Too Long

I haven't blogged in a ridiculously long time. Sorry readers! As my life in the clinic has ramped up, I have been forgetting things. I suppose that is reflective of a very good problem--having plenty of patients!

The last time I wrote about the clinic I was rather overwhelmed. In retrospect, I can  see that everyone felt that way when we started. At the time, however, I felt like it was just me--drowning in a sea of paperwork. Now, everything is starting to seem easy, and it feels so fantastic.

The most fantastic thing about clinic is seeing patients. This is what we have been waiting for, after all...  And even better than seeing patients is seeing patient become well. I have learned a few things over the last several months about patient care, which I think are worth sharing.

Less is usually better
As part of a conservative care plan, we sometimes get into a habit of giving everyone all the modalities we can possibly think of. We do this because we have learned such a large body of information about care. We think, "well, if one thing is good, then everything must be better!"  Humans are like this in general, just think of crash dieting and weekend warriors to get the picture. In my experience with patients--however brief--I have noticed that the less I do, the better the outcome. Careful decision-making between treatment interventions leads to more patient-centered, specifically-tailored care, which can only be beneficial. So instead of employing all your tools at once, methodically choose a few and carefully measure the outcomes. Which brings me to my next point...

A Better Understanding of Evidence Based Care
During the younger quarters of Palmer Florida, the term "Evidence Based Care" gets thrown around a lot. Unfortunately, it got sort of a bad connotation among some members of my class. This was mostly due to a misconception of its components. Due to its name, some of us started to believe that it included only those treatment modalities which have been irrefutably scientifically proven. In reality, these fully-studied treatment interventions account for only 1/3 of the Evidence Based Care Model. Another third is supplied by clinical experience of the majority of the profession. So if a specific technique or treatment model has been shown to "work" by a significant portion of the population, it is included in the EBC Model. The last third--and what I consider to be the most important aspect--is made of patient goals and expectations. This portion is so important, it needs its own heading...

Patient Goals/Expectations
During undergrad, in my study of Medical Anthropology, I saw countless studies on patient beliefs and care outcomes. One of the themes that ran through these is the relationship between patient involvement and positive outcome in conservative care. When people feel like they have an important "job" to do during their care plan, they seem to improve more quickly and more completely. All this being said, in the EBC Model, we give patients the tools they need to be a partner in their own healthcare journey. Tools which will get them to whatever goal they have. This goal may be simple--to get out of pain, to run a mile, to pick up a child without difficulty--but these goals can also be more complex. (ie. losing weight, feeling "well," increasing athletic performance.) No matter what the goal, the EBCM Practitioner will assist the patient in meeting those goals, all the while, educating the patient on all relevant aspects of healthcare. This gives us a title, in addition to diagnostician, clinician, and technician, which I believe to be the most important of all: Teacher. After the goal is met, the patient may be released from care, or may set a new goal. Either way, the patient is responsible for a portion of their wellness and therefore, empowered to make decisions and get well.


In addition to these exciting revelations I've had these last few months, I have made some neat plans. One of which includes a student work Visa for India!

Clinic Abroad Trips
Here at Palmer Florida, when a student reaches quarter 10, he/she can apply for a clinic abroad trip.  These trips go to a variety of developing nations and provide primary and chiropractic care to residents of these nations at no cost. Each of these trips lasts around 3 weeks and includes about 20 students, which some from each of the Palmer campuses. In June, I'm leaving for India. I'm very nervous, actually, which not my normal state. I'm excited too, though. I am looking forward to practicing my primary care skills in an environment where I may be the first doctor these patients have ever seen. During the trip, I hope to blog about the experiences in here. It is something I would have wanted to read about as a prospective student.


So all in all, I think that the clinic has majorly changed me--both as a clinician and as a person. My paradigm has been more solidly established, and I'm looking forward to finishing my requirements and implementing some of the things I have learned into my practice in real life. I only have to wait until December 16th, 2011. :) It gets closer every day.