Lessons Learned: Alex King, DO

Hello everyone, I'm Dr. Darsha Shah, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined, a podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. Before we get into the show, here's a quick message from MR Insurance, a small business that helps physicians with their disability insurance needs. MicroReveless is a CFB professional and insurance agent committed to helping physicians nationwide with their term life and disability insurance needs. He provides an objective, transparent, and education-focused process that aims to help physicians make prudent decisions and avoid over-complicating things. He exclusively offers own occupation, disability insurance policies for residents, fellows, and attending physicians. We really like Michael and know he's got your best interest at heart when it comes to disability insurance. We know he'd be happy to help you with whatever your needs are. You can find Michael at Drpodcastnetwork.com slash MR Insurance or contact him at 80817-4522. Now if you're joining us for this lessons learned episode from Dr. Alex King, I am super excited to talk about the key takeaways that Darshani had from our discussion with Alex. But if you haven't heard that, then you want to hit pause and go back and take a listen to that episode and you will truly be inspired and also learn what the field of osteopathic medicine is truly about. Once you've ended that, come all back and catch up with Darshani as we talk about what we learned from Alex and how we are going to implement changes in our practice to be better osteopaths. Without further ado, enjoy this lessons learned episode. All right, guys. Welcome back to another episode of Lessons Learns with Medicine Redefined. Today, we're talking about our recent episode with Dr. Alex King, the OMM Guru. Darshani, for me, this was super inspirational just connecting back with our osteopathic roots. But I'll let you take it off, man. Would you learn from Alex? Yeah, man, same here. This one hit home for me. Both of us are osteopathic physicians for a lot of the audience out there who may not understand the difference between DO, which is what we are versus an MD. DOs essentially do everything. We learn the exact same way as an MD does. The only difference is we have 250 plus hours of additional training in something called OMT or OMM, osteopathic manipulative medicine, where we learn how to use our hands to treat and diagnose different ailments, symptoms, visceral, somatic, whatever it may be. And for me, being a V-con learning OMM in the beginning years thinking, hey, is this booty like, what is this stuff? I've never seen anyone really practice this and then finally getting to some techniques where I'm like, wow, I can crack some bags, I can make people feel good. So I really have learned to enjoy and use OMM as much as possible. And so this one was definitely inspirational for me as well. The biggest thing that I took away from Alex, one of the biggest things was how he incorporates Eastern medicine into his Western training. So outskying trained at PCOM here in Pennsylvania, in the US, but he does things like acupressure, acupuncture, cupping, and a lot more that he finds ways to incorporate with every single one of his patients, which is really inspiring to me because he is going above and beyond learning things that we don't learn in medical school. But understanding that these types of treatments can really make a difference. And again, I think that's the mission of our podcast here, right? Is to really open people's eyes to maybe the truths and other ways that we can heal. Yeah, dude, right on. I mean, you think you touched on some of the key differences. But a lot of times patients will ask me, oh, what's OMM? I've never heard of it or maybe even family members. So his definition was something that I'm going to start using, hopefully he doesn't mind. And it went something along the lines of OMM is the coordinated and academic movement and sculpting of human tissue towards the healing process. And it's harnessing the body's inner potential to heal itself. I mean, that's so simple yet so elegant. And so that's something that I really liked. The other thing that kind of appeals to me is his point of view of how he looks at manipulation. It's obviously the hands-on aspect of OMT, right? That's pretty easy for most people to grasp. But he's also talking about manipulation through nutrients and meds and interventions like injections. I mean, it's all there. It's a part of all the tools in the tool belt, exactly the things that you talked about, how he's integrating conventional and, quote unquote, unconventional approaches. But ultimately, it's all rooted on augmenting the body's healing response. And that's what it comes down to. I think more so than ever today, we're starting to appreciate that. And that's what orthobiologics are becoming so popular, obviously, not just orthobiologics, but just biologics in general. There's applicability more so than MSK medicine. So I think that was really cool. Another thing that kind of stuck with me is him talking about the concept of OMM for him. It's an evolution, right? And giving us the example that if AT still was alive today, he would be very much into prolotherapy and very much