Integrative Healthcare


The Benefits of a Multi-specialty Practice
Integrative Healthcare
Written by Emily Fennell, PT, DPT   
Saturday, 25 May 2013 12:42
“Choose a job that you love and you’ll never work a day in your life.” From the time that I was a small child, my parents instilled that concept into our family life day in and day out. Hard work and education were always things that were a vast part of our family’s way of life. My parents encouraged me to follow my dreams and shine light onto the world everyday through helping others and making a positive impact. I now see the impact I can make is being much greater than that of a lone physical therapist. 
 
chiroadjustmentleg2It is indeed true that every practitioner has a unique skill set, and each discipline is a master of certain elements of a given patient’s recovery process. Indeed, there is a philosophy, science, and art, which must be in harmony with every doctor, in every practice. Working inside an office with chiropractors, physical therapists, and medical doctors allows for better patient outcomes.
 
I chose to work in an office that was not limited to my particular specialty because, ultimately, there is no place in medicine for doctors who feel that they can do everything themselves. Baltimore Ravens quarterback Joe Flacco was quoted after being named this year’s Super Bowl MVP as saying that he could not have made those passes without an exceptional set of receivers. That is what a team is all about, and that is how we win in practice.
 
I truly feel that there are no coincidences in life, and somehow my journey led me to the colleagues that I now have in an office with a very wide scope. Our practice is integrated with a group of medical professionals that truly believe in each other and our individual talents, as well as the cohesive way that we provide superior care to our patients. Using our individual gifts and abilities as well as a team approach to pain management allows us to achieve unsurpassed patient satisfaction.

As healthcare providers, we have the ability to make such an impact on patients with our various gifts and talents that each of us possess.

 
Helping others through working together not only yields improvement in patients’ lives, but also creates momentum to achieve purpose and meaning in our own lives. Kindness and compassion are contagious. We are a group of medical professionals that maximize our abilities to help patients and embrace our differences in that each one of us has talents and gifts that provide superior patient care. We are also a family that makes a true difference in the world. We support each other in our journey toward meeting our professional, personal, and financial goals in the hard work and passion we implement on a daily basis. 

By merging and combining our skill sets as chiropractors, physical therapists, medical doctors, and other allied professionals, it is overwhelming to think of the amount of kindness we can spread on a daily basis. When you love your job, you never work — and you get paid.
 
As healthcare providers, we have the ability to make such an impact on patients with our various gifts and talents that each of us possess. In our clinic, we are able to make even more of a lasting impression and impact with the individual qualities that each medical specialty can provide for the patients. 
 
We are living the change that we want to see in the future of health care. We strive for a world where patients get superb care from various specialties in order to provide as many treatment interventions as medically necessary to improve patient outcomes. We are constantly living this in our clinic every day, and we work to improve quality of care with each patient we treat. I feel very lucky to be part of such a wonderful group of people that help me achieve my goals on a daily basis.
 
Dr. Fennell is the Physical Therapy Director and practicing therapist of an integrated clinic in Maryland. She has been in private practice since graduation from Duke University in 2008. She completed her residency at Children’s Hospital in Washington, DC. She is a consultant for Consultants of America where she helps offices integrate PT into their practices. She can be reached at   This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
 
The Challenge of Treating Autonomic Neuropathy
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Integrative Healthcare
Written by John Hayes, D.C.   
Tuesday, 23 August 2011 20:27

O
ne of the fastest growing surgical procedures in the United State is gastric bypass surgery or lap band placement.  With that increase comes a whole new patient population:  Patients suffering from the side effects of gastric bypass or lap band placement.  Chances are they were warned about the downside of the procedure they were planning to have, but it’s a safe bet they weren’t told about Gastrointestinal Autonomic Neuropathy.  And they’re in for a really unpleasant surprise.  If you have a post operative gastric bypass patient (or patient with a history of alcohol abuse, diabetes, hepatitis C, Crohn’s Disease or Celiac Disease) and they present with some or all of the following symptoms1 :heartburn

  • Heartburn
  • Bloating
  • Nausea and/or vomiting
  • Serious difficulty swallowing because their esophagus no longer functions properly
  • Inability to empty your stomach
  • Diarrhea or constipation

you could be dealing with a case of G.I. Autonomic Neuropathy.  If they’ve only started experiencing these new symptoms recently, congratulate them on getting in to see you quickly.  In order to lessen the chance of serious nerve damage and even permanent damage to their digestive system, they need a clinician specially trained in diagnosing and treating nerve disease and damage.

