Tuesday, November 4, 2014

Consumer Guide to Steamboat Bodyworks-Salons

Steamboat Hair Company

The owner/stylist listed for this business, Lisa Beck, is licensed through the State of Colorado, COS.0046013. The business itself is registered through the State of Colorado, REG.0000002377.


Wildhorse Salon

No names are listed for this business, however, the business is registered through the State of Colorado, REG.0100036280, as required by law.

Colorado state law requires salons to be registered, which means the state can check these businesses to enforce established standard methods and procedures that ensure a sanitary environment for consumers.

Barbers, estheticians, hair stylists, manicurists, and cosmetologists are all required to be licensed with the state.

https://www.colorado.gov/dora/licensing/Lookup/LicenseLookup.aspx




Barber and Cosmetology Consumer Guide

Consumer Guide to Steamboat Bodyworks-Reflexology


Alternative Bodywork by Colleen

The State of Colorado Department of Regulatory Agencies does not require licensing for the practice of reflexology. 

Reflexology is based on the notion, which has not been proven and actually doesn't make sense, that certain points on the hands and feet correspond to and can somehow manipulate internal organs.

Reflexology can feel good, much like a massage, for which this individual is licensed, MT.0002119, however, there are no benefits beyond massage and any claims regarding internal organs and such are not only unsubstantiated, but disingenuous to clients.  

Monday, October 27, 2014

Consumer Guide to Steamboat Bodyworks-Psychic Medium

Feeding the Body Feeding the Soul, LLC
Nancy Cohen

Psychic mediums pretend to provide "readings", usually to connect clients with loved ones, which is what is offered in this listing along with "messages of love from Spirit". What psychic mediums really do is take advantage of people.

This individual also has two other listings in Steamboat Bodyworks, Energy Work and Nutrition and Diet, with RDN, Registered Dietitian Nutritionist as a credential. The knowledge and skills of registered dietitians comes from years of education based on scientific principles. Energy work and psychic medium don't.

A psychic medium energy worker dietitian is just not a good combination for consumers.


Cold reading is a series of techniques used by mentalistspsychicsfortune-tellersmediums and illusionists to determine or express details about another person, often in order to convince them that the reader knows much more about a subject than they actually do.[1] Without prior knowledge of a person, a practiced cold reader can still quickly obtain a great deal of information about the subject by analyzing the person's body languageageclothing or fashionhairstylegendersexual orientationreligionrace or ethnicity, level of education, manner of speech, place of origin, etc. Cold readers commonly employ high probability guesses about the subject, quickly picking up on signals from their subjects as to whether their guesses are in the right direction or not, and then emphasizing and reinforcing any chance connections the subjects acknowledge while quickly moving on from missed guesses.

Consumer Guide to Steamboat Bodyworks-Pregnancy Wellness

Planned Parenthood of the Rocky Mountains


Selah


Because of the nature of the health services of these two organizations, they refrain from listing names of employees. This is for the safety and confidentiality for clients as well as employees, however, clients can and should ask questions about credentials, procedures, and all health related issues in order to make informed decisions about their health care.  

Consumer Guide to Steamboat Bodyworks-Pilates

Yoga Center of Steamboat

Pilates, pronounced pi lah teez, is a specific type of exercise method, named after Joseph Pilates. Sometimes instructors are certified, but it is not a requirement for teaching the method, nor is licensing through the State of Colorado Department of Regulatory Agencies.


Wednesday, October 22, 2014

Consumer Guide to Steamboat Bodyworks-Physical Therapy

Johnson & Johnson Physical Therapy



SportsMed at YVMC



No names are listed for either practice, however, the websites that are listed provide useful information regarding practitioners and credentials.

The State of Colorado Department of Regulatory Agencies does require licensing for physical therapists.

License information for all professions for which licensing is required is easily accessible.  https://www.colorado.gov/dora/licensing/Lookup/LicenseLookup.aspx

Saturday, October 18, 2014

Consumer Guide to Steamboat Bodyworks-Pharmacies

Lyon's Corner Drug

No names are listed so no credentials can be checked.