into PRP and those types of things. So that was cool. But I know this one, you're probably going to talk about a little bit too. So I'll just kind of bring it up for you is when we asked him kind of how he practices and what his patient population looks like. He was talking about, you know, somebody will come in and do a consultation for an hour and a half to two hours. And a third of that time, he's just spending to getting to know the patient. You know, taking that incredible history and really getting to build a connection with the patient, which really sets him up for what type of treatment he's going to do and also how successful that treatment would be. He can kind of really tease that out. I mean, how crazy was that? Yeah. That was crazy. That was absolutely crazy. And I love that. Like, the third of your time, just getting to know the history. So if you know, a lot of the functional medicine practitioners out there listening to this will know this, you know, have seen the EMR for what a functional medicine, electrical medical record looks like. But when I shadowed one of the functional medicine dots, he would send out this like pre-survey before the consultation. And it would probably take on average about an hour to fill out, but it is so comprehensive. It starts from the moment you were born, whether it was vaginal and spontaneous or whether it was a C section, going through every possible like trauma you may have had, anxiety. So anything mental, anything physical, to what your diet was, to your childhood, to everything. And the reason I bring that up is because being comprehensive is understanding the individual, is being personalized. And again, another thing that we're bringing up here is the same one over and over again, personalized medicine, individual medicine. And you know, Dr. King talks about N equals one. And for those of you that might not know what that means, N is the sample size. So when you look at these big research studies, we see N equals 100, N equals 200, possibly even N equals 20,000 right in these very big studies. So obviously we know the larger the sample size, the greater the power, there's more backing behind your research. But what you have to know is when it comes to OMM, when it comes to healing and individual, it's the power of one, study of one. And so you kind of go away from the data, kind of go away from the science and look at the patient in front of you and say, hey, what are the things that will work for you, but not necessarily for Sally or Jimmy or whoever else. So that was one of the biggest takeaways that took from Dr. King. For sure, man. You know, obviously, Dr. King, I mean, this is a center piece of his practice doing OMT. And you know, I practice it. I do it quite a bit. You do it. And although, you know, I wish you did it some in medical school and you're really starting to put it on patients that are your patients in residency training. And obviously, there's such a wide utility for OMT. That's truly impressive to me. Now, I think in our world where we see a lot of MSK related pathology, using it for musculoskeletal medicine, for chronic pain from MSK stuff is pretty easy and most people to understand because massage therapy has been around for a while. Car practice or are pretty prevalent. But I think people like him who really designate their time to the craft, they're addressing issues like when he treats kids with behavior problems or treating scars that cause visual impairments and, you know, bowel bladder issues, menstruation related issues on the bowel bladder issues because I know you had to talk to them about, you know, how he's looking at the visor and those types of things. I forgot to mention at the time, but when you start rehab less than a year from now, bowel bladder is something we get really good at. And actually, I even had one of his buddies, Evan, Evan Cohen, shout out to him, are we shot to him to do a lecture because obviously constipation is something we see so commonly on the inpatient rehab setting. So that's something that can easily be treated, you know, I'm going to talk about visor. Right. Messing Terry for lease, man. I remember we went on a mission trip to El Salvador at BCOM and we had so many constipation complaints. So we would teach him as an entire release, like, hey, if you're sitting on the toilet, you can like, you know, move your hands in these directions. And it was funny because we had this one child come in who was probably like 9, 10 years old, constipated within 15 minutes, was like, mom, I got to go to the bathroom. So, you know, definitely, that's the cool thing about OMM is that once you do it, you can really see some of the magic right after. But then it's also you get the best of the acute and the best of the chronic. So a lot of these patients will come back. And here's the other thing I love at OMM because, you know, as a pre-med coach, a lot of these students ask me, why is the Pathach medicine? OMM one, we're in an opioid crisis, right? So pain management, OMM is a great solution to that, to bringing patients back to you, being more compliant with visits, not necessarily needing those pain medications. Side effects aren't really there. Obviously, you know, we learn there's some red flags where you shouldn't be doing