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.
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.
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.
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.
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.
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.
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?
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.
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.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
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).
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
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:
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.
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?
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
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.
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.
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.
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.
#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.
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.
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.
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.
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.
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
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.
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.
May, 2009, Vol. 09, Issue 05
Malpractice Claims: Sexual Misconduct
By Dixie Wall, Contributing Editor
Sexual misconduct is not a new problem among health care practitioners. Hippocrates even added to his oath, "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or men, be they free or slaves." In order to prevent this damaging conduct from happening to our clients and in our practices, we must maintain appropriate boundaries and develop open communication. It is our responsibility as the therapist to establish these boundaries, and shift them to the needs of the client.
Malpractice and/or liability claims are generally categorized into malpractice, criminal or civil. Malpractice includes acts of commission and acts of omission.1,2 Acts of commission are unintentional or intentional acts, performed by a therapist, that result in some type of harm to the client. Acts of omission is more common among primary health care physicians such as doctors, chiropractors or acupuncturists and involves a failure to refer clients out when indicated, or some type of missed problem in initial treatment of patient. Criminal suits are usually claims that involve some type of illegal implication and ramification for unprofessional illegal conduct. This month, we will further discuss these criminal acts but more specifically unprofessional sexual misconduct.
According to the Medical Council of New Zealand, sexual misconduct can be divided into three categories. The lowest level of misconduct is defined as "sexual impropriety." "This is nonphysical contact of a patient that is inappropriate jokes, crude gestures ... or demeaning comments about a patient's undergarments." The next level is "sexual transgression," which is defined as, "inappropriate touching of a patient stopping just short of an overt sexual act." This can include unnecessary contact with the breasts and inappropriate draping or lack thereof. The last and most severe is "sexual violation." This is defined as, "a sexual act between patient and doctor, there is no distinction between which party initiated the contact and whether the act was consensual." When any type of sexual misconduct takes place, the issue is no longer in the malpractice realm but becomes a criminal issue. These illegal acts are usually excluded in malpractice insurance policies.
Health care professionals are held to higher standards due to the hands-on nature of our field. The one-on-one time spent with clients creates a special personal connection between the client and therapist where the client may share personal information that would not be shared to other types of professionals. With the exception of the health care professionals, people would generally never allow another service provider to touch them. This immediately places us in a unique position of trust as separate and distinctive professionals. Unfortunately, according to the American Massage Council's claims history, sexual misconduct is the number one type of claim against massage therapists.
Sexual misconduct is not limited to sexual interaction with a client. It can be an inappropriate comment, flirtatious behavior, look or gift. This type of misconduct can harm the client in many ways and has major repercussions for us as practitioners. These repercussions may include damaged reputations, lawsuits, and ultimately losing our permits, licenses and practices. How can these issues be prevented? Most experts in practice management recommend setting adequate and appropriate boundaries.
Boundaries separate your personal space from the space of the client. Most boundaries are created by the client and maintained by the practitioner. The maintenance of these boundaries can help us maintain a thriving and professional practice. There are several types of boundaries set by in practice that can help us to prevent any misunderstandings or mistakes that could lead to sexual misconduct.
The first and most important when it comes to sexual impropriety claims are physical boundaries. What kind of touch will we accept from a client when greeting them? What type of draping techniques should we use? According to an administrator at a leading massage school in California, "draping is the number one complaint from clients receiving massage in their clinic." Massage therapists must make sure that the client is properly, consistently and conservatively draped. Always give the client sufficient time in private to change before and after the massage.
The next way to protect yourself is by maintaining verbal boundaries, keeping open all lines of communication with your client. Listen to your clients attentively and comfort them through a routine professional protocol in treatment procedures. When explaining your treatment plans for the client, make clear what you are going to do, explaining again what you are doing while doing it, and then telling the client what you just did. Set the language in conversation on the telephone in a professional level. Always avoid improper slang, language and gossip, and keep client's confidentiality a priority.
Lastly, a first impression is always made with visual boundaries. Our society is based on visual recognition and appearance. Create your own professionalism by consistently practicing routine procedures and retaining a standard dress code. Uniforms can create a comfortable atmosphere by setting a familiar tone. Keep your office clean and neat.
Through establishing, encouraging and enforcing these boundaries, you will promote your profession, as well as the safekeeping of yourself and your clients. Next time, we will discuss three additional boundaries that can help us succeed in practice.
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