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Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
September, 2008, Vol. 08, Issue 09
Questions With Direction
By David Kent, LMT, NCTMB
One of the most challenging aspects of being a massage therapist is trying to build a thriving practice with repeat clients. So, it's no surprise that many therapists have felt the crunch with the recent downturn in the economy.Unfortunately, services like massage therapy often are among the first to be cut from one's budget in times of economic crisis.
Therefore, it is now more important than ever to convince your clients to stay the course with their massage therapy sessions. This article will show you how asking some simple questions can ultimately lead to repeat clients, whether you work in a spa, outcall, seated or clinical massage setting. Soliciting a client's feedback by way of asking thorough questions will better help you understand your client's needs and deliver results. Even more important than asking questions, however, is listening and responding to the information your client provides.
One way to organize your questions is to make use of the wide range of forms available for these purposes. In fact, your questions will, to a degree, be directed by the information you obtain using forms. I have my clients complete intake forms prior to therapy. These help me develop targeted questions to clarify my knowledge about their health history, specific areas of pain, stresses in their life, ergonomics of their activities of daily living, medications they are taking, and to identify any precautions or contraindications before the session begins. Using intake forms helps me develop goals for the client's current and future sessions, which also is useful in persuading my clients to commit to ongoing treatment.
There are various types of questions. However, this article will focus on two primary categories: general and those related to a client's pain. General questions are great for helping you understand your client's expectations no matter what kind of practice you have.
Question: What are your goals for today's session?
Reasoning: If you don't ask this question, you won't know if a client wants a relaxing Swedish massage or a vigorous sports massage that integrates stretching. This also is important so you're responding to your client's needs and not responding to your perception of your client's needs.
Question: What areas would you like me to focus on today?
Reasoning: This question also relates to the previous question. At one time or another, we've all probably had an experience with a therapist who seemingly ignored the very thing that brought us to therapy in the first place. When you ask this question, it's very important to listen closely to the answer. When you listen to the client and deliver results, it increases the odds your client will reschedule and/or refer others.
Question: Have you received massage therapy before?
Reasoning: Regardless of the client's answer, this is the ideal time to communicate to the client how you will perform the session. For new clients, you might advise the client to disrobe to their level of comfort and then discuss draping techniques. For veteran clients, you might ask if they'd like you to do something extra special, such as incorporate essential oils into the session.
Question: If you have received massage therapy previously, please tell me where you received it, by whom, and which treatments were the most beneficial?
Reasoning:This information can help you understand how to adapt the session to the types of massage therapy that have produced positive responses for the client in the past. You might also ask the client what they think makes a great massage - and then do what you can to meet the client's expectation.
Question: What type of pressure do you prefer?
Reasoning: Keep in mind that levels of pressure are subjective for each client. What you perceive as light pressure and what the client perceives as light pressure could be entirely different. It's important you check in with the client at the start of and during the session.
Question: Have you ever had any negative effects and/or experiences from receiving massage in the past?
Reasoning: People respond to massage in different ways. Some get ill or are sore for several days after they receive a deep massage. This is where intake forms and questions can be very useful. Some questions might include what medications the client is on, if they bruise easily, what the client's diet is like, as well as questions related to general health and exercise.
Question: Is there anything else I should know?
Reasoning: I intentionally keep this question open-ended so the client can add additional information at their discretion. It's up to me to connect the dots. I am frequently amazed by how many clients will tell me about a traumatic accident and/or major surgery in the past that they didn't mention previously.
Questions About Pain
Question:What other health care providers have you seen recently and for what?
Reasoning: This question immediately informs you if your client has seen a doctor or if the client has self-diagnosed. I can then quickly perform a postural analysis (See "Getting Comfortable with Postural Analysis" in the July issue), check range of motion and perform relevant muscle tests and orthopedic assessments to determine if it's appropriate to proceed or if the client needs to first follow up with a physician.
Question: Have you tried different health care practitioners over time? If so, which one(s) provided the most relief? What did they do and how long did the results last?
Reasoning: Understanding more about the treatments a client has sought for pain relief will give you insight into how you can best help them. For example, if the client sees a chiropractor on a regular basis, you might suggest they schedule an appointment with you immediately before the appointment with their chiropractor for maximum results.
Question: What do you do for pain relief?
Reasoning: I am always surprised by how many people buy topical pain relievers at a drug store. Why should the drug store get the money? Consider selling topical ointments in your practice. Integrate a topical into the therapy session, then send the client home with a sample. The next time the client buys a topical ointment, it might just be from you.
Question: What aggravates your condition?
Reasoning: If the client reports increased back pain when standing or straightening after bending down, it might indicate lumbar and hip flexor or extensor involvement. A muscle movement chart can help you determine exactly which muscles to assess. Trigger-point charts are useful for educating clients about referred pain. Additionally, using the postural analysis information combined with photos helps show the client how stressed or shortened muscles have contributed to the formation of trigger points. This further leads into a discussion of how a series of treatments can be beneficial.
Asking the right questions can help your practice tremendously. I am looking forward to learning how the questions in this article worked for you. I encourage you to read my other articles that can help during these challenging economic times.
Click here for more information about David Kent, LMT, NCTMB.
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