CONA President's Message

 

Let’s start a conversation about TeleHealth, learning something new, and being able to pivot as we lean into the post-pandemic world.   

The difference between those who succeed, and those who fail isn’t because of talent, ability, circumstance, or opportunity.  It has more to do with having clearly defined goals, a plan, resilience, and the discipline to execute on what’s needed even when you don’t want to do it!  If you fail, never give up.  Because all F.A.I.L. means this:  “First Attempt In Learning.”  

Last year really served up a curveball for everyone.  I’m reminded of this, and the example set by my oldest daughter and her husband; and specifically, their ability to pivot.  In 2016 they opened a craft brewery in Midtown Sacramento. Larissa works on the corporate side of supply chain management for a large well-known clothing retailer, and Alex is a civil litigation attorney.  Fortunately they both kept their jobs despite the grueling ordeal of opening a new business.  

They secured a 10-year lease, the investors they needed, local, state, and federal licenses, among other building permits, and then the race was on with no looking back. They opened their business on what most would call a shoestring budget to some, and a fortune to others, and they did it from scratch, sound familiar?   Within months they were creeping into the black side of the ledger, expanding and serving more and more customers while developing a loyal clientele.  The first 4-years were great.  Alex was able to reduce his hours as an attorney to part-time, and eventually full-time at the brewery.  

Then comes March 2020, a baby who’s 2-months old, and they’re not an essential business.  What does an entrepreneur do when they’re in the hospitality bar/restaurant industry and customers aren’t allowed in?  No indoor or outdoor service, their wholesale bar and restaurant orders disappeared because their customers were suddenly closed also, and were no longer ordering kegs to serve their customers.  It became a domino effect, and it occurred in less than a week... among other imposed regulatory restrictions.  You become decisive, with focused resolve or perish.  

They began online sales, curbside delivery, expanded their wholesale can distribution to more grocery stores, and big box membership outlets.  They were forced to reduce their payroll temporarily, but as soon as outdoor service was allowed, they were ready with a newly built kitchen, and began serving food as required by the health department.  They then got a permit to create a new outside dining area, re-hired staff, ramped up their production, and purchased inventory for a more robust and expanded menu. Then they were closed down again, and again, and again for a third time.  

Well, I’m happy to say they’ve been resilient, and as a father, prouder than ever of their continued commitment to themselves and their family while moving forward with their plans against all other odds.  Their strategic growth and prudent expansion continues despite the lockdown and pandemic.  Their story continues, and their second location will be open this April in Napa, California.  They only looked forward, expanded what was working, continued serving their customers as best they could, while meeting all of their obligations to employees and creditors.   


Here’s The Lesson Learned:

• Have clearly defined written goals.
• Put together the action plan needed to achieve incremental milestones of achievement, and track your progress.  Readjust them if you need to.
• Discipline yourself to do what’s needed to stick to your plan and achieve your goals.
• Then celebrate, reward yourself, and enjoy the success that follows!

Here’s The Brutal Truth: The difference between winners and losers isn’t talent, ability, or opportunity—it’s the discipline to do what’s needed especially when you don't want to do it. It’s not the end of the world either, because all E.N.D really means is: “Effort Never Dies.”  A winner is able to employ their defects in the service of their assets; a loser subverts their assets in the service of their defects. 

The Bottom Line Is This:  Be a doer!  You can do so with a free course by Prof. Barbara Oakley, from McMaster University & Prof. Terrence Sejnowsk, from the University of California San Diego called “Learning How to Learn.”  It’s helped Alex, Larissa, and myself.   I think it will serve you well too.  Because if the only time you feel good about yourself is when you’re working, then you’re making life too complicated. 

O.K. since that’s out of the way, whether we like it or not, today TeleHealth is quickly becoming a cornerstone of future practice growth and strategy.  Have you ever considered implementing virtual and remote services to enhance what you’re already doing?  Or, maybe you just need a clinical refresher, and learn something new.  
  
As a chiropractic doctor, let's face it, you’re also an entrepreneur, and we’ve always had to implement new things to remain competitive.  If you think about it, how many professions compete for your dental health?  You’re right if you answered just one.  Maybe it’s someone with a DDS, or DMD degree but they do the same thing.  How about your vision health?  It’s either an ophthalmologist, (MD) or an optometrist, (OD).  But when it comes to nerve, muscle and joint conditions, specifically headache, neck and back pain there’s close to a dozen different providers some licensed and others who aren’t who people feel comfortable going to.  There’s the DC, the ND, DPT, and the MD, (including orthopedics, physiatry, neurology, rheumatology, proctology, gynecology, gastroenterology, internal medicine, cardiology, pulmonology, and family practice with a host of NP’s or PA’s to assist them).   Also there’s the OMD, LAc, PsyD,  MFCC, RD, and the ATC all of whom are licensed with professional degrees.  There’s also massage therapy, energy healers, and herbalists. 

Here’s the point, we’ve got competition from all sides, and everyone wants their share. 