Pharmacy is a term with Greek roots meaning sorcery, poison, drug, or medicine. In modern times, pharmacy is a health care profession that provides and dispenses drugs and medicine, and as such, pharmacists are required to have state licensing.



RX is from the Latin word meaning recipe.



Drugstores are a hybrid that combines the dispensation of prescription medicine with retail sales of cosmetics and other miscellaneous products. Enterprises that include pharmacies, such as grocery stores and general merchandise stores, are required to follow HIPAA (Health Information Portability and Accountability Act) to protect patient privacy, which includes communication between patient and pharmacist. Most of these kinds of businesses use some type of controls, such as barriers and signage, that is intended to keep shoppers and waiting customers some distance away from patient-pharmacist consultations. This is called reasonable safeguard, the minimum requirement under HIPAA laws, which do not require the elimination of all risks of breach of privacy as long as reasonable safeguards are used.
However, not all establishments have easily discernible reasonable safeguards and shoppers, waiting customers, pharmacy employees and retail employees may not be aware of how they might be infringing on patients' privacy. In that regard, patients' and consumers' considerations in protecting their privacy would be in their own best interest. It is always reasonable and appropriate to ask a pharmacist to ensure the privacy of all patient-pharmacist communications.

"Best of the Boat" is a designation that is not of much use for consumers. It is an advertising gimmick resulting from a popularity contest in which people vote for their favorite stores or businesses. However, the contest itself is not very popular. With a low participation rate, some businesses and stores win their category on a single vote, with other participants in the same category receiving no votes. All votes can come from relatives or friends or anyone with a vested interest in a store or business. "Best of The Boat" is designed to generate advertising dollars, not to assure consumers of quality of goods or services of any particular store or business.


Friday, October 17, 2014

Consumer Guide to Steamboat Bodyworks-Personal Trainers

Focused Fitness
Nicki Parks, ACE Certified Personal Trainer

The State of Colorado Department of Regulatory Agencies (DORA) does not require licensing for personal trainers. Nicki Parks is listed in the Ace Integrated Fitness Training® database as a personal trainer.

Requirements for ACE certification include CPR (cardiopulmonary resuscitation) and AED (automated external defibrillator) certification as well as basic first-aid.

This is important for clients. Due to the nature of personal training, which sometimes is done at the client's home or another private setting, and because physical exertion can cause injury or a health emergency, it is important for personal trainers to have relevant training to handle such situations.


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IronEdge Coaching - Heather Gollnick

The State of Colorado Department of Regulatory Agencies (DORA) does not require licensing for personal trainers.

"Numerous certifications" is listed for this individual, however, that is not much help for consumers. Without listing specific certifications, they cannot be checked and consumers are not given necessary information about the type of certification, which makes it difficult for consumers to determine whether this coach would be well-suited to their needs.  


Thursday, October 16, 2014

Consumer Guide to Steamboat Bodyworks-Osteopathic Physicians

Dr. Jennifer McPeek, D.O.

DO stands for doctor of osteopathic medicine, which indicates graduation from an osteopathic medical school and a degree that is similar to MD, doctor of medicine. Dr. Jennifer McPeek is licensed with the State of Colorado Department of Regulatory Agencies (DORA), DR.0038739.

Credential protocols suggest proper placement of professional designations as Dr. before the name or DO after the name, but not both at the same time. In addition, periods are not used in academic degrees or other credentials.

Osteopathy is a term derived from two Greek words, osteon (bone) and pathos (disease). 

Osteopathic physicians can do the same things as medical doctors, such as diagnose, treat, order tests, and prescribe medications, with a major difference being that osteopathic physicians offer OMT, Osteopathic Manipulative Treatment, which consists of manipulation or massage of joints and muscles, which is based on the osteopathic theory that the structural integrity of the musculoskeletal system has a direct bearing on the structures and systems of the body and manipulation of joints and muscles can restore health to diseased structures and systems of the body.

The only problem with osteopathic theory is that no evidence exists to support it. 

