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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
May, 2014, Vol. 14, Issue 05
CAMTC Sunset Hearings Reveal Concerns
Prostitution, human trafficking, law enforcement and operational questions come to light at legislative hearings.
By Kathryn Feather, Senior Associate Editor
In the midst of its Sunset Review process, the California Massage Therapy Council (CAMTC) finds itself addressing concerns from law enforcement agencies, city and county leaders, as well as a former board member, all urging the California legislature to sunset - or put an end to - the CAMTC and put massage therapy regulation under the California Department of Consumer Affairs.
When the CAMTC was established in 2009, many saw this as an opportunity for the profession to show it could govern itself, harness the estimated millions in potentiall annual licensing fees and provide a model for other states to follow. However, as the sunset review process continues, this experiment could be coming to an end.
Senate Bill 731 (passed in September 2008) established a two-tier voluntary certification system that allowed a massage therapist to practice lawfully throughout the state without being subject to city or county ordinances. It also established the CAMTC, a private nonprofit organization acting as the regulator of massage therapy certification.
Prior to the passage of SB731, massage therapists in California were subjected to the ordinances enacted by individual cities and counties providing for the licensing and regulation of the business of massage. It was a patch work of various regulations many therapists were eager to see disappear as they were often paying multiple fees to practice in more than one city or county.
The sunset review process is a normal assessment of state regulatory programs, established to determine whether they should be continued by the legislature. The process for CAMTC began in 2013 when the group began drafting its sunset review report and continued on March 10, 2014 with a joint hearing before the Assembly Business, Professions and Consumer Protection Committee and the Senate Business, Professions and Economic Development Committee.
Without legislative action, the CAMTC in its current form is set to sunset - or cease to exist - on December 31, 2014.
Law Enforcement Concerns
The CAMTC has had to garner support from law enforcement and city and county officials from its inception. CAMTC CEO Ahmos Netanel said the group has "a robust communication protocol with the majority of local jurisdictions. In December 2013, we reached out to more than 400 police chiefs and sheriffs and offered a no-cost training for their officers. So far, we have received more than 120 requests for our specialized training. In the past 90 days, we trained approximately 500 law enforcement officials, including police chiefs, sheriffs, FBI agents and district attorneys."
However, the League of California Cities was quick to trot out legislators, mayors, council members and law enforcement agencies to urge the legislature to sunset SB731 and the CAMTC, as they believe this process as it stands lends to the proliferation of illegitimate massage establishments, prostitution and human trafficking.
The League is seeking a restoration to local control over massage therapy businesses. The League's Legislative representative, Kirstin Kilpitcke, outlined several priorities in her testimony at the joint hearing, including having a state agency oversee certification and licensing of massage professionals rather than a nonprofit; requiring owners of massage establishments to be responsible for what occurs in their businesses; modifying the language that authorizes local governments to regulate massage businesses to the extent a jurisdiction "uniformly" regulates all other business professionals; and clarify the statue so that local governments can charge fees to recoup the costs of enforcing the statue.
These issues stem from the fact that under the current legislation, CAMTC is only responsible for certified employees and owners. If an owner of a massage business is not certified, CAMTC can take no action against that owner and local governments have, "their hands tied and cannot regulate these businesses," according to the League. The League also said that, "because cities and counties do not uniformly regulate business professionals, the existing law effectively prevents the regulation of the massage industry."
In her testimony, San Francisco Supervisor Katy Tang expressed concerns with SB 731, saying certain provisions leave the city unable to regulate and manage massage establishments and that the city has lost significant oversight authority. Tang said many establishments closed by the city have since reopened under the CAMTC certification process.
Prior to the hearing, staff for the joint committee issued 19 recommendations related to CAMTC and its operational structure. CAMTC addressed much of these recommendations in its testimony before the committee.
In his testimony, CAMTC board member Michael Callagy, a former deputy police chief, said that, "CAMTC recommends that it be given the authority to implement a voluntary registration program for establishments. Establishments that are not registered with CAMTC would be subject to whatever regulation a local jurisdiction would see fit to impose, regardless of whether all massage providers are certified or not." Callagy said the funds for such a program would come from existing CAMTC financial resources.
