To be clearly honest, I'd have to chant a prayer and explain current events according to religious antics that are indescribably indescribable to most people.
Yes, things have turned around in the blink of an eye. Folks are seeing the idea I have created and taking action based on intuition. Today alone, I logged 4 new patients out of the blue. Was it fate or was it marketing? I don't know. Being that I don't market, it may be the former. I do know that being in business has it's ups and downs and at times, it feels as if things may not work out.
Feelings such as these are not positive and they lack productivity. Yesterday, I had a long conversation with myself and basically proclaimed freedom from any harm that this clinic could do to me if it fails. I transitioned my thoughts, efforts and energy toward positive development. If there is a "Secret" out there, I do think I have found it!
We all go through life with fears and limiters that prevent us from taking full action on our innermost desires to succeed. We stamp out ideas swiftly due to a fear of rejection or the fear of failure. If those fears go away, all that is left is either failure itself or a solid foundation for growth. As a true optimist, I choose the latter.
For the first time since day one, I am looking forward to going into the clinic tomorrow morning!
Don't squash your dreams.
All for now,
Dr. Spangler
Trailhead Chiropractic
Wednesday, November 30, 2011
Saturday, November 19, 2011
Dysfunctional Movement
After finishing my first workshop on injury prevention at the clinic this week, I thought a blogpost on dysfunctional movement would be a good idea.
In October I attended the SFMA or the Selective Functional Movement Assessment seminar. This course was awesome, by the way! It helps practitioners with a baseline movement assessment that can be used in re-evaluations to see if the issue has cleared up.
I was quite impressed by the way the assessment could be broken down into figuring out which muscle groups and structures were inhibiting movement and causing imbalances/asymmetrical movement. It was also interesting how the assessment had the ability to define the dysfunction as a mobility or stability issue. After the assessment is complete, you have a nice package of information that can be used as a baseline to show improvements post-therapy.
Trying to explain this to folks who haven't had anatomy or biomechanics training last Thursday, was extremely difficult. The task of switching from medical terminology to understandable language and back, over and over, was very challenging. I could barely see straight after the workshop.
My hope at the clinic is to help explain dysfunction as a performance hindering and potential risk for injury issue for athletes and non-athletes and offer services and classes aimed at clearing up the problem.
Diving deeper into the goods of functional movement is the FMS protocol. The FMS protocol is the non-medical SFMA screen. Professional teams around the country use this approach to find dysfunctional movement in their athletes during the pre-season and if pain is causing the dysfunction, they evaluate with the SFMA screen and apply therapy/rehab.
The FMS or Functional Movement Screen, detects faulty biomechanics which lead athletes and non-athletes toward a greater risk for injury and poor performance. Here is a testimonial of the FMS screen that I found explanatory and helpful:
“We now use this program with every player as a pretest and evaluation tool before we even begin to train them. This individualizes our training as we can now focus more on improving weaknesses, imbalances and asymmetries in an effort to improve functional movement patterns. Not only that, it's an integral part of our program; rehabilitating injuries, decisions on return to play, and it's a test before training camp that tells us:
1) has the player improved?
2) do we feel good about putting him on the field?”
In October I attended the SFMA or the Selective Functional Movement Assessment seminar. This course was awesome, by the way! It helps practitioners with a baseline movement assessment that can be used in re-evaluations to see if the issue has cleared up.
I was quite impressed by the way the assessment could be broken down into figuring out which muscle groups and structures were inhibiting movement and causing imbalances/asymmetrical movement. It was also interesting how the assessment had the ability to define the dysfunction as a mobility or stability issue. After the assessment is complete, you have a nice package of information that can be used as a baseline to show improvements post-therapy.
Trying to explain this to folks who haven't had anatomy or biomechanics training last Thursday, was extremely difficult. The task of switching from medical terminology to understandable language and back, over and over, was very challenging. I could barely see straight after the workshop.
My hope at the clinic is to help explain dysfunction as a performance hindering and potential risk for injury issue for athletes and non-athletes and offer services and classes aimed at clearing up the problem.
Diving deeper into the goods of functional movement is the FMS protocol. The FMS protocol is the non-medical SFMA screen. Professional teams around the country use this approach to find dysfunctional movement in their athletes during the pre-season and if pain is causing the dysfunction, they evaluate with the SFMA screen and apply therapy/rehab.
