Think beyond the weight...

Well it’s that time of the year again. Time to take a look back at 2009 and review your successes and failures. What goals did you set out to achieve? How long did it take for those goals to be forgotten? What new year’s resolutions are you going to set out to achieve in 2010?

The holidays are a fantastic time of the year to review your successes and failures because it’s a time when we are reminded of the important things in life. Perhaps now is the best time to outline what goals are important to you and begin establishing a detailed plan to attain them.

I don’t like “New Year’s Resolutions”. Even the wording rubs me the wrong way. Why not call them “New Year’s Commitments”? Better yet, last year Chris Guillebeau from “The Art of Noncomformity” talked about the process of conducting your own annual review. According to Chris “The idea is to create a road map for the year ahead – not a rigid daily schedule, but an overall outline of what matters to me and what I hope to achieve in the next year.”

Unique to Chris’s annual review is the concept of having a yearly theme. You see when we choose goals like “Weight Loss” and “Get Rid of Debt” it limits us to only achieving weight loss and becoming debt-free. There are 3 things to consider when making your 2010 New Year’s Commitments.

1. Ensure a deeper meaning is attached:

What are you looking to achieve by losing weight and exercising more? What plan of action have you developed that systematically keeps you accountable, but also works in the context of your busy life? Having an annual theme gives a deeper context to your individual goals. If you fail to lose weight despite exercising more and eating better, perhaps now you recognize that you’re thinking more clearly and that you have more energy throughout the day. You still may be hobbled by consumer debt, but you’ve gained a greater consciousness of your monthly cashflow and perhaps you started a retirement account and put money there instead.

At the Wellness Solution Centers in Newtown, PA, chiropractors routinely provide a comprehensive physical examination that includes bloodwork, body fat analysis among numerous other measures. Initial examination takes 1 hour. Patients enter the office with the traditional goals of losing weight, but often find after an 8 week intensive program, their weight has not changed, and in some cases they have even gained weight. Now that the program has been up and running for a few years, patients now come in with goals to lower their blood pressure and improve their cholesterol and triglycerides. When they look at the full measure of their health through bloodwork and body fat analysis, they then realize that they have much more leaner tissue, less inflammation and are in fact much healthier than what they were when they arrived. Limiting your New Year’s Commitment to just one outcome measure causes one to monitor their status too frequently. Having a deeper theme to your goals will allow the completion of larger goals and keep your attention away from the small failures.

2. Individual goals may require completion of seemingly unrelated goals:

What’s been limiting you from taking action on your goals? Perhaps it’s a non-supportive relationship in your life. Perhaps its the stress of your job. Maybe it’s a lack of planning meals, or finding a time that allows you to go to the gym consistently. When it comes to health goals, many people take action in every way imaginable EXCEPT for the one actionable step they really need to take. Often times people will be chronically sick and spend every other week at their doctor’s office. Their goal may be to improve health, and they could exercise, follow-up appropriately with their doctor, but still eat McDonald’s once a day. It’s difficult to eat healthier at work, when you don’t prepare a meal ahead at home.

Our goals can very well be to lose weight, so as to improve deeper goals of self-image and confidence, but what if accomplishing that goal meant you needed to reevaluate how supportive your family and friends were? It’s difficult to take care of your debt when you hang out with high-spending friends with their parents’ credit card. It’s difficult to lose weight when those close to you are continually offering you sugary treats.

When you truly examine your goals appropriately, you have to dig deep to find the patterns behind those goals. You have to identify the root cause of the problem.

3. Inappropriate timeframe for completion of the goal:

I had a close family member approach me about a goal for weight loss. She exclaimed that she did not know what else she could do, she had been working out and eating better and had not seen any results. To figure out her problem, I had to only ask one question. “Well how long ago did you start?”. She responded “Two weeks ago”.

We live in an information age full of short soundbytes and bulleted lists. To lose weight healthily, you should look to only a few pounds a month of weight loss. When you focus on short-term gains and losses, your consistency becomes short-term.

My theme for 2009 was gratitude. It brought me a beautiful girlfriend, less stress at school and closer and more authentic relationships with family and friends. My theme for 2010 is “following through”. I’ve found that I start projects but leave them half-finished. So many great projects are left unfinished just when they approach the brink of greatness. I assure you 2010 will be different.