Also in response to the issues presented regarding increased local control, Callagy testified that, "CAMTC agrees that legislation should be passed which strikes a better balance between the needs of massage professionals and local control. For this reason, it has proposed legislation in 2014 that will provide local government with the explicit authority to address establishments that use massage as a subterfuge for prostitution and supports CAMTC voluntary registration of massage establishments."
Netanel said he "found the issues the committee staff raised to be sensible and predictable" and that "CAMTC is in the process of formulating a response."
In his testimony, CAMTC former board member and ABMP Chairman Bob Benson acknowledged some successes from CAMTC but sided with the staff's recommendation that "a strong argument can be made for the continuation of some form of professional regulation: statewide regulation is more efficient, consistent and the norm across the majority of states."
Benson, who served as the initial Vice-Chair and participated in 51 of the 52 board meetings held during his 2009-2013 tenure, stated in his testimony that, "the model of voluntary certification by a nonprofit organization was a good one for a five-year transition from a confusing hodge-podge of local massage regulation, often administered by individuals with little understanding of the health benefits of massage therapy and limited capability to assess whether someone seeking to provide massage was in fact well prepared to do so."
But, Benson went on to state that, "unfortunately, CAMTC approaches to managing its affairs have not matured. With no state funds provided, CAMTC initially had to make several expedient choices about cobbling together resources. As financial stability was secured, though, senior management turned a deaf ear to suggestions for building a stronger, lasting management structure."
"Weaknesses in CAMTC's underpinnings keep emerging. The staff background report cites numerous areas of CAMTC administrative weakness:
Benson went on to state that, "despite CAMTC spending over $500,000 a year for outside lawyers, a continuing backlog of hundreds of applications still awaits CAMTC attorney action to issue proposed denial or revocation letters and final letters of determination."
"The organization lacks a seasoned Controller/COO. Information systems are inadequate for needed controls." To prove his point, Benson cited the original report submitted by CAMTC to the legislative committee. Benson said it was, "riddled with errors on matters as fundamental as the number of certified individuals by category and the status of those who had been referred to PSD ... and it took CAMTC staff five weeks to produce corrected data."
"That's a portrait of an organization lacking sufficient administrative control. And now, on top of these deficiencies, CAMTC is seeking to shoulder additional responsibility for approving massage establishments and inspecting massage schools. It's delusional," said Benson.
Benson instead urged the committee to:
"The state board model works well in scores of other states. It is time for that model in California," said Benson.
CAMTC is currently formulating its response to the staff recommendations and concerns cited by those providing testimony during the legislative hearings. According to Netanel, April 29th is the last date for the sunset bill to be out of the committee and CAMTC is waiting to receive the proposed bill language.
In the meantime, there are currently four bills before the state assembly that could potentially impact the massage therapy profession (AB 1904, AB 1147, AB 1747 and AB 2739).
The purpose of AB 1147 is to "enhance the competency requirements for persons seeking certification as a massage practitioner by requiring an applicant to take and pass a massage and bodywork competency examination in addition to the 250 hours of education currently required." Assembly Bill 2739 would extend the provisions of the existing law until January 1, 2019.
With passionate testimony from both those advocating the success of CAMTC and those advocating for sunset and a state board, several scenarios remain. The legislature could sunset CAMTC and the state could revert back to the patch work pre-2009 regulations. The legislature could extend existing law to 2019 and keep CAMTC in operation as is or with various modifications found in the four bills currently before the legislature. The legislature could make licensure mandatory and put the process under state control as suggested by Benson and many local government officials and law enforcement agencies.
"CAMTC is proud of its successes and we look forward to working with the police chiefs, the local communities and other stakeholders to do great things for the massage profession and the public," said Netanel.
Massage Today will continue to report any updates to the sunset review process as details become available. To contact your legislature and let them know about your experience with CAMTC, visi www.leginfo.ca.gov/ to find the representative for your area. If you wish to contact the committee directly, visit http://abp.assembly.ca.gov/membersstaff or call (916) 319-3301.
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