The FMS or Functional Movement Screen, detects faulty biomechanics which lead athletes and non-athletes toward a greater risk for injury and poor performance. Here is a testimonial of the FMS screen that I found explanatory and helpful:
“We now use this program with every player as a pretest and evaluation tool before we even begin to train them. This individualizes our training as we can now focus more on improving weaknesses, imbalances and asymmetries in an effort to improve functional movement patterns. Not only that, it's an integral part of our program; rehabilitating injuries, decisions on return to play, and it's a test before training camp that tells us:
1) has the player improved?
2) do we feel good about putting him on the field?”
John Torine, Head Strength Coach for the Indianapolis Colts
If these assessments work on professional athletes that rely on staying injury free, I believe any athlete, endurance or power, can be assessed using these screens to help improve performance and prevent injury.
I have found a few road blocks in my attempt to explain this approach to the public. One issue is that it is conceptually challenging to wrap your head around dysfunctional movement. Without going through an actual assessment or seeing it performed on someone, dysfunctional movement sounds like a weird disease.
The way I see it is like this: the muscles of the body all have specific duties; some are prime movers, some are helpers or synergists and some are stabilizers. If we move in a particular way or do the same activities everyday, we develop dominant motor programs that make the the particular way we move each day, easier and more efficient. It is all about adaptation. Now, if those particular daily movements are sitting and riding a bicycle, you can see how going for a run with these dominant motor programs could leave you at risk for injury. Add in the body's ability to physically mold itself into postures from doing the same activities day after day, you can then see how our biomechanics can be altered.
Take a the cyclist from the example above who has a desk job. More than likely, this person will have very tight hip flexors due to being in the seated position on the bike daily and sitting at work daily. Looking at the time spent in hip extension each day and you can see that this person likely walks to the car to go home, walks in the grocery store and walks around the house a little, everyday. How much time is being spent sitting versus standing? I'd say it is 80% or more of sitting.
This prolonged sitting creates a movement pattern that is very efficient for the activity of sitting and not so much for the pattern of standing and walking.
Now, with this in mind, think about what happens when a muscle group becomes dominant over it's antagonist muscle group. The opposite muscle group, the antagonist, becomes inhibited or dormant.
The cyclist above likely has tight hip flexors from being in the flexed-hip position at work and in cycling. If the hip flexors are dominant, the opposite muscle groups that becomes inhibited are the glutes or hip extenders and the abdominals.
What does this do to the biomechanics? In the standing position, the person will have an anterior pelvic tilt which causes the belt line to be angled toward the feet and the lumbars or lower back will be hyperlordotic or excessively curved. This change puts tension on the hip stabilizers, the IT bands, the knees, the ankles and even the cervical, thoracic and lumbar regions of the spine.
Now go running with these issues and you are at risk for injury and degeneration of joint surfaces due to faulty dysfunctional biomechanics.
Clearing these biomechanics up with manual therapy and rehab strengthening for inhibited muscles, prevents injuries and helps the body function as it is supposed to with clean, powerful movement.
I hope this all sheds light on the power of movement assessment.
Snow Day's and Tryptophan
As the blood saturates the cells with tryptophan after a delicious Thanksgiving gorge, the eerie silence in my new clinic is starting to bug me.
These startup days can be confusing. One day you'll be busy as ever and the next, there is absolutely nothing going on. If two or three days go by with no patients, it is hard to see the bigger picture. This is why you need advisers when opening a practice. They keep you from making stupid decisions that waste your resources when a few days pass that do not grow the practice.
The natural tendency is to try to buy your way into establishing a practice. This doesn't work. I know because I just wasted a lot of money advertising in the Boise Weekly. I had hoped to get the word out to the masses, that my clinic was trustworthy, modern and legitimate. Obviously, this effort didn't blossom into new patients or inquiries. You live and learn.
During times of silence I think it is important to focus on the basics. For me, it is important to keep consistent with physical activity. My sports provide me with solid connections into sports medicine patients and they help me stop worrying about growing a new practice. It's a win win situation.
