Helping patients stay pain-free through an integrated approach – By Dr. Mikhail Burdman

There’s no denying we’re in the middle of a major opioid crisis today. In fact, the National Institute on Drug Abuse (NIDA) estimates more than 115 Americans die every day from opioid overdose.

For the most part, we can trace this issue back to the late 1990s, when physicians first started prescribing these pain medications. Unfortunately, most did not realize their addictive properties at that time.

And throughout the years, many physicians became increasingly reliant on pain medications as a go-to tool to quickly get patients out of pain and increase the number of patients leaving their offices [at least temporarily] satisfied.

We now know that prescribing opioids often does more harm than good. Patients can become hyper-sensitive to pain and in the long run, require more drugs to be pain-free. Further, pain medication is often a short-term solution leading to a long-term issue.

We know that chiropractic can help many of those suffering from chronic pain, but frankly, it’s not as simple as saying that’s the solution to the opioid crisis.

What about the patients who are already addicted to prescription medications?

When I graduated from Palmer College of Chiropractic West in 2012, I wasn’t sure where my path in practice would lead. But after returning home to Baltimore and working with other practitioners in the area, I saw a large need for a clinic that offered a safer path to pain management.

Patients shouldn’t have to choose sides between medical pain management and chiropractic – there are a number of patients interested in both, especially those who are already on pain medication. They need a clinic that helps them transition off high-dose medications and incorporates alternative therapies, like chiropractic and physical therapy, to help them begin to rebuild their strength and range of motion, and decrease aggravating factors.

Patients also deserve a clinic where all of this is done in one place, both for the convenience of making it to their appointments, but also, and more importantly, a place where their practitioners were all truly on the same team.

After realizing there was such a need for this unique, more integrated approach, I set out on building my practice, The Pain Doctors. We’re an interventional pain management clinic made up of medical doctors, chiropractors and physical therapists working together to get patients out of pain quickly, effectively, and most importantly, safely. We use the latest technology and medical advancements to provide patients with the best services to treat their pain.

Dr. Burdman in front of X-ray machine.

Dr. Burdman at his practice, The Pain Doctors, in Baltimore, Md.

It’s now been two years since we’ve opened our doors and we’re proud to say that we’ve been able to help an incredible number of patients in Baltimore become less dependent on their pain medications – something many of them didn’t think possible after consistent use for years!

It is my hope that more practitioners see the need for this integrated model in their own neighborhoods and we can all work together to help patients work to lead pain-free and drug-free lives in a safe manner.

If you’re interested in learning more about interventional pain management practices like mine, whether you’re a current student or have already graduated, I’d be happy to talk with you more about my journey and plans for the future. Feel free to contact me through my website at www.thepaindrs.com.

About Dr. Burdman: Mikhail Burdman, D.C., is the director of The Pain Doctors of Baltimore, Md. He works closely with his team of medical doctors, mental health counselors and therapists to provide patients with safe and effective treatment plans to reduce their pain and medical dependency.

Prior to his chiropractic career, Dr. Burdman was born in Moldova and came to the United States as a refugee in 1991. He graduated from the University of Maryland Baltimore County with a degree in biology. He completed an internship at the Naval Air Station in Lemoore, Calif., and went on to graduate from Palmer College of Chiropractic West in 2012. He currently resides in Baltimore, M.D., with his wife and enjoys staying active and spending time with his family and friends.

Advice for chiropractic students: Be open-minded

Palmer alumni offer their advice to chiropractic students on how to achieve success. Do you have advice you’d like to share with current Palmer students or new graduates? Emailminda.powers@palmer.edu.

“Be open-minded, respectful of other opinions, and understand it’s not how great a technique is but it’s about applying the right technique at the right time. Patients don’t care how they get fixed (most of the time). They want you to teach them about what is creating their issues and how you are going to take care of them. I use upper cervical as a primary but utilize all other forms of adjustments as needed for the right presentation of issues.

