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.
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 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?
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 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.
"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.
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?
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.
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.
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 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.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
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.
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.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
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.
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.
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
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.
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.
#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 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.
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.
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).
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.
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:
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.
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.
July, 2010, Vol. 10, Issue 07
The Initial Treatment: Generating Thousands to Your Practice
By David Kent, LMT, NCTMB
After nearly two decades of owning a clinic, managing therapists and treating patients to this day, I have learned to never underestimate the potential income of a new client, when their initial treatment includes the appropriate education.A client who is well-educated on the tremendous benefits of consistent massage will more than likely become a regular client. And potentially, after an initial treatment, one client can generate tens of thousands of dollars to your practice.
In the early 1990s, a client was referred to my clinic with symptoms of pain and restricted range-of-motion (ROM) in their neck and low back. During that initial treatment, I provided pain relief along with education to help the client understand why he was in pain and how continued treatments would help improve his quality of life. To this day, that same patient spends hundreds of dollars in monthly self-care treatments when he visits Florida. This adds up to thousands of dollars annually, and tens of thousands of dollars since his initial visit.
Whether you work for yourself or someone else, the initial treatment often determines the number of future appointments scheduled, the purchases of other products or services, future referrals and possibly the amount of your gratuity or bonus. This article will cover various ways to educate patients during their initial treatment to build your practice and attract patients who will spend tens of thousands of dollars.
During the initial treatment the patient is evaluating whether they should invest future time and money on more treatments. Since you only get one chance to make a good first impression, make it count. Start by being thorough and have clients complete health intake and pain intensity scale forms to document their past and current conditions. On a diagram of the body have the patient shade the areas that hurt, indicate the pain type (e.g. aching, dull) and intensity (0 = no pain / 10 = excruciating pain) they are experiencing. (Fig. 1)
These essential forms will help the patient to clarify and the therapist to quickly understand: When the pain started and what may have caused it? What has been tried in the past for relief and the results? Do they believe the condition is temporary or permanent? What movements aggravate the pain? If there has been a medical diagnosis: when, by whom, and what tests or imaging were performed? What activities of daily living (ADL) is this pain effecting and how has the pain modified those activities? What are their goals for today's treatment? (Read "Questions with Direction" MT, September 2008.)
Clients should feel confident that you understand the origin of their pain and have the information needed to implement an effective treatment. It only takes a few minutes to ask clarifying questions regarding information on their intake forms, check range-of-motion, perform prudent orthopedic assessments and take postural analysis photos.
Postural analysis grid charts make it easy for clients to see asymmetries of the body. While large charts are appropriate to hang on a wall, digital versions of charts are perfect for when wall space is limited or when you perform outcalls. And along with the digital age we live comes various digital applications to choose from. I show patients the correlation between their posture and their pain by using the screen on my cell phone. (Fig. 2) (Read "Getting Comfortable With Posture Analysis" MT, July 2008.)
A muscle movement chart allows you to immediately identify the muscles causing their postural distortions, limited range-of-motion and pain. This chart lists the muscles that shorten and contract producing movement in every joint of the body so you can breakdown any postural pattern. It also allows you to confirm the normal degrees of range-of-motion for each joint.
Review the trigger point (TrP) referral patterns that mimic their symptoms. If a client reports they have headaches that start in the temple or behind the eye, which then radiates behind the ear and into the neck, they are describing the referral pain pattern for TrP #1 in the trapezius muscle. This is one of the most common TrPs found in the body. Showing clients their pattern on a trigger point chart lets them know you understand the pain and have a plan to help. (Fig. 3)
Portable trigger point flip charts provide a professional presentation in any environment and are easily moved from one location and/or treatment room to another. The best flip charts on the market have laminated pages to prevent oils and lotions from damaging them. Note: Look for chart systems that are logically designed, easy to use and includes a muscle movement chart. (Fig. 4) (Read "Tools to Succeed for Massage Therapists" MT, May 2009.)
Training and Treatment
A solid knowledge of anatomy is key to delivering effective hands-on treatment techniques. Dissection seminars are the ultimate learning experience allowing you to see, touch and understand every tissue of the body. Attending this level of education sets you apart from other therapists. Physicians and other health care providers in your area will respect this level of study and be more willing to refer. Your therapist bio should be updated to reflect your advanced trainings. Certificates should be placed in your reception area, treatment room and/or your Web site.
Homestudy DVD programs are excellent support tools. The best dollar valued programs cost more; however, they come with accompanying photo manuals. This allows you to watch the DVD while reviewing your manual. Some systems include cross-referencing to trigger point, muscle movement and other charts.
Review and Recommend
Upon completion of the treatment, explain that it makes sense to you that they felt the aches, pains and symptoms that caused them to seek your services. Share that during the treatment you palpated the muscles, assessing and confirming your other objective findings. Review very briefly their postural analysis photos, correlating the photos to their pain intensity scale and trigger points that were identified during the treatment. Conclude your treatment with a few tips and recommendations to help them avoid this pain from returning. Show them stretches, the proper use of ice, and the ergonomic modification to be integrated into their daily routine. Now that they feel the relief of one treatment, explain that a series of four, six or more would provide much greater benefit. This is the time to explain the specials or packages that would be best for them.
Clients also realize we have extensive experience using various creams, lotions and topical analgesics. They respect our judgment and purchase the same products we use during their treatment as gifts for themselves, family or friends. Most products have a 50 percent markup and can add significantly to your annual bottom line without requiring you to perform any additional hours of therapy.
Never underestimate the future potential income a new client can generate. Be proactive and prepared by investing today for the tools and knowledge you need to educate yourself and your clients. Before you can expect clients to make a large long-term financial investment in your treatments, you must show and tell them all the reasons this is a wise and worthwhile investment. Integrating the proper patient education into your initial treatment can reap patients that spend tens of thousands of dollars with you over the years.
Good luck and please let me know about your experiences in the treatment room.
Click here for previous articles by David Kent, LMT, NCTMB.
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