Likewise, cranial osteopathy or craniosacral therapy, the theory of rates or pulses in cerebrospinal fluid as a diagnostic element and manipulation claimed to restore health, has lost credibility due to lack of evidence of biological plausibility, effectiveness and diagnostic value.

For Consumers

Osteopathic physicians' real value is as medical doctors and those who have completed residency training at a medical hospital have the knowledge and training consumers expect from medical doctors. Osteopathic physicians who promote manipulation do not have unique insight that offers benefits beyond possibly helping with back pain and osteopathic physicians who promote cranial osteopathy should be avoided altogether.

Thursday, October 9, 2014

Consumer Guide to Steamboat Bodyworks-Orthopaedic Surgeons

Orthopaedics of Steamboat Springs

No names are listed, however the ad on the same page as well as the website provides the names of four doctors, all of whom are licensed with the State of Colorado Department of Regulatory Agencies (DORA).

Dr. Eric Verploeg, DR.0029871
Dr. Michael Sisk, DR.0037745
Dr. Andreas Sauerbrey, DR.0033499
Dr. Henry Fabian, DR.0034169

In addition, the website provides information about education, training, specialized training, certification, specialized care, and other information which is extremely helpful to consumers who are considering orthopaedic health care. 

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Orthopaedic refers to the musculoskeletal system and the treatment of injuries, diseases, and conditions of bones, joints, ligaments, tendons, muscles, and nerves.

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Steamboat Orthopaedic Associates, P.C.

Both doctors are licensed with the State of Colorado Department of Regulatory Agencies (DORA).

Dr. Bryan Bomberg, DR.0029881
Dr. Alexander Meininger, DR.0051713

Their website includes important information regarding education, training, specialized training, certification, and areas of specialized care that can help consumers make informed decisions about orthopaedic health care. 




Wednesday, October 8, 2014

Consumer Guide to Steamboat Bodyworks-Nutritional Supplements

Family Medicine of Steamboat Springs

No names are listed, however the ad consumers are directed to lists the names of two medical doctors and one physician assistant. All are licensed with the State of Colorado Department of Regulatory Agencies (DORA).

Millie Flanigan, PA.0001325
Phaedra Fegley, DR.0043109
Rosanne Iversen, DR.0031614

This is important for consumers because this enterprise, which is also listed under Aesthetics & Skin Care, Family Medicine, and Nutrition & Diet, promotes supplements and complementary and alternative practices in its listings, as well as the ad consumers are directed to and the website provided. For consumers, having the information that these individuals are licensed in the medical field and dabbling in alternative practice, which is generally considered less safe and effective than science-based medicine, can help to determine whether this type of enterprise would be a good choice for health care.

Medical professionals who promote supplements and complementary and alternative practices are not common due to ethics and exploitation issues.



"The for-profit sale of goods to patients by physicians inherently creates a conflict of interest. Physicians engaging in this activity have a direct financial interest in selling the goods to patients; but the sale may or may not be in the best interests of the patients. Physicians may be tempted to sell items for profit even though their patients do not need the products. Even if most physicians are capable of resisting such temptation, the more ethical course is for professionals to avoid placing themselves in temptation's way, This conflict of interest is particularly troubling in the office setting, where most patients appear because they are in need of medical attention. In the ordinary market setting, consumers can be trusted not to purchase items which they do not want, thus a voluntary sales transaction is taken to be in the best interests of both parties. But the voluntariness of any sale to a patient in a medical office setting is open to serious question. . . .

The offer of goods In the treatment setting puts subtle pressure on sick and vulnerable patients to purchase them. Patients may purchase goods out of a misplaced desire to please or to "get in good" with their physicians. They may feel that they have to purchase those goods in order to secure the physician's favor. These feelings, whether justified or not, may interfere with the open exchange and the level of trust between physician and patient" 
                                                                           From American Medical Association
                                                                           Council on Ethics and Judicial Affairs (CEJA)
                                                                           Policy Statement



No reliable statistics exist on how many doctors sell such products, and those who do are breaking no law. Yet for many experts, legality is beside the point.
''You can't exploit the patient for your own financial interest,'' said Dr. Leonard Morse, chairman of the American Medical Association's council on ethical and judicial affairs. ''This is a doctor-patient relationship, and your patient's interest transcends your financial interest.''
Dr. Stephen Barrett of Quackwatch, a medical watchdog Web site, put it this way: ''I tell people to avoid doctors who sell vitamins. It's a sign of bad judgment; you've made a wrong scientific judgment, in addition to which you're selling to a captive audience at a price that's inflated.''