Helping Patients Understand G.I. Autonomic Neuropathy

Because they can’t see physical evidence of G.I. autonomic neuropathy (other than their terribly unpleasant symptoms), they probably think they’re experiencing routine side effects (if they’re a gastric bypass patient).  It’s important that your patient understands that G.I. Autonomic Neuropathy, in itself, is not a disease.  Explain to them that it’s a type of neuropathy that affects the nerves, specifically the vagus nerve that controls the digestive system. The nerves are damaged due to malnutrition and vitamin deficiency and don’t function properly.  Soon the body “forgets” how to digest food properly and their very unpleasant symptoms begin.

Aside from gastric bypass patients, Gastrointestinal Autonomic Neuropathy can be caused by other diseases or chronic medical conditions such as:

  • Diabetes
  • Alcoholism
  • Cancer
  • Crohn’s Disease
  • Celiac Disease
  • HIV/AIDS

If your patient suffers from any of the above conditions or any number of other chronic illnesses, their chances of developing G.I. Autonomic Neuropathy are dramatically increased.  If they’re coming to you with any of the symptoms we discussed above, they may have developed autonomic neuropathy as a result of their underlying illness.

Treatment and Prognosis

If you use the correct protocols, you will find the treatment regimen ideally suited to treating all types of peripheral neuropathy, including G.I. Autonomic Neuropathy.  In fact, treatment protocols have been developed specifically for patients suffering from neuropathy.

G.I. Autonomic neuropathy is a chronic condition, but it can be treated and your patient can do things to help relieve their symptoms.  Work with the patient and any other physicians they’re seeing to treat the G.I. Autonomic Neuropathy and manage their underlying condition.  Explain to your patient that your treatment protocol was designed to treat the whole patient and not just their symptoms.  You can do this by offering:

healthyfoodDiet Planning and Nutritional Support

The body needs the proper the nutrition to heal.

If they have gastrointestinal issues caused by G.I. Autonomic Neuropathy, it might be tempting to increase their fiber intake beyond the recommended daily amount, but don’t.  This can cause the development of bezoars due to the inability of their digestive system to eliminate waste properly.  Provide them with a diet plan that ensures they get the right amount of fiber, whole grains, fresh vegetables, lean meats2 and drinking enough water.

If they have diabetes, work with them on a diet to control their blood sugar.

• Individually Designed Exercise Programs

Develop an exercise regimen for your patient that will allow them to take things slowly but still work some physical activity into their daily routine.  Treating neuropathy patients requires specialized training in the design and monitoring of exercise programs. You can be specially trained in designing exercise programs to meet the needs of the neuropathy patient.

• Lifestyle Modifications

Really study your patient’s lifestyle and monitor them for ways to help them live a healthier life.  Any type of stress management program will help them manage the depression that arises from such a debilitating condition.

Early intervention with a clinician well versed in treating all types of neuropathy is still the best course of action for a Gastrointestinal Autonomic Neuropathy patient.  While you can’t reverse your patient’s condition if they have already developed neuropathy, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.

When you’re trained and ready to work with them, let them know you’re there.

 
Could There Be Something You Are Missing When Trying to Solve Your Patient’s Weight Loss Problems?
Integrative Healthcare
Written by Todd Singleton, D.C.   
Saturday, 25 June 2011 01:48


D
uring the past twenty years of practice, I’ve tried to get patients to eat right.  I’ve met with a lot of resistance!  My experience has been that patients in severe pain healed faster if they were willing to remove the foods that caused inflammation from their diets. Unfortunately, getting patients to comply with a change of diet for pain relief was a challenge.

