What I’ve learned after 30 years in practice

I graduated from Palmer in Davenport in December 1982. After graduation, I associated in an established practice for 2 years and then struck off on my own. I began my practice with a typewriter and a copier.

Most of our bills were done by hand on paper. Mountains and mountains of paper. Faxes had not been invented yet. There was no email. The social media was called a telephone. Most people wouldn’t have modern “off-the-shelf” desktop computers for another 5 to 10 years or so. And when computers began to emerge for the public, their operating system (on “modern” TRS-80 computers from Radio Shack) used CMOS. Instead of colors and icons, you were greeted with a black screen and this: C:\.

Photo from hoolawhoop.blogspot.com

There were no clicking on icons or “copy and paste” shortcuts. There wasn’t even Solitaire or Mine-Sweeper. There were some naissant black and white T.V. video games (Pong and Tanks). Pac-man would soon arrive and add color! Video arcades were on the horizon. Bill Gates would start marketing Windows in late 1985, and I bought my first “real” computer in 1987. It was a little more powerful than a calculator today, with memory measured in kilobytes, not gigabytes.

Prior to then you made duplicates of things with carbon paper and typed on a manual typewriter. Word processing would come later. In that era, “white-out” was as close as it came to word processing. Billing was time consuming. Paper work was a chore that consumed most of your clinic time. It was a very different business environment. New graduates can probably not imagine a world without DVD or Blu-ray, but this was actually even before VHS! Family memories were preserved on super-8 cameras and usually without sound. Cars had cassette players or an 8-track player.

Palmer was also a different place. Lectures were illustrated by the professor writing on a rolling sheet of acetate while the overhead projector shone it’s weak light up on the wall.

My biggest clinical observation therefore is that the modern practice is as different in day-to-day operations in 2013, as airplanes have made the world since the horse and buggy days. Information is almost instantaneous. Phone books are arcane today. Even snail-mail is on its way out. Sending out the clinic billing now goes through a clearinghouse where it’s checked, corrected, sorted and instantly delivered via the Internet with a turn-around from billing to resolution of days, not months. Patient record keeping still usually involves some paperwork, but that also is being phased out for EHR and verbiage-generating software. (Not always a good thing, BTW.) We design our own forms on our own word processors. We print them on our own color printer. We fax records. Our phones are cordless. We digitize X-rays. We back up on carbonite. We email newsletters to all our patients with the click of a button, and we track our billing through the Internet. And sweetest of all, the computer re-paginates my typing automatically, letting me add, delete and spell check my work with a simple mouse click.

As with all invention-based revolutions, from gunpowder, to the steam engine, to the Wright brothers, to the repeating rifle, to the silicon chip, the world is not the same place that it was even just 30 years ago. Everything has changed. We can do twice as much in half as much time! Our modern world is amazing, and we can only presume that our grandchildren will look back on our “modern” era as quaint and archaic, as new inventions come along.

“Grandpa, you actually watched movies on a plain big-screen television instead of in the 3-D hologram portal chamber?” But the one thing that hasn’t changed, and hopefully will never change, is the need for ethics, morality, honesty, integrity and altruism that chiropractors must generate with their patients. No amount of technology can compensate for sham treatments, unethical care or short-cuts when it comes to patient care.

Patients are also more sophisticated now. They expect to know the “how” and the “why,” not just the “what” of the care you’re giving them. Sadly, with modernization has also come some short-cuts in patient care among some chiropractors. Junk science is sadly still too alive and well within our profession. Treatment plans that plan out a year in advance on the first visit are not ethical. Ignoring X-ray guidelines to generate a revenue stream into your clinic when films are not needed is dishonest and immoral.

We have been slow as a profession to modernize our thinking. We still fear guidelines and fight to find our own true identity as a profession. While we want to embrace the modern world, this does not mean we want to embrace a less ethical world. We cannot claim to be equal partners at the health care table when we still cling to outdated and implausible case-management habits. Differential diagnosis and critical thought has been slow in making a foundation for the chiropractic profession, which still relies on health models from the 1800s. We struggle to modernize ourselves, though we long ago accepted the modern world. We struggle with defining ourselves as a profession. We struggle with money, which risks compromises that can poison the chiropractic well for future generations.

To new graduates, I would urge you to be cautious on accepting every scam wind that blows through the chiropractic profession. If you want to be successful, above all else, be grounded in ethics, science and evidence-based care. The best way to make the most money is to make yourself the best doctor you can be. The rest will follow when the core is abundantly constructed. Practice gurus, bogus techniques and eternal treatment plans are also inventions of this modern world. But though we embrace shortcuts in our time-requirements, we need to also be wise enough to reject any shortcuts in our ethics. Ethics have never changed. Loving your patients more than yourself has never changed. And hopefully, they never will.

– Garth Aamodt D.C.

PCC-12/82

www.aamodtchiro.com

 

Everyone needs a mentor … or two

I think some students may not realize the importance of a mentor. While in school, of course we had our favorite teachers and clinicians that we connected with and sought their opinions. But for me, I never really had a specific mentor. I was content with the fact that after graduation I would have numerous doctors I could call for help.

When I moved back home, I received mixed responses from the other Chiropractors. Some were barely friendly, while others were glad to offer their ear if needed.

One doctor in particular was welcoming and, indeed, this was refreshing for me. I had no other option but to start my own practice; there were no doctors hiring associates and none willing to let me join them even as an exam doctor. (I live on an island and commuting wasn’t an option for me).