From the American Medical Association (AMA), Opinion 8.063 – Sale of Health-Related Products from Physicians’ Offices

 In-office sale of health-related products by physicians presents a financial conflict of interest, risks placing undue pressure on the patient, and threatens to erode patient trust and undermine the primary obligation of physicians to serve the interests of their patients before their own.
(1) Physicians who choose to sell health-related products from their offices should not sell any health-related products whose claims of benefit lack scientific validity. When judging the efficacy of a product, physicians should rely on peer-reviewed literature and other unbiased scientific sources that review evidence in a sound, systematic, and reliable fashion.
(2) Because of the risk of patient exploitation and the potential to demean the profession of medicine, physicians who choose to sell health-related products from their offices must take steps to minimize their financial conflicts of interest. The following guidelines apply:
(a) In general, physicians should limit sales to products that serve the immediate and pressing needs of their patients. For example, if traveling to the closest pharmacy would in some way jeopardize the welfare of the patient (eg, forcing a patient with a broken leg to travel to a local pharmacy for crutches), then it may be appropriate to provide the product from the physician’s office. These conditions are explained in more detail in the Council’s Opinion 8.06, "Prescribing and Dispensing Drugs and Devices," and are analogous to situations that constitute exceptions to the permissibility of self-referral.
(b) Physicians may distribute other health-related products to their patients free of charge or at cost, in order to make useful products readily available to their patients. When health-related products are offered free or at cost, it helps to ensure removal of the elements of personal gain and financial conflicts of interest that may interfere, or appear to interfere, with the physician’s independent medical judgment.
(3) Physicians must disclose fully the nature of their financial arrangement with a manufacturer or supplier to sell health-related products. Disclosure includes informing patients of financial interests as well as about the availability of the product or other equivalent products elsewhere. Disclosure can be accomplished through face-to-face communication or by posting an easily understandable written notification in a prominent location that is accessible by all patients in the office. In addition, physicians should, upon request, provide patients with understandable literature that relies on scientific standards in addressing the risks, benefits, and limits of knowledge regarding the health-related product.
(4) Physicians should not participate in exclusive distributorships of health-related products which are available only through physicians’ offices. Physicians should encourage manufacturers to make products of established benefit more fairly and more widely accessible to patients than exclusive distribution mechanisms allow. (II)
Issued December 1999 based on the report "Sale of Health-Related Products from Physicians' Offices," adopted June 1999.

Tuesday, October 7, 2014

Consumer Guide to Steamboat Bodyworks-Nutrition & Diet


Dietary Designs
Jamie Alperin, MS, RD

MS usually stands for Master of Science, RD stands for Registered Dietitian. No listing for this individual could be found with the Colorado Academy of Nutrition and Dietetics (CAND), which is a non-profit professional organization representing registered dietitians in Colorado. There is no requirement for dietitians to be licensed with the State of Colorado Department of Regulatory Agencies (DORA).

It is best to avoid individuals whose credentials cannot be verified.

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Family Medicine of Steamboat Springs

No names are listed, so no credentials can be verified. The ad that consumers are directed to lists a physician assistant and two medical doctors, however there is no mention of anyone who may be qualified to advise clients on nutrition and diet. While medical schools require courses that include the principles of nutrition, such as physiology, most medical schools have no nutrition course requirements and some schools only offer elective nutrition classes, which is why most doctors refer patients to registered dietitians and most hospitals have registered dietitians on staff.