“So, in short, don’t use a hammer for a screw. Apply your knowledge and the techniques that you learn to properly take care of the issue. Don’t get caught up in the hype of negativity. If you focus on that, you will become that. If there is an opportunity to address something and properly fix it, then go for it. But words without actions produce zero results.

“Learn as much as you can. Even the random stuff they teach [in class] may become useful. I’ve [discovered] cases of severe issues due to the teachings from my professors at Palmer College of Chiropractic in Davenport. We find and fix subluxations, but be ready to answer all questions regarding health because you never know what you will encounter.”

– Brandon Blank, D.C.

Advice for chiropractic students from chiropractors

Palmer alumni offer their advice to chiropractic students on how to achieve success. Do you have advice you’d like to share with current Palmer students or new graduates? Email minda.powers@palmer.edu.

“My advice is to find successful people you respect and would like to be like AND listen to what they have to say. Also, don’t ever take advice from anyone who is failing or struggling. Learn how to be awesome from awesome people.”

– Brad Meylor, D.C.

Calling the Shots on Your Contract – by Dr. Jen Faber

Dr. Jen Faber

Dr. Jen Faber

When new chiropractors kick-start their career by working in a practice, they’re eager, hungry and ready to learn from a mentor who knows the ropes. On the surface, this path can offer training on the job and get you prepared to build your own practice someday. But just because you want someone to “take you under their wing,” doesn’t mean you should feel like you have no say in what you get in return.

Yet it oftentimes does.

Why? Because it’s easy to go into defeating thoughts that take away any chance you have to negotiate. Ask yourself, if you’re an associate or want to be, have any of these thoughts run through your mind:

“What say do I have?”

“I have no idea how to negotiate.”

“I have no experience, so I’ll just take the best offer I can find.”

“All I want is a job that’ll pay the bills, and I’ll figure out the rest later.”

This is a confidence gut check. It’s an opportunity to reframe your mind on how you go into a job offer and give yourself the personal power on negotiating and knowing how to do it.

Let’s set the stage here. Our profession gets a bad rap on “eating its young” when it comes to associateships. Sadly, that’s because chiropractors feel overworked, underpaid and taken advantage of by the practice. But that end result doesn’t come fully from the boss. The employee (a.k.a. the associate) also needs to set standards before day one so you go into that job with a contract that works for you …

And not one that was just created for anyone who will sign it.

Having come out of a job that nearly drove me to leave the profession all together, I know that feeling all too well. In hindsight, had I known even one tip on how to negotiate, I would have put myself in a level playing field and perhaps even the wisdom to walk away from that job before getting hired and find something better.

So I want to share with you the tools that I would’ve told my younger self back when I graduated. Negotiating is all about the approach and implementing key strategies to create a contract that actually works in your favor.

Step 1: Go Shopping

Typically the first question that runs through your mind is, “How do I even know what to ask for?” And if you’re right out of school, it’s hard to know the baseline for what’s a standard contract. So the first step here is to do your research. Go on chiropractic job boards and read the offers. Identify what the opportunities are in your location or comparable areas if you don’t know where you want to practice yet. Look at the incentives and compensation to determine what works for you and what doesn’t. Create a list of what you’ve see in offers that appeals to you so you can bring that knowledge to the table on interview day.

Step 2: Know Your Conditions

After you’ve done your market research, you’ll want to create your own job offer. Design an ideal contract that matches what you want. This is a concept known as ‘conditions of satisfaction,’ which is all about developing standards for yourself.

And this is vital because chiropractors typically go into a job offer with no preparation or strong identity on what that ideal offer looks like. You don’t want to go into this process blind, because it will make you feel like you have no say in the game, and you will come across that way when a contract is presented to you.

So think about the standards you want to create for your job contract. This relates to three key areas: compensation, benefits and vacation. For compensation, know what the standard of living is in your area and what you need to make to match it. Also think about the structure. Do you want bonuses or incentives as you grow your patient base? What benefits do you want to receive in addition to your income? How much time off do you want to have? More importantly, how much time off do you want to give your work-life balance?

