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Interviews
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Interviews
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Written by TAC Staff
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Friday, 25 January 2013 02:14 |
D r. Tarola earned a BA degree from Marshall University, 1973 and was a Suma Cum Laude graduate of Palmer College of Chiropractic, 1976. He began private practice in Fogelsville, Lehigh Valley, Pa. in 1976. He obtained Diplomate status in Chiropractic Orthopedics in 1983. He was a post graduate faculty member of several chiropractic colleges. From the late 1980’s through 2005, he lectured extensively across the country on various orthopedic topics and case management protocols.
 Dr. Tarola served as president and chairman of the board of the Pennsylvania Chiropractic Society (PCS). He received Chiropractor of the Year award from the PCS and Senatorial Proclamation of Accomplishments from the Pennsylvania State Senate.
He was a consultant to the formulation of the Guidelines for Chiropractic Quality Assurance and Practice Parameters and the Council on Chiropractic Guidelines and Practice Parameters. Dr. Tarola has published numerous articles in peer reviewed journals and contributed to chapters in volumes two and three of the text, Principles and Practice of Chiropractic.
In 2006, Dr. Tarola relocated his practice to the hospital campus of Lehigh Valley Health Network (LVHN), Allentown, PA. His practice was acquired by Lehigh Valley Physician Group (LVPG), a division of LVHN in May 2012. Twenty years ago, an idea such as this would have seemed outside the realm of possibility, however today, it appears as one of the potential future realities for a chiropractor entering practice. Read what Dr. Tarola had to say in this one on one with The American Chiropractor Magazine, when we discussed his story.
TAC: What kind of practice did you have? Was it a pain-based practice? Was it a wellness type clinic?
Tarola: My practice was and is a fairly typical chiropractic practice. We primarily see patients with back, neck and headache disorders. But we also treat patients with extremity disorders of all types. Both me and my associate have diplomats in Orthopedics and focus on orthopedic conditions. We have seven additional dedicated staff members. The practice sees over 300 patient visits per week with 50-60 new patients per month, most of which are medical referrals. All the staff was hired by LVPG and we still function as we did prior to acquisition.
TAC: What kind of techniques would you use in your practice? Are there any specific or general types?
Tarola: We use fairly standard chiropractic techniques including various forms of high velocity adjusting and mobilization techniques, drop-table techniques, distraction therapy, pelvic-blocking and myofascial therapy including instrument assisted techniques, and of course exercise instruction. We do a limited amount of nutritional counseling. We use various modalities on a relatively limited basis, including ultrasound, electrical stimulation, and mechanical traction. Most importantly, we communicate with our patients to make sure they understand their condition, have reasonable expectations of recovery and a plan if they do not respond as expected. And we educate them on prevention and lifestyle measures.
TAC: How did the health network approach you? And what was it about your clinic that made them interested in acquiring it as an asset?
Tarola: I’ve had very good relationships with the medical community in my area for over 25 years. Over the last 10 to 12 years, a prominent spine surgeon,  pain management physician and I have been discussing the concept of a multi-specialty spine program. Because of the health network’s prominent role in serving our community, we decided a number of years ago that it would probably be best to initiate this program through the network.
The idea sat idle for a time and then six years ago it resurfaced and I was enticed to move onto the main hospital campus in preparation for the development of this spine program. I relocated there, but maintained an independent practice. I joined the hospital staff to create this multi-specialty spine program. Once again it was put on hold.
About two years ago, the health network formally accepted the concept of a spine center, decided to fund it, and we began meeting on a regular basis to develop the program. The team included select members of the neurosurgery practice, the pain-management practice, two physiatrists, me and my practice associates, and numerous administrators. We formulated a process, with evidence focused clinical pathways and algorithms, similar to other spine programs such as Texas Back Institute and Jordan Hospital. It was formalized and kicked off in February of this year. At that point, the health network asked me to consider joining. This concept was advocated by many of the medical providers and some administrators I’ve worked with over the years. That’s how those discussions began, in terms of melding my practice into the network. Then through negotiations we turned the concept into a reality.
TAC: It sounds like the relationship has been very cordial and professional? Would you say that that’s been your experience, that they’ve valued your expertise?
Tarola: No question. My input to the spine program was equal to all others involved. Their approach to me and my practice during the negotiation and acquiring phases was the same and equal to their approach to any other medical practice that has come on board over the years. LVPG includes both primary and specialty practices. The network includes almost 1,000 beds at three hospitalsites, a Level I trauma center, a children’s hospital and numerous outpatient clinics. So it’s a very large and complex organization. But yes, they were professional and equitable.
TAC: Great. What was it that you had done, or have done, throughout that helped you establish your credibility to the hospital?
Tarola:Competency in clinical practice, making appropriate referrals and proper communication. It’s important for us as chiropractors to understand our strengths and weaknesses, and the strengths and weaknesses of all other providers that treat the same or similar conditions. All providers have certain things that they do well, certain patients that respond well to their care, and we all have limitations.
TAC: Absolutely.
 Tarola: It’s important to be able to communicate with all providers on their level, and with confidence. To make it known that you know what you can do and can’t do, you know what their potential is and what their limitations are, and you communicate that in a professional, matter of fact sort of way. They develop an element of respect, then trust and referrals start coming your way. I would say that’s largely how my reputation developed in my community. And then it spreads; it sort of snowballs. Providers talk to other providers.
There are a lot of medical providers that would like to refer patients to chiropractors; they just don’t know whom they can trust for their patients. Many of our patients are also patients of other medical providers, and discuss their experiences. If they get the perception that there was excess or prolonged treatment, inappropriate treatment and unwillingness to communicate, their view of that DC will be tainted.
TAC: How do you establish the limitations of chiropractic care or the care that you give to your patients? How do you demonstrate those limitations to someone that may question you?
Tarola: Through education, scientific evidence and experience. Response to treatment becomes quite clear to those that pay attention to their own clinical outcomes. The history and physical examination usually provide enough information to determine if a patient is a candidate for the type of treatment we offer. Evidence tells us that if our treatment is going to be effective, we should see a reasonable response within a rather short period. Some studies indicate effectiveness can be predicted after the 1st or 2nd treatment. If our treatment is the best option, we suggest a short trial, 2 to 3 weeks, but also inform them of other viable options, and they decide. If the patient has clinical characteristics that suggest another provider or another form of treatment would be more effective under the circumstances, we inform the patient and initiate the referral. It is important however to know what forms of treatments are available to address the patients immediate needs, and which providers in your community are most proficient at providing those services.
