A better health - care model.
"Don't forget your supplement." I reminded a patient.
"Oh right! You have a good memory. How do you remember that, it was a few weeks ago?," she replied.
I answered, "Well you have been a patient for a very long time so I guess it's like remembering something for a family member. You don't really forget stuff you want to get for your sister or something like that, right?"
She laughed.
Perspective
That conversation had been rolling around in my head for a while now.
The idea that a doctor would remember the needs of a patient.
The idea that building a relationship; a mutual commitment, as the basis of a healthcare model.
Doctors talk of patient compliance- which basically means how well you follow our instructions- treatment plans, home care, prescriptions, lifestyle changes, as a means of describing a relationship you have between doctor and patient.
It's pretty one sided.
Doctors' role:
I tell you what I think is going on.
I tell you what to do about it.
Patients' role:
You do what I tell you to do.
.....
Background
I've been in practice for over 25 years.
It's strange to say it out loud.
Time, honestly, does fly right by.
And in that time I have always been a little unconventional, even by chiropractic standards.
I didn't go into an associate doctor role out of school.
I didn't buy into a successful practice.
I just "hung my shingle" and went straight to private practice.
Part of it was because I wanted to practice my way and no one was okay with that.
But if I am honest, a bigger part was because I had a huge ego and wanted to prove to all the naysayers that I could do it.
Screw them!
No better way to get me driven to make it happen than to tell me I can't do it.
I would never recommend this to a new doctor.
It is not the glorious road it sounds like.
It's stressful.
It's a constant swim against the current.
It. is. a. battle.
But that battle helped me to understand that the entire model of healthcare was broken.
I tried over and over to conform to the model of problem solving.
Patients only come see you if they have a problem and once that problem is addressed, goodbye...until the next problem.
So after many years of this, I finally took a leap and decided that I would change the model.
I would help people understand that they could not only resolve their problems, but they could change their entire health picture (no matter what your genetics were) to one of better overall wellbeing.
That story I tell in the first Chiropractors Guide to the Universe post .
But that conversation with that patient on that day just kept rolling around in my head.
I guess I had changed things again and was just realizing it for myself.
.....
A corporation, a layoff, and the journey of clarity
In 2016, I was approached by a friend of a friend to join him on a journey to wellbeing. I was in full swing at the O Institute when I was recruited to develop a "well-being center" at a corporate headquarters here in Bellevue.
I was not looking for a job.
The pitch was the dream of changing the world; a completely different model of "well-being care" and a chance to be a part of a global movement to put well-being ahead of all else as a human metric.
I would be in charge of creating the model, based on what we were doing at the O institute-building it, assembling the team of experts, and proving that it worked.
It was a creatives' dream come true.
I should have jumped at the chance.
It took me six agonizing months to decide.
Three years later, we had built it, launched it, and proved it's efficacy.
We were proud.
But wasn't I out of a job?
A new opportunity!
Build a wellbeing solution for chronic disease.
Hmmmm... sounds interesting. My Dr. Frankenstein brain kicked in and I envisioned a world that was free of chronic disease.
A life without ridiculous drugs that were often worse than the condition itself.
A life where people could go back to doing the things that they loved because they were not restricted by a health condition that could be improved or resolved through more natural changes in lifestyle.
I took the job.
Maybe I had convinced myself that I was serving the greater good.
But looking back, it was probably more from fear of being unemployed.
How had this happened?
How had I gone from someone who charged ahead and created a whole new paradigm of patient care to being worried about a job?! WTH?!
Despite all that, I helped to create a pretty amazing model of care for chronic disease. (pat pat- the sound of me patting myself on the back).
But little did I know that it was not going to go anywhere.
In the corporate world, projects die all the time.
People commit their time, energy, heart and soul into something that they believe in and the powers above decide that things are moving in a different direction and the project just goes on a shelf somewhere.
Never to be seen again.
I was out of a job again, right?
Yes.
This time, after five plus years of working on the idea of wellbeing, I was really out of a job.
.....
A new, old beginning
The initial reaction to being laid off is panic.
You scramble for job search avenues, put your resume together, begin to put the word out that you are "open to new opportunities."
But what the hell was I doing?!
Why was I looking for a "job"?!
Wake up, dude!
You're a doctor!
"Right!"
"I could just go back to private practice!"
Okay, so I immediately thought about going back to practice full time, 5 days a week.
Get back in the game, sort of speak.
But wait....hang on....
I had always said that my idea of retirement was working 3 days a week.
Could I be "retired?"
Could I spend more time with my teenage kids before they left for college?
Could I be available for my 5 year old during the week and go to the park anytime we wanted?
Could I have time to write? Try to influence and educate people on a better way to better health?
I am not sure I can make enough money but let's give it a shot!
Back in the game!
"Right??"
But before I get too crazy, let's think for a moment..
"If I was going to only work 2-3 days a week, how did I want to spend those days and who did I want to spend that time with?"
I realize now that all of us should ask this question of ourselves.
I became picky.
I didn't want to spend my days treating people who had simple neck or back pain.
I didn't want to just treat people on a problem solving basis; the same old model just substituting chiropractic and functional nutrition for more traditional drugs and surgery.
I wanted to work WITH people.
I wanted to create a new model where people "got it." They understood that health care should be a way of life and part of your life experience, not an "as needed" solution.
Health care has to be a relationship.
"Health care has to be a relationship between a doctor and a patient, working together to create the best life you can."
In order for that to happen, you have to spend time together.
You have to share and be vulnerable.
You have to get to know each other.
And I can't do that by seeing you once a year or once every six months.
Because life does not happen in six month chunks.
I need to know that you are stressed about your kids going to college.
I need to know that you are trying to get a new job.
I need to know that you are struggling with a relationship.
I need to know what you are experiencing in your life.
"Because it's your life experiences that massively contributes to your health and wellbeing."
.....
So I asked the patients who wanted to be a part of this journey to schedule out six months in advance.
Start with January until June.
What day and time they wanted to come in, and we would repeat this every week or every 2 weeks.
That would be their spot.
About half the people got it and signed up.
Then more people got it.
Now, the majority of patients get it and have their "spot."
We discuss their life.
I learn about their kids, jobs, friends, whatever they want to share.
I learn about their stressors and we discuss how they are trying to manage them.
We discuss how those stressors "show up" in their bodies.
We discuss what's next? - what I see in happening and what they want to improve.
And we address life and health, AS IT HAPPENS.
Basically, we build a relationship; a relationship of mutual commitment to their better health and wellbeing.
.....
After a year, what can I tell you?
I love it!
I enjoy every day, every person, every engagement.
I am excited to see everyone that day.
I feel I am a better doctor.
I can connect things in people's lives that can be the direct cause of what may be going on.
I have to continuity to better understand the changes we are making.
"I let our relationship direct the care, not just the symptoms or test results."
.....
What's next?
Global change. LOL.
I'm only half joking.
I understand that large organizations like our current healthcare behemoth, cannot change from the top-down.
It's too invested.
Too much big pharma.
Too much insurance.
Too much power play.
But I am holding out hope that like all great paradigm shifts, it happens at a grass roots level.
Maybe even my practice and those who are a part of it.
Maybe we become the model of how healthcare can become health-care; a model of medicine based on building relationships between doctor and patient.
I don't know.
But don't tell me I can't do it. ;-)
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