I have found that the majority of overweight patients I’ve treated have Candida complicating their weight problems.

I have found an easier way to get patients to change their diets.  I started offering weight loss programs.  Patients expect they are going to have to change their diet on a weight loss program and all of the sudden become compliant while achieving health along the way!

When I first started focusing on weight loss for patients, I didn’t pay too much attention to Candida.  However, after cases of patients not responding as I thought they should, I looked closer at the role Candida plays in weight gain. Once I realized the significant role Candida plays, I started using it as a weight loss tool; and patient success stories have changed dramatically. I have found that the majority of overweight patients I’ve treated have Candida complicating their weight problems.

The following are some questions you should be asking your patients, to determine whether or not Candida is a contributing factor to their weight problems.

scalehelpweight1. Do you feel tired most of the time?

2. Does the fatigue alter your lifestyle?

3. Do you suffer from intestinal gas?

4. Do you suffer with abdominal bloating or discomfort?

5. Do you crave  vinegar,  sugar, bread,  beer  or  other   alcoholic beverages?

6. Are  you  bothered  by  bowel disorders?

7. Are you bothered by constipation?   Diarrhea  or    alternating constipation and diarrhea?

8. Do  you suffer from anxiety, depression, panic attacks or mood swings?

9. Are you often irritable, easily angered, anxious or nervous?

10. Do  you have trouble thinking clearly or suffer memory loss,  particularly  short  term   memory loss?

11. Are you ever faint, dizzy or light headed?

12. Do you have muscle aches or take more than twenty-four  hours to recover from normal activities?

13. Without  changes  in  your diet have you gained weight that you aren’t able to shed no matter what you tried?

14. Does  itching   and   burning  of  the vagina, rectum, and prostate bother you or have you experienced a loss of sexual desire?

15. Do you have a white or yellow fuzzy coating on your tongue?

16. Have  you  had  athlete's  foot,   ring worm, jock itch or other chronic fungal infections of the skin or nails?

17. Does  exposure  to  perfume,   insecticide,  new carpeting or other chemical smells bother you?

18. Have  you,  at  any time in your life, taken broad spectrum antibiotics?    Such as  Tetracycline  or  Penicillin?

19. Are you  now or have you  ever  used birth control pills or shots?

20. Are you on synthetic hormones?

21. Have you  ever  taken  or  had  a  steroid  drug  or had an injection for pain?  These drugs,  used  for  allergies,  asthma, respiratory   problems  and  injuries  include  cortisone  and prednisone.

After your patients have answered all of these questions, help them rate the likelihood that they have Candida, based on the following scale, according to the patient’s number of yes answers.

 

Probability of Candida


0 to 4               5 to 6         7 to 11     12 or More

arrowcandidachart

Low              Medium           High               Very High


What is Candida?

Candida is an over-infestation of yeast in the body, invading the brain and every tissue of the body. Candida can be devastating because it lives and grows on what you eat.  It makes the body crave what it “needs” and rampages until you give into cravings.  For this reason, Candida is difficult to get rid of, but it can be done, if proper steps are taken!

Candida Albicans is one of the many different types of yeast.  Yeast cells are able to grow on the surface of all living things and occur virtually everywhere.  The fact is, we breathe, eat, and drink them daily because they are part of our everyday lives.  Everyone has yeast growing on their skin, other body surfaces and in their intestines.  Normally the body's defense system keeps the total number of yeast cells under control, so Candida colonies in the intestinal tract are rarely a problem.

Due to the overuse of antibiotics, the addition of steroids and hormones in animal products, and other chemicals your patients are ingesting, Candida may end up being an issue.

In the presence of Candida, sugar has difficulty passing through cells; therefore insulin cannot do its job properly, causing low blood sugar and weight gain. When Candida is under control, patients will more easily be able to achieve and maintain their proper weight.