Making appropriate referrals to the appropriate providers at the appropriate times builds a level of trust in those providers that you have the competence to know not only when and who you should treat, but when and whom they should treat. All providers prefer to see patients they will have success with. Referring only difficult cases or patients that have been therapeutically exhausted will not be appreciated or engender trust.
Our practice approaches become known to the people and providers in the community. We are not islands anymore. The patients we see also see other providers, primary care docs as well as specialists. These providers take histories, and patients will reveal their experience with their chiropractor. If they present a history that sounds questionable in terms of the condition the DC was treating, the amount or duration of treatment they received, the kinds of recommendations that were made, a reputation can develop. That kind of information sticks.
TAC: Dr. Tarola, do you send them there with a report, or would you communicate that with the physician that you’re referring them to via phone? Do you communicate at all with that doctor? Or just arrange the appointment?
Tarola: Early on in practice, I would always telephone them and follow up with a report confirming the information that I addressed on the telephone. I  would discuss my assessment of the patient’s condition, treatment provided to that point if any and results of same, why I’m referring and for what, i.e.; evaluation only or evaluation and treatment, and what kind of treatment I felt was appropriate. For those who might want to position themselves similarly, I think you have to start out that way. It’s necessary to communicate as much as possible, make sure the communication is proper, appropriate, and that the terminology used is germane to all healthcare providers. Avoid using chiropractic jargon that no one else would understand.
I would also always indicate if I intend to continue to follow the patient and manage the patient’s case during and/or after they see the patient. And there was almost never a problem with that, providing it was reasonable and appropriate for the patient. I would never just transfer patients to medical providers unless I felt I had nothing further to offer. I would always make sure that they knew that I knew what the patient had, that I knew the treatment I could provide and how that would benefit the patient, and that I knew the treatment they could provide and how that would benefit the patient. Nowadays, although I still often communicate in this fashion, my relationship with most providers is such that a referral form is adequate.
TAC: During the first, 15 years, when you were doing a lot more of this, you were sharing research that you were acquiring with your medical providers on the benefits of chiropractic, as well as acknowledging the value that they represent. Would that be accurate?
Tarola: Yes, and still do. Any viable, valid research—on manipulation, or on something germane to their [medical providers] specialty—I forward new published articles or guidelines documents that pertain to spinal surgery, different types of surgical procedures, surgical rates, pain-management, rehab and other data—whether the research is favorable or unfavorable to their specialty or to mine. It’s important to be objective. I would send a short cover letter and say, “I don’t know if you saw this. I thought it would be of interest to you,” and maybe add some of my own thoughts on the material.
TAC: How, in your opinion, can your experience with your health network affiliation translate into national success for doctors of chiropractic?
Tarola: I certainly hope that it can serve as somewhat of a model for other chiropractors that have, or are developing these kinds of relationships. It would be my hope that this will be an impetus for other institutions to consider this type of integration. Chiropractic has evolved from a point of isolation 20 years ago and prior, to a point of acceptance, where a good percentage of the medical community and the general public understand the value of our services, and want to integrate these services. In my community, most of our orthopedic groups now have employed chiropractors. Now the largest healthcare organization in the Lehigh Valley has actually acquired a chiropractic practice, which as far as I know, is a national first. There are a number of chiropractors who are on staff or employed at various hospitals, but I am unaware of another one that has actually acquired a practice.
TAC: I haven’t heard of another, so I think you’re right on that. Now, do you see a change in the chiropractors you see coming out versus those chiropractors that may have been around for the last 40 years? How do you see chiropractors differently?
Tarola: There is a definite shift to an evidence focused approach to practice. Our educational institutions are emphasizing it more and more. Third party payers are essentially requiring it for participation. And there is a plethora of evidence on the things we do most that can’t be ignored.
TAC: On Pubmed, Google, Medline, the research journals...
Tarola: Everywhere. But I’m concerned that some of our higher institutions are still not training our students adequately enough to develop a scientific mindset. When I say scientific, that does not suggest that our practice be limited to published research. Evidence-based does not mean evidence-only. Much of what all providers do has limited supporting evidence. Evidence-based practice combines the integration of individual clinical expertise, provider experience and patient preferences with the best available evidence.
TAC: Do you feel that chiropractic’s future is tied to integrative services such as this?
Tarola: Absolutely. It is becoming more and more difficult to survive as a solo practitioner or small group. Third-party payer and government policies and processes make it attractive to be part of a larger institution or group that has some negotiating power. And these institutions are recognizing that they have to offer all available services to stay competitive.
TAC: How would you suggest that other chiropractors position themselves to take advantage of or create these opportunities? You may have already covered this, but to sum it up.
Here again however, being integrated into a larger group or institution that has influence and negotiating power might help to mitigate the effect of these trends.
Tarola: Develop an expert knowledge base of and demonstrate competence in clinical practice. Study the pertinent literature. Understand our strengths and limitations and that of all other providers that treat the same patients we see. Practice professionally and ethically. Avoid incorporating questionable business processes and therapeutic procedures. Communicate in a logical, professional manner and do it as often as possible. Always look for opportunities where you can communicate with local providers and health care leaders.
TAC: With your current perspective, do you have any thoughts on the changing landscape of national healthcare? How that may affect chiropractors and their roles in patient management? Any perspective on that at all?
Tarola: Even the hospital institutions don’t know how they will be affected by the new healthcare policies. If chiropractors are included in the process, we’ll have to adapt to the process. It’s pretty clear however, that the trend is more outside oversight. And this is occurring for all providers including hospitals. More and more therapeutic and diagnostic procedures require precertification. That trend is likely to continue. Limitations on treatment frequency, duration and methods will continue to be imposed. Here again however, being integrated into a larger group or institution that has influence and negotiating power might help to mitigate the effect of these trends.
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Interviews
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Written by Cory Littman, DC, DAAMLP
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Monday, 24 December 2012 06:40 |
D r. William Owens has been in practice for 15 years in Buffalo, New York. He has a practice that focuses on the care and triage of the traumatically injured. Early on in his career, Dr. Owens had the opportunity to help build two hospital-based chiropractic clinics: one of which allowed chiropractors to become credentialed as medical staff as opposed to allied health professionals, and the other being housed in the rehabilitation department at a level-one trauma center. He is President of the American Academy of Medical Legal Professionals and the Director of the Academy of Chiropractic’s MD Referral Program, which among other things credentials doctors of chiropractic to present lectures approved for Category I AMA continuing medical education credit for medical providers.
 In an interview with Dr. Cory Littman, Dr. Owens shares some of the ways that he is helping medical doctors collaborate with chiropractic as a first line option for spinal related problems. Dr. Owens is creating the paradigm shift where the Primary Care Medical Physician coming out of Medical Residency has accepted chiropractic doctors as primary care for everything spine.
