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.
March, 2014, Vol. 14, Issue 03
Ending the Energy Debate
By David Lauterstein, RMT
There have been many recent online discussions in our field about "energy" and the role it may or may not play in our work and education. Many people have noted regretfully that some of the discussions have given rise to divisiveness somewhat uncharacteristic in our field.Partly, this may be a function of "social" media. When it comes to sorting out emotions, it is not a very effective medium. This reminds us that, unlike massage and the world of "high touch" in which compassion is the rule, the Internet and the world of "high tech" is not a very effective context for resolving difficult emotions.
What everyone does appear to agree on is enhancing the quality of education and therapists. It may be helpful to look at what role "energy" may or may not play in improving massage education and in therapy. First, we need to know what we are talking about. What does energy mean? Importantly, it is a word for which there is more than one definition. The definitions of "energy" refer to two quite different things – a quality of action and a physical phenomenon.
Here is the definition from the free online dictionary:
The first two definitions are more subjective and refer to the world of experience and a quality of action. The second two definitions are more objective, referring to measurable physical phenomena described by science. As we look at the energetic aspect of massage and bodywork, let's keep these varying definitions in mind.
We can note in the beginning that the energetic aspect of massage refers more to the quality of action and touch, than to the scientific, objective definition. Is massage "energy work?" If we mean by energy work, pure energy work done off-the-body, it is fairly easy to say "no." Massage involves touching the body and often is defined expressly as soft tissue manipulation in textbooks and in many state laws.
Is there an energetic aspect to touch therapy done on-the-body? Using the quality of action definitions above, we can say "yes." The quality of our touch may be considered energetic. Quantifiable aspects such as pressure may be measured, but the energetic aspect is more subjectively experienced.
We need to remember that massage can (and should) be objectively studied, but it is experienced subjectively by the client. Clients are interested in feeling better, in having more pleasure, less pain, more relaxation and more energy. Using the first two definitions we see these are subjective goals, facilitated by both the structural and energetic clarity with which we engage the tissues and the nervous system of the body.
Where both the pro- and anti-energy camps get in trouble is when they leap to the objective definitions of energy. The pro-energy folks wish to see the energy aspect of massage and bodywork as objectively existing, like electricity or magnetism. While these may be intriguing metaphors for the energetic aspect of our work, there is little if any proof that the energy spoken of by some massage therapists and bodyworkers exists objectively. Again and again, we need to return to the fact that the energetic aspect refers most directly to subjective experience. This makes it no less real, our experience is real – but like thought and emotion, like love – you can't find it under a microscope.
Now the elusiveness of how to describe subjective/energetic experience has given rise to various terminologies. Some people are attracted to a particular language describing the energetic aspect because that was what they were taught or they find those concepts and vocabularies illuminating of their own experience as receivers and as givers. Some people find helpful the languages of chi or meridians, prana, kundalini, chakras, bio-energy, élan vital, psychology or phenomenology, etc. Some people prefer language referring primarily to the nervous and endocrine systems, seeing the experience of energy largely as a projection of the brain.
How can and should we reflect these varying views in our education? No one is saying this should a mandatory part of basic curricula, however, there are some ways various educators may choose in a balanced way to cover this topic.
We may cover some of energetic aspects of massage and bodywork in our history classes. Asian concepts linking up energy and anatomy have played a role in the history of massage. The "humours" in medieval medicine; the assumption of links between the spiritual and physical aspects of health; the energetic understandings of psychology and, most recently, psychoneuroimmunology – any or all of these may be helpful in producing students with a fuller picture of our work and its roots in the history of manual and mind-body therapy.
We can note that many modalities explicitly integrate structural and energetic work – zero balancing, deep massage, some forms of myofascial release. And many more assume this is what's happening – shiatsu, Thai massage, rolfing, etc.
We should cover how conscious and unconscious beliefs affect health. Chronic mindsets and chronic emotional conditions can exacerbate or even cause a variety of tension-syndromes. The placebo effect is powerful. Ted Kaptchuk, author and acupuncturist and colleagues mostly from Harvard have created a "Program in Placebo Studies and the Therapeutic Encounter." It is equally important for students to also understand the nocebo effect – the harm that can be caused by uncaring healthcare that may evoke negative feelings in the client. Placebo and nocebo effects of course may be considered as within the realm of the energetics of touch.
In looking at assessment skills and the therapeutic relationship, it is important that we consider posture, movement, and the energetics that may underlie those. We may agree on what we should not do:
We should not talk to clients about their "energy." Diagnosis, whether structural or energetic, is not within our scope of practice. When a massage therapist or bodyworker talks to the client about their energy, they are way beyond the boundaries of massage (and basic etiquette) and quite likely to evoke the nocebo affect by verbally attributing certain energy characteristics to a client.
We should be conscious that when we are touching people, it is a contact which is more than just physical. This means we need to take responsibility for the energetic as well physical effects of our interaction and touch. We need to recognize that we are touching both structure and energy.
Massage is an art and a science. We depend on research and scientific knowledge to enable us to work effectively with our clients. At the same time, every session is a person-to-person, moment-to-moment improvisation that calls for a subtle sensitivity to the medium we are working with. In the case of massage/bodywork, our medium is the most complex and sensitive life form known to exist. Of course, we need art and science. Of course, we need to know this person is a profound integration of structure and energy, tissue and issues, and to be sensitive to what is both objectively true and subjectively experienced.
To argue for or against either the structural or energetic perspective is like arguing which of your two eyes you ought to see out of. By honoring both what research and what subjective experiences teach us, we arrive at the highest quality of touch, education and therapeutic benefit. Without science, without a respect for knowledge and structure, we lose our commitment to truth; without art, without a respect for subjective, energetic experience, we lose our commitment to the soul and beauty of our work. We see better and more truly with both eyes.
David Lauterstein is Co-Director of Lauterstein-Conway Massage School in Austin, Texas. He is author of "The Deep Massage Book" and "Putting the Soul Back in the Body." David has been inducted into the Massage Therapy Hall of Fame, received AMTA's Jerome Perlinski Teacher of the Year Award, and in 2013, was recognized as "Educator of the Year" by the Alliance for Massage Therapy Education. For more info, visit www.TLCschool.com.
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