every health care discipline. It supports the theoretical foundation of any discipline and helps to distinguish useful treatments and practices from those that offer no benefit or prove harmful. In addition, integrative health care therapies such as massage therapy, chiropractic and acupuncture have developed a sizable body of research to support their use. Research on the effectiveness of these therapies has helped facilitate their acceptance by conventional health care and the general public, and is a cornerstone of the shift towards evidence-informed practice across health care more generally.
Key to this acceptance is the effort to reduce language barriers between conventional health care and more person-centered, integrative approaches to health. As integrative practitioners are usually still in the minority within the larger health care system, it is particularly important that we be able to explain our work in terms that others can grasp. Understanding research greatly improves our ability to communicate effectively with other health professionals through a shared frame of reference and a common language. In addition to this general trend, there is also an increased tendency for massage therapists, acupuncturists, chiropractors, yoga therapists, and other practitioners to work in conventional health care settings as part of a team, or to become involved in multidisciplinary practices. With the growing trend towards interdisciplinary health care, the ability to communicate across disciplines will continue to assume greater importance.
Being able to locate and critically evaluate research in one's field is essential to providing the best possible care for clients. Evidence-informed practice is here to stay as the new standard across health care, and complementary and integrative therapies are being held to it. Because news about recent research is often reported in the popular media, clients or other health care providers may approach practitioners with questions about what implications a new study might have. It is incumbent upon practitioners to be able to discuss questions that arise from research in their field. Understanding how to evaluate research findings helps one to do this knowledgeably, with ease and confidence.
Research evidence has also assumed a major role in influencing health care policy on a national and international level. Policy decisions regarding what treatments are considered "best practices" and which will be reimbursed are increasingly based on research. Cost and consumer satisfaction have also become important study outcomes of interest. I believe that reading health care research offers every complementary practitioner a valuable tool for improving the quality of care you are able to offer your clients, and for ensuring that you and your loved ones receive the best possible health care. Understanding research is vital to the continued development of complementary therapies. And there is another yet important reason to become an informed consumer of research.
Science as a Social Activity
In evaluating the merit of any particular study, it's important to remember that science takes place via human interaction, through informal communication among colleagues with similar interests, more formal presentations and discussions at conferences, and publication of completed research findings in peer-reviewed journals. Knowledge-building is a social process just as much as it is a scientific one.
Because human beings are fallible, the social norms of science help to minimize the presence and/or influence of personal bias in the processes through which speculation becomes knowledge. These norms include an expectation of integrity in the design, conduct, interpretation, and publication of research studies. Peer review serves as an additional structure to maintain integrity. Journals do however have a tendency to prefer publishing studies with positive results. This tendency has been demonstrated and is known as "publication bias."
At the same time, as the number of university tenure-track jobs and the availability of grant funding decreases, there is increasing pressure for scientists to publish positive results. The blog Retraction Watch with support from the Center for Open Science has chronicled the rise in the number of scientific retractions since 2010 and maintains a database to document these. In the end, though, both honest mistakes and deliberate scientific fraud are eventually uncovered through peer review and the nature of how knowledge-building works. Knowledge-building is always provisional — in science, new information can always displace what we thought we knew previously.
Another example of scientific integrity is the practice among peer-reviewed journals of requiring disclosure of all sources of financial support for a study, so that readers can judge the extent to which the study could be biased because of who funded the research. As an example, a study concluding that smoking poses no substantial health risks in spite of numerous contradictory studies would be viewed even more suspiciously if it were funded by the Tobacco Institute. By the same token, research on herbs and dietary supplements has sometimes been viewed more critically when funded by companies that manufacture these products.
The philosopher of science, Thomas Kuhn, articulated the idea that scientific world views or paradigms define the kinds of research questions that may legitimately be asked. What is thought to be "legitimate" can vary according to the social norms and assumptions of a culture and what is considered within that culture to be useful or important knowledge. Historians of science have detailed the ways in which the practice of science has sometimes been distorted by dominant cultural biases, such as the infamous Tuskegee study.
Ethics in Health Care Research
It is also important to define how research may legitimately be conducted, a subject that has been influenced by social norms and cultural bias as well. Present-day scientists involved in health care research have a code of ethical principles that must be applied to both human and animal research. With respect to human subjects, two of the most basic principles of ethical clinical research are to:
Experimental studies are especially susceptible to ethical concerns because they involve direct intervention by the researcher in the lives or health of the participants. For this reason, the researcher is expected to make every effort to protect the human rights and well-being of the study's participants. Current standards for research ethics have been formalized since World War II. In the U.S., the Nuremberg Code (1947) and the Declaration of Helsinki (1964, revised in 1975) became the foundation for the formation of the National Commission for Protection of Human Subjects and Behavioral Research. This commission produced a document known as the Belmont Report.
The Belmont Report proposes that three core values should underlie all research endeavors: respect for persons, beneficence, and justice. The practical implications of each value are:
An outgrowth of the Belmont Report was the development of U.S. government regulations requiring the establishment of Institutional Review Boards (IRBs), to act as ethics committees to safeguard the rights of study participants. IRBs consider the scientific merit of proposed projects in light of the study's potential risks and benefits, and assess the procedures for selecting and recruiting participants, for ensuring appropriate informed consent, and for maintaining confidentiality of private health care information disclosed during the study. The IRB approves the proposed design of the study only if its benefits outweigh its risks, and then monitors the conduct of the study as it progresses. It is standard practice now for journals to require a statement from authors describing how ethical standards for the study were met when submitting a manuscript for publication.
Understanding the background concepts that underlie how scientific research is developed, carried out and reported can enhance our ability to be informed consumers of research. Just as it's important to not believe everything you read on the Internet, it's important to think critically when we read research.
Martha Brown Menard, PhD, LMT, is the director of the Crocker Institute and a licensed massage therapist in Kiawah Island, SC. She is the author of Making Sense of Research (available here). Martha is also the co-executive director of ACCAHC.
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