Archive for September 2010

My Most Popular Post is…

September 30, 2010

Drumroll please…the most searched (and found) post is the one about blue veins/marks on the top of the nose between the eyes.  Those of you out there wondering how I know this… There is a control panel that tells me the search terms people use to find the most found blog.  This helps me decide what to write.  In terms of pediatrics, this is a situation where I have had several moms ask me and their prior pediatrician could not answer.  I am still in awe of what I just discovered.  I have seen so many, many of these cases.  The veins are not just on the nose.  There are also veins along the temple region, along the cheek or even along the jaw line.  I just wish that I had the pictures to prove it to everyone.  Let me tell you, don’t think I didn’t try.  The problem is that degree of the blue marks vary and it does not show up well on camera.  There are very many mommies out there who, despite reassurances from their pediatrician, unsatisfied, who query and search. 

Who knew? 

I thought the plantar fasciitis post would be the most popular because there are so many people out there in pain.  Clearly, there are many mommies who are very astute and trust their intuition.  Good for you mommies!  You go girls! 

So, for my future posts I want to answer questions of curiosity.  Things I notice in my patients, things I notice in people.

Retraction

September 28, 2010

I need to apologize to Judith.  Judith came in during my amazing month of treatment epiphanies.  I was cleaning up people left and right.  Just before Judith’s visit  Ray came in.  He knew exactly how long he had his back pain.  He knew what caused it (‘putting up a wall’).  I figured out the strain and proceeded to treat.  His body responded.  I felt it.  It was his first and only visit.  We got him back to 90%.  He was amazed and very happy.  There was the short leg I stretched out in one visit.  There was Danny who was in a horrendous car accident.  His knees would hurt and swell.  Finally, I resolved that it was basketball that was causing his knee problems and wouldn’t you know it?  Treating for basketball, we were done in 30mins and he said his legs felt lighter (all his previous visits were some good response after 1 hour).  There was Deanna.  I felt her body change and I saw a look in her eye that told me I should capture her response on film

After  her second visit, Judith suffered a severe treatment reaction.  I, in my arrogance, thought that I could figure her out and completely resolve her old strains.  Judith, I apologize for not doing enough of a good job.  I used too much force on your wrist and hands.  I did not carefully check you to make sure you were balanced before sending you out.

Massage…for Infants and Children?

September 27, 2010

No.  Absolutely not.   Do not do it.  Let me remind you that I trained to be a pediatrician.  I have seen thousands of children in my 13 years.  Treating children, saving lives.  As a traditional osteopathic physician, our hands are very skilled.  We can feel anatomy in a way that MDs do not.  Manual therapist, massage therapists, chiropractors, and craniosacral therapists can feel maybe almost as well as we do (and some maybe not), but because of  their lack of medical education, and certainly no osteopathic training, their knowledge is a huge gaping deficit in understanding the human body, human physiology and basic fundamental physics of a biological system.

For several years I have heard people talk of  infant massages as a gentle means of touching, contacting,  and bonding with an infant.  I never gave it much thought…yeah? okay. whatever. until now…Read my prior post  Cracking is Bad…I started seeing some unusual cases…

Two years ago a mom brought her 6 year old daughter in to see if I could help her daughter with cranial osteopathic manipulative treatments.  She had a form of strabismus, a ‘wandering eye.’   When one eye looked at you, the other was staring up into space.  It wasn’t just a little bit ‘wandering.’  It was fully tweaked out.  I asked about birth history.  As an infant she had torticollis and plagiocephaly.  Mom refused physical therapy and brought her to a chiropractor.  Did the chiropractor crack this baby’s neck? I asked suspiciously.  No.  He just ‘massaged’ her neck.  Then what happened?  They went for several sessions.  Then what?  At 1 year of age, mom said 2 things happened – the neck straightened and the eye tweaked up.  I did not want to touch this.  I referred her to one of our advanced cranial  instructors who treats children and teaches an eyeball course.  It took him 7 visits for the mom to notice the eye ‘softening.’

