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Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
April, 2014, Vol. 14, Issue 04
Finding a Bridge to Somewhere
By Ralph Stephens, BS, LMT, NCBTMB
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, NCBTMB.
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