Traveling house call doctors are not common, why did Dr. Matthew Barker DO decide to do it? Learn about osteopathic manipulation medicine and residency, logistics of mobile doctor services and how is it different than a DC or DPT spinal manipulation.
For someone who planned on becoming a chiropractor, what changed his mind to become an osteopath? What does an osteopath curriculum look like? Why learn spinal manipulative therapy (SMT) or osteopathic manipulative medicine (OMM as he refers to it sometimes)?
Why do home visits or mobile osteopathy? Is it efficient, could you make more in a hospital or doctor office setting?
Since you have a residency in SMT, and have to become board certified in manipulative medicine to be competent in the manipulation aspect of pain relief medicine, can you perform osteopathic manipulation in a hospital or is it still frowned upon?
What does the residency to become board certified involve? Not only do they learn the adjustment (SMT or OMM) but they can do all sorts of injections.
What type of rehab/ exercise training do they receive?
Does a specialized manipulation osteopath still have to work as hard as a chiropractor to get those medical doctor referrals for musculoskeletal pain?
I think many DC’s, DPT’s, and probably DO’s struggle with how to explain a manipulation medicine, listen to his mock explanation in the first half of the interview.
Misconception: how is a chiropractor adjustment different than an osteopathic adjustment?
Visceral manipulation… what does that look like: visceral somatic reflex. Example: Large intestine condition can be traced to the acupuncture meridian /point by the wrist to be stimulated to see changes.
At Home – Mobile – Travel Doctor: Osteopathic Manipulation
Why did he choose to do home visits? How did he pick the area of the city to cover?
Does he get referrals? He also rents a room as well as travels each day to see patients, why did that happen? What’s considered a good amount of visits per week for him?
How does he handle the logistics of seeing one patient, and then another potentially not available for another hour? How many visits would a patient expect to need his services?
What type of marketing does he do… hint lectures have been great?
Why is he having trouble hiring someone to expand his services?
ommtables.com for portable table and practice fusion for the EHR
American Academy of Osteopathy and Cranio Academy are two resources to find other osteopathic manipulation medicine type doctors
Mobileosteopathypa -FB matthewbarker -IG
Touch of Life Robert Fulford
Show notes can be found athttp://www.adoctorsperspective.net/114 here you can also find links to things mentioned and the full transcript.
Episode 114 house call osteopathic manipulation I'm your host Dr. Justin trust Claire today with Dr. Matthew markers perspective,
to 2017 and 2018 podcast Awards Nominated host as we get a behind the curtain look at all types of doctors and guests specialties. Let's hear a doctor's perspective.
Justin Trosclair 0:29
Thanks for tuning in. Before we begin, if you get a chance, go and write us a review on your favorite podcast app. That would be fantastic. Alright, today is your physical therapist, chiropractor and osteopath. Maybe you're a medical doctor who's been interested in what we call spinal manipulation, aka the adjustment aka osteopathic manipulation, then this will be the episode for you. We have a Board Certified osteopath, who chose to do his residency and his board certification and osteopathic manipulation, it probably looks similar to the corporate culture. But of course, it's gonna be different. And what also interested me in Dr. Barker is that he chooses to do home care, so he travels to your house does what he needs to do. And so because that's such a foreign thing for me, I don't know a lot about it. I was excited to hear about it. How's it work? logistically? You know, how do you make it profitable? You know, one guys 30 minutes away, the next lady is, you know, 45 minutes the other direction. So what do you do? How does that work? And then trying to figure out okay, what is a residency look like for spinal minute bit of therapy? What What do the other like medical doctors feel about it? Is it easier to for them to refer to you as chiropractor like, we want those referrals for all that musculoskeletal pain? Do they just go to the osteopath instead? How much rehab? Do they learn? What's the misconceptions that they have to deal with? What kind of marketing is he doing? You know, a lot of those types of things will be answered today, including what the HR he uses, and his favorite table for the moment. All right, by all means, you go to the website, top right, follow me on any of the social media like it, follow it, you'll see some cool stuff, cool pictures, latest podcasts, all that jazz. Like I mentioned before, parents are gone now. And let me tell you, I'm really proud of them. The red ventures eaters, they usually aren't, they were really going with the flow Islam are walking in usual, two different pace, obviously in China. So I'm really happy for them, that they came and they had a good time and that they were such easy going and try to make everything work. And they really appreciated what we did for him as well. So hats off to them. Love them, of course, and looking forward to hearing your guys's opinion. And ladies of course, what should the next series Be sure to find a bunch of osteopath a different types, see what they do. If you liked that idea, send me a message and I'll see what I can do. Okay, all the show notes can be found at a doctor's perspective, net slash one one for let's go hashtag behind the curtain.
