Supplement Safety: Is It Time to Give Big Pharma a Chance?
Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools.
A Little More Chiropractic, A Lot Less Pain
Why should I visit a doctor of chiropractic when I'm not experiencing pain or other symptoms? That's the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care.
The Carcinogen Most Patients Consume
A known carcinogen is being naively consumed by many, if not most of your patients, who have little to no understanding of how dangerous it really is. Depending on the age of the patient, this carcinogen is a leading, if not the leading, risk factor for death and disability.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory).
A Moment of Silence for Dr. Leon Chaitow (1937-2018)
After months of declining health, Dr. Leon Chaitow – clinician, author and teacher – passed away on Sept. 20, 2018 at the age of 80.
How to Address the Question, "Do You Accept Insurance?"
Do you ever dread getting asked the question, do you accept insurance—when you only accept cash, or when you are out-of-network? As part of my daily practice, mentoring acupuncturists to grow their practices faster and more effectively, I talk to a lot of practitioners.
Pregnancy Health: Looking at the Lower Extremities
When patients tell us they are pregnant, many times we focus on the obvious pregnancy signs and symptoms related to their current trimester of pregnancy, and the biomechanical impact on the spine and pelvis.
Procuring a Place for the Future
As the acceptance of acupuncture continues to grow in the U.S. it is important that the profession be licensed in every state, and nationally board certified.
A New NCCIH Director ... One That Backs Acupuncture
The third time is a charm—the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced it's newest director, Dr. Helene Langevin.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 1)
In the absence of acute trauma, a usual strength-building session includes concentric, eccentric and isometric exercises. Popular exercise programs typically include concentric movements as the major muscle contraction and should constitute approximately 70-75 percent of the workout time.
Paradise Lost: AWB Relief in Hawaii
In November, 2014, Acupuncturists Without Borders (AWB) was hosting a training seminar on Oahu. A couple of us from the big island (aka "Hawaii" County) contacted AWB because the big island was in the middle of a crisis.
Manual Muscle Testing for Cervical Radiculopathy (Pt. 2)
Dr. John Bandy developed a protocol that associated specific muscles with myotomal nerve root levels. The deltoid is associated with the C6 nerve root; the triceps with the C7 nerve root; and the finger abductors with the C8 nerve root.
World Acupuncture Day: A Meeting in Paris
World Acupuncture Day is an event organized by the World Acupuncture Day Organization (WADO) in response to the eighth anniversary that UNESCO has included acupuncture and moxibustion on it's Representative List of the Intangible Cultural Heritage of Humanity.
Creatine: Muscle Fuel No Longer Just for Athletes!
Erase that image of the 20-year-old, muscle-bound bodybuilder using creatine. Replace it with the image of a lean, strong, fit 80-year-old hiking up a mountain. Creatine, a staple of athletes for more than 50 years, is now being used by athletes and non-athletes alike to help slow normal age-related muscle loss, improve exercise recovery, increase strength, and live a more active lifestyle.
Travel-to-Treat Coverage Finally Becoming a Reality?
Long-awaited legislation poised to hit the president's desk extends liability insurance coverage from one state to another for DCs and other state-licensed health care professionals who care for athletes / athletic teams that cross state lines.
NBCE Exams: Better, Shorter, More Opportunities
The NBCE's Written Exams department, led by Bruce Shotts, DC, developed a solution to computer-based testing on college campuses. Their work has resulted in 11 exam opportunities per year. CBT exams are on schedule to begin January 2019 as follows:
The Husband/Wife Imbalance
The Husband/Wife Imbalance, like Aggressive Energy, is an energetic block that will result in death, unless cleared, as its presence indicates that nature has given up the fight against the internal or external pathogenic factors that have assaulted the body/mind/spirit of the patient.
Case Study: Osteoporosis and the Role of Orthotic Support
The following is the second of three case studies by Dr. Wong on conservative management of lower-extremity complaints. Article #1 (September issue) explored chiropractic management of patellofemoral arthralgia.
Bait & Switch: Are You Guilty?
