Athletic Therapy, Chronic Pain, health, nutrition, Weight Loss, Wellness

Lessons Learned – Experience Shadowing a Rural Physician By: Logan Brennan

Part I – Life of a Rural Physician

Introduction

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.

Responsibility

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,

Logan Brennan

Athletic Therapy, Biomechanics, Chronic Pain, Conditioning, Equestrian, Free Workouts, Motor Learning, strength training, Weight Loss, Wellness

At your age…

Here’s a fun tidbit I hear OFTEN second hand from clients after their friends/family/peers find out what their training and therapy plans consist of…

“At your age, should you really be lifting weights?”

“Isn’t weight training dangerous for your joints? Does that really help you feel better?”

“Aren’t you worried about getting injured again?”

“I heard that weight training is bad for you- doesn’t it cause arthritis”

First off.. I’m honestly not sure where people are finding that last bit of information from, at this point in our history. Secondly I’m also endlessly grateful that I’ve stopped frequently hearing that weight training will make women bulky- at last that myth has been put out of it’s misery. Third off- weight training is highly effective for arthritis rehabilitation and management- WHEN IT IS DONE CORRECTLY. The only time it’s going to cause arthritis is if you don’t do it in good form. This is why having the guidance of a trained professional is imperative when starting any new program. At the very least get a movement assessment and see where you need to work!

Would I tell someone of ANY age to just go and start lifting weights (no matter how much)? NOPE.

Do I prescribe and coach programs for ALL ages (yes, all the way up to 90-somethings- seriously) that involve various amounts of loaded movements, functional movements, dynamic movements, and stability training? You bet I do!

Here’s the neat things about the body.. it works on an adaptation based system. Which means- invariably- to IMPROVE our systems we have to STRESS our systems.

Here’s the feedback I get from my dedicated clients:

“I don’t wake up at 3am anymore with back pain”

“I sleep through the night and don’t wake up stiff in the mornings anymore”

“I don’t get tired during the day”

“My joints aren’t bugging me as much since I started training”

“I’m making healthier choices elsewhere in my life since starting this training routine.”

“I FEEL GOOD”

When we apply GOOD, healthy stress to our system- things change for the better. We also develop a higher tolerance for negative stressors, which means we function just overall more kick ass.

It no longer new information that the mind and the body are one coordinating unit.

Exercise, movement- of any kind- is the BEST and most EFFECTIVE medicine. The stats support it. Check these out.

According to the Conference Board of Canada, if we were to decrease the number of inactive Canadians by even 10%, we’d see a 30% reduction in all-cause mortality and major savings in health care. It is in fact estimated that more than $2.4 billion, or 3.7 per cent of all healthcare costs, were attributed to the direct cost of treating illness and disease due to physical inactivity1. The financial impact of poor health amounts to a loss of more than $4.3 billion to the Canadian economy, and the negative repercussions of inactivity cost the healthcare system $89 billion per year in Canada2. According to several studies, properly structured and supported exercise program, designed and delivered by a kinesiologist can, among other benefits:

  • Reduce the risk of high blood pressure and heart disease by 40%;
  • Reduce the incidence of type 2 diabetes by 50% and be twice as effective as standard insulin in treating the condition;
  • Help the function of muscles for people affected by Parkinson’s disease and Multiple Sclerosis;
  • Decrease depression as effectively as pharmacological or behavioural therapy;5
  • Reduce the risk of stroke by 27%;
  • Reduce the risk of colon cancer by 60%;
  • Reduce mortality and risk of recurrent cancer by 50%;

(Based on year 2009. Jansen et al., 2012 2 Based on year 2013. 3 Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women.
Barlow CE et al. Am J Epidemiol 2006; 163:142-50. 4 Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. DPP Research Group. New England Journal of Medicine 2002; 346:393-403. 5 Exercise treatment for depression: efficacy and dose response.
Dunn A et al. American Journal of Preventive Medicine 2005. 6 Physical activity and colon cancer: confounding or interaction? Medicine & Science in Sports & Exercise:
June 2002 – Volume 34 – Issue 6 – pp 913-919)

Weight training- when done intelligently for each individual- is just as effective as other types of exercise in improving health. It has it’s own set of extra benefits and of course risk factors. Just like that Tylenol you like to pop for your back pain.

There is no one way to utilize the benefits of movement. Some people to pick things up and put them down.. others like to yoga.. some like to do step classes, and others just like to go for regular walks and stretch. IT’S ALL GOOD.

The biggest emphasis I am trying to make is that adding weight to your routine when you’re doing it correctly for YOUR SYSTEM (this is where the help of a trained professional often comes in), you’re looking at more resilience throughout your body and mind.

Don’t knock it til you try it 😉

(With the correct prescription and educated advice, of course!)