For those of you enjoying Noah Wiley in The Pitt, an HBO show, the show offers a more realistic view of what happens during an hour shift in an Emergency Room in Pittsburgh, Pa. The idea is that this is what occurs in the Pittsburgh hospital where the show takes place during that hour. While the format reminds me of 24, another show featuring the character Jack Bower, a counter terrorist agent who will save your life. The show also used the one-hour-per-episode format, allowing the viewer to experience Jack Bower’s world. You can check out both shows plots in the links above. How real is the portrayal of The Pitt ER? I receive many emails from medical sources where doctors have been speaking about the show, how real it seems, and often, they do not want to watch it because they feel it is too close to what they actually experience during their ER shifts. Most doctors applaud the show for its realism. As a patient visiting the ER in New Jersey, it is often a frustrating experience sitting for hours to finally be called in to be evaluated. In my last few experiences, the ER from Overlook and even from Barnabas was understaffed and erratically run. We only see this from the patient’s point of view, which may be what they are portraying in their own waiting room in this show. In the E.R, doctors may see anything including people living on the street with chronic problems, an uncontrolled diabetic who has reduced their insulin intake due to the cost, someone being impaled by glass or some other object or even the couple who were in an automobile accident where the wife collapses due to a spleen injury she was ignoring but I even picked up on it when I saw it on the television before she passes out. Some doctors have substance abuse issues and have to deal with them. The ambulance crew shouts out vitals. A bodyboarding situation where the patient was bleeding out because everyone missed the glass that was in their back from a fall out the window. You name it, it happens during that hour. You see a nurse who is struck by a frustrated and uncontrolled patient. The little child was evaluated for possible abuse, and the caring staff who try to do their best. You get it; the show has it all and shows it in real time. How your chiropractor relates to The PITT I have been trained in bodyboarding as well as CPR. These and perhaps working on the field as a chiropractor, as I did this last year in women’s pro football, or when I worked with another chiropractor during Nitro Circus, are the few times I work on people, and you will hear me use the type of communication they use in the ER. In the ER, a team of doctors, nurses, and others coordinate, order tests, and administer lifesaving care when needed. Other times, the staff needs are smaller to deliver needed care. As a chiropractor in musculoskeletal medicine, what we do works best in small teams or with one doctor administering care while helping the patient improve. This allows for simplicity, improved results at a lower cost. Our electronic records give us what we need to administer consistent and effective care with one doctor. The ER either has you move on to a family doctor at discharge, or the patient can be admitted if more serious. Chiropractic care is more one-on-one, which is more appropriate for musculoskeletal medicine. Our focus is on giving the patient the rehabilitation they require to move and feel better. Their focus is to stabilize the patient and move on to the next. Patients often develop relationships with us that can last months, years, and decades, as is common with primary care. Chiropractors help patients over a period of time to solve or improve a longstanding problem causing pain or dysfunction, whereas the ER’s mission is to stabilize and release or admit. Both types of care are necessary and can help you avoid future problems. We are all here to help. Empathy, as you see it in The PITT, comes from nurses and doctors while trying to do the best for people, even when disaster strikes with all the craziness that can surround a packed Emergency room. In our small practice, we do the same, although since it is more one-on-one, the approach comes across as more personal. We do have our craziness as well when someone comes in experiencing acute pain, while we do our best to calm and stabilize the situation. We may need to send the patient to the ER or to urgent care if we believe they require medical intervention for a more serious or life-threatening condition. Thankfully, most patients who are in pain can be helped in our chiropractic office, and they require a few days of care and coaching to help them out of their acute painful situation quickly and naturally. Often, our approach can help them avoid unnecessary MRIs and other tests that may be ordered by doctors in the ER. Our No. The Brunswick office does have an X-ray on premises, which can be used to immediately rule out more serious conditions quickly and at a lower cost than the ER. Trust is something that is earned, and in the show, some patients trust the doctors, while others request other doctors whom they may have had on previous visits to the ER. In the world of musculoskeletal medicine, trust must also be earned as well. We still see patients from my first few years in practice who visit when they are in