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.
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.
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.
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?
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.
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.
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.
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 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.
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."
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.
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).
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.
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.
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."
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.
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.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
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.
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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?
March, 2003, Vol. 03, Issue 03
By Steve Capellini, LMT
Author's Note: The Spa Letters column features news, personality profiles, trends, and plenty of professional possibilities for LMTs in the spa industry. The style is epistolary, meaning the articles are letters to a fictional massage therapist friend of the author.
Danger! Red flag! After only a few months in the medical spa business, you're heading to a lawyer's office downtown to give your first deposition.This is definitely not something you envisioned back in those idealistic days when you were attending massage school, is it?
I know you're nervous about all the legal implications, but it's probably best to stay calm. Take this thing one step at a time. It's important for you to know people are on your side; they believe in you. It's great that Barbara, your fellow massage therapist at the medical spa, is on your side. When things get tough, it's easy to see who your real friends are, isn't it?
Of course, I'm on your side too, as always. I trust 100 percent that you had only the best interests of your patient in mind, even though she's now suing you - and the spa! Before you get caught up in the emotions of the situation, remember to focus on the facts first.
Fact: You were giving a cellulite-specific massage to a woman, using a technique known as Endermologie.® This technique employs two mechanical rollers and suction to effect the subcutaneous fat layers. The woman came to the spa for three treatments before she stopped and called her lawyer.
Fact: The woman signed up for this series of treatments of her own free will, and signed a waiver excusing the spa from liability.
Fact: The woman is blaming you and the procedure for creating a ping-pong-ball-sized indentation in the flesh of her right thigh. Yes, the depression is quite noticeable - you could rest a boiled egg there and it would not roll away. In tens of thousands of hours of Endermologie® treatments given worldwide, there has never been another recorded instance of this happening.
Fact: As a member of the American Massage Therapy Association, you have substantial liability insurance coverage. The owners of the medical spa are saying you should bear the burden of this lawsuit yourself, even though they, and the company that manufactures the Endermologie® machine, have more resources than you do.
So, what conclusions can you draw from these facts? First of all, I'd say your new bosses, the ones who promised you the stock options and the partial ownership of this "hot" new medical spa, should perhaps not be counted among your true friends. If they truly believed in you, they would be taking your side in this issue. The fact that they're distancing themselves from you, when you need them most, speaks volumes about their character.
Second, I'd say that regardless of what the woman claims, there's a good chance neither you nor the treatment caused her problem. Look hard, and I feel reasonably sure you'll find another reason. The fact that no other such case has been recorded should give you a clue. The woman feels hurt by this blemish on her body, and she is quite likely lashing out against the only source of the problem on which she can put her finger.
Finally, something definitely is going on here. The deformation of this woman's leg is real, and the situation should be addressed head-on. Even though it makes you nervous, you're doing the right thing by heading in for that deposition. When you talk to the lawyers, just be as upfront and communicative as you can.
What Does Liability Look Like?
I know it must be causing you a good deal of anguish to think that your actions (and perhaps even a lack of skill) caused physical harm to someone else. No matter how strongly I or other people might council you otherwise, there's still a part of your mind that will entertain doubts on the issue. So, let's explore your liability (or lack thereof) for a moment, and try to put your mind at ease.
You were trained by the manufacturers of the Endermologie® equipment on the device's use, and the mechanical massage maneuvers you performed could not possibly lead to the deterioration of this woman's muscle tissue. Still, let's say for argument's sake that a judge were to find you in some way liable. What would that mean? What does liability look like?
In my view, liability looks like the price you have to pay when you put yourself "out there" in an attempt to help people. If you had stayed at your position at the resort spa doing primarily Swedish massage and didn't learn cutting edge mechanical massage techniques like Endermologie,® chances are you wouldn't be in this situation now. However, you'd also be a different person. Sometimes, liability is the price we pay for being who we are. Responsible people are liable.
You should feel some small measure of comfort in the fact that you've had the courage to choose a path that is not always easy. When you put yourself into hands-on contact with the public, you're never sure exactly what's going to happen. It will always be this way.
I think the most valuable lesson you can take away from this experience so far is this - you have a good friend in Barbara. She's standing by you, even when it would be much easier for her to side with the spa owners, or at least to distance herself from you in this matter. Remember, I mentioned in an earlier letter that I thought the real reason you were working at the medical spa wouldn't be revealed until a later date? Well, perhaps this is the real reason: You were meant to strike up a friendship with your fellow massage therapist. You two are already bouncing ideas around about possible other projects on which the two of you can collaborate.
Look for the secret gold in this situation, even when things look so dire right now. Spend more time with Barbara. Write me anytime. Hold your head up high and remember who you are: a therapist with integrity, skill and a sincere desire to do right by every client with whom you come in contact.
Talk to you soon,
Steve Capellini, LMT
Click here for previous articles by Steve Capellini, LMT.
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