So now that you’ve had some time to think about it…what’s your annual theme for 2010?

Swine Flu... its not the pig's fault!

This article is considered a “musing for entertainment” as it is solely based on statistical information (and possibly poor information). The author takes no stance pro or con vaccination.

Whether or not the swine flu vaccine is safe or effective continues to be a debate and is the basis for many families deciding against receiving the vaccine. So here’s an interesting consideration for you all. (But please don’t forget that correlation do not equal causation)

Mongolia has a population of roughly 3,000,000 people. According to the World Health Organization, as of November 4th there has been 6 deaths associated with swine flu. That means that 1 out of every 500,000 Mongolians have died of the swine flu.

The United States has a population of 305,000,000 people. According to the CDC on November 1st, there have been 4000 swine flu related deaths. That means that 1 out of every 76,250 Americans have died of the swine flu.

The kicker… Mongolia does not have the vaccine, the USA does. Is it that Mongolian Hospitals are superior to the US? Hardly… Mongolia’s health-care system is considered the 147th of 190. The USA ranks at 37. Is it because Mongolia is less densely populated? Unlikely. 1/3 of the population lives in a single city alone.

One argument is that that swine flu figures are underreported, and this is likely the case… in non-severe infections. Most people who contract the swine flu are never tested. And the CDC acknowledges this fact and therefore the number of deaths cited above, turns out to be an estimation. The CDC estimates between 2500 and 6000 swine flu deaths. But there is an inherent problem here, when someone dies with flu-like symptoms they are checked for H1N1… even in ‘backwater’ Mongolia (the government has taken a very strict stand with swine flu and checks all cases in a hope to quarantine any possible outbreaks). But I’ll humor their statistics, 2500 deaths means 1 in 122000, or for 6000 deaths means 1 in  50000… again, much greater than Mongolia’s death rate.

Also makes me wonder, why isn’t the CDC reporting the confirmed cases anymore?

Are there extenuating variables involved here, I can guarantee it. But it does make you wonder…

What’s your thoughts? What is wrong with these statistics? Do you plan on getting vaccinated?

This article is considered a “musing for entertainment” as it is solely based on statistical information. The author takes no stance pro or con vaccination.

References

http://www.cdc.gov

http://www.nytimes.com/2009/11/11/health/11flu.html

http://www.photius.com/rankings/who_world_health_ranks.html

Is this the best we can do?

A Critical Point in Chiropractic History:

It is no secret that Chiropractors only see 6-10% of the population while some 85% or more of people will experience back pain at some point in their life. Underutilization of chiropractic is not a result of chiropractic not working or failing to provide value to the health system. In fact, of all the therapies for low back pain, spinal manipulation is one of the few therapies (pretty much the only one alongside exercise) to show clinical utility. Chiropractic has also been shown to be cost-effective as chiropractors manage back pain cases more efficiently – keeping patients from becoming chronic back pain patients.

Chiropractors, if you haven’t learned by now, we’ve been fighting too long for a decreasing chunk of the healthcare pie in a system disproportionately focused on acute, reactionary care. While delivering the message of chiropractic for back and neck pain, we are still seeing the same 6-10% of the population with the same message. If we were a publicly traded company, Chiropractic would be bankrupt or at least receiving a bailout. Now, I don’t see a bailout coming our way anytime soon either. Ever since I started Chiropractic college, I’ve struggled to figure out why chiropractic is so underutilized by the general population. What has Chiropractic done wrong? More importantly, what can we do to reverse the trends?

A Profession at Odds With Its Competition:

Chiropractic has struggled to compete in a biomedical model at odds with its basic principles. Although a vitalistic perspective of the adjustment will never be proven by a randomized controlled trial, many chiropractors practice passionately with vitalistic aims. This alienates us from policy-makers, from insurance companies, and other health professionals, but it doesn’t mean we are not on to something useful. As powerful as the adjustment is, it is still limited in its ability to produce clinical outcomes that can be measured by traditional standards – even the staunchest, principled among us are beginning to realize the utility of working with massage therapists and other types of professionals.