Live from China, in the Dallas area, too. The show we got a doctor of osteopathy. He said a little unique situation. So that's why we got him on the show. So good. His name is Dr. Matthew Barker. Welcome to the program.
Thank you. Thank you for having me on.
Justin Trosclair 3:11
I saw I was going LinkedIn. I was looking for people and it's like, Whoa, not stupid. Okay. I'd like to give some more of those on the podcast. We don't haven't really done that for some reason. And then as I do spinal manipulation therapy, and I said, Whoa, that's pretty cool. Because I know you guys can do it. But it seems the most more of like a side piece of most people's practice. But you're like, no, this is what I do. And not only do I do that I do house calls. And again Yeah, I mean, I was listening to some PT podcast and they're like, you know, they do home visits. And you know, one of the problems they have is like how do you even make this you know, it's not that efficient, but somehow they still are able to like charge enough so it you know, their their salaries pan out as well. And it's a service for the people that can't really travel or just whatever reason so that's kind of the setup for for why I wanted you on but before we get into all of that, being that you're into maybe you were in the spotlight of their been before you went to school, or you figured out you liked it while you're in school, but what's your backstory? How did you pick osteopath and s&t?
Yes, so I initially was interested in in medicine and health care, because I must started having neck pain and headaches and low back pain starting around age 14. And so I sought out treatment went down the Chiropractic and massage therapy route for treatment. And I did get some relief with with those modalities and you know, I really liked the the instant kind of release that I got going in and, and working the idea of working with my hands and working with patients and housing to athletics growing up so I wanted to treat athletes and sports injuries. So my initial goal is actually to go into chiropractic.
I did a lot of research, different practice schools. I went to Arizona State University for my undergrad and my specialty was kinesiology or exercise science. And I knew that osteopathic physicians could do or or learn some manipulative medicine. But the ones that I knew that did it did it very little. And so it was not the the predominant part of their practice. And so I wanted to be the predominant part of what I did. And then I found out about halfway through my undergrad as an osteopathic physician can specialize in manipulative medicine. And she can do that full time and also provide injections when necessary or prescribed medication when necessary. And so I went and chat with one I wouldn't got treated by one. And that's when I kind of switched routes from pre chiropractic school to pre med and decided to go into osteopathic medical school, Nolan, I wanted to eventually be board certified in manipulative medicine.
Justin Trosclair 5:58
And that's why I mean, I didn't even know what a doctor of osteopathy was when I was kind of in that same realm of, and it's like, wow, that would have been pretty cool. Because it would open doors that you otherwise wouldn't have, like, you know, chiropractors have a hard time getting into hospitals, and you know, those types of things. And, you know, we see patients, like you said, like, see, sometimes they need an injection, sometimes they need medicine, it would be nice to be able to offer those things when you see like this person obviously needs more than when I can give them at this moment. Yeah. So what's the program? Like? Is it like a general practitioner, you just after the school you go to like two year residences? Or what what does that look like for the audience?
So osteopathic medical school is, is very similar through traditional medical school. The curriculum, we have an almost identical curriculum and what we learn for general medicine and pharmacology, basic sciences was different our curriculum is that we have the are manipulated medicine class, which is usually a most schools for our class once a week for the first two years of medical school. And in that class that we're learning the how to evaluate and treat patients using our hands. And so we're used for learning how to look for restrictions and asymmetries in the body and tissue texture changes. And then you're you're learning a variety of different techniques to treat those with our hands. And then during the third or fourth year, most schools require like one full month, so a full month rotation in many food medicine, working with a specialist. And then after that, you know, besides that one difference, medical school training is very similar for Osteopathic Medicine versus traditional medical school. And so after medical school to four years, you're required to go to at least do one year of residency, which is called internship year in order to get a license as a general practitioner. But if you want to be board certified in any specialty, whether its family medicine, osteopathic manipulative medicine or surgery requires additional years of training, and that's called residency.
Justin Trosclair 8:13
What What do y'all learning? You know, as chiropractors we have classes, almost every trimester, we got a lot a lot of hands on throughout the entire program, because that's kind of what we mean that's our bread and butter. So when you're in your residency, are you starting to learn and do it like more hours per day as well as learning the pain management side? Are you considered kinda like a pain management specialist who also does s&t? Or how does that look what's that was one of the things we're all learning.
Are you talking about first one goes on to get board certified in minute people out of medicine or the general Pathak physician know the board certified. So the special training would come after medical school. And so part of the residency program for people are certified a minute beloved medicine is three years total after medical school. And so you have to do a certain number of months with different specialists that work with the neuromuscular system. So we do some rotation with neurology, sports medicine, rheumatology, orthopedic surgery, variety of different specialties, doctors that look at patients from a specialty perspective, that treat common conditions that we may come into contact with as an osteopathic neuromuscular mouth medicine specialist specialist. And then part of that training is also learning how to do injections, you know, trigger point injections, stereo injections, platelet rich plasma injections.