some treatments. But overall, people love it. I mean, it feels like a massage, but there's more, I think, I don't want to say more science, but there's more involvement in terms of what might be happening from the visceral standpoint, as well as the somatic standpoint. So, yeah, it's super good. Yeah. And to your last two points that you touched on, not only from the opioid standpoint, but also the constipation point, again, patients who are appropriately using opioid medications, one of the common side effects is what? Constipation. So if you do have some pain and you can't treat that because of that, well, guess what? Here's your workaround, right? So again, there's so many uses for it. I think that for us, really, who don't do it as much, it's really our own mind that's kind of limitation on that regard. But to that same point, his kind of solution, his recommendation was that if you are a primary care physician or if you are a PM in our physician who does, sees a lot of general MSK, try to learn a few, just a handful of techniques for the most common things you see. If you see a lot of shoulder pain and back pain, it might be worth your time to learn two or three techniques for shoulder pain and back pain because not every technique is going to wear for every patient. You know, same if you are a pediatrician and you see a lot of sinus infections or colds and coughs and you can help with some sinus efflourage and some lymphatic techniques to get things moving, that helps. Which reminds me, your story about kind of things that turned you to a quote unquote believer when you had talked about, you know, one of your buddies who had shoulder dysfunction and pairing his sleep. So you treated him that got better than you talked about one of your buddies who kind of had a classic tension type headache. Is that right? He had like exercise and do his headache. So any exertion and do his headache, even actually masturbation. So anything where there's some sort of like symptomatic response, it would just cool him. You'd get a massive headache that he was like, you know, very much what he called it a lymphatic block that you treated and made things a lot better for him. I mean, you know, it can help. The one thing I will caution people about that though, and this is why it's so important to make sure that you learn as many things as you can in medicine. And this is what some of my radiology attendings told me is the better differential that you can have, then you can start ruling out red flags. Obviously, if somebody comes in with a headache and has hemiparesis, you don't want to be like, you know, let me try some OMT, you know, you want to make sure you will. So that's where you need to know the contraindications. You need to know all that stuff before you can do it. So that's important to know as well. Yeah, absolutely. What were your thoughts on the myofascial release? Because I know we just had David Otay come on and talk about his stance on it as well. I know Alex. Absolutely. I mean, you just talked about how you, you, in El Salvador, where you taught patients or how to do self-myofascial release, you know, Dave talks about how he does it all the time. With foam rollers, he counsels, he recommends picking this thing up for like ten bucks on Amazon. Alex said the same exact thing, the three foot one. I think the same exact one that Dave was talking about. But the other thing that the parallels that I saw between their recommendations were that, you know, both of them talked about, you know, Dave, I think mentioned that you have this window of opportunity when you're calming down this sympathetic response, right? And you have to maximize that window of opportunity. And then to that end, Alex spoke about giving people corrective exercises to fix that chronic dysfunction, right? And then the classic examples that he had talked about was upper cross and lower cross syndrome, right? You have upper cross syndrome, right? You're going to be really tight in the pecs and, you know, weak in the upper back muscles. So if you stretch the pecs out, right? And then you don't do anything about to strengthen the posterior side, well, then eventually they're going to contract again. You're going to be back in that position. So you have to build upon that. And you know what this, this is so crazy, this would remind me of back in 2011, you know, and when I was a performance coach, I went to a, so Jody Franco and Jim Smith are super huge strengthen conditioning coaches. So, you know, if you're in that field, like you definitely know them, they're very much in the performance side, trained tons of fighting athletes and NFL athletes. They have this warm up series called Amped, right? And it's about how the progressively help people warm up. Here's how it starts. Step one, self-mive, faster release, form rolling. Step two, stretching. There's a lot of people, there's debate about stretching or not because it reduces power output, right? So, lengthening the muscle, right? Step three, do corrective exercises to activate the muscle, right? And then strength four is doing some type of like central nervous system activation and then you do a strength training. Remember when you ask Alex, hey, Alex, do you recommend people do OMT before they do therapy, which