An Upstate New York chiropractor’s dream of teaching and consulting comes to fruition

The practice of Lisa K. Bloom, DC, is constantly busy. But you’d never guess it by looking at her financial books, since there is no profit. Bloom, a full-time associate professor with New York Chiropractic College (NYCC) in Seneca Falls, NY, runs a pro-bono, consultative-only practice. It is based at the school, which makes available the clinical space and support personnel she needs for consultations.

Untying Gordian Knots
"All of the patients who come to me are under the care of other doctors who have had difficulty discovering the cause of their problems and, as such, have not been able to treat them successfully," says Bloom, who holds two diplomates—one in applied chiropractic sciences, the other in neurology. "My job is to figure out what’s wrong and recommend further diagnostic studies or appropriate treatment."

Bloom receives these referrals because of her stellar record of accomplishment in tough cases. A typical one involves a patient who, for 7 years, had experienced bouts of dizziness, tremors in her right hand, significant fatigue in the right upper extremity, and growing difficulty controlling her voice. Medications were only minimally helpful because they made her feel completely out of sorts.

"This patient had been previously seen by neurologists [who] ordered MRIs and plain-film studies—all of which were negative," says Bloom. "But my evaluation showed positive cerebellar findings and weak muscles in the right upper extremity, cogwheel rigidity, and nystagmus in her left lateral gaze. Moreover, in talking at length about her health history, I learned that, a few months before her problems manifested, she had lifted something heavy with her right hand and subsequently felt neck pain.

"Upon examining the site of that old injury, I found significant trigger points and adhesions in the right anterolateral aspect of her cervical musculature—in the superficial and the deep muscles. In working out those trigger points over the course of 2 hours in one visit, we achieved resolution of all positive tests. I sent her back to her own chiropractor with a recommendation for specific deep tissue work and cervical adjusting. I understand she did well thereafter."

Esprit de Corps
Bloom’s decision not to charge for consultative services is premised on her conviction that such work contributes to the general advancement of chiropractic. "I receive a salary from the college for [teaching], so I’ve got my living expenses covered," she explains. "I see my consultative activities as a gift to help not only the patients receive the answers they’re looking for, but also to help the doctors by making them and our profession look really good."

The difficulty in delivering such services lies in striking the right balance between giving the patient enough treatment to be assured the answer has been found, but not so much treatment that the patient becomes convinced only Bloom can provide it. "If patients get the idea that no one else can solve their problems but me, they won’t go back to their own doctor," she says. "Then, I’ll be accused of stealing patients, and no referring doctor will ever trust me again. I’m not here to take patients away, but to help [doctors] treat their patients more successfully."

To ensure this, Bloom will not keep a walk-in patient without a referral for herself. "I would examine the self-referred patient on a consultative basis only and then refer to another chiropractor," she says.

Because Bloom teaches full-time and frequently lectures on weekends, she finds that a consultative practice perfectly complements her hectic and demanding routine. "Since I am primarily in the classroom or traveling to give lectures, having a consultative practice spares me from feeling torn between those activities and the responsibility to see patients regularly," she says. "Also, this is a great way to extend knowledge, since cases I see in consultation become part of my course material and, with the patient’s consent, I have the opportunity to bring my students into the examination and treatment session as observers."

But there were two other reasons why Bloom started her consultative practice. First, she does not believe it is possible to effectively teach chiropractic without also concurrently practicing chiropractic. Second, Bloom is the type of person who craves to solve physiologic puzzles—and the conditions she sees in consultation are often mystifying.

To help her solve those puzzles, Bloom uses applied kinesiology, advanced imaging (including functional MRIs and PET scans), electrodiagnostics (such as NCV and EMG), heel lifts, and orthotics. "My philosophy is that, because I see strange cases, it can be very productive to look in unusual places with unique equipment," she says. "For example, sometimes a patient presents with what appears to be peripheral nerve problems, but on looking closely, it is actually a cortical problem secondary to head injury."