Since then, I became suspicious and started asking questions.  I started seeing more cases of chiropractors and physical therapists “massaging.”  So far my count is 4 cases of strabismus associated with plagiocephaly and torticollis.  

The reason I am now blogging about this is because last week I met my 5th case.  I need to warn the world about this.  Those who read this blog can heed my words or not.  I consider this fair warning.  Those who still opt to have their child massaged must bear the consequences.  This poor child only 4 years old wants her poor eye to be corrected so badly, it is so sad.  Mom is worried because now she is starting to notice the other eye wandering.  I asked if as an infant this child had plagiocephaly or torticollis and the mom replied in the negative.  She was taken to a chiropractor regularly as an infant.  I asked why?  Mom replied that it was for ‘preventative’ purposes.  On examination this poor child is completely electrically disconnected.  Her whole right head was locked up.  She had a huge neck spasm on the same side as the tweaked eyeball, coincidence?  As I started to treat her, her legs jerk and spasm, so much so that the mom had to hold them down.  I finally get the muscles to calm down and as I continue, muscles on the L side start to tighten.  The muscle tone in her body is completely out of balance.  They will be returning soon and I hope to have some photos.

Now, let’s talk about anatomy.  If you don’t believe an experienced osteopathic physician, at least maybe talking about the anatomy might convince you.  The family believed that it was good to have an infant’s neck cracked because the nerves controlled all of the body.  My first comment for this is that the child was healthy.  To presume that anyone can make a system that was dealing well with birth strain ‘better’ is arrogant.  I became a pediatrician first and then returned to practicing traditional osteopathy several years later and even I don’t touch a baby unless there is something wrong.  Secondly, newborns, infants and children, their tissues are not well defined – they do not have muscles, their bony skeletons immature and unformed.  Our teachers associated with the osteopathic medical schools have access to fresh, unfixed cadaver specimens (they are called to autopsy bodies withing 30min of death and arrival at the schools).  In our advanced courses, we review anatomy and the slides include these specimens.  Newborns, infants and children, their tissues are not well differentiated enough.  Full physical maturation doesn’t occur until puberty.  Do you think that the muscles of an infant is the same as an adult?  Look at your biceps and triceps muscles.  Do you think in a baby, those muscles look the same, function the same?  If so, shouldn’t a newborn be able to walk, grab things and lift?  Let’s talk about the neck.  If the neck muscles and bones of the cervical spine are mature and fully developed enough to be cracked or massaged (because they are ‘spasmed’), why can’t a newborn hold up its own neck?  The answer is that the muscles are immature.  If the bodies of infants and children were the same as adults, uhh…there would be no need for…pediatricians.  What is the tissue feel?  How can the tissue be distinguished?  What are you massaging?  The answer is that infants are gooey.   Their tissues have the feel of a sea cucumber or the land equivalent of  a slug.  Again, what are you cracking or massaging?  Undifferentiated tissues.  Don’t do it.

The mom consented and signed to allow me to teach with these photos.  It took only three visits to wake up the nerve.  They will continue to do eye exercises for the next year.  Mom reports that the left doesn’t even wander anymore and the right eye only does occasionally wander.  If it is just for the eye, she is done.  But because of the electrical disconnection, increased tone and tissue density, she will not be done for a long time.

Douches

September 24, 2010

Alright.  I have to talk and educate about this because a young woman did ask me about it.  She told me I should blog about it because other women would want to know too.  First the anatomy lesson.  Our inside organs are lined with tissues that need a layer of moisture.  The moisture is mild lubrication, it is produced and resorbed.  Under hormonal influences, it is normal to have a clear, odorless ‘cleansing’ small discharge.  That tissue is just like the mouth.  The mucosa is delicate.  Some people like to gargle with mouthwash.  Frankly, I hate it.  Listerine is medicine-y.  Scope has that synthetic -fake- sugar taste.   After the menstrual flow, everything is hunky dory.  Even the last day is a ‘cleansing’ day.  It is after doing the nasty and the exchange of body fluids that women consider using the douche. 