To “rebrand” chiropractic, we need to one: redefine outcomes assessment tools consistent with a holistic model of health and become results-driven from a Wellness perspective – ultimately forcing policy-making bodies and insurance companies alike to either recognize our worth or lose authority in the marketplace. Secondly chiropractors need to focus beyond just the adjustment and involve the other missing ingredients of the subluxation – the physical, chemical, and psychological factors that are all required for optimum expression of health. Fortunately aspects of these three elements are all supported by the literature and chiropractors should begin owning this information as it really is evidence and proof of everything we’ve been saying circa 1895.

Moving Towards a Viable Solution:

Chiropractors are taught advanced neurology, but are not given ample clinical opportunities in their education to own it out in the field. Chiropractors are taught more nutrition than medical doctors, but yet practice none of it in their clinical experience beyond fish oil, vitamin D, and health talks. Chiropractors contain some of the most motivating professionals out there. I cannot expect chiropractors to own both neurology or nutrition, or become tomorrow’s Tony Robbins, but we need educational systems that give adequate clinical experience in these fields where we can work along-side other professionals to hit at the physical, biochemical and psychological factors required for health.

We have worked our way slowly into the Veteran’s Administration system which is powerful, but we have been limited to strictly massage and mobilizations. Why aren’t we pushing for better care for these individuals. Just because a person has more serious diagnoses doesn’t mean their musculoskeletal complaints, nutritional needs and social needs simply disappear. Proper integrative comanagement has evaded the profession and left millions with poor, overpriced care, ill-suited to meet their needs. Chiropractors have the pieces, and great movements like the Foundation for Chiropractic Progress (http://www.f4cp.com), AdjustTheVote (http://www.adjustthevote.com), ChiroVoice (http://www.chirovoice.com), 8 Weeks to Wellness (http://www.wscenters.com), Creating Wellness(http://www.creatingwellness.com)  and Eat Well, Move Well, Think Well (http://www.eatwellmovewellthinkwell.com) are becoming more and more popular. Are they perfect? No. Are they pushing the market in the right direction? A resounding yes.  Chiropractors are making a strong attempt to influence Public Health at the political level, but not with a distinct message. Instead our message of “we’re just like you” is just reinforcing a secondclass persona for our profession.

From a health perspective, chiropractors must design a practice that incorporates exercise, nutrition, and psychology can be achieved with a proper business model that brings together like-minded practitioners. The branding issue with chiropractors is that patients do not trust chiropractors at all. Whether its reverberations from Wilk vs. AMA or loud, passionate chiropractors who put business and philosophical interests over patient interests, the fact is chiropractic has became a bad word in the marketplace. Don’t get me wrong, I love our profession, but unfortunately the public just simply doesn’t “get” us.

Now I do not mean to underestimate the value of chiropractic in the management of acute and chronic musculoskeletal complaints. My take is that we can do so much more and increase our market share at the same time. You see, we can’t treat chiropractic care as “take two adjustments and call me in the morning” – people need step-by-step, adjustment by adjustment lifestyle modification.

A Vision for a Increased Utilization:

For chiropractic to grow beyond the 10%, we need to jump aboard a wellness movement and incorporate acute musculoskeletal care within that framework. Baby-boomers are aging and want to keep living active lives. 2/3 Americans are overweight or obese, 1/3 kids will have now diabetes later on in life. The medical profession has not found the answer. Insurance companies are insuring sick care, not wellness. Chiropractors need to attract patients under a better definition of wellness like the World Health Organization’s offers. While demonstrating leadership and trust in Wellness, we may finally find the audience with which to demonstrate chiropractic’s worth as a viable and cost-effective healthcare option.

Combine this message with long-proven cost-effectiveness and a unified political message and Voila you have a recipe for increased cultural authority, and a favorable brand image and increased utilization for Chiropractic care.

Better together?

The 2000′s has been a time of significant change for the chiropractic community. One of the more interesting to me is the increasing occurance of state chiropractic associations unifying. Just last month Virginia’s Virginia Chiropractic Association and the Virginia Chiropractic Society (which had a great Acronym, VSC!), unified, and more states are considering similiar moves.

My question to you. Do you feel that unification of straight and mixer chiropractic associations is a good idea, for either the state or national level? Please comment.

