Archive for tag: integrative medicine

85 Days

These are the weeks of dotting i's and crossing t's. How's everybody doing? Things are moving quickly here. I can't believe how fast it's going. 85 days. There are 85 days left in my experience here at National. I honestly never thought I would make it!

Now marks the chaotic time of resumé preparing, job hunting, extra courses, licensure exams, and everything else. In addition, I'm working on a million different projects plus a comprehensive exam for the master's. *Whew* There's no rest for the weary. The deadlines keep coming. Appointments are made. Guidelines are followed. But in a lot of ways, this is uncharted territory. Sure, I've applied for jobs before -- but not like this. Corporate America has a completely different way of doing things than healthcare or small business. The learning curve here is pretty steep.

We're getting back to basics in the clinic. As the 8th Trimester students come in, we're acclimating to new people and helping them get their feet wet. They're holding their own. History taking has never been more important. Each person that handles a chart adds more information. We've all been working together pretty well -- strengths complimenting strengths. It's nice to work as a team rather than individuals all the time. Our patients can definitely be served by a group of talented practitioners.

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Today I was given information for a case study. The patient in my case study was taking 6 medications. Yes, you read that right--6. It has become the standard that the average number of medications an elder-person is taking is 3. Most are taking more. Many are taking medications to combat their medications.

There's definitely something wrong with this. But it reminds me. A patient was speaking with me during a treatment today. She was asking me what my philosophy of medicine was. Patients sometimes believe that we hate all conventional medicine, which may be true for some practitioners. But anyone that's ever had an infection, or required surgery, knows that without those tools, we're lacking. There are alternatives to many things, but sometimes, surgical procedures are the conservative approach. It's a lot to think about.

What is it that our patients are going through? What are they taking (consuming) already? Where can we step in with THE BEST approach to help our patients? These are really big questions.

Food for thought, perhaps? (That's a whole different topic). Have a great week, everyone!

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. 


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. 


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.


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. 

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