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.
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.
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:
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.
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.
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.
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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?
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.
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.
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.
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.
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.
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).
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.
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?
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.
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."
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."
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 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.
February, 2013, Vol. 13, Issue 02
Massage Therapists and the Detection of Skin Cancer in Clients
By Massage Therapy Foundation Contributor
Contributed By April Neufeld, BS, LMT, NCTMB; Sandra K. Anderson, BA, LMT, ABT
Have you ever noticed strange moles or lesions on your patient's back? This is important because skin cancer is the most common cancer in the United States, with more than 3.5 million cases diagnosed annually. Since massage therapists see a great deal of client skin on a daily basis, they have a unique opportunity to recognize potential skin cancers.
This month, we at the Massage Therapy Foundation (MTF) are reporting on a study by lead author Shannon M. Campbell and colleagues called "Skin Cancer Education among Massage Therapists: A Survey at the 2010 Meeting of the American Massage Therapy Association." It was published online on August 23, 2012 by the Journal of Cancer Education, August 23, 2012.
"While non-melanoma skin cancer (NMSC) accounts for the majority of cases, melanoma is responsible for more than 75% of skin cancer deaths. Between 1992 and 2004, melanoma incidence increased 45%. In the United States, one in 52 men and women can expect to be diagnosed with melanoma in his or her lifetime. The back is the most common location of melanoma in men, while the lower legs are the most common location in women. Prognosis of melanomas is related to anatomic location. The 10-year survival rate for melanomas on the back is around 68% while the 10-year survival rate for the lower legs is 82%," write the investigators.
These statistics indicate that early detection of skin cancer is an important public health initiative. While the majority of interventions have been through detection by medical professionals, recently attention has been turned toward the ability of non-medical professionals, such as hair dressers and massage therapists, to assist with skin cancer detection. These professional massage therapists see and palpate large areas of clients' skin, including the back and legs. In addition, massage therapists may also frequently observe areas of the skin not examined by healthcare providers, such as the scalp and soles of the feet, in addition to backs and legs.
The purpose of this study was twofold. The first was to describe the skin cancer education massage therapists receive during training and second, to evaluate massage therapists' comfort levels in identifying suspicious lesions and communication with their clients about them.
The research method involved surveying two separate groups of attendees at the American Massage Therapy Association (AMTA) annual convention in 2010, in Minneapolis. One group of 179 completed the survey at a booth in the exhibit hall; the other group of 114 were participants who attended a skin cancer education workshop at the convention. Thirty-one surveys were excluded because the respondents were either from Canada or had not completed their entry-level training. Therefore, the final sample was 262.
The survey consisted of demographic questions such as gender, age and ethnicity. Participants were also asked the number of years the subject worked as a massage therapist, the state in which they practice, age range of clients, number of clients they treat per year, average number of visits per client annually, how many clients the massage therapists have recommended see a healthcare provider over the past year for a suspicious lesion, and if they ever detected a lesion on a client's skin that was confirmed to be skin cancer.
Participants were also asked to give detailed descriptions of their skin cancer education both during entry-level training and through continuing education. Descriptions included the name of continuing education courses, numbers of hours, textbooks used, academic credentials of the course instructor, types of skin cancer covered, testing and education about how and when to discuss a suspicious lesion with a client. Additionally, participants were asked to describe their comfort level recognizing and discussing a suspicious lesion with a client, as well as recommending a client see a healthcare provider for a suspicious lesion. All comfort level questions were assessed using a scale of "not at all," "a little," "somewhat," "quite" and "extremely." Frequency questions were assessed using a scale of "never," "sometimes," "usually," "often" and "always." The observed frequencies and percentages were calculated using Statistical Analysis System (SAS) version 9.2.
Results of the survey indicated that 60% of massage therapists received skin cancer education during their entry-level training, 25% received it afterwards and 16% received both during and afterwards. The majority of participants stated that melanoma and non-melanoma skin cancers were reviewed during both entry-level and continuing education courses and that when and how to discuss a suspicious lesion was also included.
Whereas 12% of participants reported a personal history of skin cancer, 72% reported knowing a friend or family member with a skin cancer diagnosis. Of those surveyed, 43% reported wearing sunscreen usually or often on sun-exposed skin and 83% reported performing self-skin exams (SSEs) at least every 1 to 2 months. Participants also reported examining their client's skin regularly, with 44% reporting that they always do so. Massage therapists who examine their own skin at least once a year were more likely to examine a client's skin. Most of those surveyed recommended at least one client see a health care provider for a suspicious lesion over the past year.
Most participants reported being quite or somewhat comfortable recognizing a suspicious lesion, being quite comfortable discussing it with the client, and being quite or extremely comfortable sharing medical knowledge and recommending the client see a healthcare provider about the lesion. Additionally, massage therapists who perform SSEs, had detected a lesion on a client that was confirmed to be skin cancer, and who examine their clients' skin on a regular basis, and who referred clients to be seen by a healthcare professional are more likely to be comfortable recognizing a suspicious lesion.
"This study has several limitations," write the researchers. "It is an observational study that does not allow for cause and effect relationships to be identified. The sample population was from a select group at a national convention and the results may not be indicative of all massage therapists. Additionally, 114 of the 293 participants completed the survey prior to participating in a workshop on skin cancer," which means they may have a greater interest in skin cancer prevention and detection. "Further studies on a larger scale with a more representative sample are needed to confirm the data. Because many years may have elapsed between training and completion of the survey, participants may have incorrectly recalled details about their education and practice. However, this study serves as a valuable introduction to skin cancer education efforts within the massage therapy community. Additional studies should focus on improving massage therapists ability to recognize suspicious lesions and collecting data directly from massage therapy schools regarding their skin cancer education."
So what does this mean? It means that massage therapists who are already checking their clients' skin for suspicious lesions are providing a valuable and necessary service, one that can potentially save a client's patient's life. Massage therapists who are unsure of their ability to detect a suspicious change on a client's skin, and are unsure of how to discuss it with the client, would definitely benefit from a course that covers this information. It could make all the difference in the world to someone they know.
Editor's Note: Want to hear more great research all in one place? Attend the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation April 25-27, 2013, in Boston, Massachusetts. Registration is now open. Learn more at www.imtrc.org.
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