Meghan Luttrell's Blog

The Old Argument

So chiropractic is at a philosophic crossroads. Since the conception of the profession, it has been at this same philosophic crossroads; it's really rather remarkable that we have maintained as much of the core value as we have. D.D. Palmer came up with chiropractic, and B.J. Palmer had the vision to make it grow. And from day one there has been interprofessional strife about what chiropractic really is.

Some practitioners view chiropractic as more of a holistic branch of medicine; we try to fix problems from a natural standpoint, and focus on preventional methodology. Others prefer a more physical therapy approach, or, more specifically, treating musculoskeletal disorders with the adjustment as the therapy. Still others (and saddest of all) think that chiropractic school was easier to get through than medical school, so they scraped through and have "Dr." in front of their name, with no clear reason for doing it, other than prestige. I personally know people from every one of the perspectives I just described.

Sherman College's reputation has been founded on the subluxation-based philosophy of chiropractic, as the founders saw it. All things in the body are governed and healed by the body, and locating, analyzing, and correcting vertebral subluxations free the way for the nervous system to communicate clearly, thus facilitating the optimal function of the body. I found Sherman College online, and was intrigued by the word "Straight" in the name, thinking, at first, that it had to do with straightening the spine. As I learned more about the legal struggles of the school, and the unique philosophical grounding, I decided to come here. I learned that "straight" related to "pure philosophy" in the chiropractic realm.

Then, I discovered that within the "straight" crowd is even more fractioning. Some believe that adjusting anything by hand equals straight, be it spine or elbow or skull. Others believe that only adjusting the first bone in the vertebral column is the way to be straight. Usually, as I understand it, the argument has at least upheld that adjustments are important, whether they be administered by a "straight" or a "mixer," that is, one who mixes adjustments with other forms of treatment, usually physical therapy-related.

Over the past several years, though, the discussion has changed. Pharmacology will be added into the curriculum. Probably this will happen gradually, and not while I'm in school, for which I'm grateful. Osteopathy was once a separate and distinct profession of healing, involving manipulation of the joints for the purpose of improving circulation. Now, however, the profession is swallowed by medicine, and now the Doctor of Osteopathy is largely a medical doctor, who prescribes pharmaceuticals, and who also has the basic training to manipulate joints, if they so desire. To what purpose?

I once spoke at my undergraduate college, to discuss my continuing education in the field of chiropractic, and why the profession (and Sherman College) was unique. I spoke of philosophy, and one of the students said to me, "Oh, then I know I don't want to go to that school, because I hate philosophy." What?

You have a philosophy. You may know it, or you may prefer to think you make decisions based on the need of the moment, but there is an underlying drive to your life. Self-enforced ignorance will only get you so far. I encourage you to figure out your drive, before you find yourself at a dead-end one day, thinking "How did I get here?" As for my chosen profession...I don't know where it will end up. The other side of the argument believes that they are right, just as I believe I am right.

I can say I know my philosophy, and I know what drives me. I don't want to practice pharmacology; I want to detect and adjust subluxations. I don't want to electrically stimulate, administer ultrasound, or massage. Honestly, I don't care what the chiropractor down the road is doing in his or her office, as long as they are not hurting people. I guess I picked up the battle flag when I decided to become a chiropractor, but I'd really rather be just taking care of people, by adjusting their spines.

Ski Time

It's that time of year; people are talking about taking a student trip up to ski at one of the several surrounding ski resorts. Yes, we are located in the South, but, we are only a couple of hours from the mountains, where the snow does not fall, but miniscule chips of ice are sprayed all over slopes to create the best we can do here for a ski/snowboard route. My fiance is from out west (Colorado, California, Wyoming), and he is something of a snow snob. He has never snowboarded here; we are pretty much too poor to drop that much cash on a day pass.

I once "learned" to ski. I quote "learned," because I never successfully made a trip down the intermediate slope. I made a permanent residence of the bunny slope, and I learned to slide down in the "snowplow" position like a pro. I do really enjoy watching skiers, though. The crashes are much more entertaining than boarders for me; skis fly up everywhere, legs go in opposite directions, the skiers flip over in impossible positions. And I'm always amazed at the little kids that, totally fearlessly, slide down the mountain, standing straight up, gaining speed until they crash into a snowbank at the bottom...twenty times in a row. I'm too afraid of falling to be that fearless.

Maybe we'll scrape up the cash and I'll try it on the slopes again...hopefully I won't get too much ice burn from crashing.

Happy Thanksgiving

Thanksgiving was great this year.  We drove up to Tennessee (surprise, surprise) after a busy day at the clinic.  The weekend was full of food, Uker (did I spell that anywhere near right??) tournaments, and shopping on the dreaded “Black Friday.”  Plus, my best friend from high school is having her first baby, and I went to her baby shower.  I was having déjà vu the whole drive there and back.  I spent lots of nights there while we were in high school, and even in undergraduate college together. 