Dr. Cory Littman: You have started the first chiropractic elective in a medical residency program in the country. This is not part of a complementary medicine or integrated medicine initiative; this is with regular family practice residents. Can you expand on this a little?
Dr. Owens: Sure, the chiropractic elective is the first of its kind in the nation and is part of the elective rotation for the family practice residents at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. The residents, as part of their program, have the opportunity to shadow me in my practice during regular patient hours.
Dr. Cory Littman: How do you talk “chiropractic” with residents?
Dr. Owens: First, I want to mention that a chiropractor’s curriculum vitae (CV) is a very important part of building relationships. This is your professional story and shows your level of expertise and credibility. This is where the "rubber meets the road." The MD is most concerned with your ability to handle complex cases and not miss anything. They are not as interested in technique as your diagnosis skills, so when I start the conversation, we talk about the tough cases that I have managed. I like to discuss disc herniation, central stenosis, claudication and post-surgical care.
When I have the Medical Resident in my office and there is an interesting case of ligamentous instability or a large central herniation, I sit and review the MRI with them. I always put myself in a position of teacher, but I also ask a ton of questions. That is how I learn, too. I try to learn as much about the medical-education model as possible. That only helps me to reach out to local treating MDs because now I know how they think.
When the MD and I talk chiropractic, I split it into two very simple sections. First, there is the simple biomechanical lesions side: we provide specific chiropractic adjustment to the area of fixation to break adhesions, increase white blood cell proliferation, reset the muscle spindle reflex and circulate synovial fluid. I tell them those are generally the patients that we see the least. I then discuss the patients that I may see for the rest of their lives for chronic pain management. They understand pain, so that is where I start. I discuss stimulation of the central nervous system and how we can modulate pain at that level without drugs or surgery. I show them that these are patients not unlike those that they prescribe blood pressure medicine or diabetic medicine to for the rest of their lives. We are not curing them; we are managing them. The cool thing is they get to see firsthand the difference between a specific segmental chiropractic adjustment versus one that is generalized for maximum central nervous system stimulation.
I discuss stimulation of the central nervous system and how we can modulate pain at that level without drugs or surgery.
Their eyes always seem to get larger with an aggressive adjustment, even more so when the patient stands up and says, “Oh, my God, thank you so much. I feel so much better!” That creates a very visceral understanding in the medical resident about what we do.
Dr. Cory Littman: What is the most interesting thing a Medical Resident has said to you?
Dr. Owens:The most interesting thing came from the very first Medical Resident that I had in my office, and when I asked him why he was here, he said, “For a few reasons. First,” he said, “I want to see your physical exam, and second I want to see how your patients react to your treatment.” That was pretty profound to me because that represented the most fundamental aspects of the doctor/patient relationship. All the bells and whistles we try to hold onto and all the fancy techniques we spend thousands of hours learning, and that was what he wanted to see. Interestingly enough, he said at that end of that first day, “Wow, that is a pretty in-depth examination, I never expected that you would have been that thorough.” Regarding the doctor/patient relationship, he said, “I cannot believe how many of your patients said thank you, and many felt comfortable hugging you. I have never experienced that before. That is amazing.”
Dr. Cory Littman: How do the Medical Residents see chiropractic fitting into their practices?
Dr. Owens: The residents have many concerns about managing chronic conditions. After all, they are the most time consuming, costly and difficult to manage in a primary care office. Those conditions are the big three: cardiovascular disease, diabetes and musculoskeletal conditions. The musculoskeletal patients essentially clog up the flow and disrupt their day. Imagine the primary medical doctor walking into a treatment room to check on a blood-pressure reading, and the patient says to the primary doctor, "I hurt my back last night, and my right leg is giving out and numb." That is commonplace for us but throws a real monkey wrench into their day. They are looking for qualified professionals to be able to be the portal of entry for those patients.
 Dr. Cory Littman: You mentioned something in one of our earlier conversations that I feel is important to bring up here. You said, “Nowhere in their training, medical school or residency are primary care medical doctors instructed to refer musculoskeletal conditions to physical therapy only.” Can you expand on that for the readers?Dr. Owens: Yes, that is a great point. When I have conversations with the Medical Residents, I ask as many questions as possible to learn from them. Since musculoskeletal conditions are so common and have been such a burden on the healthcare system, I was interested to learn what they as primary care family physicians are taught to do when that patient walks into their office. I was always under the impression that they were instructed to “send to physical therapy” first. That turns out, at least in my experience, to not be true at all. In most cases the Medical Resident asks the attending what to do. My point is that they are being taught to, when needed, refer to the most qualified, conservative care provider. That may be a physical therapist; it may be chiropractic or others. How you position yourself and how you can help them relieve the burden is the important part. Providing them with research on chiropractic care is a very big step in this process. I should also point out that the Medical Residents really see chiropractic as different than any other profession. That is the reason in the past that they were reluctant to refer, and it is the reason when they are educated that they refer and refer often.
Dr. Cory Littman: Why are the Medical Residents so interested in research?
Dr. Owens: Great question. Readers have to understand that published, peer-reviewed, indexed research is what protects patients from crazy and potentially dangerous treatments, directs the path of future discoveries and protects against malpractice claims. In basic terms, if there is no research to show that a treatment is a standard part of the daily management of these conditions, the MD runs the risk of being sued should something go wrong. They will not refer for untested treatment, which in the past has really hurt chiropractic. Our academic institutions are publishing more and more research on the clinical and cost effectiveness of chiropractic. That is why we are enjoying more referrals from the medical community. That is how we are gaining access to the 93-97% of the nation that has not experienced chiropractic care. That is how chiropractic will thrive and secure our future.
Dr. Cory Littman: What do you have on the horizon?
Dr. Owens: I’ve been invited to lecture to the second-year medical student in December on the chiropractic perspective on the management of chronic spine pain. I will be there with a physiatrist and an MD that practices acupuncture. The point that I made prior to be being invited to speak was that I would like to address the concerns and questions the Medical Residents have on conservative spine care while they are in still medical school. It seems that it would be much more effective for these concepts to be introduced early on in their education as opposed to six months before board certification. We need to shed some more light on the fact that musculoskeletal conditions are often the number-one reason a person will see their family doctor, and what they are doing with those patients now is clearly not as effective as it could or should be with chiropractic as a first-line referrer. There are plenty of places to get drugs and surgery but only one place to have a provider with the education and skill to handle any conservative spine care case. We are different, and that is our strength if presented in a truthful and educationally centered manner.
I will tell you that I did review my statistics over the last six months, and 90% of my new patients have never been examined or treated by a doctor of chiropractic.
