Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Hospice Massage: Paid vs. Volunteer
For more than a decade I've had the honor of getting acquainted with massage therapists from around the world who touch the lives of hospice patients. Many say they feel "called" to do this amazing work and they tell stories of the personal rewards inherent in working with people facing the final days of their lives. True as this is, we also need to consider an important practical issue — if, and how, we're compensated. I want to help you understand what you might expect if considering this field of service.
If you explore hospice websites, many list massage therapy service. But what won't be apparent is if the massage therapists are being paid or if they're volunteering their time. While I'm a proponent of paid programs and believe that a skilled therapist should be fairly compensated, the fact is that some of you choose to volunteer your time with a local hospice and I respect that preference. And some hospice organizations still only include massage therapy on a volunteer basis, if at all. That said, paid programs are growing and I expect that trend to continue.
Paid Hospice Programs
I don't know of a better way to answer questions than to share feedback from your peers around the country who are working in hospice programs.
What motivates hospice organizations to hire a massage therapist? The answer here is two-fold. First, hospice providers are competitive. Patients and their families have control over which hospice company they use and hospices have a vested interest in appealing to the wishes of potential clients. Today, people want access to complementary therapies. In short, having a massage therapist on staff gives them a competitive edge. It's sometimes hard for therapists to understand that hospices are businesses because of the nature of what they do. Here is an excerpt from one hospice's website about their company that highlights both the patient care and business aspects.
"[This] hospice is a service-driven organization relentlessly focused on patient care, customer service and compliance. We are privileged to provide end-of-life care. We are focused on increasing the number of patients we serve in our current markets and driven to expand our footprint."
Secondly, a hospice company may see massage therapy as a natural extension of their mission to provide comfort and quality of life for those with an advanced illness. Compassionate touch therapy helps ease symptoms, fostering physical, emotional and spiritual well-being and can be integrated into the interdisciplinary plan of care.
How are therapists getting started with hospice? We are still pioneering paid hospice massage programs and there are lots of ways therapists are finding their way into these jobs. Recently, I got a call from Lauren, who was contracted by a hospice group. She had been performing on-site massage for the hospice staff when the director mentioned they were looking for a therapist to work with patients. Evidently, they had a program in place but had trouble finding a therapist with the skills needed. Actually, this comment doesn't surprise me at all. It's not the first time I've heard about hospice programs failing because the therapists lacked proper training in working with this population. It's not the kind of work that basic massage therapy training prepares us for.
Michelle started working full-time for hospice only a few weeks ago. She had been providing massage as a volunteer and the hospice organization decided to convert her to a full-time employee position. She said, "I'm the guinea pig for the program, but I'm feeling good and it should be a great experience".
Anita reports that in starting the massage program almost six years ago, she was surprised at how well it was received. What started out as a part-time program blossomed to full-time in less than a month. Anita said, "I have come to believe it is not for every massage therapist. There is no prescribed method when working in this field. Flexibility and a willingness to expand your knowledge are the keys to success. There is also a different mindset required to do this. Sometimes massage therapists think they have to fix everything. The hospice model is more about healing and not curing."
Angela shares that, "I found out about the job by meeting a fellow massage therapist who was also a social worker for a local hospice company. From the very beginning, when this hospice was opened, a complementary/alternative medicine program was just as important to have available for the patients as the required positions (nursing, chaplains, social work, etc). They wanted, and continue to want, to offer alternatives to patients who prefer massage, acupuncture, or music over medication." It's becoming more common for hospice groups to advertise massage positions. Online listings can be found on job search sites such as Glassdoor.com, SimplyHired.com, and Indeed.com.
How does the company fund massage therapy services? Hospice care for most patients is paid by Medicare, although some people have private insurance coverage. I need to explain very briefly how Medicare payment works. Basically, Medicare pays hospice a flat, per-diem rate that covers all aspects of the patient's care, including all services delivered by the interdisciplinary team, drugs, medical equipment and supplies. Some hospice providers pay the massage therapist out of the Medicare per-diem funds. Others use money from another source, such as charitable donations or a foundation. A case in point is one hospice that has an annual fund raising event that raises funds for complementary therapies, including music, massage and pet therapy, as well as for the care of low-income patients and other services.
What are therapists' wages? Wages for LMT's hired as employees vary quite a bit. Therapists working full-time 40 hours per week report annual salaries of $33,000 to $45,000. Benefits vary, too. All include health and paid time off for full-time employees. Some companies also provide dental, vision, retirement fund, and tuition reimbursement. One therapist is a part-time employee, working about 20 hours per week and earns $25 per hour plus pro-rated benefits. Other therapists work part-time as independent contractors and reportedly earn from $45 to $75 per session, plus mileage reimbursement. Independent contractors are self-employed and do not receive benefits.
Hospice Volunteer Programs
Did you know that hospice providers must have volunteers in their program? It's a requirement for any hospice company receiving Medicare funds, which is nearly all of them. To comply with regulations, volunteers must provide day–to–day administrative and/or direct patient care services equaling a minimum of 5 percent of the total patient care hours of all paid hospice employees and contract staff. Hospice volunteers are made up of professional and lay persons and help with things such as household chores, shopping, transportation, pet care and companionship. Complementary therapies including massage, music, art and pet therapy may be part of a volunteer program. Volunteer services to patients and/or their families must be included in the hospice plan of care. As a hospice volunteer, you would be required to complete orientation training and submit documentation of patient visits, as well as mileage and travel time. Hospice companies have an incentive to seek your services on a voluntary basis as it helps them meet regulatory requirements, while at the same time providing something great for their patients.
Some therapists that volunteer have shared with me that their reason is to give back to a hospice for what it gave to their own family during a difficult time of loss. Others say they volunteer because it's the only option they have with local hospices. A word of advice about volunteering: be clear about your motivation and understand that rarely does a volunteer position become a paid one. If you really want to give your time and service, consider doing something other than your professional service. I have volunteered for hospice but instead of massage therapy, I served on a team that provided bedside vigil for dying people who didn't have family so that they would not have to die alone.
Setting aside the debate about paid vs. volunteer programs, I'm happy to say that massage in hospice is thriving and hospice patients have access to our service more than ever before. To those of you who reach out to people at such a vulnerable and important time of their lives, thank you.