Lessons Learned – Experience Shadowing a Rural Physician By: Logan Brennan
Part I – Life of a Rural Physician
This past week I had the incredible opportunity to shadow Dr. Reid Hosford and Dr. Megan Cook at the Pincher Creek Hospital in Southern Alberta. Dr. Hosford is a General Practitioner Anesthesiologist (GPA) and Dr. Megan Cook is a Resident Family Physician working with Dr. Hosford. I was introduced to Dr. Hosford through a family friend who suggested I contact him to better understand the life of a rural family physician and to help me determine and understand if this is my ultimate career goal in life. After observing two clinical shifts, one surgery, one colonoscopy and an overnight emergency room shift, I have a significantly greater understanding of the life of a rural physician and a greater appreciation for the entire health care system. As a practicing Athletic Therapist and Community Outreach Coordinator for Integrative Movement I walked away with many Lessons Learned which I hope to share with our followers as well as apply to my current practice and future endeavours.
Demands and Life of a Rural GPA
There is no doubt physicians have a career which demands an exceptional quantity of time and commitment. As most of you know, physicians generally work long hours, are on call both weekends and nights, have massive patient loads and function in multiple roles and capacities depending on the needs of the organization and community (clinical, emergency, in patients etc).
Dr. Hosford demonstrates the importance of achieving a healthy work life harmony. I chose the term work life harmony because I believe Jeff Bezos explained it best. “Having a work life balance is a debilitating phrase which implies a strict trade off.” The term work life balance creates competing interest rather than emphasizing the interrelatedness of your occupation and life. In order to achieve work life harmony you must recognize this as a continuum rather than a balancing act. Dr. Hosford demonstrates these skills well by maintaining an active lifestyle and prioritizing his young family amidst just recently beginning his career as a practicing physician.
Teamwork and Breadth of Knowledge
Rural physicians epitomize being a career generalist. The demands and problems which a rural physician faces are diverse to say the least. From ingrown toe nails and strep throat, to drug overdoses and surgeries, rural physicians truly have an incredible breadth of knowledge and skills. Because of this variability in practice, the entire healthcare team must work seamlessly and expect exceptional teamwork from all members.
During shadowing, I was continually impressed with the level of communication, respect and accountability which every member of the team demonstrated. From administrators, surgeons, nurses, students, homecare workers and physiotherapists, every member demonstrated professionalism and was appreciative and understanding of each member’s role to achieve the collective team goal. My take away from this experience is that with the right leaders and the right mindset, teams can accomplish and solve exceptionally variable and complex problems.
Although I have always recognized the societal responsibility of physicians, after shadowing Dr. Hosford I acquired an even greater appreciation for the responsibility they bear. Rural physicians are not only Doctors. They are life savers, community leaders, policy makers, counsellors and above all genuine and caring human beings. From delivering babies and completing one-year old check-ups, to treating patients with terminal cancer and writing death certificates, rural physicals interact with the community at every level. These individuals bear massive responsibility for the health, welfare and future of the communities in which they practice and call home.
Part II – Applications to Athletic Therapy and Professional Take Away.
Critical Need to Proactively Address Diabetes and Hypertension
One of the greatest lessons learned from my experience is that our society and specifically our profession as Athletic Therapists needs to address the critical need to proactively prevent and treat individuals at risk for Prediabetes, Type II Diabetes and Hypertension.
Over the course of my shadowing shifts it was shocking to see how many patients required medication to control hypertension and regulate blood glucose levels. Now to clarify, I am not saying every patient can control their situation by other means (ie exercise, nutrition, meditation etc.) however I do believe many individuals, who if provided with appropriate resources and confidence, could take control of their health and overcome these conditions in the early phases through simple lifestyle adaptations.
In Manitoba alone, 50% of those with prediabetes will be diagnosed with Type II Diabetes by the end of 2019. Secondly, Hypertension is proven to be directly correlated with sedentary behavior. Rather than prescribing a patient basic blood pressure medications or diabetes medications which can become a crutch and create a mindset of hopelessness, we as Athletic Therapists can drastically change a patient’s outlook on these conditions and give them responsibility and control of their personal health.
Furthermore, these two conditions are direct risk factors for Cardiovascular Disease (CVD) and therefore Doctors are very quick to treat these conditions with medication. By treating these conditions immediately, they reduce the risk of CVD which is ultimately the greatest health concern facing Canadians. I believe prescribing medication for conditions which are directly correlated to lifestyle is a short term and largely ineffective means to providing meaningful lifelong changes. Furthermore, this is not the Doctors responsibility but rather our responsibility as Athletic Therapists to build relationships with Physicians and healthcare officials so that appropriate referrals and protocols exist to make long term and sustainable changes to our approach on healthcare.