Today is as good a day than ever to ask yourself this question.  Have you ever been so focused on trying to figure out how to resolve a patient’s problem, or a recurring set of peculiar patterns between patients, that you completely overlooked the obvious solution?  How about your own health and practice dilemmas?  It happens to all of us.  Once we realize how simple the answer really is... we make a strong mental note to ourselves so that we remember it for the next time… and then we inevitably forget, because it hasn’t been revisited enough times to create sufficient long term memory necessary to recall it quickly if at all.  Based on solid research from neuroscience, and cognitive psychology, what you want, and what you need are the powerful mental tools to help you master tough concepts and muscle through difficult-to-learn subjects. 

Whether you're a novice or an expert, by now you know learning always wins out.  The paper always fades, but what you know, and who you become because of it lasts much longer.  If we learned anything at all from last year, know this, you’ll find great new ways to improve your skills and techniques for learning, especially related to helping difficult patients or the new problems you face in practice.  All you have to do is look for the answers to solve them.  

Anytime you have a single dysfunction affecting the spine or other joints you’ll always find other problems in other parts of the spine as well. Whether it’s the skeletal system or the endocrine system it all works like a precision Swiss watch movement.  All parts need to be able to work exactly the right way, and in perfect balance in order to keep the right time. The same holds true in practice.   

Because of COVID-19, quarantine, masking, uncertainty, anxiety, and everything else going on since the November presidential election, it’s not too hard to guess that most people could benefit from adaptogenic support.  Maybe it’s poor digestion and a bankrupt microbiome or adrenal fatigue contributing to their problems of stress caused by any number of factors.  It might even be a lack of hydration, or trace minerals due to the amount of processed food being consumed because of the boredom from eating at home, and brown bagging it for lunch is so unconventional compared to before.  There’s pesticide residue in our food, toxins in the air we breathe and additives in the municipal water we drink, overuse of sanitizers and disinfectants as well as emotional toxicity and chronic lack of sleep.  Add that to the lack of appreciation and recognition at home and at work, and sustained isolation from friends and family and appreciate the certainty that those indeed can impair our peak performance.  

Regardless of the reasons, these days people are more interested in health and wellness than ever before, and we need to be available to solve their problems, answer their questions and provide value for all the services they receive, and rightfully should be paying for.  Surprisingly, a lot of what you do each day can now be done remotely with a secure TeleHealth provider.  Think about this, can you virtually conduct an initial consultation, followed with a scheduled more detailed PMH, basic AROM, or address stress and weight management or therapeutic activities as a follow-up, or on a check-in basis?         

You’re probably seeing patients in their mid to late 40’s with signs suggestive of early cognitive decline, and up until now, there’s been little available to help circumvent it.  Even if it's just a brief virtual check-in to encourage their continued exercise, you’re providing your patients a much greater value than you might otherwise think using TeleHealth.  


We’ve known for some time how exercise can be a valuable adjunct to learning.  It helps enhance the ability to learn, and remember by transitioning our working memory into long-term memory.  But up until recently, we didn’t know why.  I mean, why would exercise be associated with learning and memory?  In the past 18-months researchers have discovered part of the magic behind why exercise is so important, and its effect on brain function.  Exercise, especially 8-minutes of HIIT daily for 8 weeks, puts forth in your brain a factor called brain-derived neurotrophic factor and we can abbreviate it as BDNF.  As it turns out, BDNF seems to allow neurons to more easily make their lasting dendritic connections quickly during sleep thereby influencing working memory and long-term memory.  https://pubmed.ncbi.nlm.nih.gov/33414823/ and https://pubmed.ncbi.nlm.nih.gov/33260817/

So if you’ve got any remote interest when it comes to innovative new insights to learning, including recall, and long term memory concerning your patients, your practice, or for your own personal growth, remember there’s a free course waiting for you.  People are hungry for fresh approaches to learning, and they're starving to get ingenious contemporary insight and understanding that can help find solutions and solve their problems.  Sometimes all it takes is being the six year old, to the four year old, who wants to learn how to tie their shoes.   If that’s you, just follow the link below and take the free course.  

The pandemic we’re experiencing has certainly amplified problems for many people unlike ever before.  We can either ignore it, (as if it won’t affect us or our practice) become paralyzed by the fallout, or embrace the challenge and become innovative using the tools at our disposal just like Larissa and Alex did, by learning something new.  But how?  Learning something new can be hard, especially when you need to, but you don’t want to, so you procrastinate adopting it. 

TeleHealth is a good example of something new.  It provides the utmost convenience to your patients, provided in a safe, secure, and structured manner, while being able to deliver most of the same services as before, the only difference, it’s remote.  It’s new, it upsets practice flow, and at first it’s not as routine as adjusting patients until you’ve developed a daily method of operation to consult, sort potential new patients, and it becomes more familiar, and less frustrating the more you utilize these online methods for routine initial consultations, check-ins and follow-up saving you time, and expense.  The best part is, it’s reimbursable, and there are perfectly acceptable billing codes for it.  

