The Opioid Crisis Hits Home: An Acupuncturist's Inside Perspective of Addiction Treatment
My husband and I have four grown children, but we still sleep with a phone next to our night stand just in case they need us. But nothing could have prepared us for a 1 a.m.
Power of the Talk: A Simple Way to Attract New Patients
One of the most effective ways to bring patients in predictably, especially if you enjoy teaching, is by doing talks. Talks can also bring in another stream of income beyond just seeing more patients one on one.
Who's the "Father of Corrective Traction" in Chiropractic?
History teaches that a Presbyterian minister, Samuel Weed, coined the name for the profession of chiropractic from the Greek cheir for "hand" and praktos for "done."
How to Reduce Metabolic Endotoxemia
Approximately 50 percent of the Western population suffers from a condition known as metabolic endotoxemia (ME). The condition is characterized by increased serum endotoxin concentration during the first five hours of the post-prandial period.
The Medicine of Peace in a Land of Conflict
We often read about violence, despair, and political stalemate between Israelis and Palestinians. It's easy to feel overwhelmed and pessimistic. And yet there are Israelis and Palestinians working together to transform conflict into cooperation.
Weight Watchers Goes Wellness
Goodbye Weight Watchers, hello "WW." The company has changed its name to reflect its new WW brand not only on its website, but also on every aspect of its public expression, including every studio.
ACA, ICA at Odds Over H.R. 7157
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.
Winter Joint Health: Looking at Seasonal Influences
One of the most common clinical issues I see during the winter season is joint / muscle pain. These issues often appear due to the activities of winter sports or may appear due to seasonal influences on old chronic injuries.
An East & West Perspective on Sleep
You, your patients, and people all over the world are sleeping less. In 1979 a team led by American psychiatrist Daniel Kripke did a large-scale study of over a million people, which indicated that most people slept between 7-8 hours.
Dehydration ... A Commonly Overlooked Etiology
Water covers 71 percent of the earth's surface. It's found in every living organism and is considered the "universal solvent," yet we take it for granted as the foundation for optimal health.
Historic Farm Bill Provisions Legalize Hemp ... and CBD?
Until recently, hemp was classified as a Schedule 1 drug per the federal Controlled Substances Act, putting it in the same class as marijuana (and heroin, by the way).
Electromagnetic Hypersensitivity and the Science of EMFs
Movement of planet Earth's molten iron core generates a weak static geomagnetic field that varies in strength over millennia but currently ranges from 0.25 to 0.65 gauss. This is the native field in which all life has evolved.
3 Tips to Get New Patients After a Talk
One of the most effective ways to bring in new patients predictably, especially when an acupuncturist enjoys teaching, is by doing talks. It can also bring in another stream of income, beyond just seeing more patients one-on-one.
Differentiating Qi Under the Needle (Part 2)
While classic sages have said a lot on this topic, I will share my own experience with the sensations under the needle with you. You, in turn, will also need to gain your own understanding of them through daily clinical observation, thinking, and practice.
Neuroscience 101: Understanding Opioid Addiction and How Chiropractic Can Help
Opioids now account for nearly two-thirds of all overdose-related deaths in the U.S. This insidious bane is no respecter of gender, age, race or ethnicity, with nearly all categories experiencing increases.
Case Study: Forefoot Pain
Patient presents with a history of forefoot pain. Discomfort has become worse in the past six months. He has difficulty completing his four-hour shifts as a part-time hairdresser.
Pain in the Butt (Pt. 1)
Many of my patients (and probably many of yours) come in with pain and/or tenderness in the buttock region. First, I assess where the painful and/or tender spots are located and what these points represent.
Flying Into the Year of the Pig: Making Way for the Impossible
The first of the new year has passed, and some of our New Year's resolutions may have already come and gone. Fortunately, we will celebrate the Chinese New Year this month, and will welcome in the Year of the Pig.
Quickie Seminar Adjustments Have No Place in Chiropractic
Recently, I observed chiropractors treating each other in the vendor area at the annual meeting of a chiropractic association. "Quickie" chiropractic adjustments and other hands-on procedures were administered without appropriate history taking, physical examination, diagnosis or informed consent.
The Role of TCM When Treating Mental Illnesses
Mental illness is common in the U.S., nearly 20 percent of adults live with a mental illness which vary in degree of severity—ranging from mild to moderate, to severe. It is not exaggerated to say that mental illness is an epidemic.
Simple Screening Tests for Stroke and Other Brain Lesions
The drift test, arm rolling and finger rolling are three useful assessments in the identification of upper motor neuron dysfunction.
Top Social Media Do's & Don'ts for Chiropractors
For years, health care practitioners have avoided embarking on the social media highway, primarily due to patient HIPAA privacy issues and the time needed to give the process due diligence.
Outcomes for Any Occasion
Outcome assessment tools (OATs) are a necessary part of documentation and patient care. They are used to show patient progress and help practitioners show changes as a result of their treatment interventions.