Occasionally, though, Bloom’s attempts to resolve unfathomable problems fall short of the mark. "I don’t always have the answers," she says candidly. "When I don’t, I have to be willing to admit [it]. Then, I have to find someone who does have the answers. Consultative practice requires humility on the part of the practitioner."

Call of the Ivory Tower
Bloom joined the faculty of NYCC—her alma mater—at the start of the 1995-96 school year. School officials had previously sought to recruit her, but Bloom declined. She finally said yes when the course they had in mind for her would be on subluxation, a topic she finds endlessly intriguing. "That hooked me," she recalls. "That was the only course that could have possibly interested me enough to teach."

Bloom was in private practice at that time, with an office in Manhattan and a second one in Tenafly, NJ. She continued to operate them while teaching during that first year. "The class I taught met one day a week, on Tuesdays," she says. "So, every Tuesday morning, I hopped a plane from New York City to Seneca Falls, taught my class, then flew back home later that same day and resumed my private practice activities for the remainder of the week."

However, it was not long into the first semester that Bloom realized she was smitten with being a full-time instructor. "It was so exciting to be at the college," she says. "The students had such incredible enthusiasm and a powerful thirst for knowledge. I loved the positive academic environment. I loved teaching."

Thus, when a full-time position opened at the college for the following year, Bloom applied and was awarded it. "Part of me thought, this is crazy," she says. "I have all my family and friends downstate, and I have two thriving private practices. Now I’m going to have to leave all of that behind.

"Then, the other part of me said, the reason I’m leaving all that behind is to pursue a passion. It’s a risk, but it could be the best thing [for me]—and, so it was. In retrospect, I know I made the right choice." Bloom sold her private practices before moving to Seneca Falls. Soon after settling in at the college, she launched the consultative practice.

Bloom tests patient Jessica Loda’s muscles during a nerve root evalution.

Canine Epiphany
Bloom hints that she first toyed with the possibility of someday teaching shortly after entering private practice in 1990 and discovering how powerful chiropractic care is. A friend had called to tell Bloom about the tragic health problems of his girlfriend’s grandmother’s dog, and wondered whether she would examine the 5-year-old Pekinese that was paralyzed from its waist down. "I’d never adjusted an animal," says Bloom, "but I figured, what the heck? It’s a mammal—it [must have] many things in common with humans. Let’s give it a try."

The dog had been seen by a veterinarian who concluded that, apart from exotic spinal surgery, nothing could be done to help it. The veterinarian recommended the grandmother have it destroyed to end its suffering if she did not want to authorize surgery. "I could clearly see from [the X-rays] that there was an area of degeneration in the spine," Bloom continues. "I adjusted it the way I would a baby—very gentle tapping to find areas that weren’t moving properly and initiating movement. I then put the dog down on the table to see what effect the adjustment had. Unbelievably, the dog jumped off the table, shot out the door, ran laps, came back in and—to show his doggie appreciation—urinated on the carpet."

Wet spots notwithstanding, the canine encounter changed Bloom’s life. "I had known chiropractic was good, but now I knew it was more than that. In school, I never received a good explanation of why chiropractic worked. But from that point on, I decided to devote myself to unraveling the mysteries of why chiropractic does what it does—understanding the neurology behind it," she says.

From acquiring greater knowledge, it was a short leap to imparting. And, while Bloom is possessed of zeal for teaching, she does not consider herself an evangelist for chiropractic. "I have a strong message I want to share, but that is about as far as I’ll go," she says. "My message is that, if you take chiropractic out of the health care picture, you’re going to be left with a lot of sick patients without answers. What needs to happen is we must become better able to explain ourselves as a profession. I truly believe that, if there is a better understanding of chiropractic, there will be more utilization of it.

"And once you understand chiropractic, you will never want to be without it."

About the Author
Rich Smith is a contributing writer for Chiropractic Products.

Lisa K. Bloom, DC, can be reached via email: bloom@nycc.edu.