So we do get a variety of different exposure and then you're also required to see a certain number of patients that are your continuity panel. And so you're managing them from a specialist point of view. We can prescribe paid pain medications, but more often than not, we will let that be kind of separate if someone does require pain management for to be on opioids or something. Most of those patients are managed by someone who's more certified in pain medicine. But yes, those
Justin Trosclair 10:18
nice you get to have the the PRP you can do those other procedures. You don't do microseconds that's going to be somebody else though, right?
Correct. I'm not saying no one no invasive spine surgeries or or minor procedures on the spine.
Justin Trosclair 10:33
Okay, do learn much about like, like the rehab or do have to send out the physical therapist for that was that look like?
We do learn some I mean we spend some time with with physical medicine and rehabilitation specialists and so we do learn some kind of the basics with rehab but we don't have most osteopathic manipulative medicine specialist don't have like rehab in house. And so most of the time we're referring those patients to like physical therapy.
Justin Trosclair 11:00
Not do yourself you're since you're mobile, but I'll tell you that are they still in hospitals? When you get hired as an osteopath? Who does the S amp T or is it more private practice leaning? How does that look?
So when you say SMG you That means spine? phenomenal peeler.
Justin Trosclair 11:19
You like osteopathic what's what's your phrase? I should ask you that that before we even started with the adjustment the manipulation? What do you like
you caught manipulative treatment or osteopathic manipulative treatment. Okay, we don't we don't just address the spine. We treat patients from head to toe and we do visceral Oregon techniques, cranial techniques, soft tissue techniques, we do the high velocity or spinal adjustments. So just a more broad term would be like osteopathic manipulative treatment.
Justin Trosclair 11:49
I wish we would say the same thing. Yeah, I guess that's why we just say it's an adjustment. But then the research, you look at the research, you just type in adjustment you like Well, that's not really going to show up anything. So okay, so medical treatment.
Yeah. There are some hospitals that have specialist manipulative medicine console services. The majority of those hospital services are ones that have residency programs for manipulative medicine doctors, because part of the requirement to become board certified in manipulative medicine is to do to see a certain number of hospitalized patients and do manipulative treatment on them. And so for example, in the Dallas Fort Worth area, the only hospital that has in an omm are empty console service is medical city Fort Worth, which is where the there's residency program there for a minute view of medicine. There's a few other hospitals in the country where know, a one or two Dr. group that are board certified, will get a contract and have a question service but they're they're not very prevalent. Are you finding that you know, for it for a medical doctor that refer to a chiropractor, that's definitely something that we have to work on. Like we have to educate, we have this in papers with us, in our case in those rooms, just try to get them educated that hey, we're safe. Hey, this with the research shows, hey, people get better. You know, we're not all hokey pokey. You know, there's a lot of those out there. But we're not all like that. They all have a better an easier time getting relationships with the medical doctors to get these referrals are how do you kind of position yourself? Um, I think, you know, we have a lot of educating to do because most people don't know what osteopathic manipulative medicine is. It's not a very well known name. Yes, other osteopathic physicians would know about it, and you know, should be able to refer and know when to refer patients. But the the general medical community doesn't really know exactly what we do. And, and you know, what kind of patients would benefit from our services? So we run into same battle
Justin Trosclair 14:02
with that, okay? Do you ever regret going that route being that there's more education, it's a little bit more of an approved battle versus a kind of pieces just coming in, like, hey, my back hurts, do something else with it?
Well, it's, it's actually kind of exciting. You know, it's something that I'm so passionate about, but I love talking about it. So opportunities to go on, you know, podcasts are going to radio interview, I'm involved with some of the local high schools in the Dallas Fort Worth area for some mentorship programs, and I've gone in and done, you know, presentations for them. And I've gone with some of the local colleges and done presentations on what manipulative medicine so it's something that I enjoy. And then the the coolest thing is getting a patient that doesn't really know what it is and, and giving them a treatment, and just having them just be blown away with with how much better they feel. That's a very rewarding thing for me somehow very happy with the route that I chose.
Justin Trosclair 15:02
When you're having to describe to a client potential patient, what do you do? How do you describe? I'm kind of curious. I mean, maybe you have a long answer. Maybe you have something that's you like I've actually mastered it, it's only a 22nd this is what we do and is how you get better. So what do you tell somebody you see somebody one more they walk in you like, obviously, you should come see me as a patient, like what would you say?
So I'm a fully licensed physician. And what I do is i'm specialized in looking at your your body for areas of restrictions, things that aren't moving the way that they should, and using a variety of different techniques with my hands, to help them move better and help you move better, which can decrease pain, help with blood flow, help with your nerve, your nerves to work better, your lymphatic system work better, decrease your pain. Okay,
Justin Trosclair 15:48
I'd like to cover this a little bit. What are some of the misconceptions about osteopath and if you want to go osteopath manipulation therapy, you can go there as well. But you know, we all seem to have
a black cloud sometimes over it, or just people just don't understand, like, why would I go see you instead of just a medical doctor?