One of my three sons recently shared a story with me regarding an experience with a chiropractor, which stimulated me to write this ethics article. According to my son, he called a chiropractor's office and asked if his insurance was accepted at the office.
Cyberthreat Checklist: 10 Key Steps to Defend Your Practice
Living in an Internet-connected society brings many conveniences and benefits. The power of the Internet to connect us with customers, store data and find information has opened the door for many small-business owners to grow and flourish.
Vertebral Subluxation: Give Credit Where Credit Is Due
Vertebral subluxation: have any other words caused as much turmoil and controversy in the chiropractic profession? As a chiropractic term, vertebral subluxation did not make its debut until six or seven years after the profession's founding.
Chiropractic Integration a Big Success, Suggests Research
Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities.
An Effective Herb for Stress
We all know stress has become a significant factor in the increasing number of reported mental health disabilities and a contributor to various physical health conditions, such as ulcers, high blood pressure, heart disease, and so on.
On Point: Acupuncture Theory & Discussion
Welcome to my new column for Acupuncture Today, which will focus exclusively on the theoretical discussion and clinical application of acupuncture theory and acupuncture points. One of the most common questions I encounter from novice to experienced practitioners is "how do I choose the correct acupuncture point?". I hope this column can help answer some of these questions.
The NCCIH Seeks Participants for Acupuncture RCT
The National Center for Complementary and Integrative Health (NCCIH) is seeking participants for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT), which will evaluate the impact of, and strategies to best implement acupuncture treatment of older adults (65 years and older) with chronic low back pain (CLBP).
Checking Your Posture: A Wholistic View From Head to Toe
As you begin reading this article, what position is your body in? Are you sitting down, standing up, lying down, or walking down the street perhaps? Whatever position you are in, stop and observe your posture.
Avoid These New-Patient Turnoffs (Before It's Too Late)
I can't believe this doctor is making me watch this video in a room by myself, your new patient thinks to herself as she texts her best friend.
The Road to TCM, A Talk With Bob Doane
Bob Doane, a veteran acupuncturist, talks about his journey to TCM, the evolution of this medicine, and what he foresees in the future.
Cynicism, Burnout and the Search for the Ideal Patient (Pt. 1)
There is a video on the Internet that has gathered 6 million views as I write this article (so likely millions more by the time you read it). The video is of a doctor in an ER mocking a patient who is extremely weak and distressed.
Placebos, Presence and the Zero Point
We spend a huge amount of time learning the techniques and methods of acupuncture and Chi-nese medicine, and are given professional licenses based on our ability to remember and accu-rately apply them.
A Moment of Silence for Dr. Leon Chaitow (1937 – 2018)
After months of declining health, Dr. Leon Chaitow – clinician, prolific author and teacher – passed away on Sept. 20, 2018 at the age of 80.
News in Brief
The Next Generation of Chiropractic Researchers: Historic NIH Grant; Cleveland University – Kansas City VP Joins CCE Site Accreditation Team; NUHS Opens Second Veterans Clinic; R.I. Chiro. Society Celebrates 100 years.
January, 2016, Vol. 16, Issue 01
Integration: Team-Based Care and Collaborative Practice are the Future of Healthcare
By Martha Brown Menard, PhD, LMT
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.Interest in interprofessionalism dropped off for several years and was then renewed after a series of reports from the Institute of Medicine1,2 raised concerns about the quality of health care delivered in the United States, including reductions in patient safety and increases in medical errors, and noted a connection to the need for health professionals to work better together.
The lack of teamwork, collaboration and communication was leading to increased health care costs and poorer health outcomes. Leaders in quality improvement recognized the importance of team-based and collaborative care models – starting with students and continuing into professional settings – to meet the Triple Aim:3 improved patient or consumer experience, lower costs, and better health outcomes, in all settings and professions. The NCIPE and its supporters believe that high-functioning teams can improve the experience, outcomes and costs of health care.
