Archive for tag: ideas

Life's Kaleidoscope

The trimester is coming to a close, and I can honestly say it's flown by. We're all scrambling to meet deadlines in the clinic: this many of this, that many of that. It hardly seems that about 12 weeks ago we were terrified we'd be horrible at this. Truth be told, I didn't think anything about deadlines and numbers and paperwork (OK, well I did think about paperwork a little bit). That's probably why I'm scrambling now.

The last couple of weeks have been discussions about who is transitioning to the other clinic, and some talks about where we'll end up. Half of our crew is moving to the other clinic. It's unlikely that I'll see them very often. Perhaps we'll have seminars or training sessions of some sort, or get together outside of school (although we don't do that now). But in a few weeks, there will be another big transition for all of us. Some of us have been together, nearly every day, for about 3 years. This will be something really new.

Newness. It reminds me of my theory about Maslow's Hierarchy from last week. Incidentally, I've been working some more on that, but I'll spare you all the details. I had the pleasure to discuss it with two of my fellow interns today, the concept of new ideas. We were talking about my theory, and about other theories -- things in medicine and science that seem to have been left behind. We were discussing the idea that there are no new ideas.

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Image by http://mladavid.deviantart.com

Mark Twain said:

"There is no such thing as a new idea. It is impossible. We simply take a lot of old ideas and put them into a sort of mental kaleidoscope. We give them a turn and they make new and curious combinations. We keep on turning and making new combinations indefinitely, but they are the same old pieces of colored glass that have been in use through all the ages."

I grew up not far from good ol' Mark Twain's stomping grounds, but between you and me, his writing always made me crazy. No matter how much I tried, I couldn't understand the dialect he wrote. I'm not sure that I agree with Mark; it seems we're discovering new things all the time. From god particles to medicines, we strive and learn how to change, adapt, and understand the world around us.

If the last 12 weeks in the clinic have taught me anything, it's that we have no standard approach to treating anything. We have to be willing to come up with new ideas, or at the very least, new applications for old ideas. For every patient that comes in, even if they have the "same" diagnosis, what works for each one of them is likely to be something completely different.

I'm fairly certain that our discussion today came to the conclusion that there has to be something new. There has to be a pursuit of Science that crosses boundaries into new territories, that bypasses the need for a randomized controlled trial of everything, and simply embraces discovery for the sake of discovery, and implementation for the benefit of the whole. Perhaps we're all idealists. I see no problem with that. Being idealistic just promotes my love of the field and my hope for making a difference.

Neil deGrasse Tyson, in his series "Cosmos" said:

"To make this journey, we'll need imagination, but imagination alone is not enough because the reality of nature is far more wondrous than anything we can imagine."

OK, Neil. I'll take that one to heart. The greatest theories come from crazy idealists.

I wish you all many great new discoveries. May your kaleidoscope always look just a little bit different.

Taking a Good Look

Have you ever stared at something so long that it looks completely different? I do this with words. I think that's a new level of zoning out. Sometimes when I do this, it completely changes my perspective. Not all that often, mind you, but it does. Lately, I've been getting hit with a lot, that's been altering my perspective.

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I've been spending a lot of time in downtown St. Petersburg. It's not as if I haven't lived here for 8+ years, and it's not as if I haven't been downtown nearly a million times. Because of friends living downtown, I'm seeing parts of it that I've never seen before. I'm always amazed at what exists, right under my nose -- but I just haven't taken the time to see it. So now, it's starting to look completely different.

Like many downtowns across the country, ours has had its moments. There were department stores downtown, factories, big business. I've always wanted to research some of the buildings downtown, especially the Studebaker Building, which I used to drive by nearly every day when I lived on the other side of town. And then there's the nation's first open-air post office, which, honestly -- these pictures don't do justice. The inside of the post office reminds me of old time banks and Westerns -- loaded with beautifully stained wood and remembrances of teller windows. Some of these buildings have been standing for a long, long time -- constructed not long after the turn of the century, which for this area is nearly ancient.

Also, like many downtowns, St. Pete seems to constantly undergo some form of revival. New places move in; old ones move out. Things get rebuilt or renovated, torn down, and new life comes in to change the look and feel of it all. The more time I spend down there, the more I like it. There are old bars and restaurants, beautiful scenery, and the old stately architecture. I've posted pictures of the banyan trees, the Dali and Mahaffey Theater, the Pier, and a few of the marina as well. I'm running out of time to explore here -- at least while I'm still at school. I've set a loose goal for myself, of visiting every building between Beach Drive and 34th street on Central Avenue. I wonder how close to that I can get with this crazy schedule.