Smoking and Alcohol
Although both of these are the subject of constant discussion, I believe I need to give my two cents on these issues and communicate why they are important for Physicians and ATs. After spending approximately 36 hours with patients in both a clinical and emergency environment, it is shocking to me how many people still choose to drink and smoke excessively. As a society we all recognize the dangers of these activities and yet as a society we also accept and even encourage them. To everyone reading this, I challenge you to have the difficult conversation of addressing smoking and alcohol use with your loved ones, co-workers and your friends. As Jordan Peterson put it, your success as an individual, family, organization, team, or society is based on the number of constructive uncomfortable conversations you are willing to have. Have that uncomfortable conversation sooner rather than later.
Reliance on Healthcare and Hospitals
As briefly touched on above, our society’s reliance on healthcare is sobering. I am not going to sugar cote this or downplay it. The extent to which our society relies on the healthcare system to save, fix and help them on a moment’s notice is alarming. Because of technology and health care advances, the system has done an exceptional job looking after people. Yet, it has done a disservice to every individual who now believes they do not have control of their own health and that they require a doctor and or medication to stay healthy. As an Athletic Therapist I truly believe we need to emphasize the importance of patients taking accountability for their health by providing them the guidance, confidence and the basic support to do so.
Future Role of Athletic Therapists
The values, principles and scope of practice of Athletic Therapy will provide the essential framework for our profession to adapt, grow and progress to become a valuable contributor in the Canadian Health Care System. The most important component of success will be adaptation. Each one of us must learn and act on improving our recognition with other healthcare providers and prove value. Without creating and demonstrating value we will continue to be overlooked and undervalued in the health care field that can desperately use our support and expertise. There is significant opportunity for us to make a major impact in providing treatment and value to those with orthopaedic and lifestyle implicated conditions. We must strive to provide value and expect nothing short of excellence in our respective field. If we are able to do this there is no doubt in my mind that the relationship between Physicians and Athletic Therapists will not only prosper but will address and make an impact on many of the significant and current health care issues facing Canadians today.
Have a wonderful week everyone!
Let er buck,
5 Simple Health Hacks for 2018
Resolutions are overrated. Building habits and setting smart goals are what its really all about.
Sorry if I’m killing your #newyearnewme vibes. The truth is that resolutions made this time of year are generally not accomplished by 80% of us lowly humans.
The problem with habits is that they take time and effort, and that is something us humans don’t naturally drift to. Setting a fiery resolution as of Jan 1, 2018 does not come close to guarantee that you wont’ be saying the same thing next year at this time. Health is an ongoing series of habits and decisions you make EVERY SINGLE DAY. And every day is a new adventure, so the decisions will change DAILY. The best solution is forming a solid line up of habits to help you along the decision making trail.
One of the biggest barriers clients tell me about is not having enough time to include new healthy habits into their life, or being too busy to commit to a coaching schedule, complete daily tasks to support their long term health, or to take time for themselves. A lot of this involves choosing to remove the inconvenience of health from our lives (and ironically thereby making health more convenient– making it the obvious choice).
We’ll talk more about sustainable habit practices soon. In this post I am going to outline 5 SIMPLE things you can add to your day to day routine that don’t require more then 5min.
1. Get Down (on the ground)
The simple act of spending time on the ground, and getting back up again is an amazingly simple way to get the whole body moving. Most of us spend the majority of our days in a seated position. It’s well known by now that our conventional chair based positions are absolute crap for our bodies. Evolutionarily we were designed to spend majority of our time in transit (walking, crouching, etc), or in ground based positions (deep squats, kneeling positions, cross legged or other variations of sitting on the ground.).
We have seen a slow creep of convenient ways to bring different positions back into our lives- from ball chairs to standing desks, however, the majority of us still plunk down and stay for way too long.
So here’s the deal. Take a minute, get off your duff, and get on the ground. Sit however is comfortable, kneel, or even lay down and do some rolling around. Then… get up!
Do that 20-50times a day for the best results. Start with what you can handle, and build from there.
If you have joint pain or other health conditions preventing you from doing this simple movement, you need to get yourself to a practitioner who knows what’s up and deal with that. Or, comment/email us with questions and we can send you some personalized advice.
Consults are always free at IM, and having someone chat with you about where you’re at and how to get you where you want to go is never a poor investment.
One of the best tests of longevity is this simple (and yes, it should be SIMPLE), act of moving your body weight from the ground level to a up right position unassisted. No matter what your age or ability, I am confident you can get there with the right tools- and that you’ll feel much healthier for this addition to your day.
