My Interview with the Wealth Preservation Podcast

Back in March I had the pleasure of recording an interview with my friends and money managers, Josh Saunders and Mark Seither, who host the Wealth Preservation Podcast. In the first episode we talked about my business model and why I do what I do. In the second I talk more about how I have marketed my practice using networking and social media. I have had many friends, family, an

YouTube >> https://www.youtube.com/channel/UCV4PyFJJZ5sG7-QSyX2DOuA/videos

Apple Podcast >> https://podcasts.apple.com/us/podcast/wealth-preservation-podcast/id1493231689

Stitcher >> https://www.stitcher.com/podcast/wealth-preservation-podcast

Website >> https://www.wealthpreservationpodcast.com/

Adjustment >> https://www.youtube.com/watch?v=d3x_6hI70Dc

Compliance video >> https://www.youtube.com/watch?v=Ly7kaoIroJ0

Germaphobia Vs. Immunology

Full disclosure, I am a germaphobe and have suppressed my obsessive tendencies since I discovered them as a pre-teen. Like most of us, I was taught about hygiene around the 5th grade. You know, when kids are on the verge of stinking if they don’t shower often enough. Since that time when I learned about bacteria and other germs, I made sure to wash my hands often. Then, one day around 7th grade, I watched an after-school special (Gen X-ers will remember those). It was about a kid who was an obsessive hand-washer due to his OCD. As I watched this kid struggle I had an epiphany. I was that kid! My hands were chapped. I avoided touching things, just in case. I would never drink from someone else’s cup or share a spoon. I was a germaphobe!

A phobia is an extreme or irrational fear. I had taken it to the irrational level thinking everything I was doing could keep me from catching a germ. At the time I realized my folly, I understood that trying to protect oneself completely is impossible. As I have studied, I learned why trying to do so is dangerous. I am afraid that with the response to COVID-19, we are becoming, as a civilized society, germaphobes. The risk of such phobic behavior has the potential to be infinitely more harmful than the novel coronavirus we have been trying to stop.

Immunology is the study of the immune system or how the body responds to foreign substances or infectious organisms. The basic tenets of Immunology concern exposure to a pathogen and the body’s ability to fight it off. There are many weapons against invaders so, keep in mind that I am just touching upon the very basics. B-cells seek out pathogens and attack them. T-cells find infected cells and kill off the cell so the pathogen cannot reproduce. This process can take a week or more. Whenever these types of cells go to work, they create armies of these antibodies and they also record the way they attacked the antigen so that should a person ever be exposed to an antigen again, the body will be ready to the point where the likelihood of another infection is extremely low. This is why when I was a kid and had chickenpox, my parents made my siblings play with me to get it, too. That way, we would all have it and would develop lifelong immunity to the disease. In addition to T and B-cells, and there are many different types, there are also substances that we can ingest that help boost our immune system. This is seen when a newborn, who does not have an active immune system, is given antibodies through her mother’s milk or when people get an immunoglobulin shot.

The key to developing a strong and healthy immune system is to gain exposure to a wide variety of germs and letting our bodies fight off those antigens and build armies against them for the future. If we are never exposed, we cannot develop antibodies to fight off the infection. This is the basis for vaccination, expose a person to a virus so their immune system can develop the antibodies necessary to fight it off if exposed to the virus again. If enough people in a community have developed the antibodies to fight off an infection, herd immunity is achieved and the spread of the disease is negligible.

There are germs on and around us at all times. Most perform a vital function in the balance of life. If a host becomes immunocompromised, germs can proliferate unchecked. We have to keep our immune systems ready to fight off diseases. What we do not exercise becomes weak. If you completely isolated yourself for long enough, you would not be exposed to any new or changing germs. When you entered into society again, you would most likely get sick from some antigen that your peers had already developed immunity against. This is the danger of prolonged social distancing! We need to share our germs to survive as a species. You cannot develop a strong immune system by isolating yourself. Likewise, if we kill off or block the germs we need to maintain ecological balance with copious use of disinfectant wipes, excessive hand sanitizing and washing, and ubiquitous use of masks, we will not only throw off the balance but we will also have a more severe flu and cold season than we have seen in a very long time.