What exactly will cause you to be satisfied with your job offer? Be honest and specific. And then know those conditions before the interview, during the interview and especially when you negotiate the offer.

Step 3: Don’t Accept the First Offer

Any job offer that you get will be in the practice owner’s favor. It’s not necessarily because an employer is trying to take advantage of you. It’s because that employer is looking to bring a doctor into their practice and ultimately wants a new hire to be a good fit for them. This is no different than listing a house for a higher price, because the status quo is that the price will get negotiated down. That’s just smart business sense.

So don’t accept the first offer thinking that the employer won’t budge or that you have no voice in the matter. This is how any business contract works. There’s an offer. Then a counter offer. Then an agreement.

Use the conditions you’ve set to let the employer know what you want and what will make the job and offer a good fit for you. State what you need in order to move forward so both of you can have a dialogue and come to a mutual agreement. This sets such a stronger dynamic then just signing on the dotted line and hoping for the best.

The big takeaway here is this:

Don’t be willing to just take any offer just to get the job now, because you could spend years stuck in a contract that ultimately stunts your future growth. And you are worth way more than to just settle for some job when you’ve spent time, money, effort, and passion to become a chiropractor. So know that not only can you negotiate, but you should. And when you do, you’ll be able to see red flags, figure out the best fit and attract a job that matches what you want.

Jen Faber, D.C.
’06 Davenport campus graduate

After breaking away from burnout and frustration early in her career, Jen Faber, D.C., is now on a mission to coach freedom-seeking chiropractors on how build a practice they love through her individual coaching and online training programs. She is the creator of the House Call Practice Program and the Unleashed Coaching Program to empower chiropractors with the guidance, tools, and strategies to build a successful practice. Visit her online at www.drjenfaber.com.

Advice for new chiropractors

Each week, we’re asking our alumni to share their advice and experiences on the Alumni Voices blog. This week, P. Burdoc Nisson, D.C., shares his personal list of Do’s and Don’ts for new chiropractors.

If you would like to share your own practicing tips and more, follow @palmercollege on Twitter and like our Facebook page to see the weekly question on Wednesdays.

Dr. Burdoc Nisson

Dr. Burdoc Nisson and grandbaby

Do’s & Don’ts:

1. Make sure that you are in the best health that you can be (get adjusted, eat well, etc.).

2. Make sure that you have everything to help the patient that they are read for.

3. Don’t overwhelm the patient.

4. Do what the patient’s body wants done first, check if that worked and then find the next thing that patient’s body wants now.

5. If the patient’s body is not telling you what is next but is not “done,” try having them move, walk or rest.

6. If the patient comes back the next time feeling exactly the same, find out what you missed.

7. Get to know which local health practitioners do things differently than you do so that you can refer to each other.

8. Refer patients when they are not improving fast enough.

9. Use all of your senses to work with the whole patient (physical, emotional, causal, mental, spiritual).

10. Keep learning.

– Dr. P. Burdoc Nisson

How do you educate your patients about chiropractic?

“I educate my patients by showing them their posture in all 3 axis on every visit as well as explaining each of the examination test and findings as well as letting them know what nerves are being affected adversely and what organs they supply. I educate them every visit by telling them about their posture and activities of daily living and why it’s so important for the spine to be in good biomechanical condition because it affects the nervous system adversely if they are misaligned/Subluxated. Most of the new patients have been to my website and My YouTube Channel, so they have a pretty good education by just watching and listening to me treat actual patients in my office.”

– Dr. Gregory E. Johnson, Houston, Texas

The best advice I received from a chiropractor was …

Some of B.J. Palmer's original epigrams around the Davenport, Iowa, Campus.

Some of B.J. Palmer’s original epigrams around the Davenport, Iowa, Campus.

We went on Facebook and asked our alumni, “What’s the best advice you ever received form a chiropractor?”