is rehabbing stuff? Right? So, I mean, it doesn't sound like it's the one and the same thing. And I think this was so awesome about this, is in today's day and age, you know, people are always like looking at different experts and seeing where they disagree and then picking those points to be contentious about and I am always just trying to look at similarities about people. Like, what are the smart people all saying the same? Let's focus on that, right? Because that's where to go. That's true. Yeah, yeah, absolutely. And again, I think as we all, as the world healthcare becomes more and more specialized, we bring up the analogy that, you know, you can take a Ferrari engine and a Lambo doors and, you know, tires from a Rolls-Royce, you can put them all together, but what you get, you get a dysfunctional car. So again, it comes down to that integration between specialties and, you know, understanding why OMT might be helpful before therapy and different modalities like that. Yeah? Yeah. Oh, man. And another thing that was kind of cool and I'd love to get your thoughts on is when you asked them about cases that kind of stick with you, right? You've had some. I've certainly had some. And then he had the one cool case that he talked about a patient who had a history of a brain tumor and had some visual impairments, like I think some of our peripheral vision was limited. He treated the scars from the surgery and her vision improved, and would you take away from that? Like, what does that mean to you? Should we all be like, you know, what does that mean to you? So I think the biggest thing that I took away was how much we actually don't get taught about these things, right? In medical school. What we focused on in my school was more of the MSK, some lymphatics, very basics. But then nobody really tells you like, hey, there's more to this. It's up to you to kind of go figure it out. Like I'm pretty much, I'm really into OMM. I realize I don't know anything about OMM. After he told me that story in scar treatment, I was like, wait, what? This is an actual thing that we can do. So you know, for all the listeners out there, at least those in training and honestly, even those that aren't and are still practicing, there's always so much more that we can go down this rabbit hole to learn more about, right? So our knowledge is not just limited to what we're taught in medical school and residency in fellowship training, but there are masters in these fields and Alex is getting trained by one of them. But there's just, there's so much more and that story is so incredible how you just could increase peripheral vision like that and change somebody's life in a way that that patient has no idea as even possible, right? It would be a different story if they went through surgery, peripheral vision came back. That's something that humans can kind of understand, right? That's what we see on TV. That's what we understand doctors to do. But to hear somebody do OMT and then get those results, I mean, that's that really inspired me one and two, made me realize there's so much more that need to learn and I'm like, I'm hungry for this quest of knowledge. Right on. I'm the same exact way. I kind of left with that one mind blown, but two also super excited because to me, I was like, wow, there's so much to learn because I don't think and I wish I would have asked him that I just thought didn't come to me. But definitely next time when he comes on, I'm going to kind of bring that up again and ask him what he thought was that really did it for the patient, right? Because he did talk about treating some of the scars, but he said he also approached it from a very holistic standpoint. He treated the whole body. So could have been like some somatic dysfunction at C1, C2, could have been some suture treatment that he might have done. It's really hard to say. And I know the the naysayers and the people who are going to say, this is quackery, they're going to say, well, you don't really know what you did, but I bet you that patient doesn't care. Right? Exactly. Right. Exactly. Yeah. So she can see a little bit better. And I bet you that patient doesn't care. And that that just goes on to your point about N equals one, right? And and it goes to the point of leaving it exactly what the doctor and no, why are you doing doing this? Are you doing this to be a to be a servant to the patient like he talked about, right? He said his dad says that we're serving for the patients and you're truly serving society. And I mean, it's more evident today in today's with the pandemic and everything going on, right? More so than ever. I mean, we have to make a lot of sacrifices. And you kind of have to to to figure out why you're doing it or you're doing it because, you know, yes, that's where the art and the science kind of have to balance out. And that was much more on the art side. So I thought that was kind of cool. But to that point, Darcia, I want to ask you this though, because I think this was the difficult question. And you being a pre-med coach, you're getting this all the time is, you know, when people ask you why pursue M.M. I thought he had a very eloquent answer to that. And I really loved it. But wanted to see what your thoughts were and if you had any comments. Yeah. Why