Mike and I shared the cabin on the farm with my brother for the weekend.  It was cold enough up there that coming back to South Carolina, with the 40-degree weather, seems warm.  Now, my 10^th quarter is coming to an end, and I’m about to embark on my final year of chiropractic school.

Here is a picture of Deirdre’s baby shower, and the cabin.  Hope you had a great holiday!

By the way...typepad is changing the fonts on my post.  I didn't mean to bold my paragraph in there.  It was exciting though, wasn't it?

 

 

 

 

 

Thanksgiving and the Horrors of "Black Friday..."

 
Here is a picture of the road to my family's house...complete with the skunk.  I’m gearing up to travel north to Tennessee for the Thanksgiving Holiday.  One of the reasons I chose to attend Sherman College was its general proximity to my folks’ place; I’m close to my family, and I like to see them whenever possible.  Anyone following my blog will notice I was just up there last weekend (with the restless wildlife), and now I’m trundling my way up there again…again, to interact with restless wildlife.  This time, Mike will be able to go up with me.

Thanksgiving has long been my favorite holiday; a time of great food, and my whole family (complete with my future in-laws, even) gets together in my mom and dad’s farmhouse.  My brothers and sister-in-law travel in from Florida and Knoxville, my future in-laws come up from South Carolina, and we all stuff ourselves, then I get tortured with shopping on what is called “Black Friday.”  I was once pushed out of the way in a crowded store by a woman in a wheelchair.  I should add that the pushing was actually done by the woman’s impatient daughter, who was using her mother as a battering ram.  Ah, the holidays…such goodwill and cheer!!

A break from clinic, and crisis averted

My mom’s birthday is today, so I went up to Tennessee over the weekend to see her and the fam, and to get some much-needed R&R. Clinic stresses can really build up on us interns, and it can be anything from a difficult patient case, to a busy day in the x-ray department where I work, to wrangling paperwork…or all three in one day! Even though my dad’s been out of chiropractic school for forty years, he still remembers how it was, and he completely understands the hoops we have to jump through in school. Having someone who knows what my experience is like is pricelessly helpful…it lets me know I’m not totally crazy.

On my way back to South Carolina, I got stuck for a few minutes behind some…interesting…traffic. A skunk was out and about, which is kind of unusual, because they are nocturnal. I think this one was getting ready to hunker down for colder weather, and it was kind of old to boot. It trundled along in front of my car for several minutes, before implementing its exit strategy and taking off into the woods. It never sprayed my car (which I am grateful for) but I suspect that it let out a warning puff or two. It’s hard to say whether I was imagining the faint skunk smell or not…I do know that it is unwise to hurry along a crotchety, insomniac skunk. Add ten minutes to my travel time if you have to. In this case, a little courtesy goes a long way.

 

 

"Straight" By Name...No More

As most students here at Sherman College are aware, the name of our school has recently dropped the word “Straight” and is now just  “Sherman College of Chiropractic.” Some people are outraged by this, but I think that faction is few…most students don’t really care, and other students think that dropping the “straight” will attract more students in the future. While I don’t have a passionate opinion about this, I did take notice of the word “straight” in our school’s name in my own search for chiropractic schools. I wondered what made this school different from the others; my dad graduated from Palmer in Iowa and my brother graduated from Life in Marietta. I still think that a school’s philosophy in the profession is a very important reason to choose it.

I’m still wondering what exactly about the word “straight” that deters future students from choosing this school. I think that many young people like the bigger cities and flashier facilities that other schools offer, and we can’t offer either of those things…so a name change won’t make too much of a difference, in my opinion.

On another note, the word “straight” wasn’t added to the name of the college until years after it was founded, because we needed accreditation from a different agency from the CCE. The founding fathers of the school maintained that chiropractors do not diagnose disease; we locate, analyze and correct vertebral subluxations. Now, though, we are accredited by the CCE, and we do diagnose, based on our terms of accreditation. So the purpose of having the word “straight” in the name of the school is obsolete.

Entrance/Exits

Thanksgiving Holiday is looming, and entrance/exit exams in the Health Center are dominating at least two quarter's worth of students' lives right now. 8th quarter is starting sweat, looking over old notes and asking upper quarter interns what will be in the entrance exams. They will pass just fine, I have all kinds of confidence in them. When I took entrance exams, two quarters ago, it was on my birthday...that's right, on my birthday. That was a crappy day, let me tell you! I passed everything just fine, though...I guess that's an ok birthday present. Entrance exams let you officially become a Sherman College intern in the Health Center...ready to start seeing patients, both student and outpatients.