Dr. Cory Littman: Looking into your crystal ball and based on your experience, how do you see chiropractic and medicine working together into the future?
Dr. Owens: In my experience, the Medical Residents that I work with have a genuine curiosity about chiropractic that certainly starts out as skepticism. Their understanding about chiropractic as both a science and an art is based on me teaching and them learning. I focus on current scientific terminology, current research and case studies; that is the only way. I envision every chiropractor presenting continuing medical education to the MDs in their community to share our successes and create an open dialogue. I think it is critical that chiropractors be willing to learn from the MDs in their communities as well. A relationship is a two-way street, and everyone loves to teach. Allow the MD to teach you some things, and you will be surprised how quickly you can build a relationship.
Dr. Cory Littman: How has this affected your practice?
Dr. Owens: This has had a profound effect on me as a doctor, as a chiropractor and as a part of a larger and expanding healthcare community. I will tell you that I did review my statistics over the last six months, and 90% of my new patients have never been examined or treated by a doctor of chiropractic. My compliance is as good as it gets because their MD told them to see me, and I am spreading chiropractic outcomes to the medical community. That is important because many DCs are not as successful as they could be because they are all competing for the now 4.12% of the population that is looking for a chiropractor. I want to clarify, though, chiropractors do not have to start a chiropractic elective to enjoy referrals; all they have to do is reach out and build relationships with the local medical community. Teach and be open to being taught; it is that simple.
William J. Owens, DC, DAAMLP, runs the first chiropractic elective rotation for primary care medical providers at the State University of New York at Buffalo, School of Medicine and Biomedical Sciences.
Dr. Cory Littman is a 1997 graduate of National College of Chiropractic.(National University of Health Sciences). He is currently chairman of the medical documentation committee of the American Academy of Medical Legal Professionals. He maintains a private practice in Lockport, NY where he focuses on treating families and traumatically injured patients. He can be reached at dr.corylittma[at]gmail.com
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Interviews
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Written by William H. Koch, DC interviews
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Monday, 24 December 2012 05:30 |
D r. Jeff Rockwell, DC is a chiropractor, bodyworker and somatic educator, with a passionate interest in the neuroscience of manual therapy. A pioneer in the use of instrumentation in neuromuscular therapy, Rockwell has been a popular teacher on the seminar circuit for the past twenty years. Professor of Clinical Sciences at Parker University for many years, he is the author and producer of numerous manuals, books, and DVDs on neuromuscular therapy and somatic education, and he is a member of the Continuing Education faculty for Parker University. Dr. Rockwell can be reached at www.manualneuroscience.com, touchinghealth[at]aol.com or 831-713-8885.
 KOCH: Jeff, I must tell you that I have been studying your DVDs and am very impressed with your work. The ease, with which you present your material and your knowledge of the details of the anatomy of the entire musculoskeletal system, makes it very easy and enjoyable to watch, understand and apply.
ROCKWELL: Thanks, Bill, . I love and live this stuff. I am always studying, learning, refining and changing what I do as new information and scientific data comes along.
KOCH: That is the essence of being a professional. It is the reason that we say that we are “in practice.” We are never a finished product. If we are not evolving, learning and improving, we are static, stagnant and intellectually dying.
ROCKWELL: I totally agree. We are living in an incredible time. Information is coming at us so fast that it is challenging to keep up. It is very exciting!
KOCH: It certainly is. One of the things that I find so exciting, as well as rewarding, is that every new scientific finding validates our vitalistic philosophy. It is like a beautiful jigsaw puzzle that is taking shape. Science is finally able to give us the technical reasons for what we have instinctively known for decades.
ROCKWELL: Yes, the great thing is that so much is applicable to our everyday care of our patients. It has allowed me to refine my technique by taking advantage of the latest research, especially in neuroscience.
KOCH: Very interesting, I have always said that chiropractic is not about bones and muscles; it is about the brain and nervous system. If it is not about that, it is a lot ado about nothing. Chiropractic is all about neurology, if you are doing it right.
So please tell me about the neurological aspects of what you do because it looks like soft-tissue work.
ROCKWELL: I know it does, but looks can be deceiving. It isn’t about soft tissue. It is all about the nervous system and the understanding of how and why it works the way it does. That has given us a whole new insight into how best to access it and work with it more effectively than ever before.
KOCH: Okay, you have my attention. So how does what appears to be treating soft tissue take on neurological implications?
ROCKWELL: This really is exciting stuff because it brings together some of what we already know academically but positions it where it makes functional sense.
Here is what I am talking about: When we were in chiropractic school, we studied embryology. We learned that the brain and nervous system developed from the ectoderm layer of germinal tissue. We also learned that the skin was also of ectodermal origin. Right?
KOCH: Absolutely, I always found that curious. What is the significance?
ROCKWELL: The implications are huge, Bill. Neuroscience is making discoveries that are dramatically expanding our understanding of how the nervous system works and carries energy and information to every cell of the body.
KOCH: We have known for a long time that the nervous system experiences and records everything holographically throughout the entire body. Is this what you are talking about?
ROCKWELL: Exactly! And I will talk about that in a minute, but I don’t want to get ahead of myself. Let’s talk about the skin. It is not an accident that it is ectodermal, like the nervous system. The skin is, in fact, an extension or an end organ of the brain.
KOCH: I see, just like the olfactory bulb, optic nerves and eyes are extensions of the brain stem.
ROCKWELL: You got it. It is the same thing. Now, think about this: There are six yards of mechanoreceptors under every square inch of skin.
KOCH: That’s impressive. Talk about a tight network. No wonder the skin is so sensitive.
ROCKWELL: You can think of the skin as the most accessible part of the nervous system. We know that the largest population of mechanoceptors lies just below the surface of the skin in the superficial fascia.
KOCH: I am glad you mentioned that. I found your discussion of the fascia particularly interesting when I was studying your instructional DVDs. I would really like to hear more about it. I will just tell you that when you spoke of the fascia as being a semiconductor with a crystalline nature, you really got my attention, because I know that it would not only make it capable of conducting energy, but also capable of generating a piezo electric charge when subjected to deformation.
ROCKWELL: Okay Bill, since you obviously understand the importance of this, let me take it further.
I recently attended the Fascia Research Conference. It only meets every three years, each time in a different country. This time it was in Vancouver; the previous one was in Amsterdam.
KOCH: I’ve never even heard of this group. Were there many chiropractors there?
ROCKWELL: No, chiropractic was not well represented. It’s really too bad because they presented some really great information that is very relevant to us.
KOCH: Great, tell me about it.
ROCKWELL: I am going to give you a trail of breadcrumbs to follow. You are going to love this, Bill, because it explains so much.