In my personal opinion, I think this is a great idea. I believe that our professions biggest enemy is ourselves, not MDs, the government, or insurance… gasp! I know our profession has its significant differences, but really we should provide a unified front for the community.  Look at the AMA, they are an increadibly diverse group or individuals and opinions, and believe me they argue in house, but they speak to the population as a unified force. If as a profession we were to band together, I feel we would finally be able to exercise some power in government and insurance… one group of 70,000 is far more powerful than 4 groups of 18,ooo people.

What are your thoughts? or thots…

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Everyone needs exercise

*This article is considered a musing. Musings are articles of interest, but not of research quality. Instead, they are designed for entertainment or personal opinion.

My remarks for this most recent pearl of wisdom stemmed from a couple of different incidents molding together. I finally got myself back into a formal strength training program after being on hiatus for about 3 months (ah ah ah…doesn’t mean I wasn’t running around. Remember, exercise is the meaningful execution of preplanned and purposeful physical activity) when I realized I was only about 6 weeks away from my first internship and I needed to get some hypertrophy going if i was going to be of any use to my future patients (first internship is in outpatient neuro rehab – very taxing). So I wandered down to the health club, which is in a fairly affluent area and on my way in, as well as while taking inventory of what this place really had to offer, I saw a decent amount of people who were interested in their health. Lots of people, biking, running, playing basketball, lifting, etc., but knowing these white collar types, a thought instaneously flashed through my head – what does he have need to be that big for? – as I passed by one gentleman. Very prejudicial, I know, but I can’t help it – first impressions were always snap and uncontrollable with me.

After my 30 min jog on the treadmill, I stretched out and made my way to the weight room to again assess what equipment the administration thought was necessary. Outside the weight room and above the water fountain hung pictures and credentialing of all the personal trainers (serendipitously convenient, no? These guys are good). I was happy that everyone had at least a Bachelors degree in something related (although my ears pricked after reading one girl was touted as having experience with physical therapy as a result of an internship she had, but there wasn’t anything after her name to suggest she was actually a P.T.), but under one gentleman’s mini CV he only had written “Fitness is a Lifestyle!” This is true, however….

(smirk) There’s seems to be a lot of howevers with me, I’ve noticed. Some days I wish my life existed in a little more black and white instead of color. I digress. These two anecdotes overlayed something a dear friend said to me once as I was relishing in the new found power I wielded when I was selected to assist with Physical Therapy Program interviews one year: “So, what do you hope to accomplish with that question? What answer are you looking for?” Random, I know, but I do have I point.

As I worked my lower half on the leg press, I got to thinking. In this day and age of cultural norms, trends, fads, and ulterior motives, I tend to appreciate more those who have a functional, logical, and reasonable purpose for what their doing. For me, I have a functional purpose for my training – I need to be able to support, block, push, pull my patients, to perform my daily and non-daily tasks at home, as well as prevent injury when I play. And maybe the white collar folks have their reasons for living at the gym, as some truly do, but to them I ask a potentially pointed question: “To what end?” What purpose does exercising so much serve for you, and please don’t tell me it’s heavily based on self-image and trying to attract members of the opposite sex. While everybody’s got their something, that’s probably one of the worse, least self-satisfying reasons to do anything. ANYTHING. If nothing else, that kind of thinking breeds narcissism that’s insanely hard to get rid of as one ages.

My solution – find a logical, meaningful purpose. If you want to protect your joints and back against age-related changes, perfect. If you want to do a triathalon, wonderful. If you want to improve your recreational rugby game, amen. If you want to be able to take care of yourself when you reach 90 y.o., fantastic. If you’re diabetic or have high blood pressure and want to reduce your dependence on injected insulin or your risk of heart problems down the road, I’m sure medicare will eventually thank you, but I know your family and bank book will do so more readily. Whatever it is, please, have some depth to your resolution. In the end, the main idea is that you’re active in a challenging way that makes your exercising efforts worth all the blood, sweat, tears and time.

As Jimmy Lunceford once suggested, “It ain’t what you do, it’s the way that you do it.” Just something to think about it.

Taken from Katepedia – Original article, a future PT