So I think, you know, one of the biggest misconceptions or misunderstandings is most people that know that osteopathic positions, do manipulations, they think that we only do the exact same thing as what a chiropractor works, what to do. And so they may think that we only do the spinal adjustments. And so when I have patients that, you know, I've had back surgeries or, or have very frail bones, or someone that that can't, wouldn't be good candidate for a high velocity or spinal adjustment. They think that there's nothing that I can do to help them but they don't understand that that's not the only technique that I use, you know, I use so much such a wide array of techniques that are gentle enough to treat a newborn baby, or 100 year old patient, yeah, have other techniques that I could use that maybe a little different on an NFL football player, or somebody else that's a you know, an athlete. And so there's really not a patient that I couldn't find a variety of techniques to safely use on that patient and most medical conditions that I can do something to help
osteopathic manipulative medicine. So I think that's the biggest misconception is that people, you know, they only think that we do one or two things, and they don't realize how many different things we can do.
Justin Trosclair 17:35
Do have your own legion of seminars to learn different adjusting techniques or deal at Candela tin, a chiropractic seminar to learn different types of techniques.
So we have would you have an academy it's called the American Academy of osteopathy. And so that's our professional organization for anybody that's board certified or that does a lot of manipulative medicine. That's kind of our professional association. And so the American Academy of osteoporosis, he does have an annual conference, it's like a week long conference every March. And at those conferences, they have both lectures and hands on workshops to learn new techniques. And then they offer a variety of different courses throughout the year across the United States. For example, I'm I'm helping to teach a course that's coming to the Dallas Fort Worth area in February taught by dr. john port to on the visceral somatic reflects treatment, which incorporates the meridians from Chinese medicine, with osteopathic principles to treat both the Oregon and the corresponding musculoskeletal opponents at the same time within one technique. And so there's tons of course opportunities. Of course, any do or or chiropractor, you know can go to any kind of additional conferences. So I'm not sure just depends on the course requirements. So if there were like a chiropractic conference that day, except osteopathic physicians or or other kinds of specialties into those conferences, I'm not sure.
Justin Trosclair 19:17
Okay. Yeah, I would think, you know, if you saw you ran some chiropractor, you saw some kind of technique, and well, that's really cool. or YouTube video. Yeah, I would, I would assume most of the those conferences would be available to see, but what does what does visceral manipulation look like?
Well, it looks like a lot of different things there.
Because it depends who's doing it. You know, there's a lot of Osteopathic positions in Europe that have developed a lot of what today's like modern, visceral Oregon manipulation, so there's a lot of more direct how patient there's indirect treatment to the Oregon's The, the visceral somatic reflex course that I'm helping to teach is, is really an interesting where you're, you're palpitating the Oregon, and then treating along the meridian for that corresponding Oregon to create a release of the structures all along that that meridian or something like fashion. Yeah. So the the meridians travel along like fast lines, and so treats that you can treat those corresponding musculoskeletal structures along that, that line.
Justin Trosclair 20:31
That's interesting. I'm not the YouTube that later because I like this picture in my head. I'm like, obviously, it's not gonna be some high velocity thrust or something in that area. It was very gentle. Yeah, it was kinda like a massage or a very specific massage. And Mike was what it might look like to a patient.
Yeah, sometimes will, you know, for that particular technique, we're, we're sometimes moving the, the limb, because a lot of the meridians travel to the distal points of the hands, feet and onto the face. And so we're actually moving around the arm and leg or, or turning the head to adjust that are to treat that meridian. Precisely.
Justin Trosclair 21:13
Okay, treating the meridian. Is that with like, needles, is that like a finger? Or what does that look like?
It's through manual how patients so manual patient he has. So for example, you have the large bowel Meridian, which terminates onto the hand, and then it does go on to the face as well, if you look at kind of the meridian chart, and so if you pal paid along the large intestine, and you're feeling you know, in the belly, for areas of tension, things that are not soft, that should be in your along any part of the bow, so the ascending or descending or transverse colon or rectum, you if you tap that any part of that large intestine that is, doesn't feel soft as it should be, then you can monitor that location with one hand, and then pal pay anywhere long that Meridian, so common place, or that to be triggered is where where that meridian crosses the wrist, because of common, you know, falling on to an outstretched hand, or having a risk, you know, becoming injured and some other manner. And so if you help it along that Meridian, so that it actually can actually power paper change, that's your other hand at the location of the Oregon, then you're on a specific point, that you can then treat that whole entire meridian. So kind of release the fashion between where that point you found on the wrist and all the way to the Oregon.