What is available out there?  I don’t like any.  The low % vinegar solution is like the listerine.  Do you really need it?  Just like your mouth, you can just rinse with water.  How?  Buy the plastic bottles.  Unscrew or squeeze out the solution and continue to sqeeze out the air in the bottle.  Then leave the spout under the running faucet and release.  The release will create a vacuum and suck in the tap water.

Bunions…Again?

September 23, 2010

Yep.  This month has been crazy.  Should I post some more before and after photos?  I promise you this will be the last on this topic.  I am so done.  Been there, done that.  Bunions, bunions, bunions.  Okay.  I got this.  I know how to treat bunions.  I can do it with my eyes closed.  I can do it in my sleep.  This is the year of someone referred me to you because they knew someone, i.e., friend of a friend referral whom you were able to help with osteopathic manipulative treatment.  Marjorie came in for shoulder pain of about one month.  I told her that the shoulder injury is the straw that broke the camel’s back and should be readily addressed.  It seems to her that all her problems are on the R side of her body.  We also tried to work on underlying/pre-existing strain.  I did not know what to expect.  Going in today, I told her that it has been raining bunions.  She mentioned, “Oh yes, I have one too!  Can you help me?”  I said, “Of course!”  I told her I would use the last 5-10minutes of today’s visit to take a picture and then treat both feet.  Well guess what?  I used a new maneuver today that I just starting this week and wouldn’t you know?  We achieved spectacular changes in the tissue.  I actually finished in 30 minutes and told her we would start on her bunion.  The bad foot felt better to me and we both heard and she felt the bunion joint crack.  I am biased and I thought the foot looked better.  I moved over to the good foot.  I was pretty quick and the good foot looked even better!  So I took pictures and she signed them over to me.  Should I post them?  It is just more of the same.  Results.  Another one for BUNION CURE.  I will move on from here.  I’m hoping that in the new month I will have interesting cases and pictures that have to do with problems above the level of the pelvis.  I am currently working on an eyeball case that will have neat pictures and another limping case that hopefully will pan out to have good before and after video.  Wait for them!  I am really excited.  Wait until I tell you about their cause/source.

Please people, tell me if you want me to post these photos.  It is a lot of work for me to load up, etc.  Will more pictures convince you?  I am getting lots of new patients coming in and I am working on documenting different types of cases (currently an eyeball case and a child limping case) to show to you the global philosophical approach of osteopathic physicians.

I am doing so well cleaning up these cases that for my cash patients I am considering a money back guarantee.  How many doctors do that?  When you pay good money to see a specialist, and they tell you that you do not need surgery because you are not that bad, you still have to pay for the opinion and time even if you don’t get results.  When you go to McDonald’ and you are unhappy with that meal, do you ask for your money back?  I don’t know just yet.  Then again, why should I.  I don’t want to work that hard to prove myself to people.  The pictures are there and they are quite clear.  The skeptics and cynics and continue to live in their pain and misery.  If you trust the CMS, go ahead, take your chances and bear the consequence.

Vaccines

September 20, 2010

Okay.  I will now admit it.  I am a pediatrician and I have not vaccinated my children.  I don’t know if I will.  I might do it later.  I might change my mind and not do it at all.  Firstly, I breastfed my babies.  Secondly, they rarely eat processed foods.  Every day the 2year old has fruit and vegetables and 2 meat dishes.  The only thing she gets to drink is water.  I’ve done everything right.  The girls are hardly ever sick.  The 2year old is pretty much out of the risk period.  The question goes back to why? 

Vaccines do not cause autism.  It is very clear.  There are some children who are susceptible to vaccine injury.  That is the neurological familial set up.

I think that I don’t want to adulterate their pure bodies.  They have been treated by the best osteopaths for their birth strain.  As they grow up and acquire more traumatic strain, I am there to treat them.  They are unstrained and as pure and close to the Most Natural State as possible.  The balanced unstrained system is not susceptible to and should be able to ward off any infection.  Because they are mechanically pure and unstrained, biochemically, if they took meds they would respond within the statistical norm, as expected and predicted – no adverse reactions. 

