Sidebar: Popular Complementary Therapies
The following is a brief overview of the complementary therapies most commonly requested by cancer patients to manage the symptoms and side effects of their treatment.
Acupuncture is a component of traditional Chinese medicine that involves inserting very thin needles through the skin into energy "meridians" to bring the body's energy fields back into balance. The National Institutes of Health recently released a general statement saying that acupuncture may be effective for chemotherapy-induced nausea and postoperative pain.14 The procedure has few side effects. Individual sessions can last up to an hour, or be simple treatments in the infusion center to deal with nausea before, during, or after a chemotherapy session. While the initial session will require a separate area for the acupuncturist to interview the patient, subsequent sessions can be performed in the infusion center. Acupuncturists usually charge by the session, which can run from 20 minutes to an hour and cost anywhere from $35 to $85.
The amount your office will receive is usually $20-$65 per session if you use a fee-for-service arrangement. You may want to consider hiring an acupuncturist on a part-time basis, since you will be performing infusions daily.
Massage therapy can promote relaxation, ease stiff joints, and improve mobility and flexibility. Sessions range from 15 minutes to a full hour. Massage requires a space that promotes relaxation, even if the patient is fully clothed, and may require curtain privacy if the patient wants a deeper treatment. A corner of an open therapy room rather than the center space is a good option. Allowing your staff to take advantage of the massage therapist, even for 10-minute neck and head sessions, will raise morale and result in a better-run office. A massage therapist, non-salaried, will typically cost you between $25 to $40/hour (for a guaranteed salary you may be able to reduce that fee significantly). Massage can be billed as fee for service at a rate of $60 to $80 for an hourly session. Massage therapists often use folding tables that can be stored out of the way when not in use.
Reiki (pronounced "ray kee") is a form of spiritual healing, reportedly from Tibetan Buddhist practices, that was brought to the West in the late 1800s. Reiki practitioners rebalance and replenish the "life energy" in energy-poor areas of the body.
The patient is fully clothed during the treatment session and is usually sitting up. Sessions are usually half an hour or less. Because deep concentration is required for Reiki, a session should be conducted in an ordinary treatment room or a small, curtained space if a busier area of the office needs to be used. Reiki masters use only their hands, so your practice will not have to store supplies for these therapists. The fees for this service are similar to that of massage.
Reflexology is based on the premise that putting pressure on specific nerve reflex points can stimulate the natural healing powers of those areas. Lesser ailments such as headaches, nausea, and allergy attacks are amenable to reflexology. Sessions range from 10 minutes to a full hour. Reflexology practitioners work one-on-one, but do not require quiet or seclusion.
Since only the feet, hands, and ears are being accessed, there are no privacy issues involved and the therapist can work in a more public setting. Reflexologists sometime use implements to help them apply pressure and spare their hands, but these are small and can be transported to your office by the practitioner. The fees for this service are similar to massage, sometimes slightly less.
Therapeutic touch is based on the belief that the body has unique energy fields, defined in terms of quantum physics. The practitioner's hands are used to rebalance disruptions in the flow of energy, stimulate healing, increase well-being, and decrease pain. Therapeutic touch is taught in more than 80 North American colleges and is widely practiced by nurses in many American hospitals to supplement conventional treatment. Nurses who are trained in this practice usually provide it free of charge as part of their work in the office. Scheduling will be your only concern. Therapeutic touch practitioners who are not trained in nursing charge hourly fees similar to a massage therapist.
Practitioners of the following methods may need a larger space in which to work -- perhaps your waiting room with the chairs cleared away before or after normal office hours. If there is a room off the waiting area that can be used during office hours, the door can be left ajar with a sign posted saying "Yoga class in session," which may actually attract new patients to the therapy. Classes can be run daily or several times a week. Be sure to include both morning and afternoon times so all your patients can attend, as well as staff when their schedule permits.
Most of these therapists have a standard fee per person per class in a fee-for-service set-up. Your office may want to pay a fixed amount for the class so the therapist always receives adequate reimbursement, no matter how many people attend. Class fees to the practice can range from $50 to $150 per hour session. Some practices offer this as a free service to their patients. Others may charge a nominal fee ranging from $5 to $15 per session.
Guided imagery uses the imagination to help people cope with stress and activate the body's self-healing processes. Recent research has shown that harnessing the power of the imagination can positively affect bodily functions and boost the immune system. Practitioners can conduct guided imagery sessions individually or in groups. Often tapes of guided imagery practices or music accompany a session. Since patients need to concentrate, quiet is usually required. Sessions last from 20 minutes to an hour.
Qigong (pronounced "chee gong") is an ancient Chinese system of movement, breathing techniques, and meditation designed to develop and improve the circulation of qi (chee, or life energy) around the body. Qigong is taught to groups, although individual sessions for people with special needs can easily be accommodated. Many wheelchair users are part of ordinary Qigong classes in China, and are considered as adept at the practice as the more able-bodied participants. Classes last up to an hour.
Yoga has grown in popularity in the West as a form of exercise and relaxation. Yoga is usually done in classes, and a yoga teacher will ask for the use of a room with adequate floor space for people to sit and/or lie down. The teacher may bring a supply of cushions and a floor cover, and ask that these supplies be stored at the practice site if there is space.
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