For now, I will be using the silent times to focus on email marketing and making new connections in medicine. Interestingly, I met an MD the other day who told me that 80% of the patients who seek his care have severe back pain. That seems ridiculously high, but he said so and I trust that he is correct. Making connections like these are critical in establishing a medical practice.
I developed a new Winter Injury Prevention and Performance Program designed to reduce tight musculature and improve performance via activation of dormant muscle tissue. The intention is to provide a cost-effective way to help endurance athletes avoid injury and perform better. Hopefully this will take off and pave the way to the clinic's success!
Here's to good intentions and motivation!
All for now,
Dr. Spangler
Trailhead Chiropractic
These startup days can be confusing. One day you'll be busy as ever and the next, there is absolutely nothing going on. If two or three days go by with no patients, it is hard to see the bigger picture. This is why you need advisers when opening a practice. They keep you from making stupid decisions that waste your resources when a few days pass that do not grow the practice.
The natural tendency is to try to buy your way into establishing a practice. This doesn't work. I know because I just wasted a lot of money advertising in the Boise Weekly. I had hoped to get the word out to the masses, that my clinic was trustworthy, modern and legitimate. Obviously, this effort didn't blossom into new patients or inquiries. You live and learn.
During times of silence I think it is important to focus on the basics. For me, it is important to keep consistent with physical activity. My sports provide me with solid connections into sports medicine patients and they help me stop worrying about growing a new practice. It's a win win situation.
For now, I will be using the silent times to focus on email marketing and making new connections in medicine. Interestingly, I met an MD the other day who told me that 80% of the patients who seek his care have severe back pain. That seems ridiculously high, but he said so and I trust that he is correct. Making connections like these are critical in establishing a medical practice.
I developed a new Winter Injury Prevention and Performance Program designed to reduce tight musculature and improve performance via activation of dormant muscle tissue. The intention is to provide a cost-effective way to help endurance athletes avoid injury and perform better. Hopefully this will take off and pave the way to the clinic's success!
Here's to good intentions and motivation!
All for now,
Dr. Spangler
Trailhead Chiropractic
Friday, November 11, 2011
The First Month
I finished my first month of private practice today!
Nobody told me about the obstacles of launching a new clinic back in school. It is almost like they keep it hidden because of how incredibly hard the process actually is. Regardless, the first month is done and the 6 month lead up to opening for the first month of practice is now history.
The details involved with sculpting a practice into launch form is intense. If these details are not covered, your message will be misconstrued, saying you don't care about the details, so why should I trust you with my problem? Nobody wants that.
During the last, say, two years of school, I sat in the back of the class developing the concept of my now 1 month old clinic. All the details were designed and redesigned numerous times. Colors were selected for the website, then trashed and reselected. Themes were taken on and then canned for better ideas. On and on it goes. This process brought me to the business plan which encompassed an ideology that was based in ethics. Something that is lost in many other clinics due to a lack of a business model and a lack of an personal identity. You can have any ideology but it comes down to delivery.
What is it you want to portray to the public? Nobody that I know wants to be that guy selling chiropractic at the annual fairgrounds. Who wants to be a salesman or a gimmick? I don't. That has been a real challenge working with advertisers because they all seem to go after the 'discount' to get people in your door. They don't understand that we are doctors first and a business second. Those who get this concept backwards, end up pushing discounts to the public and always struggle with their identity.
I've decided if I advertise with anyone, they have to make the effort to get to know my business whole-heartedly and they must have an angle that portrays me as the person I see myself as. Otherwise, I am selling myself short and allowing public skepticism to continue running it's course. Also, if an advertiser doesn't understand me or my ideology, how is it they can develop my brand in their publication and portray me as I see myself? They can't and that is the point.
For instance, I met a nice group from the magazine, Healthy Idaho, today. They were working the angle of using my knowledge to gain interest in local business wellness initiatives. It was respectful and they took the extra time to tour my clinic and gain a real grasp of what I see for the future of the clinic. Now, these are the types of people I want to work with. Not people who are rushed to make a sale to their advertising agency or those who try to up-sale me.
It's all about passion and the weeds are being pulled.
