How to take the DABCI course.
Dr. Cessna was a big guy who was a genius and critical in the development of the DABCI system of chiropractic medicine. The nutritional therapies he taught us worked then and still do. We would ask him how they worked and he would tell us, "Look, I'm teaching you to diagnose. The therapy works. If you want to lcnow how it works, learn that on your own time. Just do the follow-up test to see if it was effective. Maybe you'll find a better way." He was right; perform or order the tests to diagnose, then again to see if the treatment you prescribed worked. The DABCI course is about diagnosis.
If you want to be a chiropractic internist what is the best way to proceed?
1. Start the DABCI course with lesson #1. Don't stop until you finish the course. Then take the test and obtain your Diplomate. Don't use that sorry old excuse I have heard dozens times of, "I can do this work without a Diplomate; I'm not going to take those exams." The exams gauge your progress. Chiropractic boards in every state recognize the DABCI as a specialty and the DABCI means something very important to your patients. It demonstrates to your patients that you have gone above and beyond and that you are not just another chiropractor. It plays an important part in patient referrals.
2. Get the schedule and block off the class dates on the calendar. Plan your life around the course and study time. Block out at least 10 hours of study time every week outside the clinic. In your clinic, do not do anything but chiropractic, no personal stuff, if you have a few minutes, break out the DABCI notes and books and get to work. Study in the bathroom, in the car, or at the pool. You are returning to a medical school with this course so every moment you have needs to be learning. Don't waste time on unrelated stuff.
3. Book your airline tickets and the hotel one year at a time, not a month at a time. Pay for it up front if possible to seal the deal to yourself that you are serious and you mean business. If you have spent the money, you will follow through.
4. Attend a course away from your home town.
5. Stay in the hotel where the course is or where your fellow DABCI, students are staying. Eat dinner, meet in the bar, in their rooms, but get together and discuss the course work (and patients). Don't treat the course like a CE credit. It is important stuff you have to know and master. Treat it like life and death, because it will be to your patients.
6. Introduce yourself to every student in class and get the student's email and cell phone numbers, so you can contact them anytime. Call them and discuss patients, bloodwork, testing, etc. Out of town colleagues will share more freely.
7. What ever is taught in that module, go home and set that up in your clinic and perform that particular series of exams on every patient in your clinic the following month. If you feel guilty charging because you don't know what you are doing, do it for free, but do what you are taught in that module on every patient. Master the work by practicing. Patients love new exams and testing that you are learning to benefit them. Remember, patients don't care about you, they care about themselves. The more valuable you become to them, the happier they are. It would be nice to think they love us, but the reality is that they love us to the amount we help them get what they want.
8. Take the patients clothes off. Do the exams exactly like we teach in the course. Don't skip steps. Physicians don't examine through blue jeans and shirts. Inspection can only be performed with clothes off. Have a second person in the room with you for examinations.
9. Practice taking the history until you become an expert at obtaining pertinent information. Learn the art of using questions to control the interview. Don't let them get off track telling you about grandma's dog. You have to extract the correct information, and that is done with questions. Questions are the most powerful tool we have at our disposal. You can practice this all day long. Ask questions to everyone you meet about stuff they know, or themselves. A funny thing will begin to happen; people will start to really like you and think you are wonderful conversationalist and you haven't said one word you've only been asking questions about them.
10. Control the history with skilled questioning of the patient. Ask specific questions concerning their problems. What symptoms do you have? Can you point to the pain? Can you describe your pain? if they insist on grandma stories stand up and put your finger on where the pain or complaint is and ask them if this is the spot. Time is valuable. Don't waste it talking about something that is not related to the task at hand; the history and exam.
11. Practice, practice, practice what you learn in class. Use it in the office again and again. Buy the equipment and do the test on every patient the month you buy it, even if you do the tests for free. Patients love free stuff and will agree to a free test without hesitation. Look at every eye, in every ear, palpate every abdomen, do pelvic exams if you can, look at their toes, their anus, hair, breasts, fingers, everything. Do the exams, do the exams, and do the exams. You sell yourself with your history and exam. Your patient will decide whether to stay or not stay with you during the history and exam. You want him or her to go home and tell their spouse that no doctor in their life has ever been that thorough. Ask questions during the exam about what you find; scars, the tenderness, or anything else. They love talking about themselves and they will love you for asking. Today, doctors are not doing quality physical exams on patients. Make sure you are and they will see you care. Be the best.
12. Study, study, study, and study some more. Break the back on the binding of your blood interpretation manual by using it in your office. You have to become the best diagnostician in your town. Look it up. Think about it and call your fellow students. Contact a fellow DABCI and ask questions. If I'm in good a mood, I'll speak with students and I'm a crotchety old guy. Old timers love to see new guys dedicating themselves to the DABCI work.
13. Think diagnosis. Find the medical diagnosis first, then start thinking like a chiropractic physician and figure out the functional pathology. Always ask yourself why. You might find elevated liver enzymes, but the viral tests are negative. Don't stop there. Keep looking for toxic metals, bacteria, leaky gut, occupational issues, etc.. Functional diagnosis is the basis for chiropractic medicine. It is the continual search for why natural function is malfunctioning. This is the essence of the DABCI program and what makes DABCIs different than any kind of doctor in our society.
14. Don't miss any classes, don't miss any tests, and most of all, don't miss any Symposiums or DABCI Getaway Weekends. Become involved in the DABC1 group and participate. You get out of the program and the meetings what you put into it.
If you proceed through the DABCI program the way I outlined above and incorporate it into your practice, it will slowly evolve into a combination of chiropractic and internal diagnosis. If you keep the musculoskeletal side going full steam, it will propel your internal diagnosis side and vice-versa. The beauty of this type of practice is that if you heal your patient's internal problems they will feel great and then go dig up the yard or ride a bicycle up a tree and they will return with a musculoskeletal complaint. You will not lose your patients because they are well. The most important thing is that you become a valuable part of the decision making process for your patients even if they need allopathic intervention. You become an invaluable irreplaceable asset to your patient as Dr. Cessna said.
Finally, not only is the internal diagnosis practice professionally rewarding, it will be financially rewarding also. So, make the commitment and get to work. "If you want to leave footprints on the sands of time, wear work shoes."
by: Tim McCullough, BC, Med, DC, DABCI, APC
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|Title Annotation:||Diplomate in Diagnosis and Internal Disorders|
|Date:||Dec 1, 2013|
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