I can't believe it's already been a week since I last wrote.
Time at the VA is FLYING by. I'll only be there a couple more weeks
and then I'm back at the student clinic. Six weeks after that is
graduation. I'm having this great realization that graduation is
coming up on me like a freight train. Sometimes I feel like I'm
stuck down on the tracks, and sometimes I'm the one driving.
I'm working feverishly on finishing the master's work. That's
over in about a month. Just in case anyone was thinking about doing
this at the same time as getting your DC, be forewarned: it's a TON
of work -- especially the last quarter. This is not for the
faint-hearted. I honestly can't believe that I've done it. There
are times when I definitely feel like a masochist. It took me 6
quarters (a year and a half), but I'm almost done. Now to get all
of the papers and projects done; that will be a feat.
While I'm working at the VA, I'm finishing up all the paperwork,
volunteering, and other things needed. Last weekend I made a trip
to Sarasota to the American Youth Cup Series I. Apparently the park
where it was hosted, Nathan Benderson Park, is home to a world
class rowing event. In fact, the 2017 rowing championships are
being hosted there. It's a unique facility with a round lake. There
are a number of events coming up there -- including several
additional rowing events, a pentathlon, and a 5k. I'm hoping to
attend a few more of them.
It was a quiet day (no injuries); the weather was chilly and
windy (for Florida). Dr. Guadagno, Dr. Jake LaVere (a distinguished
recent National alumnus), Nick Herrild, and myself braved the
chills to be on hand in case anything should happen. When we
weren't watching the crew members running around or rowing, we were
sharing stories and business information. We had a pretty good time
talking about future business endeavors, practice models,
conferences, and plans.
Here's a wind-blown picture of the 4 of us.
As I continue my time at the VA, I'm seeing what it's like to be
in a completely different model of care. There are things that I've
learned that I know I will carry with me into my future practice,
and others that I know I won't. One thing I really appreciate, and
I touched on this last week, is the willingness to try something
new (or discharge from care) if things are or are not working.
People come in and they get better -- they stop coming in. People
come in and they don't get better -- they stop coming in. It's very
simple. It's ethical practice.
Well, I best stop writing here and get to some of my papers!
I hope that everyone here -- regardless of where you are in the
world, are staying safe and warm.
I'll see you all next week! Have a great one!!!
How is everybody this week? Staying warm? The weather here has
been up and down -- cooler than normal for a Florida winter. In
fact it's been cooler this winter than it has been any winter that
I've been here. That having been said, we don't have any snow --
not even a flurry. So I suppose, if you're into the warmth, this
might be the place to be.
This week is FLYING by. I've been at the VA hospital all week
and I absolutely LOVE it! The docs there have been amazing! I've
seen at least 2 new techniques and hope for more. I'm learning a
new system of care, which is great -- and seeing how a LARGE system
coordinates care for a large amount of people. One of the most
fascinating things is observing complicated patients with
complicated problems and how they navigate the medical system.
I've been able to hear new doctors' perspectives on healthcare,
specifically about medical ethics. Being in academia so long, we're
sheltered by ideal situations and our own personal beliefs about
the infrastructure in medicine. The truth is, that out "in the real
world" things are VERY different. Some doctors keep patients coming
in for visits for "wellness care," for prescriptions, for
therapies, for whatever reason, when they don't need them. They
suggest these things sometimes because they feel that the patient
needs or wants them, and sometimes for financial reasons. It's the
frank truth, and there's a lot of controversy around this.
One of the docs I'm working with and I have been talking about
discharging patients. His philosophy, and I completely agree with
him, is that if we can't make someone better, help them function
better, feel better, improve their daily function, then we're the
wrong person for them to see. Maybe it is that our care isn't what
they need -- maybe they need a surgeon, or a pharmaceutical, or
something that is out of our scope, or just not our specialty.
Regardless, we have to know when it's time to stop.
We have to decide what type of physicians we're going to be. We
have to decide (with our patients) how best to help them -- even if
it doesn't involve us.
I want to wish everyone an AMAZING week! This weekend I'm
working with a team for the American Cup rowing series. I can't
Week 4. What? How did that happen? Time is absolutely
I feel like one of those time warp photos - you know the ones
where someone stands still and everything passes them by 800 miles
an hour. Just like this.
I feel like I just can't get everything done fast enough -- that
the "to do" list keeps growing and growing, and as soon as I get
things checked off, a million are piled up in its place. And yet,
things keep getting checked off. We are now officially done filling
out college applications for Grey. I've ordered my application for
Oregon licensure. I'm nearly halfway done with this last quarter of
the master's program, and I start at the VA next week.
I spent the last week, besides doing everything else, reading
journal articles. I read 14 articles on various (potentially)
controversial topics in nutrition: dairy, egg, whole grain, and
meat consumption. It addressed cholesterol and eggs, lactose
intolerance, dairy allergy, whole grains and cancer, and several
other topics. But even after all of that, it was pro-ingestion.
These papers were FULL of statistics. Each one loaded with numbers
trying to support its case.
And then I looked at the lists of conflicts and references.
In Journal Club, we were taught to read everything with a
critical eye, to see the potential conflicts, and judge the studies
accordingly. For everyone that I talked to about these articles, my
only comment was -- "Statistics can manipulated to support
Always read with a critical eye. You never know what information
might be valuable, and what might be... 87.
Have an amazing week, Everyone. And if you come across some good
studies, feel free to send them my way.
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
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
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.
(Image source: caglecartoons.com)
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
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!
It seems like ages since we last "talked." How was your
Christmas? Did you have a Happy New Year? Hope everyone has made
great strides on their new year's resolutions (or didn't make
While everyone was away, I was hard at work here in the clinic
seeing patients and thinking about what's coming up next. Which
reminds me, we only have a handful or so of weeks left. I am
pulling things together, working hard on my master's, seeing as
many patients as I can, and focusing on getting as much exposure as
In a few short weeks, I'll be starting a rotation at the VA
hospital where I'll be helping to treat a number of our veterans.
Here at our clinic, we typically take our time with patients.
Depending on what type of visit, our appointments can be 90 minutes
long. However, at the VA, appointments are much shorter, and
instead of about 5 patient visits per day, each practitioner sees
about 20. That's going to be a big change. I'm anxious to work with
a wide variety of patients and deal with some of the unique
problems they're facing. It should be great experience!
We've welcomed our new interns to the clinic. Three fresh and
new interns are now working with us - one of which started
Trimester 1 with me, but took a different path. Several of the
interns in the other clinic started with me as well. It's good to
see them make it to this point! I'm really proud of all of them and
honored to call them my colleagues.
We're down to the wire on a lot of things around here. At my
house, we're almost done filling out college applications for Grey
- down to one that's due in about a week. We'll sit in wait on all
of them to see where he ends up. I have done some research and it
turns out the state licensing exam for Oregon is the day after
graduation. Yikes!!!!!!!!!! (Unless I want to wait until July -
which I don't). So, plans are being made to fly out of Chicago
right after the graduation ceremony and take the exam the next
morning. Grey and I have set a tentative date for moving: June 10.
This has brought a flurry of activity into the house: getting rid
of things, deadlines, prep-work, etc. There are times when I feel
completely overwhelmed, but I'm also REALLY excited. That having
been said, I kind of feel like this:
Have an AMAZING week Everyone. Back to work! It's going to be a
• After the DC Degree
• Botanical Medicine
• 1 Year at National
• Marketing Project
• First Week in Student Clinic
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