In the course I mentioned above, you’ll be introduced to a tool for tackling procrastination.  You’ll be given some practical information about memory, and discover surprisingly useful insights about making learning easier, so that you can implement whatever you want to with less effort, and finally discover why sleep is such an important component to all of this.  Better yet, why not develop a short course on sleep, offer it to your patients as a bonus, a stand alone premium, part of a monthly paid membership, a new patient promotion, or a virtual course you offer to members of the 5-different chambers of commerce in your area, or the county board of realtors?  If you want to find out how, I'm easy to find, on Facebook and LinkedIn, just direct message me or drop me an email, and we can talk further.

Here’s a good example, not only is math extraordinarily sequential, so is anatomy, physiology, pathology, and diagnosis.  Each is fundamental, and critical to being a good clinician.  But that’s not all, because so is the fact if you fall off anywhere along the way of learning, or you forget somewhere down the road, you can be completely lost as you stand still, and time marches forward leaving you behind in the dust.

Equally important are the communication and adjustive skills you’ve developed in order to be an excellent chiropractic doctor.  After a while we lose touch in recalling what it actually took to get to where you are today.  If you think about it, adjusting the spine and its appendages is as easy as riding a bicycle; you’ve done the same adjustment perhaps 10,000 times or more.  But that’s just it.  If you’ve been in practice 10-or more years, you probably rely on 5-7 standard adjustments, but likely no more than 15-20 different adjustments month in and month out.  It’s easy to ignore the nuances of the 100’s of other adjustments you’ve learned, (usually associated with the name of a technique) MFR, ASTYM, or other instrument adjusting so you simply stick to the ones you know well, execute consistently, and the ones you enjoy doing.  It’s easily justified too.  Because of the 30+ recognized chiropractic techniques, why make an adjustment that’s successful for you only 60% of the time, when you can rely on another one that’s 98% successful, and you perform it easily every-single-day?  It only makes sense, and that’s the core of the practice we once knew.  Some of the daily tasks we always relied on, and were accustomed to doing face-to-face can now be done virtually, and many states have passed legislation allowing parity in billing for those same services.     

But if last year was any indication of how circumstances beyond your control can affect your practice, being able to pivot, and deliver services differently is also something you can learn.  It’s not hard, only new.  That’s why learning how to learn something new, in days like these is so important, and that’s why I’m such an advocate of Telehealth, and in my opinion you should be also.  Because it saves time, saves money, and is infinitely more convenient for you, your current patients, and the ones who want to be your patients.  

Learning how to deliver conventional services in a legal manner remotely and profitably is more important now than ever before.  Whether we like it or not social distancing is here to stay, among other legislative mandates, and when it affects a profession like being a chiropractic doctor, and the way we customarily deliver services, you’ll want to add a new, and more convenient dimension to your practice and embrace it.  Makes no difference how skilled you are, or how much your practice members adore you. If they’re afraid to come in to receive the care they need, then your ability to remain in business becomes equally affected. 

So why do we miss the obvious when trying to resolve a certain problem or condition?  Because it’s so easy to skip the basics. There’s way more to being a competent, skilled, and knowledgeable chiropractor, and more than just being a “good adjuster” or an “artful chiropractor” to be successful and remain solvent.  You need the clinical skills inside the foundation of the business along with the marketing, management and the administration pieces in all places.  But if you’re a lousy or shoddy clinician, good luck building and keeping a practice these days.     


Believe it or not, people are hungry for fresh approaches to learning.  Most of the time, the things we overlook are so incredibly simple!  We all need to keep learning right?  Keeping our clinical skills sharp so that we can keep delivering exceptional results for our patients, and grow our business.  What do you think of when you hear the word entrepreneur?  

Sometimes we forget this is the land of opportunity.   With a little bit of help I put myself through college, and after I earned my DC degree I knew I would never starve, because if one job wouldn’t cut it, I would get 2-jobs. If 2-jobs wouldn’t pay the bills, I would get 3-jobs.  And I didn’t care what the jobs were, because nothing was ever beneath me, and I never considered myself too good for anything.  I also knew nobody owed me anything, and that nothing was ever free, and neither should it be.  I was willing to WORK MY REAR END OFF, and I did. That hard work made me who I am today, and I wouldn’t trade that gift for anything.

In this country, we have the freedom to pursue our dreams - we just need to understand that no one owes us anything, and what we do with our lives is 100% OUR own responsibility!  Because the moment you accept full responsibility for EVERYTHING in your life is the moment you claim the power to change ANYTHING in your life.

We are so fortunate to have citizenship in the United States of America - even now!  The mere fact that you own a device where you’re reading this post makes you more blessed than most of the world. If you have clean running water, electricity, a few items in your pantry, and a car in your driveway, you’re among the most privileged people on this planet!

Success starts with a heart of gratitude for what we have, followed by willingness to never blame our circumstances or other people for where we’re at.  So don’t let the fear of something different keep you from the joy of something new.  

Our country is not perfect, and I pray that God will help us do better, and become better humans… with less division, less hate, and more love for one another accepting all of our differences as long as they're good and decent.  But even though it’s not perfect, and there are many things that need to be fixed, nonetheless I love this country, and I love our flag, I love our Constitution and our Bill of Rights, and most of all I'll forever love our freedoms!  

https://www.coursera.org/learn/learning-how-to-learn


Make it a good day,


Lewis Meltz, DC, DABCO
CONA President