You will recall that in school when we learned about proprioceptors, the only ones they spoke about were the Pacinian, Ruffini and Meisner’s corpuscles. Later, we began hearing terms like mechanoreceptor and nociceptor, right?
KOCH: Sure, nociceptors being the ones registering pain and mechanoreceptors noting mechanical changes in tissues or joints.
ROCKWELL: Yes, that’s how we have thought of it--up until now. The latest thinking is that nociceptors are in reality more like danger receptors. They not only register pain, but they even alert us to potential danger, such as an unpleasant person or even a situation that doesn’t seem to be “quite right.”
KOCH: I see what you mean: like an indefinable thing that causes the hair on the back of your neck to stand up; that intuitive sense that is more quantum than triggered by one of the six senses.
ROCKWELL: Right, something that you know but can’t quite put your finger on why or how you do [know]. Wild, isn’t it?
KOCH: Yeah. At the risk of sounding like I’m stuck in the 1970s: “Far out!”
ROCKWELL: I want to tell you more about the mechanoreceptors and, specifically, the nociceptors. Stimulation of the mechanoreceptors affects neuroplastic changes in the brain. Now here is the really interesting part. At the Fascia Research Conference, we learned that high-velocity thrusts, as in the P-A thrust of the typical adjustment, affect the higher centers of the brain, causing neuroplastic changes that last only 20 seconds. However, very light tangential forces cause positive neuroplastic changes in the brain that last 20 minutes.
KOCH: So light forces create more positive, long-lasting changes in the brain than do heavier ones. That sure is counterintuitive.
ROCKWELL: The way it works is that the Ruffini corpuscles are slow to respond but continue to buzz and stimulate the brain for about 20 minutes, as opposed to the Pacinian corpuscles that only fire for 20 seconds. It is naturally easier to piggyback on 20 minutes than 20 seconds of brain imprinting.
KOCH: What you are saying is that the mechanoreceptors do not like strong compressive forces but are most responsive to tangential forces. Would that be as you show in your DVDs when you use the Therapy Edge™ attachment on a VibraCussor®?
ROCKWELL: That is exactly what I am doing. That’s why Ed Miller at Impac, Inc. designed that attachment.
KOCH: I have a Therapy Edge™, but when I first got it, I was not crazy about it. That is because I didn’t understand how to use it. I started getting used to it only after watching how you use it. Now that I understand the neurophysiology behind it, I have to keep reminding myself to go lightly. It just requires a little retraining for an old full-contact chiropractor like me.
ROCKWELL: I like to explain it this way, Bill, we have all learned to speak to the body in “mesoderm-ese.” That is, we have been used to working on muscle and skeletal structures, which come from the mesoderm layer of embryonic tissue.
Now we find that in many instances, the body would rather be spoken to in “ectoderm-ese.” It’s like another language that the brain understands better and is more responsive to. It makes sense because the tissues we are working on are of ectodermal origin.
KOCH: This might be a silly comparison, but if you speak to a child in a soft voice, you will most likely get a better response than if you constantly yell at him.
ROCKWELL: I don’t think it’s silly at all. I think it’s a good comparison. It is all about imprinting the brain.
KOCH: Jeff, what you are talking about is a new paradigm in neurology.
ROCKWELL: It certainly is a new paradigm: A different understanding of how the nervous system works. Think about this. Nerves under pressure or tensile stress become hypoxic. Pain isn’t just reporting on that stress, it is a cry for movement to get the microcirculation of blood around the nerves going.
KOCH: I can’t argue with that logic. It is the nerves’ way of saying that they are starving and gasping for breath.
ROCKWELL: This is why we all have a type of reflex behavior known as pandiculation. You know it as the urge to stretch and yawn. It is another way in which the body causes us to move instinctively.
KOCH: That makes sense. We see that in our pets. Dogs and cats stretch and yawn all the time. It is an instinctive activity that keeps these naturally active predatory animals strong and supple in a much more sedentary lifestyle than they would have in the wild. It is also why the practice of yoga is so beneficial to us.
ROCKWELL: Speaking of blood flow, we all know that the cerebellum modulates muscular coordination, but we recently learned that it controls the distribution of blood to all of the organs of the body.
KOCH: Wow! That is huge. It explains why even a mild level of cerebellar ataxia is so devastating to the whole body.
I have seen a number of cerebellar ataxias through the years and have had good results with them. I currently have two young women in my practice who have Fredrick’s ataxia, a genetic form that is only passed on if both parents have the gene.
Both have benefited greatly by chiropractic. While there is no cure, I have been able to slow the progressive deterioration that people with it normally experience. It also explains why I have been successful in improving the circulation to their extremities. I’ll bet that I will do even better when I speak to their bodies in “ectoderm-ese”.
ROCKWELL: Bill, you obviously get all of this, so I am sure you will agree with another paradigm shift.
It is for us to move away from being an operator to an inter-actor. An operator, in the way a surgeon operates on a patient, is purely allopathic. It is something that the patient submits to in faith. When we work with our patients as an inter-actor, it is a joint, cooperative effort.
KOCH: I agree with that. It is symbiotic and much better aligned to our vitalistic approach to healthcare.
ROCKWELL: That’s it, Bill. I believe that it is the direction we need to go as a profession.
KOCH: There is no doubt in my mind that you are correct. It is the right message for our time. Healthcare as we have known it is changing as we speak. Now more than ever it is important for people to be proactive and informed in order not to be victimized by the medical industrial complex which is already rationing care based on cost effectiveness, not patient needs.
Those of us who practice interactively with our patients will be well positioned to be the natural choice in healthcare for those who are sophisticated and smart enough to seek our services.
ROCKWELL: Amen to that. We are on the same page.
KOCH: Thanks Jeff. I really enjoyed this conversation and certainly learned a lot.
Dr. Bill Koch is a 1967 cum laude graduate of Palmer. After 30 years of practice in the Hamptons, NY, he retired and moved to Abaco, Bahamas, where he and his wife Kiana travel by boat to provide chiropractic care to the residents of the remote out islands. Dr. Koch, author of the book Chiropractic: the Superior Alternative, writes a blog: Mentoring Young Chiropractors http://DrWilliamHKoch.com and Chiropractic the Superior Alternative and the newly published Conversations with Chiropractic Technique Masters (available at Amazon.com). He may be contacted at outislandd[at]hotmail.com.
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Interviews
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Written by TAC Staff
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Monday, 24 December 2012 02:21 |
H oward F. Loomis, Jr., DC has been the leader in the clinical application of plant enzymes and is the person responsible for bringing food enzyme nutrition to the forefront of the health care field. After graduating from Logan Chiropractic College in 1967, he entered practice in Missouri and practiced there for 26 years.
