My first official clinic observation

Tuesday night I had my first clinic encounter observation, as part of my Intro to Clinic class. Exciting! I've observed dozens, if not hundreds, of clinical encounters, through shadowing my chiropractor, and other mentors since. Also, I've observed plenty with my wife and kids. But there was something different about this one. I think being in a clinic jacket, in a professional role, changes the perspective immensely. With observations, you are a silent party, but you are definitely taking notes as questions are being asked, findings delivered, treatment administered, and so on. This is an excellent opportunity to quitely assess what you would do with that same encounter, and to learn from the intern and staff doctor.

I can't discuss the particulars of the encounter, as that would breach HIPPA rights. While I could discuss details without divulging identifying information, I'm not even going to do that, as the details could identify the patient. I wouldn't dream of breaching that trust. It really is a profound privledge to be trusted with sensitive personal and health information, when you think about it. There are things discussed in a doctor's office that that person might not be willing to share with anyone else, including loved ones. This is just another aspect of how much responsibility is placed on a doctor.

In a few more months it will be me that is making those calls, and being observed by a fellow student. Time flies here.

Lots of tests and practicals this week!

I just finished two back to back. Had a mideterm test in visceral disorders. It was mainly on CBC (complete blood count blood indices test) with all the anemias and leukemias. But there was urine on the test too. Well, not literally... The first test was over UA (urinalysis) and everything it can uncover, and there were several review questions of that material on this test, especially because several diseases can cause abnormal findins on a CBC and a UA, so cross-correalation is important. Radiographic findings also relate to alot of things we look for when we order lab work too, so that is on the visceral disorders tests too. I'm definitely at a point in the curriculum where it's critical to put together all the seemingly disjointed material covered in dozens of other classes. DOn't think for a second that once you get through an anatomy or physiology course, and pass the class, that you're done with that material. Besides having to know it for Boards, you really need to know it to be a competent doctor!

After that test I had to take a Pelvic class practical. This one focused on being presented with a mock patient, with films and physical findings. and then having to determine listings, best adjustment, pre and post checks, care plan, and patient instructions. I missed one silly point because I accidnetally said ASIS when I meant to say PSIS. (These are bony landmarks of the pelvis, one is on the front of your body and the other on your low back. Obviously I didn't have them confused, just my Dislexia kicking in at a very inoportune time!Oh well just one point.

I've got an exam in Intro to Clinic wednesday, and a clinical psychology test thursday. Friday I'm delivering a 20 minute presentation on the social implications of Hepatitis B in my Social Aspects of Epidemics undergrad class. I also have a group investing project that I'm involved with in my Economics undergrad class.

Like I said, busy week!

Not to mention I'm putting up 200 feet of privacy fence, stick-built (not pre-fab panels, but piece by piece), scraping, priming and painting the garage, tilling and reseeding the yard, while I have several indoors renovation projects going on too, like hardwood flooring and tile throughout the entire house, etc...

Life is never dull!

Well, gotta go to extremities class to play with stinky feet.

Palmer Package Club

This morning I went to Palmer Package Club. Clubs meet once or twice a week on campus, and there are plenty to choose from. Every specific technique has its own club, then there are clubs that revolve around other interests, like sports, pediatrics, etc. Palmer Package Club focuses on Palmer Package, which is the group of techniques that are part of the standard curriculum here at Palmer. The main components are based on Toggle, Gonstead, Diversified, and Thompson. They are tweaked here and there to reflect current research, best practices, etc. Palmer has done an excellent job at integrating several techniques into an extremely cohesive "toolbox" of adjusting protocols and techniques. We get tons of hands on with all of these techniques within the specific courses, of coarse. THe club is an extra opportunity to go through the entire history taking, exam, findings, and actual adjustment, with another student, and a doctor observing. It's the real deal, not a mock experience. This to me really is the best tool in learning to put it all together, and practice a real chiropractic adjustment, rather than just setting up, then practicing the thrust into the air, which is of course all we can do without having a real patient with a real need for an adjustment, something that can't be controlled or guaranteed in a classroom setting.

So this morning I went through the whole process of finding two subluxations, reviewing films, history, everything, then pick what I thought would be the best adjustment technique for those subluxations, and correct them. It went great! I had to switch techniques on one of them because it didn't respond to the manuever I had first chosen, but then I was able to pick a different procedure that would work better, and it did! It's a great experience to be able to be put into that clinical mindset, where I have to think on my feet, reassess, and move forward. Next tri I'm in the clinic, so I've got to start thinking this way!