Exit exams are still coming up for me; just before I graduate, I have to pass them. It's kind of a strange requirement; if I don't do well on exit exams, does that mean I've been a crappy intern for a full year? I think it makes more sense to do periodic intern procedure grading (which we already do.) I've heard that exit exams are supposed to kick us in gear and get us prepared for Part IV of the National Boards, which is a practical exam, with actors portraying certain symptoms and case histories, and the interns have to figure out a diagnosis/treatment plan. However...exit exams are usually after the Part IV...so I don't see that they help prepare interns for the National Boards. Exit exams are a part of every chiropractic college (as far as I know), though, so it must be one last chance for the college to monitor the state of intern knowledge and skill before they are set free into the world.

Good luck to my fellow interns who are taking the entrance or exit exams next week! I hope you all do well.

All Hallow's Eve

We had two trick-or-treaters this year; I think the rain discouraged a larger turnout. They were a little girl zombie, and her big brother zombie victim, with some of his brains eaten. Cuddly.

Mike and I met up with some other Shermanites to see a band called The Consumers. We were tipped off to this event by Dr. Power, of the Sherman College Health Center, because his son is the lead singer. Incidentally, the younger Power will be starting his first quarter here at Sherman College in January, if my sources are correct.

The show was great, complete with tons of crazy costumes (see if you can spot who the guy in the bottom picture is supposed to be), great music, and a projection of The Evil Dead in the background. For those who have never had the pleasure of watching The Evil Dead, now is the time. It is one of the worst, and therefore one of the best, movies ever made. And, part of the movie was filmed in the town where I went to high school:  Morristown, Tennessee. In fact, the credits at the very end say: "Filmed in Morristown, Tennessee, and Detroit."  Evidently Detroit has no state. 

Has anyone seen "The Hangover?"

The Health Insurance Game

I have heard lots of hype lately about how much we all need health insurance coverage, and about how so many thousands of people die every year because they have no insurance. I feel the need to mention, at this point in the blog, that this is untrue. In fact, the reason that hospital prodedures are so expensive is because they are required, by law, to treat any sick person that walks through the door, regardless of whether they can pay for the service. As per Dr. Wise, Sherman College's on-staff business and insurance knowledge guru, the insurance companies haggle with the hospitals, until a deal is reached in which the hospital charges $2,000 for a procedure, and the insurance company then pays the hospital $800, which is what the hospital was hoping for in the first place. And yes, this is also how it works in chiropractic offices across the country. DCs charge a couple hundred dollars for a visit's worth of adjustments (or manipulations, pick your flavor), P.T. modalities, etc, and they will get maybe half that from the insurance company.

So then, one might ask, would it not be cheaper A) for the patient and B) for the practioner, because of a serious decrease in administrative costs, to charge a reasonable fee, and avoid the insurance fee-bloat game, in chiropractic and in medicine? Yes. Yes it would, and many people in private offices are doing this. Which begs the question, what is the actual healthcare problem in America today? I can guarantee, it's not that every family needs health insurance coverage. It's that the insurance game is out of hand.

Dr. Berry, from Greenville, Tennessee, runs a cash-based medical office.

 “The only way I can keep my price so low is by avoiding the crushing overhead and hassles that other physicians allow third-party payers to impose on their practices,” testified Dr. Berry, who plainly posts prices in his office, ranging from “Poison Ivy - $25” to “Simple Lacerations - $95.”
When patients buck at the concept of foregoing their insurance and $10 co-pay, Dr. Berry uses a simple analogy. “If you don’t have insurance for routine car maintenance, then why have it for routine medical care since fees at our clinic run anywhere between an oil change and a brake job.”

Read the rest of this article:   http://www.aapsonline.org/press/nr-optout.htm

Technique Woes

I've been exploring a couple of chiropractic techniques this quarter. Here at Sherman, we have what are called "technique clubs;" we meet at ten o'clock breaks or in the evening to practice setups and talk about analysis. This quarter I've been attending Gonstead Club and Results Club, which discusses the work of Pierce. I'm learning some good stuff about analyzing x-rays, and fine-tuning some of my setups. In classes here, we get an overview of several ways to move segments, and a conglomeration of ways to analyze the spine, using x-rays, motion and static palpation.

We get a decent start, but I am currently irritated with that system. Now that I am actually on the floor here, seeing and adjusting patients, I think we should have taken specific technique packages, including the analysis and the adjustments that go with them, and learned them as a whole. Mixing up the work of Thompson, Gonstead, Palmer, Pierce, and others into one class causes confusion for me, because each of these people had a special way of analyzing the spine, and coupled their technique choices with this analysis. Analyzing the spine with Gonstead, then adjusting with Thompson doesn't make much sense to me, and it doesn't help to make the decision about what I need to do with the patient lying on the table in front of me.

I know I'll get better at this with more experience, but I have to start somewhere--and I wish this start had been more clearly organized.