What aspiring chiropractors need to know… Part 2

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OK, that takes care of the materialistic opportunists looking to make a quick buck.  For the rest of you who are still with me, here’s the next thing you need to know: not all schools are created equal.

In fact, while there are some common features set forth via accreditation board mandate, stark differences remain.  The main point is that you need to do some soul searching and preliminary research to get a feel for what’s out there and to figure out who you are, what kind of doctor you want to be, what direction you want to go in, what you’d like your education to emphasize, how you want to practice, what you’d like to specialize in (if anything), and so forth.  Then research each school heavily to see if it’s a good fit for you.

Do yourself a favor and don’t choose a school based on climate or the caliber of neighborhood it’s located in.  It’s only 3 years of your life; after that, you’re free to go.  Don’t cheat yourself out of a good education because of a bad climate.  You’ll want to live close to school anyway; your budget will be so tight it squeaks.

Please, also, don’t pick a school based only on their National Board exam score ranking; while a school’s placement in comparison to other schools can be indicative of the quality of instruction received there (at least in that particular area), it may or may not necessarily be the whole story, as many schools are resorting to more drastic methods of manipulating scores, such as only allowing those with a certain GPA to take Board exams, or hiring outside companies to come in and teach board review classes.  (Most schools do the latter, and this is a legit phenomenon, but please understand that this will inflate the scores and since these companies are filling in the gaps, the Board scores may not reflect the actual quality of the instruction itself.)

Next, understand that whichever school you do choose, there are pros and cons.  As of now, unfortunately, all of the schools are privately owned (usually non-profit, but still…) which keeps tuition high, political underbellies rampant, and curriculum largely unstandardized.  Some of the Presidents of some of these schools are really flaky.  Do not form your opinion of a school by what the recruiters have to say, or only by attending a sanctioned open house or tour.  Talking with recruiters and attending open houses and tours are smart things to do; just understand that no matter which school you go to (and this is not exclusive to chiropractic schools!) you will be fed the company line an treated to a dog and pony show.  If students assist or host these events, understand that they are typically ultra-positive-thinking yes-men and women handpicked by administration to portray a carefully crafted image.

Once you apply to a school, you’re put on the prospective student list, even if you’re not slated to start for another 3-4 years.  During this time, you may receive invites to attend seminars or talks or other school-related events.  These events often consist of captivating speeches and anecdotes expertly delivered by charismatic motivational speakers.  Come with an open mind, but don’t get swept up too quickly in the feel-good vibe of the event.  These speakers may tell you stories about how they treated this or that with chiropractic.  These stories are often true.  Even if the speaker made them up, chances are, what they claimed happened, probably has to someone.  Chiropractic is like that.  Indeed, it’s the gift that keeps giving, providing people with many unexpected pleasant effects–that is true.  However, take the actual speakers with a grain of salt–an open, but uncommitted mind.

Because see, even though certain speakers will tell you that peoples’ asthma or diabetes disappeared while they were under chiropractic care and chances are that has actually happened, you’re going to spend the first year wondering when you’re actually going to learn to treat someone’s underactive thyroid or heart murmur.

And sometime during your second year, after listening to different professors make conflicting claims about what is or isn’t actually in your scope of practice to diagnose and treat, you’re going to finally discover that you better diagnose any little problem–it’s your ass if you don’t–but you can do exactly dick to treat it.

You’re going to get depressed at some point during your education because all of your Business classes are going to revolve around submitting insurance paperwork (which fewer and fewer chiropractic doctors are opting to do), which only pays you for treating musculoskeletal conditions–what I call the Stereotypical Triad: back pain, neck pain, and headaches. I.e., you’re a glorified physical therapist without the advantages of a master’s degree, hospital access, or a solid network of MD referrals.

At this point, you’re going to want to hang yourself, and shoot out the tires of the BMWs driven by the excessively-paid charismatic speakers who convinced you to get tangled up in this mess in the first place.  This is known as The Collapse, where most of your higher aspirations of helping people with any condition (after all, you are a doctor), through any natural means possible, without the use of drugs or surgery, all fall flat onto a thick ICD-9 book full of senseless codes. Forty bucks and you can use maybe 8 of those codes.  After all, chiropractic is considered a specialty, and you have a small window of conditions you can claim to treat.  With the treatment of practically every condition being considered outside of our scope of practice, you start to wonder if you’re becoming a real doctor at all.  The doubt sets in.  But the rah-rah cure-all seminar guys sorta forgot to mention that part.

I went through my Collapse about halfway through, where I realized that despite the fact that I was attending probably one of the best schools there is, my education still had the completeness of Swiss cheese, and I could’ve bought a Lincoln Continental brand-new for the same price.

During your final year, though, your spirits hopefully start to come around, realizing that you’re too far in to back out, and what the hell, it’s just another year anyway, most of which is resident internship.  My saving grace is the fact that I discovered the neurology fellowship.  While it’s post-doctoral, you can start before you graduate.  I also started researching a little more heavily and I realized that I’m not relegated to the back pain, neck pain, and headaches regime, that I can indeed help peoplep with certain conditions, it’s just that I’d have to approach it in such a way that I wouldn’t get bitchslapped.  Most people find their way; there is more than one way to filet a fish.  Just know that the dark days do happen and try weather the storm.

Know that in the end, if you truly like to help people, and if to help those people get their life back gives you warm fuzzies, you’re in the right place.  You’re doing the right thing.  And if you have a good heart, a sharp mind, a good memory, good people and communication skills, and a little business sense, you will go very far.  Most peoples’ main obstacle is not prejudice from the MDs (although there is, and you should be aware of that), it’s themselves–a combo of laziness (mediocrity, the mentality of just doing the minimum to get by) and lack of self-confidence (i.e., if you don’t believe you can treat a certain problem or help someone in a certain way, you won’t).

You also have to be fully aware of the power of an adjustment, for good or bad, and be mentally present with that patient at the time you’re delivering that adjustment.

Above all, don’t be lazy and blame every condition on subluxation and every treatment setback mere chance or a lack of patient compliance–the only way we’ll feel like, and be considered, real doctors is if we act like it.

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