Is your practice safe?

• Is your documentation adequate for defense in litigation or complaints to regulatory boards? Does it include needle angle at high-risk locations?
• Do you know what standards the CNT manual (7th ed.) sets for minimizing pneumothorax risks? Sterilizing cups, gua sha tools? Preventing and managing heat lamp and moxa burns? Medical record-keeping?
• Do you routinely provide and effectively document a verbal, face-to-face informed consent regarding risks, prior to treatment?
• Do you know what social media marketing techniques are legal vs. illegal, as well as what terms to avoid using on your website?
• Do you know how to avoid triggering insurance audits for suspected over-billing?
• Can you recognize when you're in a "high-risk" relationship with a patient, and manage the situation without charges of discrimination in health care or "patient abandonment" that risk license suspension?
• What would you do/not do if you were concerned someone was going to file a malpractice suit against you?

If you're unsure, these Classes are for you!

I invite you to benefit from my experience as an Expert Witness in malpractice litigation, complaints to regulatory boards, and insurance audits to help you manage risks while supporting sustainable practice growth.

--Anthony Von der Muhll, L.Ac., DNBAO, DAOM

Avoiding Lawsuits I: Essential Principles & Practices

2 Safety PDAs

• Common myths, misperceptions, and wishful thinking regarding suits & complaints -- and how to avoid them
• What constitutes malpractice?
• Knowing and managing personal, professional, and cross-cultural risk factors
• Overview of 10 essential risk management principles & practices
• Avoiding and managing higher-risk patient-practitioner relationships
• Setting & maintaining alignment of appropriate patient-practitioner goals

Avoiding Lawsuits II: Clarifying Gray Areas in Scope of Practice & Consent

2 Safety PDAs

• Providing and documenting effective verbal, face-to-face informed consent
  • Live webinar includes practice and instructor feedback
• Appropriate health education as a risk management strategy
• Clarifying common "gray areas" in state licensing laws and scope of practice
• Introduction to general Standards of Care for acupuncture professionals.

Avoiding Lawsuits III: Safety & Documentation

2 Safety PDAs

• Knowing Standards of Care, and who defines them and how they are established
• Standards and best practices for avoiding and managing:
  • Pneumothoraces: screening for risk-elevating factors; high-risk locations, safe vs. unsafe needle angles and depths
  • Nerve trauma and arterial puncture: high-risk locations, safe vs. unsafe needle angles and depths, and monitoring during needle penetration
  • Heat lamp and moxa burns: screening for risk-elevating factors; recognizing and managing accidental burns
  • Suction cups, including "wet" and "fire" cupping: knowing contraindications and screening for risk-elevating factors; avoiding and managing injuries
  • Gua sha: knowing contraindications, risk-elevating factors, and contraindicated areas; avoiding injuries
  • Slip-and-fall injuries: screening for risk-elevating factors and preventing accidental falls
  • And more...
• Recognizing warning signs that patients may file suits or complaints
• Managing patient complaints to minimize risks of escalation to suits and complaints
• Critical documentation of safety protocols and management of adverse events

Avoiding Lawsuits IV: Ethics & Laws in Marketing and Billing

2 Ethics PDAs

• Avoiding allegations of professional misconduct
  • "False Advertising:" more serious than it sounds
  • Self-dealing and profiteering from unnecessary treatment: a slippery slope for acupuncturists
  • Fee-splitting and kickbacks: common, but usually illegal
  • Risk-elevating prepaid treatment "packages" and concierge practices, vs. safer alternatives
• Risks of social media marketing; managing negative reviews
• Best practices in fee-setting, collecting co-pays, and providing discounts
• Avoiding insurer audits: best practices in coding and billing
• Accessing further help when needed
  

California Scope of Practice Laws: Clarifying the Gray Areas

2 Ethics PDAs

• Responsibilities and rights as a "primary health care profession"
  • Is it legal to make a "biomedical" or "Western diagnosis?"
  • Case management and referrals
• Definitions of acupuncture vs. non-acupuncture needles; therapeutic aspiration of blood
• Health education vs. counseling: avoiding out-of-scope prescriptive psychotherapy
• "Asian massage” vs. other manual therapies
• “Naturally-occurring substances” vs. synthetic supplements
• Light therapies: lasers, LEDs, infrared
• Therapeutic exercise prescription vs. physical therapy
• Terms to avoid in advertising, communication, documentation, vs. better alternatives

Clinical anatomy, kinesiology, and the jing-jin ("sinew meridians" or myofascial tracts)

• Bones, muscles, discs and facet joints, and neurology
• Postural and motion dysfunctions
• The arthritic progression: strain/sprain, derangement, degeneration, from qi stagnation to bone bi/phlegm and blood stasis knotted together

History-taking: key diagnostic questions

• "Red flag" symptoms of urgent/serious medical conditions potentially warranting referral to physician care: stenosis, tumors, infection, fractures, and radiculopathies
• Differentiating symptoms of muscles, joint, disc, and spinal cord, and nerve root injuries
• Neural hypersensitization and psycho-social factors
• Functional capacity questionnaires for reporting to managed care insurance

Physical exam of the low back, core and pelvic girdle: how findings can guide acupuncture treatment

• Observation, inspection and palpation
• Joint exam: active range-of-motion and passive stress testing sacroiliac joint and pubic symphysis
• Neurologic exam: upper motor neuron; leg reflex, sensory, and motor function; sciatic neuropathy
• Manual strength testing and referred pain pattern charts for 10 key muscles of the low back, core and pelvic girdle
• Special orthopedic tests for the lumbosacral spine
• Documentation of physical exam findings
• Measuring and reporting functional capacity baselines and treatment outcomes
• Clinical flow charts to facilitate efficiency and accuracy in examination

Diagnosis and Pattern Identification

• Lumbosacral sprains/strains, postural and motion dysfunctions, and myofascial pain of the iliopsoas, quadratus lumborum, paraspinals, abdominals and gluteals
• True sciatica vs. radiculitis vs. piriformis myofascial pain
• Radiculopathies and stenosis
• Post-partum pain, insufficiency of the iliolumbar and sacrotuberous ligaments, and dysfunctions of the sacroiliac and pubic symphysis joints
• Chronic lumbosacral pain, spondylosis, arthritis, degenerative disc disease, scoliosis
• Spondylolisthesis and compression fractures
• Failed low back surgery syndromes

Treatment

• Myofasicial trigger point needling: quadratus lumborum, iliopsoas, gluteals, hip external rotators, and abdominals
• Joint stabilization/mobilization aka prolo-acupuncture: iliolumbar, posterior sacroiliac, and sacrotuberous ligaments; lumbar facet and pubic symphysis joints, and spondylolisthesis
• Active cupping: suction + thoraco-lumbar AROM
• Gua sha and tui na to restore lumbo-sacroliac joint mechanics
• Electro-acupuncture for radiculopathies, cord compression and sciatica
• 3-edged, lancet and 7-star needle therapies
• Exercise therapy, sport and work ergonomics

Build on your skills with the Review/Practicum Lab