The notion that we need to shelter in place until a vaccine is developed, is preposterous. We are so focused on the virulence of the Coronavirus that we are completely ignoring the fact that now is the time most of us should be sharing and therefore building up immunity to the flus and colds that will hit us later. These are the same flus and colds for which they have never created an effective vaccine. It is shortsighted to focus only on COVID-19, and that is just from an immunological point of view, the social and financial dangers, notwithstanding. Viruses move through communities quickly. If we have not developed herd immunity to COVID-19 at this point, which I truly believe we either have or are close, then let’s fight it head-on. Those with compromised immune systems and others with higher risk factors need not be in the fray. Those are the individuals who should shelter in place. The rest of us need to share our germs. If we remained isolated, there will never be a good time to rebalance.

In my opinion, and I share this with many other professionals who are much smarter and more educated than I, it is now time to ease back into society. It should be a process. Stop wearing your mask unless you are symptomatic, have a high probability of being an asymptomatic carrier, or around people who are known to be susceptible. Ease up on the sanitizing of every surface. Shake hands. Hug. Meet with friends and neighbors. Be social. Obviously, do all of these things with those who do not appear to be at risk or with those who may have been exposed. Staying inside might have been important while we were analyzing the threat and flattening the curve, but now it is time to save lives by not staying in.

Photo by Tai’s Captures on Unsplash

 

 

“Do you accept Kaiser?” “Yes, we do, sort of…”

We get calls every day asking if we take Kaiser patients. Of course, we do! However, we are not contracted with Kaiser so that is a bit of a misleading statement but let me explain. Kaiser Permanente is one of the largest health care providers and insurance companies in California and its innovation has become revolutionary. Kaiser is both an insurance company and provider of healthcare which has given it a unique way of managing the growing costs of healthcare while still providing quality care.

As a provider, Kaiser does not actually provide chiropractic care. They have acupuncturists, physical therapists, and, of course, all of the traditional medical professionals. At least, as far as I know, they do not employ chiropractors to perform chiropractic care. As an insurance company, they have some policies which include chiropractic care. Kaiser does not actually manage chiropractic benefits for their clients. Instead, they contract out chiropractic benefits to a company named ASH or American Specialty Health. If a chiropractor wants to be on the list of providers for the people who have chiropractic benefits on their Kaiser policy, they must be contracted with ASH.

I am not contracted with ASH nor do I have plans to become contracted with them. ASH is an  HMO or health management organization and their model of business is not compatible with mine. HMO’s are willing to cover patients in acute pain who have an injury on their list of conditions suitable for chiropractors to treat. They have models that require justification for care through paperwork. I like more flexibility in treating my patients and I hate extra paperwork. HMO’s have done well in reducing the cost of care for insurance companies. In theory, this means lower premiums and copays for patients.

So, how exactly do I take Kaiser patients? I am glad you asked. First, most Kaiser patients do not actually have chiropractic benefits. So, it makes no difference whatsoever to see an in-network or out-of-network chiropractor. We have a great practice with very affordable fees and super friendly staff. Why wouldn’t you want to see us over anyone else?

For the patients who actually have chiropractic benefits through ASH we can still help. I may not be contracted with ASH and therefore have the privilege of taking a reduced fee in exchange for a policy that will tell me that I can only see a patient six times before having to file another report to get a few more visits until they decide that the patient should be better so they are not paying anymore; then, by the time I get done writing reports and fighting the insurance company, I have wasted enough time and money to make it completely not worth it; but, I can see patients with Kaiser/ASH at no additional cost to the patient.

I routinely accept patients’ regular copays as full payment for care. Compare that to a doc who will take that copay for the six visits the insurance company gives and then charge full price once the insurance company deems their lingering issues resolved. Of course, sometimes patients prefer my monthly care agreement because it works out to be less expensive than paying their copay every time. Either way, it is a better deal for the patient because they are not under the scrutiny of the insurance company but still enjoy the contracted copay or less. In addition, they get great care and it can be completely customized without strict policy guidelines. In that way, we are happy to take care of Kaiser patients and everyone else who has insurance whether we are in-network or not.

