Scope of Care

There has been some remarks to my previous post about the Burnside Clinic that I felt were not the vibe I'd like to present to nearly 1,000 readers per month. I removed them and have decided to write a bit about why. I would like to clear the air with the past blog post to make it known my intentions for the course of action I had in mind for my patient with a suspected drug issue.

At the Burnside Clinic, we see all types of people who cannot afford any medical care due to their present circumstances. We must make immediate decisions for the people we see that have a multitude of issues going on at the same time. There are some, not all, who are on drugs and alcohol who need help just as bad as those who come in that are not on drugs and alcohol. The problem is how to deal with these folks. Do we educate them on the harm they are doing to themselves by using drugs and alcohol or do we ignore it and fix their musculoskeletal problem and wish them luck? It's a tough call. As chiropractors and according to the laws that exist for first contact providers, we have to intervene or we are at risk of doing injustice. As for my patient, I will recheck blood pressure and I have already spoken to Dr. Yancy about having her there when I take the reading so that she can be involved in the process. I should have added this to my last blog post, which may have been more clear. Sorry. I sometimes portray these interactions with patients as one-on-one, when in fact, there is typically a licensed provider in the room.

Some students feel they are not prepared to deal with circumstances like this and it makes them uncomfortable when they have to actually deal with all this. I totally get it. In our education at Western States, we are informed on the negative consequences of excessive alcohol and drug abuse. What we are not fully prepared to do is refer in a necessary manner. I feel totally out of my league when it comes to this but I trust my attending physician will help me take the appropriate action. As far as the comments that were left that I deleted, I never once said I was going to treat the individual with the drug problem for the drug problem. I will only treat them for their low back pain and upper thoracic pain. Will I manage the drug issue? Absolutely. Will I help the person get off drugs? Hell no! I know what can happen when a person tries to quit cold turkey. Their system can go into all kinds of medical uncertainty.

My point of the last post was to talk about how difficult it really is to manage these individuals. Not to suggest chiropractic was a treatment for these individuals. In our clinical internship, we learn the ropes of patient management. When a problem is beyond the scope of chiropractic we quickly refer to the appropriate specialists who can manage the problem more readily. We don't learn this in school. We learn this in the internship under the guidance of experienced chiropractic physicians. I am glad Dr. Yancy is there to step in and provide guidance with the process of dealing with challenging cases.

I hope this clears up what it was I was trying to portray from the past blog post.