A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
March, 2005, Vol. 05, Issue 03
What Scope of Practice?
By Ralph Stephens, BS, LMT, NCBTMB
Most professions clearly stake out a scope of practice and then work to expand it. They work to plant it into law in each state and then grow it at every opportunity. Not the massage profession.We have consistently avoided defining our scope of practice. Our national leadership has consistently refused to draft model legislation and work to pass a standard law in every state so practitioners can have mobility, and the public can depend on a massage professional to meet consistent competency standards. Instead, volunteer therapists in each state have written their own laws from scratch, with minimal, if any, guidance. In the last two years, both the AMTA and ABMP have published some models, but they are suggestions - more guidelines than goals to accomplish.
Most massage therapists do not understand the legislative process and the nuances of drafting practice legislation where words mean something and a lack of words means something; mistakes have been made, not learned from, and made over and over, wasting years, thousands of dollars, and countless hours of effort. For proof of this, consider the hodgepodge of inconsistent licensing laws that have been passed, some of which are more of an impediment than benefit to practicing professionals.
In some states, teaching a seminar entitled "Medical Massage" is against licensing regulations. Due to poorly written laws, in some states, massage therapists cannot practice CranialSacral Therapy; in other states, stretching and exercises have been removed from our scope of practice. Some of our best educators cannot teach in some states because the way they practice the strokes (the same used by all forms of touch therapy) is not described or titled "correctly." Quite honestly, this is an embarrassment.
Whenever we have been challenged, we have given up scope of practice. Our scope is now more restrictive than it was 20 years ago. Some of our licensing efforts have become nothing more than a tax to practice, in some cases a voluntary tax. Want a license? Here you go. Don't want one? Fine - do your thing. The few good state licensing laws are constantly under attack, and there appears to be little effort by the professional associations to defend what we have, much less go for more.
Unfortunately, we are so politically correct that we dare not offend anyone. Since any time a group takes a stand on something - right or wrong - it offends someone or some other group, the massage profession has been very careful not to declare a meaningful scope of practice, a meaningful definition of our profession, or a meaningful piece of model legislation. The absence of leadership is not due to incompetence. Consciously or unconsciously, it is driven by money.
Nothing had better get in the way of the cash flow. The cash flow comes from anyone and everyone getting in easily and quickly. Zip them through school, sign them up in some association, sell them an insurance policy and maybe a license. In a few years most fail because of a lack of skills in both technique and business management; however, they are replaced by even more, quickly trained therapists.
The legal environment does not really matter; in fact, better for it to be muddled. As long as we can push some oil around and use the word "therapeutic," the system works very well for the system. "The mill" grinds up therapists, while the regulators, insurance vendors and associations fleece them. The 500-hour standard is a joke - it's not even long enough to be recognized as a profession by the government, which always sets the lowest possible standards for everything (well, except for taxes). Yet, a significant number of people in this profession feel 500 hours is too high.
The only thing saving this profession is the incredible power of caring touch, the good hearts and intentions of the majority of the people entering this profession, and the far too few excellent schools, whose owners really are dedicated to quality training and to the profession. Sadly, most of these owners have been therapist/educators for a long time and they are nearing retirement. When that generation hangs up their towels, I wonder who will carry on? Oh well, the cash flow won't go down without a fight. Corporations and bureaucracies are very good at maintaining the status quo. That said, may I suggest what I think our scope of practice should be? (Since it is my column, of course I can!)
The scope of the medical massage therapist or any massage therapist/bodyworker is simple. We should have the scope of practice to assess and treat - yes, treat - minor myofascial complaints. "Minor" meaning surgery is not required. (So the complaint can be major to the person with it! But surgical intervention is elective, not required.) Myofascial - meaning muscles, tendons, ligaments and fascia.
To do this we treat (there's that "T" word again) the soft tissues and the tonus mechanism (system) of the body using manual manipulation methods; stretching and movement; hydrotherapy; mechanical/electrical devices, which effect muscle tonus; nonprescription medications (homeopathy, herbals, supplements, etc.); and nonprescription topical applications. This is clear, simple, concise, and very open. If you think about this, you will realize what an incredible scope this would give us. I'll bet we could get that (and more) in every state with well-written legislation and the support of our patient base. Of course, to get it, we may have to increase training and competency. (Uh-oh. That will threaten cash flow. Sigh.)
Yes, this would probably mean a split in the profession to separate the amateurs from the professionals at both the school and therapist levels. The professionals might have to be divided into relaxation and therapeutic levels. Not necessarily, but probably. More training coupled to competencies, not just hours, will likely be required.
Obviously, this is an editorial / philosophy column. It is not intended to impose anything on anyone but to create awareness, plant seeds and encourage you to think. Keep thinking. I'll be back with more for May Day.
Try This: When faced with a complicated or seemingly difficult patient complaint with an intimidating diagnosis, approach the patient lovingly and respectfully, giving him/her your undivided attention. Respecting all applicable contraindications without causing pain (discomfort is ok, but pain is not), work to reduce muscle tone, ischemia and trigger points, increase circulation, and restore range of motion. By normalizing soft-tissue and movement, it is amazing how many complaints quickly lessen or go away.
Click here for more information about Ralph Stephens, BS, LMT, NCBTMB.
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