About one year before graduation we at Logan heard that the Florida board had started a three-month/300-hour internship program that was a prerequisite to sitting for the Florida board examination. Most of the people at school thought the program was a slave labor program or just another way to limit the number of chiropractors entering the state. To put it mildly, everyone was upset. At the time I was president of the Florida Club at Logan and everyone had questions concerning the program.
I have since graduated from Logan and have been involved in the internship program for two months. The experience is invaluable and priceless, and now I can answer all those questions.
In my first two months, I've seen numerous hot low back cases, migraine headaches, herpes zoster, Bell's palsy, tennis elbow, whiplash, sciatica, reflex sympathetic dystrophy syndrome (RSDS), work and sports related injuries, auto accident cases, and malingering cases as well. I have sat in on numerous depositions and have witnessed actual chiropractic testimony in a court of law. I have also had the opportunity to watch magnetic resonance imaging (MRI) and computerized axial tomography (CT) scans performed at the Epsom Clinic in Orlando, and have reviewed their results. I have had the opportunity to work with a neuroradiologist at an MRI center in Palm Bay. I have been adjusting, examining, and x-raying patients on a daily basis.
My orthopedic and neurologic examination skills have improved tremendously and I'm now fairly fluent with the use of the Cybex Inclinometer for range of motion studies and impairment ratings.
I have learned the delicate but very important art of progress notes (SOAPs). All of the daily progress notes on every patient are dictated and typewritten so that my grandmother could understand them -- the reason being, one day my grandmother (or yours) might be on a jury and will have to read and understand my notes. I have definitely learned the importance of good documentation, especially since attending the last Florida Board of Chiropractic meeting in Tampa, where I watched a doctor lose his license for poor record keeping and altering his records. Scribbling hieroglyphics on a ledger card just doesn't cut it. One of the most important things to learn is patient management and bedside manner. If you don't make a patient feel comfortable and at ease, the patient won't come back.
According to the board members and board examiners that I have talked with, the two skills that the recent graduates are missing are case management and how to run the business end of an office. Besides the case management skills that I am learning, I've learned how to run the office, from the paperwork, to managing the employees. I'm learning how to avoid all those little stumbling blocks and mistakes that all new practitioners make, and which consequently cause them to fail in practice.
I applaud Logan for such an excellent education, but I take my hat off to the Florida board and their internship program for showing me how to use my education in a practical way. It is my firm belief that this program will increase the quality of chiropractors coming into the state of Florida, and I would urge the chiropractic boards of all other states to look at Florida's internship program and start a similar program of their own.
On a personal note, I would like to thank Dr. Stanley S. Kaplan and Dr. Paul M. Lombardi for taking me into their practice and their families, for giving me priceless knowledge, and for helping me fine tune my skills as a chiropractic physician.
Todd M. Narson, D.C.
Cocoa, Florida
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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A central challenge in creating our identity is that chiropractic is a method of care, not a technique or procedure. This is an important concept for us to promote. Our patients are treated with lifestyle modification, exercise, nutritional supplements, diet and a whole-body approach to accelerate the natural healing process. We are not simply CMT providers.
The results of a global survey released late last year (2023) unveiled some startling findings among medical and nursing students. The “Clinician of the Future: 2023 Education Edition” surveyed 2,212 students, of which 446 were in the United States, from 91 countries.
