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.
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."
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.
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?
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.
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.
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).
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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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.
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.
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.
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.
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.
June, 2010, Vol. 10, Issue 06
Heating Up Your Practice Safely: Feedback From Readers
By Dixie Wall, Contributing Editor
After receiving many compelling comments to the two-part series, "Heating Up Your Practice Safely," I was inspired to publish some of the common questions and insightful comments I received. As always, I appreciate your questions and comments and am always open to being educated by my readers.
"Thank you for the much-needed article on safety while using heat during massage therapy. I would just add multiple sclerosis to your list of conditions in which to avoid heat. Though it is considered to be an auto-immune condition, some may not know that and cause great harm. Thank you so much."
Thank you for your response to my article. Multiple sclerosis is an important addition to the list of diseases contraindicated for heat therapies. Multiple sclerosis is a chronic, often disabling auto-immune disease that attacks the central nervous system, which is made up of the brain, spinal cord and optic nerves. More specifically, the body's own defense system attacks the myelin sheath (the fatty substance that surrounds and protects the nerve fibers in the central nervous system) leading nerve fibers vulnerable to damage. The injured myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is interrupted by scar tissue, nerve impulses traveling to and from the brain and spinal cord are distorted or incomplete, producing the variety of symptoms that raise a red flag for heat therapies. Among these are numbness, tingling, weakness, spasticity and unsteadiness of a limb. Fever, hot baths, sun exposure, and stress have all been associated with triggering or exacerbating an attack. Thanks for your contribution.
"I enjoyed your article in this month's Massage Today on hot stone therapy. I practice in Florida and as of March of this year my liability carrier (International Massage Association) announced that due to the increase in claims due to burns, they will no longer cover hot stone therapy. I have talked to other massage therapist with different carriers and they have had the same response. I've also noticed in various spa advertisements that they have dropped hot stone therapy from their ads as well, and one has changed from hot stone to warm stone.
"I have wanted to take a course for some time now but am shying away from doing so because of the change in policy. My question to you is, if the client signs a consent form and ends up with a burn and the therapist is not covered, what the legal ramifications would be. Of course this would have to happen now! Thanks for your input and I look forward to your forthcoming articles."
It appears as though your current massage malpractice insurance policy no longer meets your individual needs. I don't give legal advice, but I do know it's never wise to gamble with one's livelihood by carrying a policy that does not cover all the modalities you practice. It may be time to switch insurance carriers.
"I think you have pointed out a lot of great things in your article about hot stones. I would have liked to have seen something about the hygiene, i.e., how to care for the stones, cleaning and sanitation, since the stones are kept in the perfect environment for bacteria to flourish."
Thank you for your response. You bring up a crucial issue. Due to the increase in bacterial and virus outbreaks over the last decade, the Centers for Disease Control & Prevention (CDC) has put a major emphasis on hand washing and routine sanitary procedures, especially in health care settings. Hospital and clinical settings are a major cause of the spread of many of these "super bugs." Unlike the common cold or a flu virus, these new super bugs spread by direct skin-to-skin contact or with contaminated objects. Carelessness or lack of proper sanitation procedures may make the massage therapist a perfect route for transmission of infection.
According to the South Carolina MRSA Infection Protection Act: "Methicillin-resistant Staphylococcus aureus (MRSA) is a common staph infection which is resistant to many antibiotics and which is increasingly prevalent in health care settings. A study published in the 2007 issue of the Journal of the American Medical Association, found that MRSA infections occur in approximately 94,000 persons each year and are associated with approximately 19,000 deaths; approximately eighty-six percent are health care associated."
In our practices, we have an obligation to ensure each client is protected from these "super bugs" with the safest routine clinical procedures. Different practitioners have their own unique way of sanitizing and/or cleaning their stones and massage tools. Some boil their stones in salt water or wipe with alcohol, others scrub the tool with soap and hot water. I've even heard of therapists using the dishwasher to sanitize the stones. With all the different methods of sanitation what is the safest standard procedure?
One of my teachers, Jenny Ray at Sacred Stone Therapy, has provided me with the latest information on sanitary procedures from the Geothermal Therapy Association (GTA). According to Ray, "The CDC has recently approved GTA recommendations as sufficient for protecting the client from H1N1, HIV AIDS, MRSA and other staph infections. The recommendations are as follows:
Stones should be washed as soon as possible after treatment, as the longer the oils and bacteria stay on, the harder they may be to remove. The critical issue is that the antiseptic routine must be done between each individual client. For more information, refer to the GTA Web site at www.stonewalkersassociation.com which will soon be moving to www.geothermaltherapy.com.
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