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.
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.
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.
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.
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:
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.
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.
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.
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.
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.
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.
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?
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).
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.
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?
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."
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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."
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.
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.
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.
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.
Choosing Our Words Wisely ... Language MattersWhen you visit a massage therapy website or pick up a rack card for massage therapy services, one of the first things you might register is how a practitioner refers to you. Are you a patient or a client? A diabetic, or a person with diabetes? A cancer survivor, or a person with a cancer history? You look at how they discuss their clients, and their work.
These terms are also important in our professional conversations, when we discuss our work with others. Whether it's an informal social media thread, or a conversation with a nurse, language matters.
Debates about language can quickly become passionate and fierce. When does a label describe a person, and when does it limit or reduce someone to—well—a label? When does a label reveal a personal bias, or a treasured group identity? Many people throw off labels entirely. Others embrace them. Most people identify with some labels, but not others.
One of our professional obligations is to use thoughtful language about our work and about the people we serve. Language has the power to welcome, reassure and support people. It also has the power to offend, injure, or dismiss people.
In cancer care, massage therapists have many different ways to describe their clients and their work. Do we do oncology massage? Massage therapy for people with cancer? Something else?
How We Talk about Clients
"Person-first" or "People-first" language began in movements for the rights of people with disabilities. It designates the person as most important, followed by the diagnosis or disability. Following this lead, I choose "client with cancer," "clients with cancer and cancer histories," or "people with cancer and cancer histories."
The person-first approach honors the person. This is essential, because people tell us that cancer treatment can make them feel more like a disease or a body part than a person. Yet some of the descriptors above can also feel like a mouthful. After repeating, "clients with cancer and cancer histories," many times, it's worth searching for a sensible shorthand alternative.
For that, "oncology client," or "oncology massage client," are strong possibilities. This shorthand is not person-first, but it emphasizes the work I do, and the context in which I do it. It does not focus on the client's diagnosis so much as the clinical aspect: I am providing services in cancer care.
Other attempts at shorthand, resulting in "the cancer client," are well-intended but come off as less sensitive. It is possible that "cancer client" came when "cancer patient" was transplanted from the medical setting to the massage therapy setting.
Cancer client sounds awkward to me. It sounds too much like "cancer person," and I start visualizing people in packs, all sharing a diagnosis. Even "breast cancer client," while making it easier to discuss appropriate massage care, can feel reductionist. "Client with breast cancer" only takes a microsecond longer to say or write.
Trying this on: "cancer client," "thyroid cancer client," "pancreatic cancer client." Although these call up common clinical considerations, they don't sound clinical, nor as sensitive. It doesn't describe how I think about my clients, or care for them. It doesn't describe the context.
Moreover, "cancer client" more flagrantly violates the person-first rule. I always feel a little twitchy when I hear it. Better would be something like "oncology client," or "oncology massage client."
Anything but "cancer massage"
This brings us to the language describing the work itself. When I hear "cancer massage," I imagine someone directly massaging a tumor, which we would certainly not do. We take pains to learn about any and all tumor sites in order to avoid pressing on them. "Cancer massage" doesn't sound clinical. I see it as too casual and informal, and not up to the task of truly describing the work. "Oncology massage" is better because again, the work is done in the context of cancer care. But it falls short, as well: The massage techniques themselves should not be the only focus.
Oncology massage Therapy, or OMT
"Oncology massage therapy," (OMT for short), is the most descriptive term I've found. It describes a whole approach, not just the hands-on massage part. It captures the interview, the clinical thinking, the therapeutic relationship, the precautions, along with the specific hands-on modifications.
It also captures the therapeutic aims of the work. The inclusion of "therapy" makes it sound as serious as it is: Oncology massage therapy aims to reduce symptoms of cancer and cancer treatment. It is designed to help clients cope, supporting them through their experiences. In recent years, I've added "therapy" onto the end of each instance of "oncology massage." I've come to see its critical place in our work.
Having solved this, at least for my own practice, I can loop back to the question of how to refer to my clients when I'm discussing my work with other professionals. Here's one more possibility: "OMT clients." Short, descriptive, respectful. Done. At least for now.
Not the Language Police
Although language is important, I am not qualified to be the language police. I slip up sometimes in teaching and conversation. I don't get it right for every client, reader, or MT.
These days, there is plenty of language to think about. People hold strong views on how we should tell stories of cancer diagnosis, treatment, post-treatment, and beyond. There are cancer journeys and cancer battles, and survivors and thrivers. There is beating cancer, and surrendering to the experience.
If you Google "language of cancer," you'll find many opinions about the militarization and demilitarization of the language describing experiences of cancer. You'll see people weigh in about how these terms make them feel while they're in the middle of it. For some, "kicking cancer's butt" is violent imagery, and they feel weak, inadequate, and blamed for not being able to somehow kick butt. For others, the same images are inspiring and motivating. To each their own.
I try to take my cues from my clients in conversation, and balance that with what I'm comfortable hearing from my own mouth. For example, "cancer thrivers" feels forced, and a bit trendy. I counseled one OMT to choose something different for a website because it looked like she might be trying too hard to get it correct. I wanted her to speak to those, as well, who don't necessarily feel like they are thriving, but who need her care.
Unless or until "thriving" settles in to stay for a while, "survivorship" is more natural for me to say. My speaking and writing style is a little more neutral and old-fashioned. Because people sometimes feel strongly about one word over another, I try to land wherever we can all be the most comfortable. I'm curious about where other OMTs and OMT clients land, as well.
Listen for the Humanity
Language describes human experience, so it's important to choose our words wisely. However, in most cases, I don't have to get that language perfectly right to connect with my clients. My clients don't necessarily need me to be fully up-to-date and hip. They need my presence, and my listening ears. They need me to ask, "Is this the way you'd describe you/it/the experience?" They need me to ask what things are like for them, and to respond with care and skill. So I listen for the humanity in words.
For my clients, I look for words that describe as open and expansive an experience as possible. For my own work, I settle on language that is clinical and professional. In the end, I hope my speech is as thoughtful as my hands, and that both are in service of my clients.