So I went for it. I had to. Luckily I became friends with another doctor and ended up working for him part time. As a new business owner and new doctor in a seasonal location, I had to find a part-time job. So I started working for him, simply running his office. This is hardly the ideal situation for a new Chiropractor, but I had to work somewhere, and I thought this was acceptable since I was still in a Chiropractor’s office.

Months later, this doctor has become my mentor, and I’ve realized that this relationship is invaluable for a new doctor and new business owner. Although I graduated with full confidence of my ability to diagnose and treat spinal complaints, I quickly realized that there was a huge gap in my education. Not that I blame Palmer at all, it’s just that much of it is learned by trial and error. Although I am glad that I started my own business right out of school, I highly recommend to whomever chooses to go this route to have a mentor. Right now I am still running my mentor’s office part-time, which is another invaluable experience. Even though I’ve worked in customer service before, working in a doctor’s office is completely different. I have a whole new respect for the person who runs the front desk.

Luckily, I also have my mentor’s team as a resource as well. Not only have they been in business for 20 years, but their insurance knowledge is vast. Even if we covered more on insurances in school, it probably would not be enough.

Much of what I’ve learned for insurance has been trial and error, so having another resource is essential. Although both the ACA and my state organization provide doctors with insurance resources, it’s not enough.

A mentor is an important resource, and they can be valuable for your practice growth. Not only am I able to discuss patient cases and get a second opinion if needed, I can easily access a successful business model, remove some of the stress of the insurance maze (that is often overwhelming) and improve my own personal and business skills. But perhaps most importantly, I have a network of people who want to see me be successful and are willing to help me get there. This alone is the most valuable of all.

Sincerely,

Kimberly Burke, D.C. (Florida Campus, Class 113, 2011)

Oak Bluffs, MA

www.islandspinecenter.com

Advice from an alumnus to students

Hi there. I’m a recent alumnus. I graduated in June 2012. If I had a piece of advice for a student it would be to find yourself. Know what you want to do and come out of the gates running! Way too many of my fellow classmates are still not practicing or are but not putting their all into it. And make sure you have a strong understanding that Chiropractic saves lives. Know that fact as much as you know the sun will rise tomorrow and tell your community and don’t stop.

These two simple things will put you so far ahead of the game, others will strive to keep up. Understand that not everyone will like your message, and THAT’S OK! But the ones who are ready to hear it will and will LOVE IT! Don’t let the nay sayers stop you. Your message is the most important message they have heard. And most important tell the story of chiropracTIC.

– Dr. Nathan Wall

Wall Family Chiropractic

 

Dr. Richard Visser meets Michelle Obama

I participated in the “Building a Healthier Future Summit,” which was held in Washington March 6-8, where I had the honor of meeting First Lady Michelle Obama. Learn more about the summit here.

Richard W.M. Visser, D.C. (West ’93)

Dr. Visser is on the left, shaking hands with First Lady Michelle Obama.

I sent 40 prospective students to Palmer

Earlier this month, Dr. James Caballero sent an e-mail to Palmer, which said he was sending the names of 40 prospective students to the College. Here’s how he did it and why. –Editor

The 28th Annual Career Fair at the Oxnard Community Center in Oxnard, Calif., was held earlier this month. This was my sixth or seventh year attending the fair to promote Palmer College. But I’ve also participated in other career fairs, including one at Pepperdine University in Malibu.

I got involved in recruiting for Palmer about 10 years ago. They asked me, and I decided it would be a great way to contribute to PCC. I have always talked to students, patients and others who were interested in chiropractic. But the only one I officially sent was my son, Dr. James A. Caballero. He attended PCC San Jose (Palmer’s West Campus) and graduated in 1991. He has an active practice in San Diego.

To all alumni I would simply say that recruiting students is the best way to help Palmer and our profession. It also gives you good exposure. Most fairs are put on by school districts, and they really appreciate our attendance as presenters.

Doing a booth at a fair is really easy. All I ask the students who approach is, “Are you interested in the health field?” They usually say yes, then I follow up with, “Fill out this card, and Palmer College will send you information on becoming a Doctor of Chiropractic.” They generally fill out the card. It is surprising how many are thinking about chiropractic! Also, at this last fair, most of the sign-ups were young women.

By the way, at this fair I was approached by the city of Ventura, Calif. They asked me to be in their first Career/Job/Volunteer Expo on May 17.

If you are interested in attending recruitments for Palmer, contact the Alumni Office at alumni@palmer.edu and they’ll set you up with plenty of information and materials.

Best regards,

James Caballero, D.C. (Davenport ’74)

 

The wonders of chiropractic

I graduated in 1978 at PCC and feel fortunate to have learned chiropractic adjusting and the Toggle Recoil. Back in those days, they allowed visiting doctors to teach seminars. I feel very lucky to have studied with Dr. Bernard Jenson (Nutrition), Dr. Raymond Nimmo (Receptor Tonus) Trigger Point Therapy. I forget the name of the French doctor that taught Polarity.

I was introduced to the Activator Method, SOT, Pierce Stillwagon, Thompson and more. I want to thank all my instructors for helping me realize that the power of healing comes from within, and it is better to promote health than to fight dis-ease. We become doctors of chiropractic to help our community and make our world a better place.

Learn and practice to be excellent in your healing art. The Spirit interfaces with our body and brain. The brain communicates this intelligence and energy with the body through the nervous system. Energy needs to move. Find the interference, remove it, bring more balance to the being, and health will follow.

– Doyle Rood, D.C. (Davenport ’78)