 In 1980, he was introduced to the work of Dr. Edward Howell, M.D. and his Food Enzyme Concept in his books, Enzymes for Health and Longevity and Enzyme Nutrition. It changed the entire focus of Dr. Loomis’ practice.
In 1985, after years of work on the clinical application of plant enzymes, Dr. Loomis founded 21st Century Nutrition (now known as the Loomis Institute™ of Enzyme Nutrition) for the sole purpose of educating other health professionals on the use of plant enzymes.
He has lectured extensively at various chiropractic colleges as well as chiropractic state associations. He currently writes columns in several recognized chiropractic journals and other publications.
Dr. Loomis practiced continuously until the end of 1993, when he sold his practice, retired, and moved to Madison, Wisconsin to develop his own enzyme supplement company, Enzyme Formulations, Inc.
In 2002, the Loomis Institute™ was approved by the State of Wisconsin as an educational institution, a relationship that continues today.
In 2007 he joined with his alma mater to create the 72-hour Internal Health Specialist Certification Program for the Logan College Postgraduate Department. This program is open to chiropractors as well as chiropractic students who have reached their 7th trimester. Thousands of health care practitioners around the world rely on the education and products developed by Dr. Loomis for their clinical success and fulfillment.
TAC: What kind of products and services do you offer chiropractors?
Dr. Loomis: The Loomis Institute teaches chiropractors an objective and scientifically valid system of physical examination for determining nutritional need, as well as the best information available about food enzymes and how to use them in practice.
Enzyme Formulations, Inc. offers food enzyme and herbal supplements based on specific individual patient need, not on a one-size-fits-all concept.
TAC: Tell us more in depth about the services and products you offer chiropractors and how or why you offer them.
Dr. Loomis: Because of the success we enjoy as a company, we are able to provide unprecedented clinical support to the practitioners who attend our seminars, free of charge. This has always been something I would have found helpful when I was in practice, and I am happy to be able to offer it now. For example, if a chiropractor has a question about how to use a product or what to recommend with a specific set of clinical results (24-hour urinalysis, case history, and/or physical exam findings), they have access to an experienced chiropractor on staff who will guide them through the process of recommending a specific plan for that individual patient.
TAC: Are chiropractors the only professionals that use your methods for their patients?
Dr. Loomis: No. While the Logan Internal Health Specialist Certification Program is offered specifically for chiropractors to utilize their unique education, the Loomis Institute seminars train many different modalities of health professionals in the use of food enzymes.
TAC: How many practitioners have learned the Loomis System?
Dr. Loomis: Over 1000 health care professionals have learned the Loomis System and are successfully incorporating it into their practices.
TAC: How did you get interested in enzyme therapy and the effect enzymes have on the body?
Dr. Loomis:My interest was in understanding why, when there is no history of injury, some people develop back problems and others do not. Was there a nutritional component? I could never find the clinical parameters that would allow me to say “this person needs calcium, this one needs magnesium, that one needs calcium AND magnesium, or that one needs better protein digestion.” At the time, I was convinced there was no objective means of using nutritional supplements. It seemed would be a nutritional component because the body’s ability to digest and assimilate protein (and consequently improve its ability to carry calcium and other nutrients to the tissues) is very important. It has been my experience that most people who have symptoms of musculoskeletal dysfunction, such as osteoporosis, herniated discs, bursitis, leg cramps, and many more problems, do not readily digest protein. However, by 1979 I had given up trying to apply the objective measurements of physical examination, blood and urine testing to the practice of nutritional supplements, having failed to find consistent results.
 In 1980, I was fortunate to be introduced to the work of Edward Howell, M.D. and his “Food Enzyme Concept.” After reading his two books, Enzymes for Health and Longevity and Enzyme Nutrition, I was convinced that he had found the missing link for providing consistent results in clinical nutrition.
Dr. Howell had graduated from the University of Illinois medical school in 1919, the year before the first vitamin was discovered. After graduation he practiced at the Lindlahr Institute in Chicago, which was the Mayo Clinic of his day. They specialized in the treatment of chronic degenerative disease using a system of fasting and raw food diets. This was in a time period prior to the discovery of insulin, and diabetes was the major degenerative disease. Cancer was not as readily diagnosed as it is today, and diabetes was the number one killer.
Dr. Howell was impressed with the results obtained with raw foods and fasting and he struggled to find an explanation. He became convinced that there had to be something else in food besides protein, carbohydrates, fat, vitamins and minerals. This led to his eventual fascination with the enzymes found normally in food and the role they played in pre-digestion before stomach acid can be produced.
In the early 1980s I made trips to Ft. Myers, Florida and spent time with Dr. Howell in his home. He allowed me access to his accumulated notes, including his extensive bibliography for Enzymes for Health and Longevity. He was very gracious in sharing his time and information with me and he completely changed my attitude about nutrition and the importance of enzymes. Gaining permission to copy many of his accumulated notes and bibliography was incredibly valuable since they were destroyed when he died in the late 1980s.
TAC: What type(s) of diagnostic testing procedures do you use and why?
Dr. Loomis: We utilize a Case History and review of systems physical examination with chiropractic postural and spinal evaluations, coupled with range of motion tests. When needed, we order blood tests and 24-hour urinalysis testing. We place emphasis on determining the causes of a patient’s symptoms and the stress responsible for them. Using this procedure is time-honored in the healing arts and stands up to legal as well as scientific scrutiny. It also makes it possible to develop a specific, science-based plan for each patient.
TAC: How has the evolving understanding of stress points affected current approaches to teaching this type of therapy?
Dr. Loomis: In our seminars, we ask the class, “Who in this class considers themselves to be average?” Of course we never get a positive response. My point is this: nutrition is often practiced as is pharmacology, using a bell curve to determine what and how much of a particular supplement the average person needs instead of treating each body individually. The Loomis System uses palpation of muscle contraction (stress points) to determine when visceral dysfunction is responsible for a patient’s symptoms and is causing and perpetuating structural misalignments and subluxations. In other words, once the cause is known, the treatment becomes obvious.
The beauty of the stress points is that they are objective. They are either positive or not. Paired with the 24-hour urinalysis and our case history form, a very clear, individualized plan of treatment is evident. Chiropractors do not need to guess anymore when it comes to nutrition.
TAC: What types of conditions/patients respond best to this approach to care?
Dr. Loomis: Those who respond best are those whom I call the “walking wounded.” People who have not been diagnosed with a disease, but still suffer with unresolved symptoms. These people are desperate for help, and they are so grateful when someone finds the cause of their symptoms. Their quality of life improves dramatically.