Since Candida and other yeasts are all around us, we can never be completely rid of them.  We can, however, bring them under control without the use of prescription drugs.  To achieve the greatest degree of success, an effective balance of dietary changes, nutritional support, and the increase of friendly bacteria are necessary.

When patients completely change their diets, the body will rid itself of toxins and unhealthy Candida.  Addressing your patients’ Candida problems will help them to become healthier, while enabling them to more easily lose the weight they desire.

 

Dr. Todd Singleton graduated from Los Angeles College of Chiropractic in 1990 and went on to own some of the largest MD/DC/PT clinics in the country.  In 2006, he switched from an all-insurance practice to an all-cash practice, by adding a weight loss business to his practice.  He currently runs a very successful weight loss practice in Salt Lake.  He has taught his successful weight loss model to around 300 chiropractors across the country.  For additional information, go to www.ChiropracticWeightLoss.com.

 
Taking an Alternative Approach to Conventional Treatment
Integrative Healthcare
Written by Michael Failla, D.C.   
Monday, 31 January 2011 19:00

As chiropractors, we're already well-versed in the human body's remarkable self-healing power and the pinnacle role of the spine and nervous system in the body's overall health and proper functioning. We've educated our patients about proper spine maintenance and how we can help them improve the operation and nerve flow that supports their health. Although the majority of our patients may be coming to see us to simply reduce immediate back and neck pain or headaches, many may not realize that chiropractic treatments can provide support for a wide range of problems that can help them realign their bodies and also help them start cleaning out their medicine cabinets.

In the nature of our work, we have before us a great platform on which to incorporate alternative approaches to the use of prescription drugs in our treatment regimens and patient counseling. The ability to reduce or even eliminate the need for prescription drugs provides our patients with a two-fold benefit: less stress on their pocketbook, and less stress on their physical system. Even in cases where we cannot fully eliminate their need for medication, there may be valuable space available to provide treatments that support their body's ability to fully benefit from those needed prescriptions.

In our effort to decrease our patients' dependence on conventional and often invasive methods, it's providing a certifiable result that is the key to creating a successful bond between our patients and alternative treatments. Using accurate documentation and employing effective software tools facilitates your ability to create successful treatment plans and track results effectively. Software that applies interconnectivity within your office helps to ensure the transfer of next steps to your front desk staff in real-time, so that your patients remain invested in their alternative care and aligned on the road to health before they step back outside your office doors. By tracking the different health conditions and treatment plans experienced by your patients, you can obtain a broader view of the support and treatment that is best received and, thus, start formulating effective game plans going forward.

Whether a patient buys supplements and seeks additional care from your office or not, dietary changes, massage, and other health management methods should be mindfully tracked and included in your patient's journey to better health. Track improvements with outcome assessments and keep up-to-date notes so that you can discuss any improvements or concerns at each upcoming treatment session. Employ a system of automated alerts to remind you to discuss ongoing treatment options with your patients on a periodic basis. Accurate management of alternative treatment plans can help harness the body's natural healing ability and record your patient's response to alternative treatments. Over time, as patients see previously undiscovered health improvements under your hands that reduce their dependency on conventional drugs and maintenance, these results will continue to enforce the bond between chiropractor and patient.

We represent a large and unified alternative to prescription medications, costly injections, and invasive surgery. As we work to educate our patients on how our treatments, paired with dietary assessments and supplements, can help improve their overall health, we're reaching beyond the singular relationship we have with each of our patients. We're developing an alliance for a healthier, more natural future...redesigning the perception of treatments, and redefining our true alternatives. If we are mindful and accurate in tracking the way our alternative treatments are being received, and we help our patients fully realize the benefits they're experiencing under our care by providing solid, visible proof, we can begin to enhance what our patients take away from our treatment plans and send them along (and ourselves) with a better understanding of the value of our services.

 
Calling from Tuscany
Integrative Healthcare
Written by Dr. Rodger Murphree, D.C.   
Friday, 24 September 2010 15:17

Calling from Tuscany

by Dr. Rodger Murphree, D.C.