Okay, seriously, let’s talk about this.
Majority of people are not drinking nearly enough water. Especially those of us who live in the sub zero temperatures on this planet.
I can tell the minute I look at someone, and work on their tissues, what their hydration is like.
Why is hydrating so important? Well why is gas and oil necessary for your car?
Water does many things for our body. Our brain function relies on proper hydration and will use majority of what we get into ourselves immediately just for baseline functioning. All our tissues all the way down to a cell level require water to be healthy. If our cells aren’t healthy, our tissues don’t function at their full levels, and we pay the toll. Joint stiffness, muscle soreness, fatigue, headaches, bloating, water retention, arthritis, sleep issues, low mood quality, you name it I can probably relate it back to your poor hydration habits.
For those of you with existing health conditions or looking to lose weight. This should be of extra importance for you!
How much do you need to drink? You should have a water bottle with you throughout your day, and be taking sips routinely. Generally, I would say 2-3L/day for a healthy adult is adequate. Bet thats a lot more then you’re currently drinking!
For those of you raising protest about more frequent trips to the bathroom, your kidneys thank you in advance. This won’t be a long term inconvenience, but like anything allow for an adjustment period. Try adding herb or fruit (lemon is popular!) infusions! Tea counts as intake as well, but coffee and other sugary drinks not so much.
Want to make this easy? Get yourself a water bottle you’ll love to carry around with you, and keep it full! Just the simple act of having it near you through your day will remind you to take sips from it.
3. The 80% Rule
Coming off of the holiday season and rolling into our new diet plans is always easy when we start… but forming the right habits now will make that February crash and burn easier to prevent.
When it comes to nutrition, there are a lot of things I could throw at you in terms of the latest trends in dieting and why they are probably bulls*** and why you should stick to whole foods and a variable diet full of the things we all know that are good for us… but instead I’m going to leave you with the simplest guideline.
Eat SLOWLY and MINDFULLY, and stop putting things in your mouth when you feel 80% full.
Get the DISTRACTIONS (aka, your phone) away from your eating area, and enjoy what you’re eating. Finding 80% full for most of us is pretty difficult at first, but having minimal distractions and eating slower will help the process. 80% full to me feels.. satisfied. Not hungry, not stuffed. Not empty, but not bloated or brimming. Pay attention to what your literal gut is telling you, and then LISTEN TO IT.
Doing this now while you’re high on resolution plans will make the habit before you hit the Valentine’s day chocolate sales . Trust me.
Feel like you need a little more help building your nutrition habits? Check out our membership page or book a consult to learn more about our coaching programs. (The consult is free 😉 )
4. Learn How to Breathe
We posted on our instagram a few days ago about the Alligator Breathing exercise. If you missed it, find it here and the video here!
We’ve talked about breathing before. The mechanics of it are something a lot of us get wrong a lot of the time, and switching back to diaphragm breathing or alligator style breathing not only benefits the rest of our movement, but also our nervous system and therefore our entire being.
No matter where you’re at, a high performance athlete, runner, weekend warrior with aches and pains, office worker, retiree, everyday human with average health, working on getting yourself to a healthier place, or still stuck where you are, changing your breathing can literally change your life. From mood improvement, sleep enhancement, pain reliever, stress reliever, and focus enhancer- this could be your first step towards something better.
Was that cheesy? #sorrynotsorry
As an added bonus it ties into our next step…
5. Take Five
I don’t care who you are you have time to take 5minutes for yourself.
This isn’t about making sure you hit the gym everyday, or only eat the perfect meals, or even about adding a dedicated meditation practice to your day.
I want you to take 5 minutes to do whatever the heck you want to do.
Some suggestions I could make would be:
- spending 5 minutes practicing your breathing
- going for a stroll outside your office (even better, in the actual outdoors)
- taking 5minutes to get up and down off the floor, or do any other combination of movements that you want to do– check our instagram for ideas here!!!
- 5min letting your mind clear while sipping your favourite drink (OR THAT WATER YOU SHOULD BE DRINKING ANYWAY)
- Writing out your intentions for the day, week, month and the goals that will help those intentions come to fruition.
- 5 technology free moments to meditate on all the things your grateful for today (write these down for added benefit!)
You get the point. The minutes are yours, use them wisely and in a forward thinking way with your health goals in mind.
Those are all simple things right? How many of you will actually add them in? I’m curious!
As I mentioned above, consults with IM coaches and therapists are always free. Our drive is to help you with your drive towards health. Whatever level you are at. Click here to book your consult with us. We’ll even include some goal setting tricks to get you started!
Let’s make 2018 all it can be!