Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Compassion and Compassion Fatigue: Balancing Your Emotions in the Treatment Room
I entered massage therapy to serve others, and oncology massage therapy because of how deeply that service affected me. In general, massage therapists enter the profession because we care: about people as a whole and in particular about their health and well-being.
But, could caring end up hurting or draining us?
Those of us helping professions — nurses, doctors, social workers, chaplains, massage therapists, and more — can be strongly affected by working with clients experiencing trauma in the form of a health crisis. This strain can happen as a result of working with one particular client, or it can be a cumulative pile-on of a number of different emotionally difficult cases.
There is a lot of discussion and not much agreement out there about the exact meaning of the terms "compassion," "empathy," "compassion fatigue," and "burnout." We'll lump them together under "being deeply affected by a client's experience."
Deeply Affected by a Client's Experience
Whatever we call it, it's important to look at any hard-hitting emotional toll on ourselves when we care for people experiencing pain, trauma, mortality, and suffering. Imagine you are seeing a particular client diagnosed with advanced cancer, and she shares with you how hard and emotional her treatment is, how she is too fatigued to play with her children, and how, most of all, she is terrified of dying before she gets to see them grow up.
That's all just from what your conversations. During the hands-on session, you learn about the physical pain in her hands and feet, the restricted movement from past surgery or radiation, and the ongoing wear of chemotherapy on her hair and skin. You know these things intimately as your hands touch her body in a full hour of time. This intimacy can challenge the separation we need — or think we need — between ourselves and our own fears of cancer, mortality, pain, and suffering.
So our knee-jerk reaction to this might be, "How can I protect myself? How can I establish good boundaries like we were taught to do in massage school?" We don't want to feel our clients' emotional pain and distress, so we might rush to put up strong dividers between "us" and "them."
When our clients represent our worst fears, and we spend a huge amount of effort to protect ourselves from those fears, our lives and our work can suffer. Here, the discussion typically turns to the boundaries we must have for this protection. Healthy boundaries can help us manage our own emotional well-being, but it's worth discussing what those boundaries should look like. The boundaries in my own work that have been most important are regarding self-care, rather than separation or protection from clients' experiences.
Taking on My Own Suffering, Not Others
My first lesson in this came from Irene Smith, more than twenty years ago. Irene is a longtime massage therapist, educator, and author. She founded Service Through Touch, serving people with HIV in the San Francisco Bay area in the 1980's. She has gone on to teach us much about massage in illness and at end of life, and maintains her blog and schedule at www.everflowing.org.
Irene said, "I don't believe that we take on another human being's suffering. I believe that what happens is that we find ourselves in an experience that simply opens us up to our suffering."
With her words and instruction, Irene taught me that, while I might think I am absorbing my client's expressed or unexpressed pain, in reality, the situation is provoking my own pain. If I follow her guidance, I can learn much about my old losses, current fears, and the human condition in general. As I've learned about myself, I've become more present with others.
With this lesson, my relationship to compassion began evolving. I have learned important lessons from several teachers about joining with people and separating from people during hard experiences.
Many Teachers on Compassion
Lauren Muser Cates, an oncology massage therapist and educator, has some more passionate wisdom for us in her blog post, "Boundaries, Schmoundaries." She suggests that instead of putting up walls to try to keep ourselves "safe" and "protected," which can leave us feeling empty, we should work with staying open to others' experiences and ourselves. Lauren tells us that boundaries have their place in the practicalities of massage therapy — scope of practice, payment, set hours, and so on — but "When it comes to emotion and our essential humanness, boundaries, as they've been taught to us, are a myth."
Additional teachers came to me a couple of years ago, when I put together a series of webinars on hospital-based massage therapy (HBMT). I sought out several people who had HBMT programs in place for years, looking for their wisdom on program development, longevity, and the practicalities of making massage work in the hospital. In the process, I interviewed and recorded people from five HBMT programs: Paula Gardiner, MD; SatSiri Sumler, LMT; Carolyn Tague, LMT; Briane Pinkson, LMT; and Karen Armstrong, LMT, about their HBMT work.
When participants in the conference asked these people about the emotional impact of their work, a common theme emerged. The panelists spoke to the importance of some sort of contemplative practice — often yoga or meditation — in maintaining balance and resilience. Self-care was mentioned, of course, but with a particular emphasis on reflection and stillness. I heard their message loud and clear.
More recently, I have come to know the work of Joan Halifax, PhD, founder of the Upaya Institute and Zen Center in Santa Fe. She has worked and been present in end of life care for decades. She has shared important wisdom about compassion through her writing, speaking, and teaching.
In particular, I remember her stating once that true compassion can be enlivening, not draining. She, too, underscores the need for a contemplative practice, so that the mind can be resilient when challenged by pain and suffering. For those of us looking for "everyday compassion for everyday use," she has developed the "G.R.A.C.E." method of cultivating compassion.
These are some of the teachers I have encountered along the way of my own calling in oncology massage, but one more is worth mentioning: myself. I am glad to be able to count myself on my list of teachers. From meeting myself and listening closely, I become better able to be with my own feelings and vulnerability. Lived in more presence, my life is teaching me to feel whole in my own pain and suffering, and to be more present with the pain, suffering, and wholeness of others.
It's also teaching me how that wholeness looks in practice. In fact, in this very column, years ago, I shared my own list of self-care measures. Little has changed over the years on that practical little list. If you read that column and substitute "hula-hooping" for "skating" as my preferred physical outlet, plus add "meditation," the column will be entirely up-to-date for 2015.
Test Your Compassion Fatigue
Because wholeness comes with awareness, I am a fan of most anything that helps us ask the right questions. Once can test one's own compassion satisfaction, compassion fatigue, and burnout levels at many different websites, but one of my favorites is the Professional Quality of Life Scale at the Compassion Fatigue Awareness Project.
The inherent emotional aspects of our profession, those same aspects that may have drawn us toward populations such as oncology massage, hospice and palliative work, can make things like boundaries, presence, and compassion a messy affair. There is rich wisdom to be learned in this messiness, if we choose to pay attention.