Columbia Integrated Care

The transition has occurred to the outpatient setting at Columbia Integrated Care.  In the last two weeks at the CIC, I have had the opportunity to be a secondary intern on over a dozen different cases.  These experiences have afforded me the opportunity to meet many of the patients who utilize chiropractic care, as well as, see a variety of different approaches to patient care.  I have been very impressed!

The CIC differs in many ways compared to the Campus Health Clinic.  One way that it differs is the level of care.  Dr. Roberts is very involved in all her patient's care at the CIC.  She makes sure all the work we do is done at the level of practicing field doctors.  No one really knows what this is like until you experience it.  At the CHC, it feels like a real setting but the patients are not paying for services.  At the CIC, every service is purchased, so this means all the interns must provide excellent, well-documented care.  All the outcome markers must be tracked each visit for changes because those changes determine 3rd party payment reimbursements.  The main difference at the CIC, is the fact that everything matters and there is no room for mistakes.

Today, I had my first outpatient.  I worked up two problems starting with the history and then moving to the physical examination to rule out disease.  Upon completion of the PE, I presented the findings to Dr. Roberts, she asked my 12th quarter intern if he agreed with the results and the treatment plan and she gave me the go ahead to treat.  This was my first experience treating a patient who was effected so extremely by a problem.  The results of my treatment after I applied it were instantaneous.  The patient reported immediate relief and the active range of motion improved significantly.

What were this patient's other options?  Steroid injections, anti-inflammatory medications and surgery.  The issue was musculoskeletal and biomechanically oriented.  I corrected the joint dysfunction, worked some soft tissues using pin-and-stretch techniques and reciprocal inhibition to deactivate a tight muscle.  The end result is not here though.  In the coming weeks, I will know whether or not the manual therapy I delivered was adequate in resolving this issue.  Of course, a few visits are needed to make a therapeutic change that returns the tissues/joints to normal.   I also realize there is more negating factors going against resolving the issue like; repetitive movements, compliance with exercises and compliance with care at the CIC.

The paradigm of the healing arts is so complicated, particularly when you are looking to reverse the effects daily life has on the body without drugs or surgery.  It then becomes a matter of behavior change and trust in the care the patient is receiving.  If the therapy is appropriate and the motivation is there to make change happen, results will follow.

All for now