This practice is listed under several headings in Steamboat Bodyworks; Aesthetics & Skin Care, Family Medicine, and Nutritional Supplements. All listings, as well as the ad consumers are directed to, include mention of supplements or alternative medicine, which is a term that always means supplements.

For that reason, Stephen Barrett, MD, of Quackwatch cautions:


Beware of Unqualified Individuals
…a small percentage of licensed practitioners are engaged in unscientific nutrition practices. The best way to avoid bad nutrition advice is to identify and avoid those who give it. I recommend steering clear of:

  • Anyone who says that everyone needs vitamin supplements to be sure they get enough. Most people can get all the vitamins they need by eating sensibly.
  • Anyone who suggests that most diseases are caused by faulty nutrition. Although some diseases are diet-related, most are not.
  • Anyone who suggests that large doses of vitamins are effective against a large number of diseases and conditions. That is simply untrue.
  • Anyone who suggests hair analysis as a basis for determining the body's nutritional state or for recommending vitamins and minerals. Hair analysis is not reliable for this purpose. 
  • Anyone who claims that a wide variety of symptoms and diseases are caused by "hidden food allergies"
  • Anyone who uses a computer-scored "nutrient deficiency test" as the basis for prescribing vitamins. There are valid ways that computers can be used for dietary analysis. But those used for recommending vitamins are programmed to recommend them for everyone.
  • All practitioners—licensed or not—who sells vitamins in their offices. Scientific nutritionists do not sell vitamins. Unscientific practitioners often do—usually at a considerable profit.



More information for consumers


Both enterprises, Dietary Designs and Family Medicine of Steamboat Springs offer two trendy weight management concepts; metabolic testing and body composition analysis.

Metabolic testing involves a breath test that measures the amount of oxygen the body consumes, which is called the resting metabolic rate, which is then calculated with a factor based on physical activity level, which then determines caloric needs to maintain, lose, or gain weight.

Body composition analysis, the measurement of the amount and distribution of body fat and lean mass, uses testing methods that have questionable value:

Skinfold measurements, used to predict body composition, are limited in assessment for whole body lean mass or total fat mass, so are reliable only to predict regional fat mass, or fat mass limited to certain areas of the body. In addition, accuracy of skinfold measurements is dependent on the skill of the practitioner.

Body mass index (BMI) cannot distinguish between fat and lean masses.

Waist circumference (WC) is a measurement of central fatness, but not total fat.

Waist-hip ratio measurements show inconsistent or no significant relationship to abdominal fat.

Bioelectric impedance analysis (BIA) is highly inaccurate and not routinely used.

Are metabolic tests and body composition analysis necessary for weight management?

These tests generally run over one hundred dollars a pop and practitioners advise regular retesting, in order to check progress. These tests are claimed to be useful for weight gain, maintenance, or loss, and to provide information about individual metabolism rates that may be low, normal, or high. But, by far, the most common use of these tests is for weight loss and boosting metabolism.

Consumers can save money by skipping the body composition analysis, after all, most people have at least a general idea of their body composition.

Consumers can save even more money by skipping the metabolic testing. Metabolism is regulated by the body to meet the energy needed for functions such as breathing, cell repair, blood circulation, digestion, etc., which accounts for about 70% of calories that are burned every day. Other factors that influence metabolism and are outside anyone's control are body size and composition, sex, and age, which leaves physical activity as the only factor that can increase metabolism, which, incidentally, is what the sellers of body composition analysis and metabolic testing would recommend.

There is no cost to figuring out a physical activity that can be enjoyed enough to do on a regular basis. Body composition analysis and metabolic testing do not make people into regular exercisers if they weren't already.

One more thing

Body composition analysis and metabolic testing sellers often recommend supplements to boost metabolism. Those kinds of supplements do not have any effect on metabolism, but are useful to boost the bottom line for the people that sell them.

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Feeding the Body Feeding the Soul, LLC
Nancy Cohen, RD, Nutritionist

There is no requirement for registered dietitians to be registered with the State of Colorado Department of Regulatory Agencies (DORA). This individual is listed with CAND, Colorado Academy of Nutrition and Dietetics, a non-profit professional organization representing registered dietitians in Colorado. The accepted credentials for Registered Dietitian Nutritionist are correctly expressed as RDN.