Justin Trosclair 22:49
Wow. Watch out. Obviously. I was curious about that. Just from the question. Yeah, that's really interesting. Okay, now, what made you choose home visits? switching gears here? How's that working for you? What does that look like? Is it an all day affair? Give us a little rundown on that.
So currently, my my work situation is I am, I have five months left to complete all of my requirements for my board certification in both family medicine and osteopathic manipulative medicine. Okay. And so in 2016, I got my my life, my general practitioner licensed to practice medicine. And I still have my all my requirements left to get board certified in both family and manipulative medicine. And so that's what I call my day job, mostly Monday through Friday eight to five. And I wanted to start my own practice, which I started in 2017 is called mobile osteopathy. And my practice, since I'm only available to see patients in the evenings and weekends, I was trying to think about the best way to set up my practice. And in it, I could have rented space and tried to get patients to come to me kind of at odd hours, but I thought it would be better if I could just do house calls. So turn my disadvantage of of not having very no time to see patients during normal business hours into an advantage. And so now I can I can market to a very large geographic area, because I can go to one part of town one day in a different part of town The next day, and see patients, you know, after I finished up my day job, and then see patients all day, like on a Saturday, for example. And it allows me a lot of flexibility patients are pretty, you know, they're okay with a 30 minute time window, if I'm coming to their home first and then having to come into the office and so ended up being really good for me because the patients love it. I mean, I'm getting a lot of patients that are busy professionals or I treat kids that are in school and so they're not have people aren't having to miss work aren't having to get taken out of school. And then I end up getting a lot of new patients just because I'm there in the home treating one family member and and the next time they say hey, next time you come back want to treat, you know, this other family member to and some treating three and four people or entire households, just because they're seeing what I do and that their their family members benefiting. So that was my initial model was just doing 100% house calls. And as I've gotten busier, I've had to actually rent some space part time. And so I do rent a room now inside of a polarity studio that I use one evening out of the week, and one Saturday a month. And part of that reason, besides being busy was I've gotten a lot of patients that will call from outside of my house call radius, and they want an appointment. And since they live too far for me to travel to, I didn't have a place that they could come to. So now I thought that problem by having some options for small time.
Justin Trosclair 26:10
And that offices sort of you start hearing a bunch of phone calls from the Gainesville area or something. So like, Okay, let me get an office kind of in that general area, so that they can do they drive 30 minutes down, and they're like they're there.
No, I have an office with this in the Dallas Fort Worth area that's within my services own that I already, you know, travel to. And so that way, now I have an option for patients that live outside of my travel radius that can come to me.
And so that's that's worked out well.
Justin Trosclair 26:43
Do you have to carry special liability insurance or malpractice to do home visits?
No, it's included whether I see a patient in the office or in their own my policies to same
I do for the office that I rent, I have to have general liability as well as my malpractice liability. But that doesn't carry over to the house call the think it's just the malpractice at the house at the house visits.
Justin Trosclair 27:11
One does insurance cover Minnesota therapy for you guys? And then also doing home visits? Are you taking cash only? Is it a mix of insurance? How does that play out?
So I take cash only I'm just out of network with all the insurance companies. And so I provide my patients with the super bill that they can submit to their insurance company for for reimbursement. It just depends on whatever they're out of network coverages. Generally, most insurance companies do pay for manipulative medicine, it's considered a procedure, just like an injection would be or a skin tag removal. It's just a different procedure code. And it's coded based on the number of body regions that you treat. So anywhere from one body region up to 10 body regions, but they only nine for one. There's like several different codes. Yeah, depending on how much how many body regions you're treating. So yes, most of them do cover it. I'm just concerned out of out of network. Now for his house calls. I think most of the insurance companies, if you use the house call code, that there's supposed to be like a medical reason that you're doing a house call. Right. And so there could be some issues with that if you're just doing it because you don't have an office.
Justin Trosclair 28:31
I don't feel like driving to the doctor's office doesn't count. Yeah, for a home visit.
Justin Trosclair 28:37
Okay, do you get the charge an extra fee for your travel? Or is that just kind of included in the prices.
So when I set up my practice since I didn't have an office space and and even now actually I charge the same price for my this the office visits that I do offer and the house call visits that I offer as long as there are with then the my travel radius. And I just calculated that into my costs, the fact that I don't have you know, a building overhead that I'm having to pay for, but my my house called practice prices are pretty much the same as what i would i would do in an office anyways. Okay,
Justin Trosclair 29:18
do you have to have the bring your own tables? Everybody should go anything like that?
Yeah, my trunk. You know, believe it or not, is like the perfect space for everything I need my my manipulated medicine cables fits in there just right, I've got a bag that I carry into the home that has, you know, equipment to measure vitals to an Otis scope or up Thomas go my little binder and there was some handouts in it. And then I carry one other tool that I use sometimes it's called a professor. Yeah. Yeah, I don't take that into every house. And then I do have like a rolling stool that I carry in in the house with me to sit on. Okay.