All for now,
Dr. Spangler
Trailhead Chiropractic
Nobody told me about the obstacles of launching a new clinic back in school. It is almost like they keep it hidden because of how incredibly hard the process actually is. Regardless, the first month is done and the 6 month lead up to opening for the first month of practice is now history.
The details involved with sculpting a practice into launch form is intense. If these details are not covered, your message will be misconstrued, saying you don't care about the details, so why should I trust you with my problem? Nobody wants that.
During the last, say, two years of school, I sat in the back of the class developing the concept of my now 1 month old clinic. All the details were designed and redesigned numerous times. Colors were selected for the website, then trashed and reselected. Themes were taken on and then canned for better ideas. On and on it goes. This process brought me to the business plan which encompassed an ideology that was based in ethics. Something that is lost in many other clinics due to a lack of a business model and a lack of an personal identity. You can have any ideology but it comes down to delivery.
What is it you want to portray to the public? Nobody that I know wants to be that guy selling chiropractic at the annual fairgrounds. Who wants to be a salesman or a gimmick? I don't. That has been a real challenge working with advertisers because they all seem to go after the 'discount' to get people in your door. They don't understand that we are doctors first and a business second. Those who get this concept backwards, end up pushing discounts to the public and always struggle with their identity.
I've decided if I advertise with anyone, they have to make the effort to get to know my business whole-heartedly and they must have an angle that portrays me as the person I see myself as. Otherwise, I am selling myself short and allowing public skepticism to continue running it's course. Also, if an advertiser doesn't understand me or my ideology, how is it they can develop my brand in their publication and portray me as I see myself? They can't and that is the point.
For instance, I met a nice group from the magazine, Healthy Idaho, today. They were working the angle of using my knowledge to gain interest in local business wellness initiatives. It was respectful and they took the extra time to tour my clinic and gain a real grasp of what I see for the future of the clinic. Now, these are the types of people I want to work with. Not people who are rushed to make a sale to their advertising agency or those who try to up-sale me.
It's all about passion and the weeds are being pulled.
All for now,
Dr. Spangler
Trailhead Chiropractic
Tuesday, November 8, 2011
Quack
As I venture into my fourth week of private practice, I have noticed a trend. This trend is one that is worth a blog post, clearly.
Could this trend be one of mistrust, fear and anxiety toward chiropractic? Why would there be such resistance to an ethical approach to care? Lets explore...
I've noticed since being in practice, a lack of trust with chiropractic. Of course, you could throw me under the bus with being "new" to practice or whatever, but you cannot discount entering a fire fight with a knife.
The fact is, we are seen as non-expert, unprofessional, quacks whenever we open our mouths. When we advise manual therapy or rehab to be done 'onsite' in our clinics, we are viewed as the devilish chiropractor that is only in it for the money. Obviously, this upsets me because new patients have lumped me into this category without any effort to earn such a response.
If the profession could take some needed notes from a newby doctor, I'd say, quit thinking with such short projections and change your mindset to a 5-year or 10-year plan that solidly plants you into your community. When I say plant, I am hoping you know what that means. In my mind, it means to be trusted and viewed with integrity versus being viewed as a money driven quack.
When I decided to stay with chiropractic, I told myself I would not let the discrimination bother me, but as the weeks tick by and the offensive, demoralizing things happen, I tend to sway toward the pissy-end of the spectrum.
What can be done? Don't be a quack is the only thought that comes to my mind. Believe that the mission of providing conservative orthopedic care is worth it's shortcomings and adherence to the ideology of health via fitness is actually plausible.
I look at the handful of patients that have pushed away and those that have committed to my approach and I see two different sets of people. One has the goal of achieving a pain free life through the use of my care and adoption of home-based therapy and the other wants a quick fix. I can't judge the quick fix folks though because they have been conditioned to look at health care this way over the matter of decades.
We aren't all quacks, is my statement. There is a large group of chiropractors that I pride myself to be in the presence of, professionally. We see eye-to-eye and we approach patient's with objective minds and clear goals that sway from the mainstream allocation of pharmacy for symptom reduction.
The nice thing is, we are not stuck using a set methodology that consists of Norco, Naproxen and Flexeril for any ache or pain. At our clinic, we utilize a unique/ethical approach.