Traditionally, IPE has referred to interprofessional education. The most commonly accepted definition, adapted from the Centre for the Advancement of Interprofessional Education in the United Kingdom and the World Health Organization, states that it "occurs when two or more professions (students, residents and health workers) learn with, about, and from each other to enable effective collaboration and improve health outcomes." According to the NCIPE website, "While called by different names, we call it interprofessional practice and education, or the "new" IPE. We use the phrase "interprofessional practice and education" (IPE) as a way to create a shared space between interprofessional education, interprofessional practice and collaborative practice. The 'new IPE' does not replace the principles related to these concepts – rather, it embraces them."
The "new" IPE is not about education for education's sake. It's about improving health, creating support systems and trying different models of practice. It intentionally supports people – including health professionals, health workers, students, patients, families and communities – to learn together every day to enhance collaboration and improve health outcomes while reducing costs. This is an exciting vision that holds opportunities for the massage therapy profession, and one that is relevant to all of us as health care consumers.
Implications for Education and Practice
The increasing focus on interprofessionalism as part of health care means that there may be more opportunities for massage therapists to work as members of health care teams in clinical settings. Exactly what form this may take remains unclear, however. While massage therapists are regulated providers in the majority of states within the US (44, at last count, and the District of Columbia), relatively few currently work in integrative health care settings such as a chiropractor's office or in hospitals — approximately 12% to 25%, according to 2014 industry estimates.4,5 One factor in this disparity is the relative lack of academically-based entry-level education massage therapists typically receive, and the perception of other health care professionals that there is a high degree of variability in the quality of massage education nationally.6 Those responsible for hiring decisions at health care facilities and within human resources departments may not know what specific qualifications and criteria potential massage therapy team members should meet, or how to credential them to work in that setting.
Another issue is that many massage therapists typically work as individual practitioners, rather than as members of a team. Medical settings in particular tend to be hierarchical in nature, and some massage therapists may have little experience in how to work with others in such a structured environment. As newer members of the team, massage therapists will be expected to "speak the language" and be familiar with practices such as charting and medical records, standard procedures for infection control and universal precautions, and applying research evidence to practice. It will also be important for massage therapists in these settings to be able to explain what they do and their clinical decision-making process to co-workers using language that other health care professionals can understand. Massage education will increasingly need to incorporate topics such as these into the curriculum so that graduating students who choose this career path can be prepared to work as effective and respected team members in health care settings.
So, what can current practitioners who are interested in working more interprofessionally with conventional health care providers do? The NCIPE has created the Nexus: A means of connecting health professions education, specifically interprofessional education, and transforming health care practice – creating a true partnership and shared responsibility, conversation, language and learning. In the Nexus, clinical practices in transforming health systems that partner with health professions education programs think and act differently, serving as learning organizations that support continuous professional development while educating the next generation of health professionals.
The Nexus provides a wealth of online resources, which can be accessed at: https://nexusipe.org/. These include a directory of members, educational resources, IPE events, and updates on ongoing research projects. Massage therapists can register as a user on the site at no charge, and can download papers, participate in discussion groups and attend webinars. There are also several free, e-learning modules on topics such as "Interprofessional Communication" and "What is Interprofessional Education." The NCIPE is a wonderful resource for educators and therapists interested in interprofessional education and practice.
An additional resource is the Academic Consortium for Complementary and Alternative Health Care. ACCAHC also provides many free resources for integrative health practitioners, such as a desk reference on the integrative health professions, a webinar series, resources for evidence-informed practice and credentialing of practitioners, and a newsletter with current events in integrative health. Sign up for the ACCAHC newsletter, the Collaborator, at their website: www.accahc.org.
Perhaps most important, however, is for practitioners to network with other health care providers, both conventional and integrative, within their own communities. Attending events at local hospitals and introducing yourself can be a great way to increase referrals as well. Look for continuing education opportunities for health care providers at area universities, and consider attending these, especially if there is a lunch or social time scheduled as part of the event. You may be able to attend at a reduced cost if you are not registering for CEUs, or if these are not offered for massage therapists. And if you are interested in attending a national event, think about the International Congress on Integrative Medicine and Health, focusing on research, education, clinical practice and policy, to be held in Las Vegas, NV, May 17-20, 2016. Visit the conference website for more information: www.icimh.org/.
Click here for more information about Martha Brown Menard, PhD, LMT.
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