Justin Trosclair 30:00
Do you like the table you got? would you would you buy it again?
Yeah, you know, it's been pretty durable. I got it from omm, tables.com. And it's, it's actually designed to withhold more impressive for citizen. Its body is titanium or aluminum. So it's a little more sturdy. And lightweight. I've been happy with it. Okay. Oh, and what software? Do you use electronic records? I do I use Practice Fusion. And then I take my my iPad Pro to do my dog. My charting, hunch, like Practice Fusion, I want to say was free at one point. And it was internet based? Is it still the option is still internet based? And it was free? They started charging for a couple months back.
Justin Trosclair 30:47
Wow. That's it a couple months? That's cool. Are you happy with it?
Would you recommend it to anybody else? For my purposes, it's fine. I don't know. I don't have to utilize a lot of the features because I don't do you know, billing through it and things like that. And I don't I'm not using it currently for like, appointments. So for what I'm using forward, it's great. I've had any problems with it.
Justin Trosclair 31:12
Okay, as a very common question people have in our Facebook corporate groups. Hey, man, I gotta finally upgrading or I hate the software I have? Who should? Yes. So. And then how do you set up your geographical area? Like, I'm not 100% familiar with the Dallas Fort Worth area, but let's just say, I don't know, the Northwest area and you like, okay, somebody calls, you know, yeah, I only go on Mondays to this area. And then is that enough to get results if you can only go once a week.
So I chose that my area based on where I live, and then also where I most frequently located during the day. So like my, like where my day job normally is. So I live in like the North Fort Worth area. And then I work in like the downtown Fort Worth area. My goal was to add, you know, worst case scenario, drive an hour or less to get home from any appointment.
So that's kind of how I set up my radius was based on you know, just drive time of, of how I wanted to, to manage my drive time. What was your question?
Justin Trosclair 32:24
I don't know, but do have a follow up based on what you just said?
So I'll go with that one. Sure.
Justin Trosclair 32:28
All right, you got somebody in the radius? How? How many people can you really see after work? Because when you got to draw that can be 10 minutes, the next person could have been seen maybe? Because they're only like five minutes from that house. But they're not available, but for another hour? So how do you manage all of that? Do you end up wasting a lot of time? Or is it you just find people that can fit into your your schedule? How does that play out?
People tend to be a little more flexible in the evenings. And so I haven't really had too many problems with having to wait around in between appointments. I do you know, I do pay a lot of attention to, to scheduling people kind of an either in the same area, or at least in a trajectory to get back to my house. I'm going to see them on the same day. So that I'm not backtracking.
But I've been able to do pretty good job with that. I do see between 10 and 20 patients a week, right now. Yeah, luckily, I haven't had too many issues with
waiting around a long periods of time. Sometimes I'll get out of my day job earlier than I anticipated. And so a lot of my patients are have been okay with me, you know, coming early, I just call them say hey, finished up earlier you available earlier. And so I can easily move patients around, the politicians have been very flexible with that.
Justin Trosclair 33:54
Like you said, if they, if they're the type of person that will want the doctor to come to their house after I hours, they probably have that flexibility to where if somebody comes up, you can say hey, actually, Can we switch disappointment? Or it's 530? is better for me? Okay, okay, well, we shouldn't make 530 work instead of the seven o'clock that I was hoping for?
Korea? Yeah, they've been very people are really flexible with the house calls just because, you know, you're, you're doing them an extra convenience. I do remember your other question you were asking me, you know,
what if I can only see a patient once a week, if that's, you know, problematic. Yeah. So typically, I will see a patient for the first three visits spaced apart from each other between one and three weeks. So I don't really I don't really ever see anybody more frequently than a week. And usually, it's usually two to three weeks between those first couple of appointments. And then I would say, you know, 90 to 95% of my patients. And after that third visit, I kind of revisit what their goals of treatment are, and what relief they've gone with the treatment. And most people at that point are getting relief and feeling better. And so we just start spreading the appointments out more, my goal is my patients to see me as little as possible while getting the max benefits. And so for some patients, if it's an acute injury, then they'll need to see me two or three times, and then they're, they're back to their baseline and happy and so then they just call me the next time they, you know, injure themselves. And further patients that have like a chronic condition, you know, degenerative disc disease, or, you know, they have scoliosis or other some other anatomic problem that's going to set them up for pain down the road, they may benefit from some kind of, you know, maintenance treatment, and that can go anywhere from every three weeks to every three or four months. So it just it's very patient dependent.