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We're in Week 10, which means midterms are over here at National, and I'm looking at finals for Western States. I can't believe how quickly things have passed. I keep going back and forth about jobs and locations and being excited about being out in practice and clinic and a million other things. I was forwarded a list of job openings all over the country, towards the end of last week. I couldn't help but look -- thinking that it was all very premature, and yet I'm being told that I SHOULD be looking right now. I'm still thinking it might be a little presumptuous.

And of course, this week I have to turn in a sample business plan. It's hard to anticipate things like that when you have no idea where you'll be. Of course, I could go anywhere. The question becomes where, and when, and how, and why. We've all talked about setting up our own practices -- well, most of us have. Some, I think, are planning on joining practices and others might just associate for a short period of time. When I thought I had a clear plan before, now I'm not so sure. Life sometimes gets in the way of plans. John Lennon said something like, "Life is what happens when you're busy making plans." For right now, I'm only making immediate plans, with the rest in the background.

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Maybe I just need a change in perspective.

Marketing Presentation

The marketing presentation is over. I'm really glad. I was sweating it big-time. I put a lot of work into it -- the design and layout of the logo, the tagline, all the wording for the sample brochure -- all of it. Even though it made last week's schedule pretty intense with all of the other activities, now it's done and I can watch my classmates do theirs (and enjoy them), and also focus on other things.

GreyforestlogoSo the plan for my future practice is to be both multi-disciplinary and integrated -- where the practitioners not only work together, but complement each other in abilities to provide a larger scope of practice. The basic premise is that in order to take care of the whole person, we have to approach the whole person. So we'll have everything integrated into the practice from seminars, movement classes, and functional medicine to counseling, acupuncture, and herbal medicine. My idea is to have five practitioners to start with: Chiropractic, Naturopathic, Acupuncture, Massage, and Behavioral Medicine. I'd like to also have an herbal compounding pharmacy on site -- in addition to a number of nutraceuticals available.

 

I've also entertained some ways to expand down the road. The addition of hyperbarics, a medicinal and natural foods café, and inpatient care seem more than logical. I realize that they're big and potentially lofty ambitions, BUT I think with the right team of practitioners, we can definitely do it. Anybody want to help?

Upcoming Week

This week I have a few things due: notes from my head-to-toe practical; my community resources listing and BETS research (I'm working on Alzheimer's and choline -- or hoping to); and on Friday I have my functional rehab practical. I'm so glad I'm going early with that one as well. That REALLY frees up my week 14. There's nothing like having a little bit of extra time to study for things or work.

Master's Program

The Master's is going well. This last week it was tough to get everything done because of the exams, presentation, and practical. I was scrambling to get it all done by midnight on Sunday (all of my Master's work is due by midnight Sunday). As it was, I was falling asleep finishing the last assignment. It could have gone better, but that's what happens when you're falling asleep answering questions. The topics for last week were mostly gut immunity -- which I find fascinating. I'd really like to figure out all of the possible permutations of gut disruption -- beyond gluten and casein, microbes, etc. Did you know that 70% of the immune system is located in the gut? Even inhalants are partially mediated in the gut. If you're really interested in learning more about this -- try the Textbook for Functional Medicine -- chapter 28. While some of the physiology is a little tedious, putting the pieces together is pretty fascinating.

Well, that's all from me. I've registered for next tri -- except for electives. I'm trying to decide whether to take acupuncture or not. The jury is still out.

Have a great week everybody. Good luck with studying, projects, and whatever else is going on. This Friday we have the Turkey Bowl. Can't wait.

Marketing Project

How was your week last week? Has everybody recovered from Halloween? Now we're in the home stretch. It's the start of Week 11 -- time to start thinking about finals and projects and practicals.

All I can think about right now is the MARKETING PROJECT! I know I've mentioned it before -- but to reiterate... We're tasked with developing a business plan including start-up costs, developing a marketing calendar, business cards, logo, brochures, website, etc. It's a LOT of work (and worth a lot of the class). In addition to all of that, we have to do research on the location where we're hoping to practice, what type of demographics are there, and whether we think the area can support our type of venture. 

Location

As of right this second, I'm looking at Portland, Oregon. I've been drawn to the Pacific Northwest for quite a while. I miss the seasons (but not so much the cold), and everything I've heard about Portland and surrounding areas, is absolutely amazing. There are other reasons, of course. One of the biggest ones is the liberal scope of practice allowed in Oregon -- including obstetrics and minor surgery (with additional certification of course). The broader the scope for me -- the better; it's how I intend to practice. 