The listing names the services that are offered, which all fall under accepted professional standards, except for the item at the very end, "and more..." and that "more" is what consumers should be wary of as this individual has two other listings in Steamboat Bodyworks, one under Energy Work, the other under Psychic Medium, both of which are a long ways outside the standards of practice for the profession of registered dietitians.

Registered dietitians who offer psychic readings should probably be avoided.

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Tim Trumble, Dipl. OM

Dipl. OM stands for Diplomate of Oriental Medicine, which is a certification by the NCCAOM, National Certification Commission for Acupuncture and Oriental Medicine, however, Tim Trumble's name does not appear in the NCCAOM practitioner database or its registry, so this individual's use of this credential appears to be illegitimate.

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Yampa Valley Medical Center
Nutrition Services

No names are listed. Consumers must go to the website to find out more about these services and the people who provide them. However, the website is not entirely helpful in that no information is given regarding registration and none of the names that are listed could be verified as registered. In addition, some names are followed by other credentials that are unfamiliar and are not deciphered. The use of established protocols for credentials would make it easier for consumers to read and understand, as well as verify.

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Consumer Guide to Steamboat Bodyworks-Naturopathic Doctors

Dr. Michelle Hana Linet ND, CMT

Dr. Michelle Hana Linet is licensed with the State of Colorado Department of Regulatory Agencies, DORA, as a naturopathic doctor, ND.0000039, and is the only naturopathic doctor listed for the Yampa Valley area.

Dr. Michelle Hana Linet is also licensed with the State of Colorado Department of Regulatory Agencies, DORA, as a massage therapist, MT.0003458, however no certification could be found to verify the CMT credential.

Professional protocols for doctor credentials would be to place Dr. in front of the name or the degree, in this case ND, after the name, but not both at the same time.

Two services offered in the listing warrant caution to consumers; herbs and homeopathy.

Herbs, the kinds recommended in a health care setting setting, should always be researched and discussed with a primary care doctor before considering as rational, safe, and effective health care.

A good place to start:



Homeopathy is considered unethical, the use of which can result in harm from relying on and wasting money on unsafe and ineffective products. 

National Center of Complementary and Alternative Medicine (NCCAM)

    There is little evidence to support homeopathy as an effective treatment for any specific condition.
  Although people sometimes assume that all homeopathic remedies are highly diluted and therefore unlikely to cause harm, some products labeled as homeopathic can contain substantial amounts of active ingredients and therefore could cause side effects and drug interactions.
  Homeopathic remedies are regulated by the U.S. Food and Drug Administration (FDA). However, FDA does not evaluate the remedies for safety or effectiveness.
  Several key concepts of homeopathy are inconsistent with fundamental concepts of chemistry and physics. There are significant challenges in carrying out rigorous clinical research on homeopathic remedies.
  Tell all your health care providers about any complementary health practices you use. Give them a full picture of all you do to manage your health. This will help ensure coordinated and safe care.

National Council Against Health Fraud (NCAHF)



Recommendations

To Consumers
Be aware that homeopathic products and services are marketed in a “buyer beware" situation at present. Homeopathic products are not required to meet the standards of effectiveness of drugs. Homeopathic services are poorly regulated. Physicians who practice homeopathy operate below the standards of responsible medicine…Consumers should not entrust their health to physicians or nonphysicians who practice homeopathy.

To State Legislators
Because homeopathy is scientifically indefensible: 1) Enact laws requiring that medical products sold within your state meet the standards of accurate labeling, truthful advertising, and premarketing proof of safety and effectiveness. 2) Abolish state licensing boards for homeopathy. 3) Do not allow homeopathy in the scope of practice of any health care provider.



In the US, the president of the National Council Against Health Fraud said, "Homeopathy is a fraud perpetrated on the public with the government's blessing, thanks to the abuse of political power of Sen. Royal Copeland (chief sponsor of the 1938 Food, Drug, and Cosmetic Act)."[240]