A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
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.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
May, 2009, Vol. 09, Issue 05
Malpractice Claims: Sexual Misconduct
By Dixie Wall, Contributing Editor
Sexual misconduct is not a new problem among health care practitioners. Hippocrates even added to his oath, "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or men, be they free or slaves." In order to prevent this damaging conduct from happening to our clients and in our practices, we must maintain appropriate boundaries and develop open communication. It is our responsibility as the therapist to establish these boundaries, and shift them to the needs of the client.
Malpractice and/or liability claims are generally categorized into malpractice, criminal or civil. Malpractice includes acts of commission and acts of omission.1,2 Acts of commission are unintentional or intentional acts, performed by a therapist, that result in some type of harm to the client. Acts of omission is more common among primary health care physicians such as doctors, chiropractors or acupuncturists and involves a failure to refer clients out when indicated, or some type of missed problem in initial treatment of patient. Criminal suits are usually claims that involve some type of illegal implication and ramification for unprofessional illegal conduct. This month, we will further discuss these criminal acts but more specifically unprofessional sexual misconduct.
According to the Medical Council of New Zealand, sexual misconduct can be divided into three categories. The lowest level of misconduct is defined as "sexual impropriety." "This is nonphysical contact of a patient that is inappropriate jokes, crude gestures ... or demeaning comments about a patient's undergarments." The next level is "sexual transgression," which is defined as, "inappropriate touching of a patient stopping just short of an overt sexual act." This can include unnecessary contact with the breasts and inappropriate draping or lack thereof. The last and most severe is "sexual violation." This is defined as, "a sexual act between patient and doctor, there is no distinction between which party initiated the contact and whether the act was consensual." When any type of sexual misconduct takes place, the issue is no longer in the malpractice realm but becomes a criminal issue. These illegal acts are usually excluded in malpractice insurance policies.
Health care professionals are held to higher standards due to the hands-on nature of our field. The one-on-one time spent with clients creates a special personal connection between the client and therapist where the client may share personal information that would not be shared to other types of professionals. With the exception of the health care professionals, people would generally never allow another service provider to touch them. This immediately places us in a unique position of trust as separate and distinctive professionals. Unfortunately, according to the American Massage Council's claims history, sexual misconduct is the number one type of claim against massage therapists.
Sexual misconduct is not limited to sexual interaction with a client. It can be an inappropriate comment, flirtatious behavior, look or gift. This type of misconduct can harm the client in many ways and has major repercussions for us as practitioners. These repercussions may include damaged reputations, lawsuits, and ultimately losing our permits, licenses and practices. How can these issues be prevented? Most experts in practice management recommend setting adequate and appropriate boundaries.
Boundaries separate your personal space from the space of the client. Most boundaries are created by the client and maintained by the practitioner. The maintenance of these boundaries can help us maintain a thriving and professional practice. There are several types of boundaries set by in practice that can help us to prevent any misunderstandings or mistakes that could lead to sexual misconduct.
The first and most important when it comes to sexual impropriety claims are physical boundaries. What kind of touch will we accept from a client when greeting them? What type of draping techniques should we use? According to an administrator at a leading massage school in California, "draping is the number one complaint from clients receiving massage in their clinic." Massage therapists must make sure that the client is properly, consistently and conservatively draped. Always give the client sufficient time in private to change before and after the massage.
The next way to protect yourself is by maintaining verbal boundaries, keeping open all lines of communication with your client. Listen to your clients attentively and comfort them through a routine professional protocol in treatment procedures. When explaining your treatment plans for the client, make clear what you are going to do, explaining again what you are doing while doing it, and then telling the client what you just did. Set the language in conversation on the telephone in a professional level. Always avoid improper slang, language and gossip, and keep client's confidentiality a priority.
Lastly, a first impression is always made with visual boundaries. Our society is based on visual recognition and appearance. Create your own professionalism by consistently practicing routine procedures and retaining a standard dress code. Uniforms can create a comfortable atmosphere by setting a familiar tone. Keep your office clean and neat.
Through establishing, encouraging and enforcing these boundaries, you will promote your profession, as well as the safekeeping of yourself and your clients. Next time, we will discuss three additional boundaries that can help us succeed in practice.
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