pursue Autopathetic Medicine? I mean, like for me, it comes down to, and I think this is the issue in today's era is that pre-med students think that you learn holistic medicine in osteopathic school. I don't think you really do. I think, you know, I don't know if you did where you were all, but it's, yeah, go ahead. I'll let you. Yeah. Yeah, yeah. So I think there's this misnomer sometimes and it's a tragedy that we market ourselves or the schools may market themselves as, hey, come learn holistic medicine where the mind, body, and soul are connected, sure, 200 years ago and 80 still was coming up with these things. Absolutely. Today's world? No. Even curriculum as MDs are doing again, the only difference with the OMM, but what I really gained from it was a skill set of using your hands and being open to diverse kind of modalities and treatments. And I think that's what I really loved about it. Yeah. Yeah. It's, it's quite tragic actually that, you know, the only difference really, again, if you kind of, I'm sure they're, I can't speak for all the osteopathic schools out there. There are a ton now, but at least in my training, obviously, your training and the couple folks that I do know, the real difference really is just the additional curriculum piece of getting manual therapy with your hands. And again, I spoke about one of the things that attracted me to osteopathic medicine that I talked about during the trail was the core tenets of osteopathy, right? The four main tenets. And I wish that was really how they approached it from that quote unquote holistic mindset because I mean, the list is just a vague word, like what does that even mean? It's really practicing. But you know, the difficulty is, and I think that for a lot of pre-meds and is man, but you know, I want to do it. And then if I want to do neurosurgery, if I want to do dermatology, it'll be hard to get into and all that stuff. And again, like I said, you're feeling this a lot more. So hopefully it'll be valuable to your audience. But his point about if you're fascinated by science and the medicine and you want to keep the options open, then yeah, you want to pursue the path that you're passionate about. So if you're truly passionate about, hey, the body's ability to, you know, again, those tenets that kind of drew me towards it, then go down that path. The worst that you're going to have is, I mean, you might have some limitations. I think unfortunately just that's the world we live in today. But in today's day and age where burnout is an all-time high, you want to be true to yourself, right? And again, it's truly a selfless profession with tons of sacrifices. So if you tend to practice your passion and you learn about these things, then you are going to turn that into your craft, right? And you're going to be under your craft. And so that's kind of, I think, the advice I'm going to give to a lot of pretty meds if they do ask me that. Yeah. And let me put this out here too, because I don't know if many people know this, but you know, the only schools I've really got into from medical school were the Caribbean St. George's and Vicom of Virginia. So you know, I was going to take the school that's in state, given you know, you do your clinical training all four years here, it was a better option for me. So you know, I was almost kind of forced to go into the osteopathic route, but it was the biggest blessing that, you know, I came by because of me now going into PM and R, you know, having that advantage of using my hands, having that advantage of just thinking differently too. And yeah, I do get that question a lot. I want to do dermatology, neurosurgery or so. How do I, you know, do I still go down the PM and R route or sorry, do I go down the osteopathic route or not? It's a tough choice. Obviously, I think, you know, the stats show that it is definitely tougher for an osteopathic student to get into those higher specialties. But like you said, you got to stay true to yourself. And if you really do want to use OMEM in your practice and treat holistically or learn some of that at least, then it's definitely the right way to go. And I have zero regrets being an osteopathic physician. So right on, brother, that's really well said. And hopefully people got a great primer of what osteopathic medicine is all about. And if you guys have any questions, please feel free to reach out to either myself on social media or Darshan social media. We're pretty active on Instagram and even Twitter. And you can, of course, follow us on Twitter and Instagram at MetaRead Defined. And even reach out, MetaReadFind at jimla.com, we'd love to hear your feedback. Any other questions that you might have, we're happy to continue the conversation. Take care, man. Well, that's a wrap on this Lessons Learned episode from Dr. Alex King. But before we end, don't forget to reach out to MR Insurance Consultants where their goal is to assist physicians in obtaining the most comprehensive coverage available to fit their unique situation. Reach out for both excellent and quality service at drpodcastnetwork.com slash MR Insurance. Now for that important disclaimer, remember that everything in this podcast is for educational purposes only. 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