What information is reviewed by the Providers?
Imaging discs, reports and/or lab work
Medical, surgical, social and family histories.
Current dietary and exercise habits.
Spiritual concerns, if applicable
Personal support services, health advocate, etc.
Personal quality of life measures
Controlled Substance Prescription Database
What type of counseling is provided in the clinic?
How to best optimize your health given time restrictions, current fitness level, and financial constraints
Safe initiation of exercise or starting you on individualized home exercise program (HEP)
Transitional Care as part of Palliative Care services if patient and family are not ready for Hospice Care options
‘Needs’ for imaging, medications, supplementation, dietary changes.
Additional SMART Goals, DBT or CBT or ACT psychological modalities are provided through Deborah Levasseur, PhD (see The Psychologist)
Specific information about medications and prescriptions:
Patients will be educated on the most effective evidence-based (or at least consensus-based) medication options, rotations, and/or regimens (in collaboration with existing providers).
At each visit, there will be an opportunity to discuss current supplement and medication regimen as they relate to one’s personal goals, as well as the appropriateness for any controlled substance prescriptions. All prescriptions will be provided via electronic prescribing service directly to pharmacy.
New Patient prescriptions for controlled substances will be provided up to a maximum of five (5) days, and only AFTER Dr. Behling has reviewed the PDMP (controlled substance prescription database) for non-duplicate and/or inappropriate requests.
CONSENT FOR CONTROLLED SUBSTANCES will be required for regimens more than 5-days in duration - OR - more than a total of four 5-day prescriptions (20 days) in less than six months.
Urine drug testing will be required prior to 5+ day regimen of controlled substances - AND - may be required at any time if taking controlled substances for longer than 6 months for a minimum of twice a year, especially if there are concerns about misuse or inappropriate ‘sharing’ of medications.
North Shore Osteopathic, LLC does NOT offer treatment with THC/medical marijuana.
Do you take my insurance?
North Shore Osteopathic, LLC is pleased to offer affordable specialist services payment plan options to make this type of care accessible. Our Providers and Specialists are generally NOT In-Network for insurances, and may or may not be enrolled with Medicare.
All patients are expected to pay providers for fees in full. Patients will then receive invoices and Superbills to submit to their insurance companies for reimbursement.
Does insurance reimburse all evaluations and procedures?
Some of our offered procedures are not reimbursable by insurance companies and/or ACA insurances /Medicare/Medicaid.
Please see our Evaluation and Management Fees section for more specifics as to what is likely NOT to be covered.
If not using insurance, this will not be an issue for you.
What should I wear?
It's important that you feel comfortable, so wear a loose-fitting shirt and pants, or bring these clothes with you to change into.
Hospital gowns will be made available for areas more difficult to reach or if you forget to wear something accessible.
Gait evaluation is always part of the examination, so please bring low-heeled shoes or socks for this purpose.
If you have assistive devices, prosthetics, orthotics or other bracing that your regularly use, please consider bringing these in as well to at least your initial consultation.
Do I have to remove my clothes?
Massage therapy may request you to remove as much clothing for treatment access as you feel comfortable - with the exception of underwear/underpants.
Depending on the area of the body requiring treatment during Osteopathic Manipulation or other minimally- or non-invasive procedures, you may be asked to remove accessories or one layer of clothing (usually bulky jewelry, belts, ties, sweaters, and nice button-down shirts when you have a t-shirt underneath).
Hospital gowns will also be available to limit exposure during examination and/or any procedures.
Can I bring a friend or relative?
Yes, friends, family members, care providers and/or advocates are encouraged to join us in the room for consultation and successive evaluations and treatments unless the patient prefers privacy (exception in that case is if the patient has significant cognitive deficits, the advocate will be asked to be present).
Do you offer urgent or same-day visits?
PLEASE CONTACT THE PROVIDER DIRECTLY WITH THIS REQUEST. Every effort to schedule Urgent visits will be scheduled within 24 hours.
Walk-in services cannot be accommodated. Please schedule at least 3-hours prior, and NOT less than one (1) hour prior to the office start time.
If you are having intense and intractable pain or dysfunction post-treatment, CONTACT DR. BEHLING IMMEDIATELY via 603-316-1264.
As per usual practice, non-treatment urgent issues should be first evaluated by your Primary Care Provider and/or the nearest Urgent Care / Emergency Room.
I already receive massage, bodywork, OMT, Chiropractic care, etc.…
We encourage patients to be open and upfront about who else they are working with to mobilize joints, tissues, viscera and/or limbs.