All for now,
Dr. Spangler
Trailhead Chiropractic
Could this trend be one of mistrust, fear and anxiety toward chiropractic? Why would there be such resistance to an ethical approach to care? Lets explore...
I've noticed since being in practice, a lack of trust with chiropractic. Of course, you could throw me under the bus with being "new" to practice or whatever, but you cannot discount entering a fire fight with a knife.
The fact is, we are seen as non-expert, unprofessional, quacks whenever we open our mouths. When we advise manual therapy or rehab to be done 'onsite' in our clinics, we are viewed as the devilish chiropractor that is only in it for the money. Obviously, this upsets me because new patients have lumped me into this category without any effort to earn such a response.
If the profession could take some needed notes from a newby doctor, I'd say, quit thinking with such short projections and change your mindset to a 5-year or 10-year plan that solidly plants you into your community. When I say plant, I am hoping you know what that means. In my mind, it means to be trusted and viewed with integrity versus being viewed as a money driven quack.
When I decided to stay with chiropractic, I told myself I would not let the discrimination bother me, but as the weeks tick by and the offensive, demoralizing things happen, I tend to sway toward the pissy-end of the spectrum.
What can be done? Don't be a quack is the only thought that comes to my mind. Believe that the mission of providing conservative orthopedic care is worth it's shortcomings and adherence to the ideology of health via fitness is actually plausible.
I look at the handful of patients that have pushed away and those that have committed to my approach and I see two different sets of people. One has the goal of achieving a pain free life through the use of my care and adoption of home-based therapy and the other wants a quick fix. I can't judge the quick fix folks though because they have been conditioned to look at health care this way over the matter of decades.
We aren't all quacks, is my statement. There is a large group of chiropractors that I pride myself to be in the presence of, professionally. We see eye-to-eye and we approach patient's with objective minds and clear goals that sway from the mainstream allocation of pharmacy for symptom reduction.
The nice thing is, we are not stuck using a set methodology that consists of Norco, Naproxen and Flexeril for any ache or pain. At our clinic, we utilize a unique/ethical approach.
All for now,
Dr. Spangler
Trailhead Chiropractic
Tuesday, November 1, 2011
Staying True
As the weeks tick by in private practice, my ideology is tested daily. If you have read the previous blog posts, you know the ideology of chiropractic I have tried to portray over the years. When you go into business these ideals are tested and retested daily.
Everyone wants to make a buck. It is all about 'my' rent and 'my' car and 'my' student loans. Who cares about the patient and what 'they' really need, right?
Of course, this is not how my clinic operates. We do not create dependency on passive treatments. We use passive treatments to restore function to dyfunctional regions of the body. Once function has been restored with manual therapy, we utilize this new functioning system to create stability and strength to the area. The lack of stability and strength is largely the reason why the region became dysfunctional in the first place.
The biggest problem with my profession is that we are forced into a small business mindset and this creates mindless technicians. Yes, I could easily have patients come back over and over for passive care to simply alleviate their pain for a short timeframe. However, I am against this because this would push me into the category of chiropractors that disgusts me and the public. Dare to be different!
How can you make a small business tick without repeat customers? My answer: focus on quality care and wait for referrals. This takes patience and consistency with care.
If you believe our role in health care is to extinguish fires, then you fall into the technician category. If you feel it is important to diagnose, treat and prevent issues from occurring later on, I'd say you are a modern chiropractic physician and you deserve the recognition from the public and your peers in medicine.
What if the patient gets better and a large void develops in my schedule? If you truly care about getting people better, they will not only pay more for the quality services but they will also refer their friends and family because they trust you. In the long run, you have built an ethical practice which follows the Hippocratic Oath and this creates a foundation for our profession to be fairly judged from.
Be thorough and be patient.
All for now,
Dr. Spangler
Trailhead Chiropractic
Everyone wants to make a buck. It is all about 'my' rent and 'my' car and 'my' student loans. Who cares about the patient and what 'they' really need, right?
Of course, this is not how my clinic operates. We do not create dependency on passive treatments. We use passive treatments to restore function to dyfunctional regions of the body. Once function has been restored with manual therapy, we utilize this new functioning system to create stability and strength to the area. The lack of stability and strength is largely the reason why the region became dysfunctional in the first place.