***Photo by Miguel Bruna on Unsplash

Our Complicated Decision to Remain Open

I want to thank everyone for sharing their thoughts and concerns with me regarding whether Thomas Chiropractic should remain open as “Essential” during the pandemic. It is an extremely complicated decision and, for now, the responsibility rests completely on my shoulders. After much thought and prayer, we have decided that it is best for the community, my staff, and our families to remain open. As such, Dr. Karp will be working today from 7:30-12:30 and 2-6. We will continue with normal hours until further notice.
 
I have weighed the risks and contemplated the solutions. My patients who also have “Essential” jobs have pleaded with me to help them stay healthy so they can perform under the stresses and strains of the current situation. I have patients who are in the tender and tenuous stages of healing where any loss in momentum could be devastating. I have other patients who have a very difficult time functioning without regular chiropractic care. Finally, I have an abiding and sincere belief that chiropractic adjustments support the immune system to such an extent that patients who continue care have a demonstrably better chance of fighting off any virus.
 
Our office is well equipped to maintain proper social distance. We have a decent-sized lobby and six separate treatment rooms. People sign in with a new or freshly cleaned pen. With the decrease in patient visits since the call to limit social contact, the number of people in our office at any given time has not exceeded the recommendations. I appreciate many of the suggestions given regarding sterilization. The truth is that it is impossible to maintain a sterile environment. We certainly do our best but we cannot wipe down every surface that someone might touch and keep it wet with sanitizer for the length of time necessary to kill the germs after anyone comes in. Providing masks, gloves, and disposable table sheets would be amazing but impossible. Even the hospitals are running low on these supplies and you cannot buy them anywhere. It is an expensive and logistical conundrum. That saying, I welcome patients who have their own masks and gloves.
 
At the end of the day, it is always safest to just stay home, even under non-crisis circumstances. As humans, life is a risk. I believe that the risk of spreading the disease in my office is low at this time. I know many of you vehemently disagree with me. I respect your opinion and your right to have that opinion. I will also remain your friend. I take this risk of my own free will and choice. The liberty and freedom to make such a choice are extremely sacred to me. If you choose not to make the same choice, I will be ready to help you, God willing, after the disease has run its course and life returns.
 
If you choose to also take the risk to come into my office for care, please do so of your own volition and exercise your own precautions. If you know me at all, you know that I am an advocate for individual responsibility, especially regarding one’s own health. I implore you not to come in if you are displaying any symptoms that might endanger anyone in the office. If you are an at-risk individual and you need special accommodations, please contact me. We can make arrangements while you wait in your car. Take the responsibility upon yourself to limit hand contact with surfaces that get touched often or to use a barrier when you touch any such thing. Avoid touching your face unless you have just cleaned your hands.
 
I hope you will respect my decision in this matter and understand that it may change as circumstances are so volatile. May we all remain supportive even in our differing opinions and show our greatest quality by expressing love even when understanding is lacking.

Thoughts On the Coronavirus and All Infectious Diseases

As with anything that dominates the twenty-four-hour news cycle, the Coronavirus or COVID-19 has a spectrum of concern. Please educate yourself on this virus by checking out the CDC’s website. I am writing to give my thoughts from a holistic healthcare provider and, hopefully, a reasonable perspective to help you navigate the fear while still protecting yourself.

You are starting to see memes about surviving the latest end of the world. Let’s be honest, every few years the news goes crazy about some infectious disease that could wipe out entire populations. The disease runs its course, many are infected, several die, and the disease gets under control and passes from global consciousness. Some diseases, particularly the ones they create a vaccine for, stay in the public consciousness because of the shot. These are, generally, very nasty viruses. There is definite cause for concern. However, we need to step back and avoid panicking so we can really fight the spread of such diseases.