TAC: It's been said by some experts that one can get all the nutritional products they need from eating a balanced diet. What do you say when someone tells you this?
Dr. Loomis: That is true only if you can digest that well-balanced diet. And who decides what the best diet for your specific needs is? Does one size truly fit all? I have noticed that no one in the healing arts specializes in restoring normal digestive function and, if it fails, what compensates for inadequate digestion? Only the immune system. That is why this work fits so perfectly within the chiropractic paradigm for health restoration and maintenance!
The reality is that naturally occurring food enzymes are removed from much of our food supply, and taking digestive enzymes replaces the enzymes that belong in the food to begin with. I do not advocate taking multiple supplements. In fact, in our seminars we focus on improving the diet first, then making sure that diet is properly digested. If these two factors are working well, then multiple supplements are not necessary.
 TAC: What type of chiropractor/chiropractic practice fits best with this paradigm?Dr. Loomis: Because of their educational perspective and unique training in palpation and adjusting, all chiropractors are well-prepared for this type of analytical approach. We do not offer a specific chiropractic technique. This nutritional system is a perfect adjunct to any type of chiropractic office.
TAC: How do you see nutritional supplementation changing in the future?
Dr. Loomis: The answer to that question lies with the pharmaceutical industry. They and the Food and Drug Administration will determine that. However, I have always believed that eventually food enzymes and improved digestion will surface as the key nutritional component.
One thing is certain, food enzymes will not go away and they cannot be patented. That is why I have endeavored to bring this work into the mainstream chiropractic education and place our profession at the forefront of health maintenance.
TAC: Where do you see the future of chiropractic headed?
Dr. Loomis: Hopefully the profession will find its way and fulfill its promise as it was envisioned by D. D. Palmer.
TAC: Any final words for our readers?
Dr. Loomis: Illegitimatis Non Carborundum.
You may contact Dr. Loomis at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
or 1-800-662-2630.
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Interviews
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Written by TAC Staff
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Sunday, 25 November 2012 20:13 |
D r. Peter Heffernan has been in practice 37 years in the same location in Waukesha, Wisconsin. He built a 100-patient-per-day practice within one year of graduating from Logan College of Chiropractic in September of 1975. By the end of his second year in practice, he had built a 500-patient-per-week practice. “We did a 90-minute pre-care class educating patients and families as to what chiropractic was. It was very successful. We started with 100 new patients a month with no outside advertising,” Dr. Heffernan explained. “I hired many associates over the years, and I was fortunate to have a partner for over two decades. We sustained a practice that saw between 20,000 and 30,000 patient visits a year,” he concluded.
 As a chiropractic educator, Dr. Heffernan taught the 90-minute chart presentation for Renaissance International from 1978 through 1980. He has a Fellowship in Applied Spinal Biomechanical Engineering (ASBE) and served as its executive director from 1985 to 1992. He also served on the Board of Directors of the Wisconsin Chiropractic Association for six years. He currently serves on the Board of Trustees at Life University.
“I’m 60 years old this year, and I'm still very excited about being in practice. For me, it's always been about long-term involvement, planning a career that will last well over 50 years. I've enjoyed refreshing myself when I'm not in the office. You have to take time off and enjoy things.”
To that end, Dr. Heffernan was a competitive windsurfer and still windsurfs recreationally. He began windsurfing in 1985 and has won several trophies. When he sailed long boards, some races were 14 to 15 miles long. He also surfed with short boards, which are high speed and have a smaller sail and board for faster winds.
“One of my favorite spots is Padre Island near Corpus Christi, Texas, where we sail in Laguna Madre, a beautiful 80-mile-long body of water about two-and-a-half miles wide. Padre Island lies off the coast of Texas, and if you sail the water between Padre Island and the mainland, it's only about four-and-a-half to five-and-a-half feet deep. So, if you fall off your board, you can touch bottom. You're getting more chop than you are getting big swells, so it's a great place to learn how to become a better windsurfer.”
Relating windsurfing tech to chiropractic tech, Dr. Heffernan says, “Windsurfing is all about physics: how you stand, where your weight is, your foot positioning. If you're biomechanical oriented, if you're into sheer force, velocity and gravity—all the basic principles of physics—it's really, really fun.”
The American Chiropractor (TAC): You are a proponent of Applied Spinal Biomechanical Engineering (ASBE). What should readers know about this adjusting technique?
Heffernan: The fundamental is that kinesiopathology, which is the motion component of the subluxation complex, is also the most objectively assessed component of the subluxation complex. When we adjust vertebrae, we want to know which vertebrae are hyper-mobile, which ones are hypo-mobile and what direction the vertebra has failed. ASBE quantifies the motion component of the subluxation and also the direction of failure.
We use the XYZ three-dimensional coordinate system that was originally developed by White and Panjabi in their book Clinical Biomechanics of the Spine back in 1978. And Harrison's work in biophysics also incorporates the three-dimensional coordinate system. Specific segmental adjusting is done along the architecture of the facet-joint plane.
The work was originally developed by Dr. Ronald Aragona from Manchester, New Hampshire. There are over 5,000 isometric, isotonic and isokinetic-coupled maneuvers. It's a very specific, easy system to use and practice.
TAC: What are the primary principles of ASBE?
Heffernan: One of the primary principles of ASBE is that you're trying to restore the spine to bilateral symmetry of function. If the spine is more efficient or stronger on one side than the other, the patient does bilateral exercise like walking or riding a bicycle or anything that is repetitive and bilateral.
When a person who has an asymmetry in their spine (where one set of muscles is tighter and thicker or one set of muscles is more efficient than the other) does bilateral exercise, the efficient side becomes rapidly more efficient than the inefficient side, and the gain or the net result of bilateral exercise is more imbalance. So we assign exercises where a patient would do much higher repetitions of exercises on the inefficient side, and over time this would result in an improvement in bilateral symmetry.
The adjustment itself will help, but the patient has to be involved in the rehabilitative process in order to get the spectacular gains. Otherwise, you are often just managing instead of correcting. And these days you must also be mindful of the key factors of nutrition.
TAC: That is an interesting comment given that you have considerable chiropractic tech. Why do you feel it is important to add a nutritional component?
Heffernan: “I was actually resistant to the whole area of nutrition for years because I just wanted to stay a biomechanically based, subluxation-correcting chiropractor. But I think it's obvious to anyone who's observing the world that we live in that the country is morbidly obese; people are highly inflamed.
 It's just been well documented over and over that when you're dealing with nutrition, there is a condition that has been termed “post-prandial dysmetabolic syndrome,” which is eating hollow calories and the body treating it as a poison. When we're consuming non-nutritive, hollow calories, the body interprets it as a poison, and it creates an inflammatory response.
