This is an excellent article and I enjoyed reading it immensely.
My job has been to help patients after their injury. But what if I shifted focus and spent more of my time educating patients on the benefits of strength acquisition and its relationship to fracture prevention?
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This is an excellent article and I enjoyed reading it immensely.
I guess it goes without saying that I fucking loved this.
I'm intrigued by your practice.
I'm a family physician in the Austin area. I'm relatively young in my practice. Graduated from residency in 2015. I spent two years in a small town in east Texas practicing rural medicine (delivered 160 babies there, carried a 3-4 patient/day inpatient census, high volume (25-35/day on my schedule) rural health clinic, etc.) Lost my practice there when the hospital I was working for closed due to bankruptcy. I moved an hour east and took a job at another rural hospital only to find out 15 months later that they were in talks with bankruptcy attorneys. At that point, I gave up on rural medicine and took a job in the Austin suburbs. I've got 3 young sons and a wife who's adventurous enough to stay home with them. I couldn't keep bouncing between financially strapped hospitals.
My current job is ambulatory clinic only which is way better for my home life. My kids and wife are a great deal happier with my schedule, and I honestly am too. I don't have the same level of professional satisfaction here that I had out in the woods though. I'd be completely fine just coasting through an unchallenging clinic practice. I'm happy with the leisure time that I have here and am generally happy with my job. I just find myself daydreaming about finding some niche in medicine that gets me away from endless E&M codes billed in the pursuit of maintaining what I would consider to be mediocre health at best if it were MY body (A1c under 7, secondary prevention of MI/CVA, obesity, chronic pain, etc.)
You figured that out. You wrote a book on it. You've got a gym. I'd love to hear about that process. I'm currently waiting on a 90 acre plot of land I've got in east Texas to sell so that I can dump some money into a garage gym for me and my wife and get to rocking on NLP and beyond. I'd love to squat 500 lbs before I turn 40 (I'm 37 currently). I'd love even more for my practice to be about helping people to OWN their senior years and be physically capable of doing whatever they want to during the retirement they worked for 50 years to get to. I'd love that a lot more than just trying to keep their A1c under 7.0 so that they can hopefully die with both feet attached.
Last edited by Mark Rippetoe; 07-01-2019 at 10:31 AM. Reason: spelling
Dr. Hurlburt, you should get yourself post-haste to the SS Gym in Austin. I know you're a few miles away, but you owe it to yourself! You'll see your dream in action, right there.
America (and the world) needs more docs like you, Dr. Barnes, and of course Dr. Sullivan. (I came to SS via The Barbell Prescription too!)
It's a big leap. Less money, but less horror. First step, as you correctly intuit, is to do the program. Then coach others doing the progam. Then work toward your SSC. One foot in front of the other. It can be done.
Check out our piece on Dr. Nantschev:
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I didn't start lifting weights until I was 66. I'm very thankful that I was directed to Dr. Sullivan by my friend Coach Dr. Karl Schudt. I've gained considerable strength since then and now plan to compete in my fifth Fall Classic in Chicago. It's good to be alive and strong.
I appreciate the responses. This is something I've been bitching about for a couple years now but didn't know about starting strength. I went ahead and started the program at our local Y since we already have a family membership. The squat racks are pretty nice and see less action than the rest of the gym, so I haven't had to wait. They've got barbells from Rogue and Fringe and a mix of iron and bumpers.
Thankfully, NLP will take a while, and so will intermediate training and learning to coach to some degree. This will give me a few years to figure out my direction. I'm still stuck on the idea that I can somehow integrate strength and conditioning training into a primary care model of some sort. It'll obviously end up being concierge/membership/cash based since the big payers (federal and commercial health insurers) don't have any real interest in this kind of thing, but I'm pretty tired of non-physicians dictating care anyway.
I'd like to think that healthcare would move in this direction at some point anyway, but I just don't believe it ever will. The majority of the diseases I treat in primary care are caused by behavior that is exactly the opposite of strength training, and I get looked at like an alien at least 4 out of 5 times that I suggest getting stronger as an appropriate intervention. This doesn't mean that I have to be an unwilling participant for the rest of my career.
It's not that I don't want to treat these diseases anymore or even that I think prescribing pharmaceuticals to treat lifestyle driven disease processes is inherently wrong. It's just that it's exhausting to know that I'm enabling destructive behaviors by just adding more pills when positive behavior changes would legitimately have done more good. We've got great meds to treat lots of problems, and I'm thankful for it. I just wish that we hadn't subconsciously or at worst passively decided at some point that the answer is always to just add more meds. Easy doesn't work. We chase people down the drain with pills and injections that can be used effortlessly. I'm convinced that strength training could be like throwing an actual life preserver ring if started early enough.
First of all by doing the NLP you have skin in the game, your patients will take notice. Mine have. Talk about strength training to them, tell them why. Refer them to Starting Strength and the Barbell Prescription. You know what happens next? They return to you thanking you and telling you how they have started to train. They show you how easy they can get up out of a chair( with no hands!), they smile, you smile and you know deep inside that you are helping them and you remember how wonderful it is to have the privilege of being a physician. Try it. It works.
Fred Barnes, MD, FACS