If you are receiving ‘aggressive’ tissue and/or joint manipulative care elsewhere at the time you decide to work with Dr. Behling, it is likely that Dr. Behling will NOT treat you while other providers are still treating you so as to avoid medicolegal complications - Dr. Behling will require direct communication with the Therapists providing Massage, Bowen and Acupuncture. Note that Dr. Behling works directly with Nicole Mosier on site to perform gentle and more aggressive soft-tissue work.
If you are receiving treatments or therapies elsewhere and develop intense pain or functional deficits, we encourage you to contact the Provider that most recently treated you.
What if my condition changes over time?
It is important to tell a therapist or Physician if your medical condition or medication regiment changes over time. This includes any new injuries or noteworthy changes in your baseline “regular” bowel, bladder, balance, cognitive function or mental health status.
Care Providers treating your spine and joints should regularly re-test your muscles, nerves and range of motion to determine if any progressive improvement or decompensation has occurred.
As a Physician, Dr. Behling can prescribe additional medication or supplements, diagnostic testing and/or imaging, or even set up a referral for another clinical provider's care if there are significant changes or concerns.
Is Osteopathic Manipulation painful?
Physicians who practice Osteopathic Manipulative Medicine learn over 20 modalities (ways) of achieving improvements in range of motion, circulation and function.
Some of these techniques are more appropriate than others, depending on your age, condition and personal preferences. For instance, for someone with fused neck vertebrae, high velocity ‘cracking’ is not appropriate, nor is traction. However, there are several other treatments that can minimize pain and improve range of motion.
Manually preparing the tissue and using newer technologies such as pEMF, ICES and LED arrays also help to prepare the sites for OMM as well as can be used after OMM to improve aftercare. A good example is treatment of a trigger point — One could needle the area, receive manual treatment, LED, pEMF, or ICES to alternatively soften up the muscle and reset the muscle reflex to break down the muscle spasm. The same goes to mobilize and break up adhesions and scar tissue.
Please expect ongoing explanation and direction of positioning and treatment during procedures so you have ample opportunity to question or redirect care if it does get uncomfortable.
BOTTOM LINE: You are in charge of your own treatments.
Must there be a follow-up appointment after I have a procedure or medication change?
A Follow-up visit is expected and standard of care, ideally 1-2 weeks BUT no more that 3 weeks after a procedure or adjustment in medication (or start of a new medication).
This is not only to determine whether the initial procedure was successful or had unexpectedly failed -OR- caused some adverse event.
What kind of treatments do you provide for anxiety and depression?
Anxiety and depression should treated holistically and empirically, as well as in collaboration with the patient and any other advocates or practitioners involved.
EVERY APPOINTMENT with Dr. Behling will review lifestyle changes, nutrition, personalized exercise routines, medications and non-pharmaceutical supplementation, essential oils and/or any obstacles to your wellbeing, including support systems, or lack thereof.
Other well-received adjunctive therapies are available on-site including: 30- to 120-minute appointments in our low stimulation room with our Structural Integrator / Acupuncturist using essential oil formulations, music therapy, pEMF, myofascial release and/or other therapeutic options.
Additionally, a progressive new technology called ICES can provide continuous low intensity Transcranial Magnetic Stimulation (cTMS) - which has been shown to be beneficial - although requires twice weekly treatment for eight (8) weeks.
How often do I have to be treated to get results?
This depends on how much relief you get after your first treatment. After any physical or biochemical changes, your body should be given a chance to recover, which usually takes between 4 and 8 days (depending on the procedure)
The exception to this is if a patient is suffering from a very painful condition that requires gentler procedures in the first place, which will then allow for more frequent appointment intervals i.e., every 48-36 hours. Generally, patients are not requested to return the same week of a procedure so that s/he can determine if normal / regular activity is better tolerated after a treatment or procedure.
Other than for Neuromuscular Re-education via Vibration Therapy, PEMF, ICES (and the cTMS) - return visits are usually not less than every 5 days.
Please note that there are "standardized" treatment protocols listed with the American Osteopathic Association, but individualized care is always more productive and satisfying for all parties.
What if I want to just have a “general massage”?
Generally speaking, Osteopathic Manipulation does not involve a ‘general massage’. Tissue manipulation is often involved, but usually focused on a specific site, joint, or area of injury so that it is most similar to neuromuscular/medical or deep tissue bodywork.
To facilitate more timely care, Dr. Behling will also offer collaboration with Nicole Mosier for any patients that require significant or more aggressive tissue manipulation so that her clinical time is best spend in diagnosis, individualized Osteopathic Treatment or education.