Here are their answers:

• Dr. Jon Søvik – “You should become a chiropractor.” – Atle Aarre, D.C., ’91 alumnus

• Dr. Brad Yee – “… to study to be a chiropractor ….”

• Dr. Karen Doherty – “Why be a C.A. when you could be a Chiropractor?” asked my student doctor Alliette Pike. That was in June 1977. That question changed my life. PCC ’81”

• Livtar Khalsa – “Exercise!”

• Dr. Bob Kauffman – “Early to bed, early to rise, work like hell and advertise!” – Dr. B.J. Palmer via epigram (of course!)”

What’s the best advice you’ve received? Leave it in the comments below.

Chiropractors: How important is it to have a mentor?

We got on Facebook and Twitter and asked how important you think it is to have a mentor as a chiropractic student and as a chiropractor. Here are some of the answers:

“Only if you want to be successful.”    – Bobby Moore, D.C.

“VERY, VERY IMPORTANT!!!”    – Brad Meylor, D.C.

“It is of the utmost importance! I was surprised at how few students had mentors while I attended Palmer.”    – Brandon Perrine, D.C.

“I have had some great mentors in my life. Although I most often just stumbled into them, keep your eyes open. They can help you become so much better than you expected to be. I was blessed with two on-campus mentors while a student at Palmer. A mentor can make the difference between you becoming an okay chiropractor and a great chiropractor.”    – Doc Nisson

“Everyone can use a good mentor. I am thankful for all the mentors I’ve had in starting my chiropractic practice.”    – @ChiroLasVegas, Twitter

What do you think? Tweet us @palmercollege, post on Facebook or leave a comment below.

Chiropractic changed my life

Chiropractic changed and saved my life. I remember I was in 6th grade. I was rough-housing with my sister and fell off the couch. I hit my head on the coffee table and subluxated my upper thoracic vertebra. It had been a couple of months when I started developing severe asthma, and I had never had asthma before my entire life.

Dr. Greg Johnson adjusting one of his patients.

I went to every allergy and asthma specialist in the tri-state area. All they did was give me pills and allergy shots for the next two years. My asthma got so bad that I was taken to the hospital and put in an oxygen tent, shot me up with epinephrine, and I had to quit playing all my sports activities.

Finally a friend of my mom’s referred her to a chiropractor who was a Palmer graduate that had helped another child with their asthma. She took me to him, and within three months of being treated by this Palmer graduate, I had no more asthma.

I knew in the 8th grade I was going to be a chiropractor. Traditional medicine failed me miserably. I knew I wanted to go to Palmer College of Chiropractic in Davenport, Iowa because I wanted to go to the best school for chiropractic in the world. Palmer has always been The Fountainhead of chiropractic, and I graduated from Palmer in Davenport in 1981.

I have treated tens of thousands of patients in my 32 years of practice. I am as passionate about chiropractic now as I was then. I see chiropractic changing people’s lives every day and have had several patients go to Palmer themselves after being treated by me. I believe strongly that Palmer College chiropractic teaches their students how to adjust the spine better than any chiropractic college in the United States. I am now sharing what chiropractic benefits are for people on YouTube.

I encourage every Palmer graduate to continue to educate the world about the benefits of chiropractic care. Continuing education is also very important for your continued development and skills. Becoming a chiropractor and going to Palmer College was the best thing that could’ve ever happened to me. I believe every chiropractor should visit Palmer  in Davenport  just to see where chiropractic actually came from.

If I could pass any tips along to Palmer students, it would be to study hard and really learn about the spine and the nervous system. Chiropractic is about so much more than just “cracking” necks and backs. Chiropractic philosophy is exactly the way B.J. Palmer taught it in his day. The vertebral subluxation complex does exist, and correction of this disorder will save many lives. Chiropractic is the most rewarding profession anyone could ever be in. Don’t forget to keep getting adjusted yourselves throughout your professional career. Keep changing lives through chiropractic care.

Sincerely,

Your Houston Chiropractor

Dr. Gregory E. Johnson D.C.

Davenport Campus, Class of 1981

 

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