Posting as a Doctor

There are times when I have wondered about posting blog entries as a doctor.  I'm curious about any legal ramifications since I would imagine, posting as a doctor is different than posting as a student.  In many ways, I believe the argument could be made that I am and always will be a student of sorts.  Whatever the case may be, I know I still have plenty to learn.  One of the books I received for Christmas is one called Grain Brain by David Perlmutter, MD.  It is the first book I am reading post graduation which I believe may be beneficial to both myself and patients.  The tag line at the top of the cover of the book reads, "The Surprising Truth About Wheat, Carbs, and Sugar -- Your Brain's Silent Killers"  So far, I've read the entire introduction and the first 26 pages of the book and would like to keep some salient notes

At the beginning of the Introduction is a quote by Nei Jing, 2nd Century BC
"Maintaining order rather than correcting disorder is the ultimate principle of wisdom.  To cure disease after it has appeared is like digging a well when one feels thirsty, or forging weapons after the war has already begun."

On page 8, 3rd paragraph down we read;
"Beyond calories, fat,protein and micronutrients, we now understand that food is a powerful epigenetic modulator - meaning it can change our DNA for better or worse.  Indeed, beyond simply serving as a source of calories, protein and fat, food actually regulates the expression of many of our genes.  And we have only just begun to understand that the damaging consequences of wheat consumption from this perspective."

At the bottom of page 8 and top of page 9 a report from the "Archives of Internal Medicine revealed that postmenopausal women who were put on statin drugs to lower their cholesterol had a nearly 48 percent increased rise of developing diabetes compared to those who weren't given the drug.  This one example becomes even more critical when you consider that becoming diabetic doubles your risk for Alzheimer's disease."

Page 13 list the Authors website, www.DrPerlmutter.com

Page 23 - "The chief function of the body is to carry the brain around"  ~Thomas A. Edison

On page 33, the book cites two of the biggest myths that people continue to cling to
(1)  a low-fat, high-carb diet is good and
(2)  cholesterol is bad

Page 34 - The Framingham Heart Study is mentioned - started in 1948 and includes 5,209 men and women between the ages of 30 and 62.

Page 34 - Study from Boston University studying 789 men and 1,105 women and followed for 16 to 18 years and given cognitive test every 4-6 years.  Results - people with the highest cholesterol levels scored higher on cognitive test than those with lower levels.

I'll end today's reading at page 50.  A couple other books I got for Christmas that are closeby are Anti cancer - A New Way of Life by Dr David Servan-Schreiber, who is both an MD and PhD. and a book called The Lost Keys of Freemasonry by Manly P. Hall.

That second book on Freemasonry reminds me I had an opportunity to become a 3rd Degree Freemason a couple months back but skipped that ceremony in order to get an extra three adjustments in towards graduation.  Unfortunately, I was left off the original email sent out by the head of our clinics, Dr Wittmer which indicated only 40 of our adjustments could come from our secondary clinic so, it would have been very easy to have skipped the adjustments, obtained my 3rd degree and become a Master Mason and still max out the allotted adjustments.

I still have a hard time understanding why such simple and straightforward things are so hard for some people to understand.  With a secondary clinic, we were allowed to obtain 4 out of 10 or 40% of our new patients from the secondary clinic but were only allocated 20% of our adjustments.  Those numbers don't match and is a gross lack of parity.  I know Dr. Witmer tried to counter this obvious observation by stating that our "education" was to come from our primary clinic however, I only attended the secondary clinic on my days off so it never interfered with any education to begin with.

Back when my brother graduated from Logan in 1996 and even as far up as December of 2007, a semester before I started at Logan, students were allowed to treat patients at any clinic.  These days, the clinic mantra is "Quality over Quantity" which sounds nice with the alliteration and all but doesn't mean a hill of beans.  What should be a concern is experience which keeps getting limited by Logan administrators.

Throughout all of trimesters 8 and 9, a full 8 months, I had a total of 32 adjustments, 16 adjustments per trimester.  In 12 days at my secondary clinic, I had 40 adjustments.

In school we learn that it is illegal to abandon patients however, that is exactly the situation Logan's limitations but me in - once the 40 adjustment limit was hit, I still needed more adjustments to hit that magic 200 adjustment number for graduation so, most all current patients at the secondary clinic had to be abandoned so I could maximize time at a clinic where the adjustments still count.

It's hard to keep track of the number of patients and extra experience that could have been obtained in Logan's outpatient clinic system if not for the limitations.  One couple wanted to see me but didn't like the idea of making 110 miles round trip commutes to clinic and I can't say I blame them.  I talked to that couple since and they went to a locale chiropractor and racked up $1,200 in bills.  Well, Logan could have had a good portion of that money as income and I could have benefited from the experience.
Another mother & son had to be given up due to the similar reasons.  They didn't have a 110 mile commute but did live much closer to two other clinics and thought it was stupid to drive all the way out to St Peters, MO to see me when other clinics were so much closer.
I could have also seen a newborn as well as a 70 year old male patient with shoulder issues.

Honestly, I'm kind of lucky I had 16 adjustments per semester in Tri's 8 and 9.  One intern I talked with at St Peters only had 6 adjustments in Tri-8 and another intern down at my secondary clinic only had 5 adjustments in his first trimester.

I recall hearing about how our clinic (St Peters) had the highest patient retention rate, ie, patients who would show up for the most number of adjustments.  When I first heard that I thought maybe there was something special about the overall protocol at St Peters but, after talking with so many Alumni and even people still in the DC program what I believe to be closer to the truth about those numbers is that the interns at St Peters have the highest propensity for buying their patients.  I hardly fit in that category since I only had two active patients in the last semester, one handed down to me because the intern couldn't find anyone else to take them and a 2nd I procured on my own.

When I first entered outpatient clinic in the Summer of 2011 a rule change went into effect which no longer allowed interns to trade clinics.  Obtaining a clinic is done via lottery so, most people can end up at a clinic which best suits them but, if you're name is at the end of the lottery list then you can end up in a very unfavorable clinic mainly due to proximity of where you may live as a student.  I remember there were three of us in my class who owned their own homes and any of us could have been royally screwed given a bad clinic location.  The other two people both got drawn early in the drawings and picked the Montgomery clinic which was located at Logan so there was no extra driving involved for them.  I wasn't so lucky.  But, I realize now, the whole reason for not allowing interns to change clinics - well, the original reason was because some people were picking favorable clinics and could sell them, often for $1,000 or more to students who got screwed in the lottery system.  But, had the system which had been in place for over a decade before simply been maintained then there would have been no reason for anyone to have to switch clinics in the first place.  It's like Logan created their own problem.

It's hard not to think of the students and administration people I've talked with up at Northwestern who said their interns average 600 adjustments each.  It's hard to imagine.

On a plus side for Logan, I'd have to say their graduation ceremony would be pretty hard to beat and I do believe the quality of teaching as far as their regular classes are concerned are probably about as good as it gets.  They're still struggling and trying to find the right formula for their outpatient clinic which, is pretty evident since the rules for outpatient are constantly changing every trimester.