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Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
Have a Heart: Say No to Soda
It's not enough that soft drinks and other sugar-sweetened beverages have been linked to cavities and weight gain, among other negative health consequences.
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
News in Brief
Controversial Florida PIP Law Under Review; D'Youville Chiro. Students Learning Art of Co-Managing; And the Award Goes To...; F4CP Recognizes Major Contribution by ChiroTouch.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Side Effects From Big Pharma: Wellbutrin – Dangerous for You and Your Baby
Are some of your pregnant patients taking Wellbutrin? If so, it could be a danger to them and their baby. This drug is extremely popular, but it has a serious history.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
April, 2010, Vol. 10, Issue 04
Do the Planes Land?
By Keith Eric Grant, PhD, NCTMB
In the South Seas, there is a cargo cult of people. During the war, they saw airplanes with lots of good material and they want the same thing to happen now. So they've arranged to make things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head to headphones and bars of bamboo sticking out like antennas - he's the controller - and they wait for the airplanes to land. Richard P. Feynman1They're doing everything right. The form is perfect. It looks exactly the way it looked before. But it doesn't work. No airplanes land. So I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but they're missing something essential, because the planes don't land. -
These are interesting times to watch separate threads of technological, political and multidisciplinary professional maturation converge and, at times, conflict. They are, in part, also interesting times for me personally to observe because I've long had involvement in different "camps."
One of the threads has been moved toward evidence-based medicine (EBM). A tutorial produced jointly by Duke University and the University of Northern Carolina-Chapel Hill sets out a definition: "EBM is the integration of clinical expertise, patient values and the best evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology."4
In EBM, we have the combination of patient/client-centered treatment with evaluation of evidence on effective treatment for specific conditions. The application of the concept was well discussed in a New York Times article by David Leonhardt.2 I do want to stress that being evidence-based does not remove the need or effectiveness of good client communication and rapport, nor contradict the observation that such rapport is, in and of itself, healing.3
Another response of health care to technology has been the emergence of standards for managing competency. These include maintaining learning modules, identifying learning gaps relative to job descriptions, and maintaining competency profiles for individual practitioners. While there are more general initiatives, much of the work in the health care realm seems to be centered with the MedBiquitous Consortium. These efforts will enable the management of job-oriented learning in health care to be more task-connected than has previously been possible.
On the political level, with the great majority of states regulating massage, a consortium of agencies with such regulatory responsibility becomes possible. This possibility was realized in 2005, with the creation of the Federation of State Massage Therapy Boards (FSMTB). It places the discussion and assessment of entry-level requirements where, under the U.S. system of laws, the legal right and responsibility of regulatory rests with the individual states. Within such discussions, however, are considerations of the essential body of knowledge that defines massage therapy as a profession and the definition of massage therapy as a health care profession. These, in turn, raise questions and conflicts.
One conflict comes in the definition of massage therapy as a well-defined health care participant, versus the much broader definitions that were used to move a panoply of practices out from under local government regulation. A second conflict is the definition of knowledge; whether what is claimed to be knowledge is specific enough to be verifiable, has a sound evidence base for effectiveness, and is consistent with known laws of physics. My opening quote is drawn from such considerations of science versus pseudoscience; in short, "do the planes land?"
Finally, technology has quickened the base and the inclusiveness of discussion. Particularly in recent months, forums under the Ning groupware platform have become a place for discussion, often with some fire and heat. Here, specifically, I'm thinking of the Massage Professionals site and the Science-Based Massage Therapy site.
Ultimately, these discussions will involve comparisons between organizations, countries, viewpoints, academic and organizational activities, and massage therapy with evolution of health care in general. The discussions are likely to be heated at times, but rarely dull. It can be an exciting and painful process to watch a profession evolve and mature.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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