All the chronic diseases that our country is suffering with—arthritis, heart disease, diabetes, autoimmune illnesses, Alzheimer's —all the diseases that we see that are so prevalent in our society are all different forms of chronic inflammation.
Chiropractic is based on the principle of addressing stress, toxins and traumas as the cause of subluxation, and so it should become absolutely obvious to any chiropractor who’s serious about helping patients get better that patients are just not holding their adjustments. It's becoming difficult to even give them an adjustment. You have to use a lot more effort. It's just a lot more difficult to give a spinal adjustment to a highly inflamed, morbidly obese patient. So you have to address nutrition in order to get subluxations correctable, or in order for people to hold their adjustments.
TAC: How did you begin?
Heffernan: It became clear that I had to address nutrition. I started to talk to patients about hollow calories and how they need to eat more nutritive foods, and I started to think in terms of providing fish oil as an antioxidant, as an anti-inflammatory, and also Vitamin D3, which was the “sunshine vitamin,” and general multiple vitamins.
We started to do some nutrition, but we didn't know how to do it. The time component with a patient is critical, so how do you engage them on nutrition in a few minutes and still give them an adjustment and still make a living?
TAC: So how did you overcome that dilemma?
Heffernan: I was fortunate to discover Dr. Freddie Ulan’s Nutrition Response Testing to use as a nutrition system in the office.
This came about because my youngest daughter became very ill. She had been receiving chiropractic care her whole life. She was born at home without drugs and vaccinations. As she got older, she had to have an emergency appendectomy when she was in graduate school. After that she started to get sick; her digestive system started to fail her. It got worse and worse, and over a five-year period it threatened her job, and she's the primary breadwinner in her family.
We had already sent her to other chiropractors, acupuncturists and gastroenterologists to try and help her, and she just got progressively worse. But when she was tested with Nutrition Response Testing and given a program of nutrition, within a few weeks she was feeling amazingly better, and over a period of months she totally regained her health.
I started to send some of my tough patients with autoimmune illnesses and other problems for Nutrition Response Testing, and they, too, were getting excellent results. That certainly got my attention, and my daughter, Amy, and I (she is a chiropractor and my partner in my practice) decided to pursue training in Nutrition Response Testing.
We were initially exposed to Applied Kinesiology and the use of whole food nutrition (Standard Process), and we started to incorporate this in our practice. It was exactly what we were looking for. Ulan Nutritional Systems also has a practice and patient management component to its training that is easy to implement and highly effective.
So with Nutrition Response Testing, rehab and specific chiropractic, we regained our ability to really help people in this modern world where people are so sick.
TAC: Tell me about whole food nutrition. Why Standard Process?
Heffernan: Well, that's something I didn't understand until I started to study it. The body has electromagnetic fields. You have the nervous system that carries electrical energy, multiple redundant energy fields that carry information and energy throughout the body. Even on the surface of the skin, you have electromagnetic energy. And people have a field of energy around their body. So the body is exquisitely intelligent in its ability to interpret the environment, and it can tell the difference between a synthetic vitamin and an organic nutrient.
When you make synthetic vitamins from coal tar, even when you have the amino acid sequence in the vitamin correct, the body still knows it's coal tar.
When you make synthetic vitamins from coal tar, even when you have the amino acid sequence in the vitamin correct, the body still knows it's coal tar. It knows the electromagnetic signature of things that are toxic, and this is why, as an example, synthetically made ascorbic acid doesn't work as well as vitamin C with all of its bioflavonoids and its cofactors.
If you have nutrients that are put together in whole food supplements, it's actually food, concentrated food. It has the electromagnetic signature of natural plants, and the body recognizes that on an electromagnetic level.
TAC: Can you coordinate for our readers the nutrition viewpoint with the fundamental philosophy of chiropractic?
Heffernan: Yes, certainly. Being 60 years old, I lived through a long period where science kept gaining more and more dominance, and we almost turned science into a dogma or a religion.
We went through a long period of mechanistic reductionism and materialism—not giving any credence to energy. But we're living in a quantum world. We understand now that all matter is collapsed energy, so chiropractic aligns itself with that idea that there's a life energy, a life force. And Nutrition Response Testing is highly congruent with basic chiropractic philosophy, utilizing the same intelligence and working with it—whether it's with a chiropractic adjustment to remove interference from the nervous system, or if you're supporting the nutrition that the body needs to rebuild itself and to maintain health.
TAC: I know you have varied interests and hobbies besides windsurfing. What are they?
Heffernan: In the late 70s, I had a patient of mine who was a machinist, and he could do virtually anything. He had an engine machining shop, and he'd rebuild cars. I always had a fascination with trying to understand how an automobile motor or engine worked, how the spark plugs create an explosion, push the pistons down, moving in a sequence, turning the crankshaft.
I bought a 1965 convertible Corvette, a red one with black interior. It was already missing the original motor. I took that car completely apart, re-machined it and welded the frame. I actually took the frame out and had it acid-dipped, took all the bad metal out of it, wire-welded in all new metal, rebuilt the internal and external gusset plates and put the frame back exactly the way it was.
 I learned how to paint, and we did zinc-chromate priming and Imron painting so it will last forever. I put in stainless steel brake lines, stainless steel gas lines, stainless steel exhaust, stainless steel sleeves in the exhaust ports—everything to last for a long, long time. I put a blueprinted 350-horse power motor in the car, all re-machined, with a Mallory ignition system, poly carburetors, dual-plated Edelbrock manifold, and Hurst four-speed shifter. The car would go 140 mph. It was a phenomenal experience.
I've applied that same attitude and philosophy with almost everything I've done in life: Determine an area that you're incompetent in, then work your way into competency, and then unconscious competency. And then just keep doing that over and over and over with many different things in one's life.
Accordingly, what is so remarkable about the Advanced Clinical Training with Ulan Nutritional Systems is that it's the only fully integrated, methodical teaching system of theory and practical work I've ever been exposed to in chiropractic. It eliminates all the confusions. There's a lot of drilling, there's a lot of partnering and learning the fundamentals such as how to rule out “blocking” and “switching,” where the autonomic nervous system is not in a position to be tested.
Dr. Ulan’s system makes applied kinesiology very duplicatable and very predictable in its outcome. It's exciting to see one practitioner after another get the same results and the same findings, and my patients get the ultimate benefit.
Peter Heffernan, DC, is currently enrolled in the Advanced Clinical Training program at Ulan Nutritional Systems, Inc. He practices in Wisconsin and can be reached at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
or his office at (262) 549-4555.
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