The biggest problem with my profession is that we are forced into a small business mindset and this creates mindless technicians. Yes, I could easily have patients come back over and over for passive care to simply alleviate their pain for a short timeframe. However, I am against this because this would push me into the category of chiropractors that disgusts me and the public. Dare to be different!
How can you make a small business tick without repeat customers? My answer: focus on quality care and wait for referrals. This takes patience and consistency with care.
If you believe our role in health care is to extinguish fires, then you fall into the technician category. If you feel it is important to diagnose, treat and prevent issues from occurring later on, I'd say you are a modern chiropractic physician and you deserve the recognition from the public and your peers in medicine.
What if the patient gets better and a large void develops in my schedule? If you truly care about getting people better, they will not only pay more for the quality services but they will also refer their friends and family because they trust you. In the long run, you have built an ethical practice which follows the Hippocratic Oath and this creates a foundation for our profession to be fairly judged from.
Be thorough and be patient.
All for now,
Dr. Spangler
Trailhead Chiropractic
Monday, October 24, 2011
A New Life
Every student studying medicine or a related health field knows what it is like to want the end result more than the process of obtaining the end result. You are forced to your wits end with tests and deadlines and can never find a chance to calm the fire. We sit there and wish it would just hurry up already so life can continue in a much more leisurely fashion.
Well, that time has come for me. Although, I can't say it has been less stressful than school. It's a different kind of stress, one that is more "real". Yes, things are quite real these days.
All through school I planned every detail of my clinic down to the colors, the theme and the equipment. I went on a hunch that people value quality health care services and no matter what, they'd see my genuine effort and decide my clinic was a good fit for them. Fortunately, this has happened, to some extent. We aren't bursting at the seams with too much to do, but there are a few that have trusted me and my staff with their needs. As we do good work, the word will spread and we will obtain more clients looking for trustworthy chiropractic and rehab.
We have been successful and great results have transpired from our efforts. Each time I work with a patient at the clinic, I have a sense of gratitude for how hard it was to get to this point. We can only share stories of these things and there are others with larger stories than mine.
My first patient at the clinic was a great one! A family stressed over their child's inability to compete in their sport due to thoracic pain and a dream lost due to a lack of a treatment plan. I evaluate the patient and find the issue to be restricted joint movement in the CT junction and upper ribs. I adjust the patient and do some pin and stretch on the muscles and have my LMT massage the tight muscles. The patient feels better immediately and the next day performs a personal best in a competition! Now, we are looking at the State competition!
This is definitely a success story and one to use as motivation to continue onward with this new practice. I know more stories will come through this sweet chiropractic clinic as we grow, some will be more challenging and provide less immediate success, but we intend on doing our best.
All for now,
Dr. Spangler
Trailhead Chiropractic
Well, that time has come for me. Although, I can't say it has been less stressful than school. It's a different kind of stress, one that is more "real". Yes, things are quite real these days.
All through school I planned every detail of my clinic down to the colors, the theme and the equipment. I went on a hunch that people value quality health care services and no matter what, they'd see my genuine effort and decide my clinic was a good fit for them. Fortunately, this has happened, to some extent. We aren't bursting at the seams with too much to do, but there are a few that have trusted me and my staff with their needs. As we do good work, the word will spread and we will obtain more clients looking for trustworthy chiropractic and rehab.
We have been successful and great results have transpired from our efforts. Each time I work with a patient at the clinic, I have a sense of gratitude for how hard it was to get to this point. We can only share stories of these things and there are others with larger stories than mine.
My first patient at the clinic was a great one! A family stressed over their child's inability to compete in their sport due to thoracic pain and a dream lost due to a lack of a treatment plan. I evaluate the patient and find the issue to be restricted joint movement in the CT junction and upper ribs. I adjust the patient and do some pin and stretch on the muscles and have my LMT massage the tight muscles. The patient feels better immediately and the next day performs a personal best in a competition! Now, we are looking at the State competition!
This is definitely a success story and one to use as motivation to continue onward with this new practice. I know more stories will come through this sweet chiropractic clinic as we grow, some will be more challenging and provide less immediate success, but we intend on doing our best.
All for now,
Dr. Spangler
Trailhead Chiropractic
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