Many have written articles about how to protect yourself. I would echo those which encourage you to wash your hands often and avoid close contact with potentially infected individuals. However, we still need to live and function in society. The best defense is not a mask, gloves, or boarding yourself up at your house, but a stellar immune system.

Antoine Bechamp in the 19th Century claimed that it wasn’t germs that cause diseases but that leaving our bodies susceptible to disease was the problem. He argued that there are always germs in great supply about and around us and that until we give them a place to thrive, they stay under control. To prove his point he drank a glass of water infected with cholera and never got sick, so the legend goes. He lived into his 90’s so he, at least, had something going for him.

I am not suggesting that anyone take a flight to China, not that there are any available, to prove the superiority of your immune system. However, we can and should do all we can to keep our immune system performing well. I could write a whole article on keeping your immune system healthy. I will sum up some good ways by saying you need to eat well, drink plenty of water, exercise, get enough sleep, avoid sugar and alcohol, and get adjusted.

I know, I am a chiropractor and I always figure out some angle to work adjusting into the solution. The truth is that chiropractic adjustments have been shown to significantly boost one’s immune system.

Right now, the Coronavirus is not really prevalent in our area. There are a few cases that have been quarantined. Health officials are doing a good job of educating people about what they can do if they suspect an outbreak. In our office, we are taking the normal precautions to ensure that we are not a source location. Please, keep up on your care. Staying healthy, like I mentioned earlier, is still the best defense.

 

When Adjusting the SI Joint Isn’t Enough

If you have never had SI joint pain, you are probably wondering where this particular joint is located. If you have had or currently have SI joint pain, you know it can be a pain in the butt, literally. The Si joint or sacroiliac joint is formed by the sacrum, the trapezoidal bone below the lumbar spine and above the coccyx, and the pelvis, or ilia. There are two joints on either side of the sacrum. The movement of the SI joint is called nutation and it is pretty slight. One does not really even notice the movement until it gets stuck and then it is all too obvious.

A chiropractic adjustment can do wonders to relieve the pain associated with an SI joint that is not moving properly. I have found that using the drop table is particularly effective. I usually follow it up with a side posture adjustment. Sometimes, however, that is not enough. On occasion, I find a stuck SI joint even after the adjustment. In these situations, I look to the pubic symphysis.

The pubic symphysis is a tricky joint. It is formed where the pelvis meets in front. It is a cartilaginous joint that is planar. What I find when something is wrong is one of the pubic rami is higher than the other. Because the pubic symphysis is on the opposite side of the SI joint but still the same bone, if it is not moving right, the Si joint will have problems, too. I use an activator to adjust the pubic symphysis. This is a fairly sensitive area so using the activator makes it more comfortable both physically and socially.

So if you are having problems getting the results you need from a typical SI joint adjustment, have your chiropractor check your pubic symphysis. As with all treatment, it can take several visits before you see significant results. Still, you should start seeing some signs of improvement fairly quickly to help you know you are on the right path.

 

5 Things to Consider When Looking for a Chiropractor

It can be tough finding a chiropractor that you can trust and who will be the right fit for what you want and need. This list is by no means comprehensive but over the years I have noticed trends that can help you pick the right doctor of chiropractic for you and your family.