the area as they trust our honesty, integrity, and, of course, skill. The public is unpredictable. In the show, one nurse gets punched while another patient has to be sedated because he is out of control, and everyone who knows them says they are never like that. Of course, this is television, but sometimes medical conditions can cause people to act out of character, which sets up another interesting plot line. In our office, we have also had various situations of patients who do the unexpected. It comes with the job. Caring for others in the ER is what they do in the show. Offering someone who was living off the street a sandwich, for example, who is hungry. While we do not feed others, sometimes we will give charity care to someone in need. We have done this in other ways, using our Turkey Drive and adopt-a-family programs for many years to help others. Diagnosing and solving complex problems that save lives. Solving life-threatening problems is what they do in The Pitt. Some patients die. Some patients’ families want everything done, even when the doctor believes it will not help them and may cause unneeded end-of-life suffering. Some patients are stabilized and sent home. Some patients who require more evaluation want to leave and go home against what the doctor believes is best. On busy days, chaos reins and teams of providers work on patients to save their lives. It can be very stressful for everyone involved. In the chiropractic world of musculoskeletal medicine, we are primary care for the musculoskeletal system. We look at the whole person because your painful condition is often from mechanical dysfunction from the feet up. Years of experience allow me to do quick evaluations of your structure, and after a thorough history, a manual evaluation of what is wrong before ever treating you. We use manipulation of the joints of the spine and extremity that can often offer quick relief of pain, myofascial release to improve how you move, and patients are given the exercises they need during their regular visits to help them improve and recover quickly. Some days, chaos rules, especially when barometric pressure is low, which makes people more sore and agitated. We maintain a high level of service for all patients, but instead of a team, it is usually the staff. We, too, are saving lives but in a different way. Diagnosing a problem that has become chronic and painful is often what we do. Patients do not always do what is in their best interests for various reasons, but my job is to help them the best I can, just as they do in The Pitt. In our office, the care does not use medications, immediately order scans or other tests, or do invasive procedures to save a life. We do great exams, and our manual evaluation skills and our holistic approach to history and care help patients find simple and effective paths to a pain-free life. If a patient’s knee problem is due to a pelvis and foot issue, they will most likely be diagnosed and treated best through chiropractic with simple approaches that improve how they walk and move. Most patients do not think about this, but in 30 years, they are likely to have avoided that knee or hip replacement if they followed our path when we recommend it. We look at functional improvement, which, years later, allows them to be more active, more body aware, and healthier. Chiropractic patients are more likely to understand that there are better approaches than taking Advil, which does nothing to solve mechanical problems. Avoiding medical interventions is great for your health and helps you avoid the risks that come with them. Our view on saving lives is not immediate life and death, but is for better, more active lives into your 60’s and beyond. Dealing with administration and how they may limit care due to cost risks. In the Pitt, we do see administrators choosing what care will and will not be offered depending on the patient, their insurance, and the medical appropriateness. Doctors are often negotiating this with bean counters, a necessary evil in the show. In our office, we too are faced with some difficult decisions because of insurance barriers, denied MRIs that are, in our opinion, medically necessary, and high deductibles, etc. Insurers often get in the way with tiers, patients making financial decisions on coverage rather than on their own health, and it is not unusual for an insurance carrier to make a game out of reimbursement, which is why so many patients no longer trust their insurance will do the right thing. We all have our challenges, but until our government allows for universal healthcare, this unfortunately will always be a concern. Patients, too, must be willing to pay out of pocket to get what they need as well, when an insurer will not. It is your body and your responsibility. The good news, chiropractic care is far more affordable than the medical side of the menu. As I often tell patients, especially those who have medical savings accounts, you can get the care that you need by using the medical savings account. Taking care of things early reduces cost and damage to your body that is avoidable. Helping others is what we do. Helping others in the show, The Pitt, is what they do. As always, we are here to help. Need help now? Book online or call either office for an appointment.