Quick Sacroiliac Assessment: Treating Different Types of Pain
The lower back is a generator for a number of types of pain. The lower back involves several different articulations – the lumbar spine with vertebral bodies, discs, and facets – the sacroiliac joints – and the lumbosacral junction.
Know Your Clinical Flags: 5 Different Colors to Consider
In health care, the term red flag is used to describe signs and symptoms that can indicate the presence of serious health conditions. These conditions generally carry an increased likelihood for serious complications, disability or even death.
March, 2006, Vol. 06, Issue 03
Success With the IRS
By Dixie Wall, Contributing Editor
The IRS is cracking down on spa owners for classifying their therapists as independent contractors when, in fact, they are employees. The penalties for this violation are severe and can equal 100% of the tax that should have been withheld, or more.This punishment can be held against both the spa owners and the massage therapist. The reality is that, in this business, it's estimated that up to 99% of spa and wellness center owners with booth rentals or independent contractors would not pass an IRS audit.
Many businesses have been gravely affected by audits due to their ignorance of tax laws and bad legal advice. The choice of whether to classify a massage therapist as an employee or an independent contractor depends on several factors, such as the specific goals of the business and the personalities of the individual therapists.
This important difference between an employee and an independent contractor is determined through strict IRS regulation and under common law. Each factor depends on the degree of control shown in the relationship between the business and the independent contractor or the employer and the employee. It's not imperative that he or she actually exercise this control, but that he or she has the right to do so. There are three degrees of control and independence: behavioral, financial, and finally, the parties' relationship.
Attempting to "simply" follow each specification of the IRS's 20-point test will produce a large gray area of misunderstanding. Nevertheless, to follow each of the 20 specifications to a T would be like driving in exact accordance with the Department of Motor Vehicles handbook it's nearly impossible.
In the behavioral category, a business determines whether it has a right to direct and manage the employee or independent contractor. Any instructions given to the worker, including when, what and in which order to do the work, which tools to use, what workers to hire, and where to purchase supplies, are all contributing factors. Since an employee usually receives formal training from the employer, the key question is whether the business has the right to control the details of workers or whether the independent contractor uses his or her own methods.
The financial control category of an employee usually is seen as an extension of the employers set business structure. Independent contractors are more likely to have non-reimbursed expenses and an investment in the facilities he or she uses. Moreover, the method of payment from the business to worker is paid as a flat fee, rather than an hourly wage.
Ken Cassidy, of Cassidy's Management Consulting, has been working with the IRS to make them more familiar with the spa/salon independent contractor system. "Typically, at the end of the calendar year, the salon/spa owner provides the independent contractor and the IRS with a 1099 tax form showing how much he or she has been paid in fees. The IRS would be unlikely to consider a massage therapist who worked at the same spa every day an independent contractor," Cassidy said. "According to the IRS, 99.5% of spa workers don't qualify as contract laborer people, or independent contractors. Independent contractors don't work on a regular schedule, with regular hours, and they usually work for multiple businesses." So, when you find you're in a 9-to-5 monogamous relationship with your employer, you are an employee.
The category that defines the parties' relationship is determined by written contracts. If the business provides benefits such as insurance, a pension plan, vacation or sick pay, it would indicate an employee-type relationship. The permanency of the worker at the location and the extent that the individual has freedom to conduct his or her own separate entity also is a contributing factor. The spa owner must save all those fringe benefits for the employee, because an independent contractor trades in benefits, as well as financial security, for their freedom.
Ultimately, to share a common interest in the same business would imply an employer or employee arrangement. An example of this setup could be paralleled with a dance teacher who works at a dance studio. She brings all her own music and decides exactly what and when she will teach. Since the owner of the dance studio and the dance instructor are in the same type of business, the IRS considers them integrated. However, if the dance studio hires a plumber to fix the toilets every week, the plumber is still independent because he is in the business of plumbing, not the business of dance.
Another system of dealing with these issues, the Licensee System, was developed by Ahmos Netanel, president of Lucrative Spas. The Licensee System utilizes an outside company as a middleman between therapists and their clients. "This method has survived four different tax audits," Netanel said. "The system appeals to spa owners to work with self-starting therapists who don't require a lot of management."
In the end, the booth-rental system may save the business owners overhead costs by saving the money otherwise spent on taxes. Many start-up salons recruit these booth renters due to their tendency to be more productive than employees. Becoming a booth renter gives the therapist a greater sense of flexibility to conduct business when and how they choose. Some salon and spa owners recoil at the thought of receiving only rental income, while others feel uncomfortable with the loss of control. This usually can be avoided by putting together a contract for all parties involved, which states all requirements and establishes a standard of professionalism, such as discussions of termination issues and any other specific recoup costs.
Your choice of whether to have employees or independent contractors should depend on factors that would make one outcome favorable to another. To ensure the success of the individual employee and small-business owner, their personalities, long-term goals and their finances must be carefully and clearly contracted. In the age of the paper trail, it's wise to document everything, in full, with adequate legal advice. Remember, if you misclassify, you are eligible to be pulled aside, and unlike the DMV, the IRS will stick you with more than a speeding ticket.
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