  1. What style of Chiropractic do you prefer? Chiropractors have a fairly broad scope of practice and have expertise in many different styles and methods. Do a little research on the doctor before you go in. Read the doctor’s bio. Look at how they practice. Some chiropractors just adjust, which is what we do in our office. Some emphasize nutrition. A lot of chiropractors really want to treat the whole body and have a lot of extra equipment and programs to help improve your health on all levels. Others only focus on pain relief. Every chiropractor has their own individual style but there are also various technique systems. There is Gonstead, Applied Kinesiology, Activator, Sacro-Occipital Technique, and the list goes on. If you know you like a style, look for a doc who practices that way. If you have no preference, in terms of style, look for someone with similar values or who is likeminded.
  2. What type of care do you want/need? There are basically three types of care and some chiropractors do all three and some only do one or two. The three types of care are acute or symptom care, corrective or rehab care, and maintenance. It can be frustrating to see a chiropractor who only wants to do long term corrective care if you only want to focus on your symptoms. Likewise, it can be a problem if you really want corrective care and to rehab from an injury and the doctor only wants to see you when you have pain. On that same note, some patients are put off by chiropractors who recommend nutritional supplements, orthotics, pillows, or other corrective equipment. Other patients want and need a bigger commitment to improving their health. Finally, some chiropractic offices have physiotherapies like electrical stimulation, lasers, ultrasound, heat, massaging tables, and ice packs. Therapy takes longer to utilize. Some patients like the extra time spent in the office. Others just want a quick treatment. The type of care may change based on your symptoms and healing progress so be sure to find a chiropractor who can either adapt or is in line with what you need at the moment.
  3. How far away is the doctor’s practice from where you live or work? This may seem obvious but I see people all of the time who come from a long way away because their friend referred me or they didn’t put in their location in the search parameters before they read my reviews. Most chiropractors will want to see you more in the beginning sometimes as much as every day. Travel time and gas costs add up. It is best to decide early if commuting to get adjusted is worth it. You also need to consider if it is better to find a doc closer to your work or to your home depending on your work hours and the doctor’s schedule.
  4. Do the doctor’s hours work for your schedule? Most people lead busy lives. There is a lot to do in a day. You need to consider whether your doctor’s hours and schedule work for your lifestyle. Does early work for you or do need someone open late? Are they open on the weekend? Further, do they require an appointment or do they take walk-ins? Most doctors prefer to make appointments for new patients and some always require an appointment. You need to decide if it is better for you to have scheduled appointments or not? On that same note, if the doctor only takes appointments, do they run on-time?
  5. Do the doctor’s fees work for your budget? Healthcare these days is expensive. Doctors have a lot of overhead because of licensure, regulation and the cost of rent and payroll. Because of that, doctors’ fees range greatly. A good rule of thumb is to ask how much an adjustment costs. Chiropractic Economics Magazine puts the national average cost of an adjustment at $65. Most docs will charge more for therapies and other services, so keep that in mind. Whatever the fees, make sure you have a way to pay for the cost of the care you need. Most chiropractors have plans that can help save you some money if you pre-pay. Insurance can also help but is not always very reliable. Going in with a fair idea of what it will cost definitely helps you make a good buying decision. If money is a concern, discussing fees with the doctor after they have a good idea of what you care will look like is very important.

Time Vs. Expertise

There is a story about a remote research facility that was having a problem with their generator. They tried to get a few technicians to fix it but it never worked right. Finally, they brought in an expert. The expert looked at the generator, tapped it twice and it ran perfectly. He sent the bill for $2002.00. When the scientists saw the bill they were incensed at the price for so little work on the part of the expert. They demanded an itemized statement. The expert sent one which read: $1.00 per tap x 2 taps = $2.00 + $2000 for knowing exactly where to tap.

I tell this story to help people understand that when you meet with an expert it is about their skills, knowledge, and experience, not their time. I have patients come in who are surprised at how much an adjustment costs considering how little time it takes. We are especially expedient in our office. To those patients I say, you are not buying our time, you are buying our expertise.

Most patients love that they can come into our office and get a great adjustment in a short amount of time. It does not take us long to figure out what is going on with a patient and adjustments by their nature are quick. We don’t do therapies like e-stim and ultrasound. We are not nutritional counselors. I have no problem with chiropractors who do that but that is just not how we choose to practice. We focus on giving good adjustments that help people with their busy lives.

In addition, the greatest benefit of chiropractic is not an adjustment but regular and consistent adjustments. We really encourage patients to get adjusted often and regularly by making it convenient and quick to come in. We also make it very affordable to get adjusted a lot. The price per adjustment if you just come in once in a long while is expensive. However, if you want to come in regularly, the price per adjustment is downright cheap in our office.

We will always strive to spend as much time as you need to give you a great adjustment. We are here to listen to your concerns. We never want patients to feel rushed. That saying, care in our office is not based on time. Care is based on service done with skill and care.

***Photo by Veri Ivanova on Unsplash