 

My article "Greener Pastures" (June 2008) about my trials and tribulations of owning an integrative medical clinic triggered a number of emails. A number of doctors asked why I would want to sell my practice when it seemed as if "I had it all."

After selling my medical practice in 2003, I wrote my first book, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome. Over the next few years, my clinical nutrition practice continued to grow. Once again, I began working long, hard, stress-filled days consulting with "medical misfits." Trust me, seeing five to six new fibromyalgia patients a day will take its toll on you. (Warning: Don’t try this. It’s extremely dangerous to your health.) When my Treating and Beating Anxiety and Depression book hit the bookshelves in 2005, I was flooded with mood disorder patients. I started feeling a bit crispy—not burnt out, but definitely crispy.

Once again, I received some sage advice from a valued mentor: Work smarter not harder. It turned out to be harder to work smarter than I thought. But, "Ok, I can learn to do that."

I’m writing this article on a sunny Friday morning while I watch my three- year-old son, Ridgeway, run around chasing butterflies in my backyard. Ridge and I are spending the morning together, something we routinely do; and, while all my neighbors have hurried off to work, I’ve not changed out of my boxers and T-shirt. In fact, I haven’t even brushed my teeth yet (gross).

Thankfully, there’s no need for me to be in my clinic all the time. In fact, my staff seems to take more orders and get more done when I stay away. I now see patients or do phone consults two to three days a week. I used to feel guilty about only being in my clinic three days a week, but I’ve gotten over it.

I now take several extended trips each year: a month in Italy, two weeks in Canada, two weeks off at Christmas, and a couple weeks at the beach each year. And, best of all, by learning to work smarter, my patients (and customers at large) purchase my nutritional products, books, and CD’s, whether I’m in the office or not. My website works 24/7 and my staff, all two of them, are happy to take phone orders Monday through Friday. I had a record week in web sales while I was walking the streets of Venice last summer.

 

 

I still work hard, writing books, speaking at public and chiropractic seminars, consulting with complicated patients, managing my web business, writing for various professional and public magazines, and helping doctors in my Doctors VIP One on One Clinical Nutrition Program reach their million dollar goals. But I work pretty much when I want to, with whom I want to, and how I want to.

Earlier this year, I spent two days with Google AdWords and online marketing "guru" Perry Marshall. I’d been following Perry’s advice, reading his books and online marketing tips for years before finally signing up for his three-month coaching series. I’d grown my online sales over the years from $400 a month to $45,000 a month, but I had hit a plateau and just couldn’t seem to go any higher. I had a decision to make: I could continue to read all I could about online marketing and sales over the next several months, work even harder, put in more hours, and hope that I could increase my sales, or I could cut to the chase, hire Perry and be done with it. Seems like an easy choice doesn’t it?

Well, the eight grand that I had to pay for Perry’s time (along with travel expenses) had something to do with my procrastinating over the decision for months. I bit the bullet, got on a plane to Chicago and spent two days with Perry. Perry didn’t disappoint. Within the first ten minutes of dissecting my business, he’d helped me reduce my online marketing expenses by almost half, thus doubling my profit. He then went on to show me how to cut my clinic hours by a third while increasing my clinic revenue by a third. Hey, that $8,000 was a bargain!

The financial windfall is great, but for a 47-year old dad with two children and one on the way (read, "I’ll never retire"), gaining more time to spend with my family is priceless! This whole work smarter, not harder idea has got me planning on living in Tuscany doing Skype doctor and patient consults, and flying in every two months for office consults and doctor seminars. Ciao, for now.

 

Dr. Murphree is a board certified nutritional specialist and chiropractic physician who has been in private practice since 1990. He is the author of five books for patients and doctors, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Won’t Tell You, and Treating and Beating Anxiety and Depression with Orthomolecular Medicine. To contact Dr. Murphree or for more information about his Doctors VIP One-on-One Nutritional Coaching Program, visit www.Essentialthera.com or call 1-888-884-9577.

 
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