Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
August, 2008, Vol. 08, Issue 08
A Definition of Medical Massage
By W.D. "Peter" Lane, LMT, CNMT, NCTMB
There is a need to define the frequently used term "medical massage." One proposed definition would require a medical massage therapist to have significantly more training to qualify for licensure.The curriculum for medical massage would include cadaver studies, chemistry and nutrition, as well as an internship. The state would provide a separate license for a medical massage therapist, which would allow the practitioner to bill insurance. The insurance component would compensate a therapist for the additional required education. A medical massage therapist would work with a patient's primary care physician to provide optimum health for the patient.
One of the most vexing issues facing the massage therapy industry today concerns the term "medical massage." All health care professionals know what it is, yet few are able to define it. Yet, when we as bodywork practitioners answer the question of what medical massage is, we will further the goal of legitimizing and establishing advanced bodywork in the health care environment.
Why is "medical massage" creating such a stir in the massage and medical community at large? Who should be allowed to practice medical massage and how? When is it indicated and when is it not? I attempt to answer these questions from the standpoint of a licensed massage therapist and a certified neuromuscular therapist who has been treating patients in New Mexico for the past 12 years. My opinions are based on practicing in both the massage and medical environments.
I have come to these opinions based on a sincere desire to see the perception, understanding and appreciation of bodywork advanced throughout the U.S. with some degree of uniformity. More importantly, the bodywork industry needs a universal definition so when a patient seeks out the services of a medical massage therapist he or she will know that therapist is licensed and properly trained to treat their pathology. It's important to define medical massage to both eliminate imposters and to protect legitimate medical massage therapists.
In my opinion, medical massage should:
These days, many other definitions of medical massage are floating around the country. Some serve the limited financial gain of a person or organization promoting a particular definition. Some definitions state medical massage should only be practiced in a doctor's office under the absolute control of an MD or DC. If practiced in a PT clinic, it must be under the domain of a PT. One organization states only students who take their "national certification examination" in medical massage should be recognized as a medical massage therapist.
From an insurance billing perspective, there has been recent litigation attempting to prevent a bodyworker from filing insurance unless they are a "medical massage therapist." Fortunately, when the judge asked for a definition of medical massage and none could be offered, he ruled in favor of the massage therapist. It has become quite clear these definitions do not have at their core the benefit of the patient.
Under the definition I propose, an LMMT (licensed medical massage therapist) should be someone who has received training requiring more than the universal 500-hour training threshold that has become the norm for massage therapists. The curriculum should require more hours in anatomy and physiology, pathology, patient assessment, kinesiology, musculoskeletal anatomy, including cadaver studies, chemistry and nutrition. The curriculum would include alternative therapy electives, a segment on business and ethics, practice management and insurance billing.
I also propose a significant clinical practicum and internship. Included in this formula is a continuing education requirement that exceeds the current eight to 16 continuing education units required biannually by many states. The extra education can be accomplished within the context of a 2,000 to 2,400-hour program similar to the structure of training programs in place in Canada where 2,200 to 3,000-hour programs are standard.
An LMMT would have the option of practicing in a controlled environment such as an HMO, working in private practice or something in between. The state would be required to adopt separate licensure for LMMTs. Furthermore, the LMMT automatically should be included in the mix of approved therapies for insurance billing.
The benefits for patients and therapists are obvious. The patient will know his or her therapist is properly trained, qualified and competent to treat the condition they have been referred for. The therapist will have the satisfaction of knowing their training will bring measurable results to the patient and they will be compensated for their work by insurance. The insurance industry benefits by knowing an LMMT is ethically and legally following a standard of treatment and documentation. By arriving at a national consensus about the definition and training of an LMMT, the U.S. will have gained a cost-effective tool in containing spiraling health care costs.
A quality-driven, credible medical massage therapy program should be predicated on proper program development and organization complimented by a competent and experienced teaching staff and utilized in an active clinical environment. Too often, education and competency have not paralleled each other and curriculum has not been problem-centered and patient-based.
The following curriculum outline is designed to assist preeminent institutes for higher education in the medical massage industry. The medical massage program can be implemented in stages as instructors are trained and certified or offered as a comprehensive second-tiered advanced program.
Medical Massage Therapy Curriculum Outline
Anatomy and Physiology:
ACI-Cell anatomy and physiology
The chemistry and physiological processes of the body.
Musculoskeletal pathology and related disease processes.
Nutrition and your patient. Pharmacological and nutritional interactions and outcomes.
Medical Massage Theory and Disciplines:
Assessment Procedures and Protocols
Advanced Musculoskeletal Palpation:
Cadaver Dissection I-V
Medical Massage Clinical Practicum
Medical Massage Externship Program
Business and Ethics:
Insurance billing for the medical massage therapist.
History of Medical Massage
W.D. "Peter" Lane is director of the NeuroMuscular Therapy Center of New Mexico in Albuquerque, N.M. He is an instructor of anatomy and physiology and maintains a private practice treating patients who present with a variety of soft-tissue dysfunctions. For more information about the NeuroMuscular Therapy Center of New Mexico visit www.salubria.org.
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