Justin Trosclair 36:00
Okay, do you get patients how calls like something like sciatica, you know, as a chiropractor, we're looking at, say sciatica are like really bad headaches. I'm like, man, I gotta see somebody once a week, it takes a while for them to really get the maximum benefit. versus if you see once or twice a week or two, maybe two, three times a week, and about a week or two, like, boom, hit it hard, you hit it fast. That's kind of our little philosophy, you hit it hard, you hit it fast, they get better fast, and then, you know, dropping down some kind of maintenance of based on what they need. But is that common and what you've seen?
So I haven't found, I haven't found that I that I needed to treat patients that frequently. And I don't know any osteopathic manipulative medicine specialists that see patients, you know, especially more than once a week, but even once a week is not very common. And I think what allows, you know, patient was psychiatric, or headaches or so forth, to get longer lasting relief is we're, you know, treating the the bony joints, that ligaments, fasher, we have techniques to kind of calm down, you know, muscle spasms, or things of that nature. And so patients don't need to get treated as frequently
Justin Trosclair 37:14
as we're good. Okay, what kind of marketing? Do you do any marketing? What do you do?
Most of what I've done is, is actually just, you know, talking and educating other people in the healthcare industry, and so meeting with potential referral sources to learn about their services and tell them about mine. And I started doing that early on in my practice, and
I'm doing a lot less of the reaching out at this point, because I'm pretty busy seeing patients some, you know, booked out about four to six weeks right now. So I haven't been able to do as much of that lately.
Justin Trosclair 37:56
Have you ever thought about hiring somebody to help you out?
Yeah, you know, I've been trying to hire someone for the last year actually have gone, what's going on? So unfortunately, there's not that many people with my training, and so forth. None of the none of the people that do have the right training, want to do house calls. So still looking for the right person? Yeah,
Justin Trosclair 38:22
what's their common complaint to not want to do home visits?
I don't know. I, I'm kind of like, a rare person that I really don't mind doing. Like house visits, I kind of I grew up doing some door to door sales. I did that as in a in my youth, I served across lighting mission, which was a lot of door to door and talking to people on the streets. And then I also,
for several years had an alarm business that I did door to door sales, some very comfortable go out into people's homes. Yeah, so I wouldn't say I'm like the typical doctor. Okay.
Justin Trosclair 39:03
Yeah, cuz I guess you could probably see some really messy people in some weird situations, or how do you do you have to run into other doctor touch me the wrong way, and then you get sued for some kind of sexual harassment type of stuff, because nobody else is there,
you take that risk, no matter where you practice, unless you have somebody in the room with you at all times. So unless you even if you have a practice location, unless you have someone in the room with you at all times, someone could make the same claim. Okay, as if, as if I'm at the home, you know, the only thing that that you do have to your advantage in an office is if you do feel uncomfortable with the patient, but they're kind of coming off weird, you can pull someone into the room.
See, so it is a little bit more of a risk. But I've, you know, I've had great patience, and I haven't, luckily run across that there are some, you know, additional things that you can add on to your malpractice insurance to protect yourself more in that regard. But luckily, you know, it hasn't been an issue. But, you know, it is a risk no matter where you're seeing patients unless you have someone in the room with you.
Justin Trosclair 40:17
Okay, and any five year goals that you're looking forward to.
So I would I would really like to have
like a wellness center where I'm doing osteopathic manipulative medicine, doing injections, PRP stem cell injections, I'd love to have like a massage therapist and house dietitian, nutritionist. I psychologist kind of have a multi specialty center. And I'd still love to find, find other doctors that are willing to do the house calls, you know, as part of my practice that can still offer that service.
Justin Trosclair 41:02
Is there a hotbed of your board certification somewhere in America? Is there a spot where they felt in the accumulate in the country?
And does that make sense? Yeah,
Justin Trosclair 41:15
I would think that was because you'll have a school that can do it. So like, yeah, we just never left.
Yeah, and unfortunately, there's not there's not a ton anywhere. So
it's a great field to go into if you're interested in you know, this kind of specialty for people that are in medical school, because there is a high demand for board certified manipulative medicine doctors to work at the medical schools. And there's a high demand for patients to so it's a it's a very easy arena to grow a patient patient base and
Justin Trosclair 41:53
don't have a website where you have a listing. So if I lived in New Orleans, or if I live in Chicago, I can say oh wow, there really is only like to know area.
So one place that all direct patients to is the cranial Academy, they have a website because not all doctors get trained, not all osteopathic physicians get trained and cranial treatment. And so typically, only doctors that do a lot of manipulative medicine, whether their board certified or not board certified in it, but they do a lot will become a member of the cranium Academy. And so they have a you know, a find a physician. And also that's a pretty sure way of finding somebody that does a lot of manipulative medicine.