So, in my research adventures, I've found things like: how many chiropractors are in the area, what the per capita income is, what the average salary for chiropractors is in the area/state; and what types of practices are in the area. What I've noticed is that there seem to be two types of DCs in the area: single practices with maybe some physical or massage therapy, and single or group practices focusing on sports medicine. There are a couple of multi-disciplinary practices, but not many. There are a lot of sports medicine chiropractic physicians. This is great for me, because I have no interest in working with sports medicine. And for those of you that might be thinking about relocating to the Portland area -- it looks like there's some pretty stiff competition. 

Scope

I've had to spend a fair amount of time thinking about what all my practice will offer, what I'm willing to take on as far as scope, and how many other practitioners I'd like to work with me. This has the potential to become HUGE. I have always intended to have a multi-disciplinary practice. The more research I do, the more practitioners that I want to bring in -- not just Chiropractic, but Naturopathic, Traditional Chinese Medicine and Acupuncture, Massage Therapy, and Behavioral Medicine.

Management

At the outset, I'm feeling like we need about 8-10 practitioners to create the best, most effective type of practice. As wonderful as these ideas are, the logistics of setting something like this up, are daunting/enormous. And honestly, this is the kind of thing that I absolutely hate. You can ask any of my classmates or professors for my response when we talk about money and billing and other business management type stuff. The first thing I say is "Can't I hire someone for that?" They always cringe, tell me that I need to know it, and keep going.

I feel fairly safe in saying, that this project will probably be the extent (for the most part) of my forays into business management. I am learning a ton, but I also acknowledge that my talents lie elsewhere. First, I'll draw up the budget for equipment like massage and flexion-distraction tables, band aids, acupuncture needles, alcohol wipes, cotton balls, phlebotomy equipment, basic physical therapy equipment, herbs and supplements, office equipment, waiting room chairs, and silk plants. Then, I'll factor in things like electricity and Internet service. Yes, I'm in WAY over my head. I never thought I'd be doing something like this -- just practicing medicine. It takes a lot more than I'd ever imagined.

Maybe I should start looking for that business manager now. 

2013-11-12_xkcd _marketing _interview
(Source: xkcd.com)

Have an AMAZING week, everybody. I'll let you know how it goes.

It's November!

It's November! What? Did the time change work for you? I ended up staying up even later.

This week is the calm before the next storm. We have one more, big round of exams and projects due next week--including the Marketing project. This is the culmination of all of my mind-ramblings of the last couple of months, and the chance to pull some pie-in-the-sky ideas into my project.

Last week we had a speaker in Marketing that had been on the show "Shark Tank." Unfortunately, I took pictures for everyone else and not myself. He spoke about what it was like to start up a business, some of the struggles associated with it, and some of his experiences since his business started. I'll go ahead and give a shout out to him (and his brothers) who own Nardo's Naturals. They make natural skin care products and they're centered here in St. Pete.

The geek botanical person in me was intrigued by some of the ingredients they use in their products--lots of essential oils and coconut oil. You absolutely cannot lose with those. And of course it just reminded me how much I want to include natural products in my future clinic--which brings me back to the Marketing project.

When the speaker last week asked us what we wanted our future practice to be like, I opened my mouth and said something like: "I want a multi-disciplinary practice with Functional Medicine, Chiropractic, Naturopathic, Acupuncture, Physical and Massage Therapy, Well-being classes, and an Herbal and Compounding Pharmacy." I think his eyes nearly fell out of his head. Big ambitions, I suppose. I'm not sure what will be more difficult, setting up the practice, or finding the right people to work with me. Either way, these plans will be coming together in paper, brochure, website, and business card form--in the next 10 days. Boy, I sure have my work cut out for me. I don't have anything finalized, except the ideas, which have been floating around in my head for quite a while. When I get it all done, I'll share it with you guys. I have no idea where all it will go.

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I hope everybody had a Happy and Safe Halloween. On Wednesday of last week, MoPal (Motion Palpation) hosted a Halloween potluck. We had some great costumes. My tri's very own Lexxi (dressed as Ms. Pacman) and Dave (dressed as Walter White from "Breaking Bad") stole the show and won best costumes. This is where the pictures for this week hail from. It was nice to see so many people get together and be festive.

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I, for one, am glad that most of the candy is gone. No more temptation. I have a small handful left. I'll feed it to the kids and make them run around the neighborhood about 80 times--and then brush their teeth. We have a few weeks to behave ourselves before Thanksgiving--which really should be renamed to something that involves "gluttonous intake of food and falling asleep on the couch." It looks, though, like we might actually have a Fall/Winter here this year. The temperature has been erratic and sometimes cold and sometimes hot--but it's more acting like it's trying on the cold for size. Layer. That's my recommendation. Today I'm wearing flip-flops and a sweater. Go figure. That's Florida.

Have an amazing week everyone. May your feet be warm, and your sleep be plentiful. Remember to take a little bit of time out for yourself this week. It's important.