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.
September, 2008, Vol. 08, Issue 09
Questions With Direction
By David Kent, LMT, NCTMB
One of the most challenging aspects of being a massage therapist is trying to build a thriving practice with repeat clients. So, it's no surprise that many therapists have felt the crunch with the recent downturn in the economy.Unfortunately, services like massage therapy often are among the first to be cut from one's budget in times of economic crisis.
Therefore, it is now more important than ever to convince your clients to stay the course with their massage therapy sessions. This article will show you how asking some simple questions can ultimately lead to repeat clients, whether you work in a spa, outcall, seated or clinical massage setting. Soliciting a client's feedback by way of asking thorough questions will better help you understand your client's needs and deliver results. Even more important than asking questions, however, is listening and responding to the information your client provides.
One way to organize your questions is to make use of the wide range of forms available for these purposes. In fact, your questions will, to a degree, be directed by the information you obtain using forms. I have my clients complete intake forms prior to therapy. These help me develop targeted questions to clarify my knowledge about their health history, specific areas of pain, stresses in their life, ergonomics of their activities of daily living, medications they are taking, and to identify any precautions or contraindications before the session begins. Using intake forms helps me develop goals for the client's current and future sessions, which also is useful in persuading my clients to commit to ongoing treatment.
There are various types of questions. However, this article will focus on two primary categories: general and those related to a client's pain. General questions are great for helping you understand your client's expectations no matter what kind of practice you have.
Question: What are your goals for today's session?
Reasoning: If you don't ask this question, you won't know if a client wants a relaxing Swedish massage or a vigorous sports massage that integrates stretching. This also is important so you're responding to your client's needs and not responding to your perception of your client's needs.
Question: What areas would you like me to focus on today?
Reasoning: This question also relates to the previous question. At one time or another, we've all probably had an experience with a therapist who seemingly ignored the very thing that brought us to therapy in the first place. When you ask this question, it's very important to listen closely to the answer. When you listen to the client and deliver results, it increases the odds your client will reschedule and/or refer others.
Question: Have you received massage therapy before?
Reasoning: Regardless of the client's answer, this is the ideal time to communicate to the client how you will perform the session. For new clients, you might advise the client to disrobe to their level of comfort and then discuss draping techniques. For veteran clients, you might ask if they'd like you to do something extra special, such as incorporate essential oils into the session.
Question: If you have received massage therapy previously, please tell me where you received it, by whom, and which treatments were the most beneficial?
Reasoning:This information can help you understand how to adapt the session to the types of massage therapy that have produced positive responses for the client in the past. You might also ask the client what they think makes a great massage - and then do what you can to meet the client's expectation.
Question: What type of pressure do you prefer?
Reasoning: Keep in mind that levels of pressure are subjective for each client. What you perceive as light pressure and what the client perceives as light pressure could be entirely different. It's important you check in with the client at the start of and during the session.
Question: Have you ever had any negative effects and/or experiences from receiving massage in the past?
Reasoning: People respond to massage in different ways. Some get ill or are sore for several days after they receive a deep massage. This is where intake forms and questions can be very useful. Some questions might include what medications the client is on, if they bruise easily, what the client's diet is like, as well as questions related to general health and exercise.
Question: Is there anything else I should know?
Reasoning: I intentionally keep this question open-ended so the client can add additional information at their discretion. It's up to me to connect the dots. I am frequently amazed by how many clients will tell me about a traumatic accident and/or major surgery in the past that they didn't mention previously.
Questions About Pain
Question:What other health care providers have you seen recently and for what?
Reasoning: This question immediately informs you if your client has seen a doctor or if the client has self-diagnosed. I can then quickly perform a postural analysis (See "Getting Comfortable with Postural Analysis" in the July issue), check range of motion and perform relevant muscle tests and orthopedic assessments to determine if it's appropriate to proceed or if the client needs to first follow up with a physician.
Question: Have you tried different health care practitioners over time? If so, which one(s) provided the most relief? What did they do and how long did the results last?
Reasoning: Understanding more about the treatments a client has sought for pain relief will give you insight into how you can best help them. For example, if the client sees a chiropractor on a regular basis, you might suggest they schedule an appointment with you immediately before the appointment with their chiropractor for maximum results.
Question: What do you do for pain relief?
Reasoning: I am always surprised by how many people buy topical pain relievers at a drug store. Why should the drug store get the money? Consider selling topical ointments in your practice. Integrate a topical into the therapy session, then send the client home with a sample. The next time the client buys a topical ointment, it might just be from you.
Question: What aggravates your condition?
Reasoning: If the client reports increased back pain when standing or straightening after bending down, it might indicate lumbar and hip flexor or extensor involvement. A muscle movement chart can help you determine exactly which muscles to assess. Trigger-point charts are useful for educating clients about referred pain. Additionally, using the postural analysis information combined with photos helps show the client how stressed or shortened muscles have contributed to the formation of trigger points. This further leads into a discussion of how a series of treatments can be beneficial.
Asking the right questions can help your practice tremendously. I am looking forward to learning how the questions in this article worked for you. I encourage you to read my other articles that can help during these challenging economic times.
Click here for previous articles by David Kent, LMT, NCTMB.
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