You can you know, you can find them other ways there are other search search engines out there for you know, find a doctor that does manipulation. But I know that there's a lot of doctors on those searches that don't very deep very much manipulation. Sure
Justin Trosclair 43:02
I can do a manipulation. Yeah, so
yeah, I do three a week. I think if the safest bet for finding somebody who's who does a lot of manipulation is finding somebody who does cranial treatment.
Justin Trosclair 43:15
Okay, and what is your website or how do people get in contact with you the one more information Dallas area?
Yeah, my website is www mobile dash like the minus sign pasty apathy.com
I'm also very active on social media so I have a Facebook business page mobile osteoporosis EPA. And then I have a Instagram account at Dr. Matthew Barker. You can follow me on those I post interesting medical facts and updates and you know practice updates of what I'm up to with mobile ASCII apathy. And then I see patients in the Dallas Fort Worth area and then also in Midland, Texas. There's another location which is about four and a half hours from the Dallas Fort Worth area.
Justin Trosclair 44:05
Okay, before we let you go any favorite books, blogs or podcasts that you you'd like to recommend or think people should just definitely check out?
I'm sick left
field this point.
A great book would be Dr. Robert Fulford. Touch of life. Dr. Fulford was a very well known osteopathic physician. The reason why I liked that book is it really talks a lot about the osteopathic philosophy and what osteopathic manipulative medicine is. And but it's under, you know, kind of written more to the general public, as opposed to like a medical textbook. Very good.
Justin Trosclair 44:46
Any closing remarks before we end the interview today?
No, thank you so much for for having me on the on the podcast, she ate it.
Justin Trosclair 44:54
Absolutely, really appreciate it. You know, I hope the audience I think the audience will like it, you know, we have a lot of physical therapy and chiropractors as a, as a base audience and to to learn more about what you do and how all three of our paths are kind of blended together. Yeah. And then, you know, following up with with a little more of the details on how you actually make this thing profitable, as well as making it work logistically. So you tweak my interest, I know people can be interested in it. And I really appreciate your time today.
Thank you, you have a good day.
Justin Trosclair 45:28
That wraps up another episode. If you can send me review that's dot net slash subscribe, Apple, Google Stitcher, Android devices, you just click that button, it'll take exactly the page, you need to you can write a review, hopefully a five star review, I said it does help for other people to discover what we're doing here. And one thing I haven't really talked about too much is the doctor's perspective. NET slash support page through about a host a cup of coffee, go for it. If you want to pledge alohar fee, there's buttons for that there's even monthly recurring for those who feel like wow, this is like the cheapest mentor coach program I've ever seen. Because you interview so many different kinds of doctors and and have been able to implement things that I've heard and it works. So monthly recurring payments, which also you can get you my books for free t shirts for free. The first book, you know, that deals with health and exercise, getting on a diet, getting your financial health and order as well. things I learned in China, you know, that books is available as well. And one thing that I don't have, I don't have like a full blown page about coaching and things. But there's a little button there. I've had people request, hey, doctors and non doctors asking me can I do more than just answer a couple of questions? Or could you be my coach for a little while and I say, yeah, we can do that. So something I haven't really advertised, but it's something that I can do and do whether it's marketing strategies for new patients growth, those types of topics, you're interested, just email me Justin at a doctor's perspective. net. If you have any ideas for guests, please send an email Justin at a doctor's perspective. net, I'd love to hear who you think would be good or a profession that you may not have heard yet, and we've got over 100 episodes is gonna be like our third year super excited, didn't win a little mini series like we've been doing, which has been fun. I hope you've enjoyed them as well that's that's the feedback I've gotten. Want to remind everybody that we have some great affiliate links available if you're into instrument assisted soft tissue manipulation, we've got the edge tool, and we got the hot grips stage about 10% also with the edge you've got the like blood pressure cuff restrictions system, you got the G sweet, inexpensive and more in case you're talking to him cash practice and of course I got my own electric acupuncture pin to go with the needle acupuncture book and that time you know have a bundle set bringing them all together for a great price muscle have the free downloads at a doctor's perspective, net slash blueprints. And what lately I've been doing is substituting a fifth one like I've done a neat and depend on the guest I might do a different type. So check back there. You've got the primal paleo grass fed protein bone broth style, save 10% on that no sugar, allergy free, gluten free, dairy free all those types of things mentor box get taught by the author, we got set preset for those philosophies bands that you may have heard about on one of the episodes really like those. If you want to know what hosting us for podcasting, blueberry, pure VPN, it's one of those ones I use to help keep my payment secure as well as access the internet more safely in the Amazon products that you might want. Click the link in the show notes pages. So all those resources can be found a doctor's perspective, net slash resources. There's also t shirts at.net slash t shirts, put up some new designs from time to time like making lemons out of lemonade shrimp Oh boy, plus all the Chiropractic and podcast swag that you could want. As always, listen critically think and implement Have a great week.
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