Likewise, if they are given vaccinations, I do not believe that they will have any problems.  Their bodies would appropriately mount an immunological response within minutes of an injection.  In their lifetime, as they grow up, I may not be around to watch over them every second.  I expect them to acquire and accumulate strain.  I also expect that they will come to, through peer pressure or recklessness, in time, adulterate their bodies.  I want to delay that adulteration as long as possible.  The immune response component of the vaccine is not the problem, it is all those other chemicals, vehicles that go into the production of a vaccine that bother me.  As with pills, the active ingredients are packed and ground up with ‘binders’ and ‘inactive ingredients.’  Let’s not forget about how emotionally traumatic it is to get vaccinated.

There is also the mattter of this world versus that.  Which world?  The biochemical statistical world, the world of the orwellian double plus ungood CMS (read my blog on the Conventional Medical System and Pseudotumor) misthink versus the physics based mechanically unstrained biological systems world of the traditional osteopaths.  I used to think like them, those of the CMS.  I used to want to be one of them.  I used to be skeptical that Osteopathy could stand alone as major global philosophical medical model. 

FYI, when A.T. Still, MD started the Osteopathic Schools he never intended for them to work  ‘synergistically’ with the CMS.  He intended for Osteopathy to usurp the CMS as a superior approach to disease prevention/treatment.  In the  world of the CMS, a diseased system, is overwhelmed, sick and on the verge of collapse.  Intervention is invasive, abrasive often offensive and necessary to save lives.  But thereafter, you are left to pick up the pieces to learn to live on a day to day basis.   I used to and still do  live in and practice in that world.  In these last few years I have saved childrens’ lives.  I get terribly stressed to think about what could have happened if I had missed those diagnoses.  Also in these years, with increasing work in OMT on adults and children, I have balanced systems so that they recover and return to the Most Natural State, unstrained, and in Health.  In an office visit I will present some options, if a parent chooses the CMS, I actually do not try to persuade them otherwise.  In fact, I shut up.  Why?  Because, it is my job to present treatment plans.  They choose what they are comfortable with.  If they choose the CMS, they, or their child,  in effect becomes the ‘control’ subject and I end up observing how their choices play out (read my blog on Scoliosis and Short Leg after Fracture).

What I am saying is that I know something else, something different.  I know another way.  If you have seen the pictures in my past postings, achieving results where others cannot, where others have failed, you too will see.  These patients saw their MDs, been through physical therapy, tried chiropractors, acupuncture, you name it.   Now MDs who choose not to vaccinate their children, well…they are just crazy.  Most of them are not.  In fact most MDs I know trust their CMS and do not deviate from it.  They hold fast to it, even at their peril and loss of their health.  I know of 2 MDs who have had back and neck surgeries.  Needless to say the outcomes were not good.  One of my patients is an ICU nurse who had neck surgery.  I am able to correct the rest of her issues (back, hip, leg and knee pains) except those upstream from the surgery. If an ICU nurse, completely immersed in the CMS chooses to see a pediatrician DO traditional osteopathic physician, well that says a  lot, doesn’t it?   MDs would have to hold to the CMS because if they found out about the traditional osteopaths, they would have to be intectually honest and give up their life’s work.  That is too much to ask of any one.  I too was lost, once.  I have found my way back.

I always say that when an MD can get the same results I get (see all those pictures on the website, youtube channel, and past posts), then we will be able to see eye to eye.  In the meantime, they can pooh-pooh me, I’ll ignore them and go about my way.  My colleagues who do traditional osteopathic work encourage me to be strong and not cave in to my allopathic MD pediatrics training.  They too discourage vaccinations.   

Those of you parents who read this are probably now majorly confused.  Sorry.  What do you do?  Most of my patients hedge their bets.  They try to breastfeed as much as they can.  Most have allowed me to treat birth strain.  I have even treated moms after their second child.  Boy, I always heard that every woman needs to be mechanically treated after 2 kids.  Now I believe it.  The mechanical distortion is extreme…Those who come to me late, the strains have already set.  They get some limited vaccines.  I tell parents what to look for so that the child can get OMT early.  We try not to use antibiotics.  We try other meds first.   I am now also adding homeopathic remedies to my armamentarium.

I especially respect those parents who know their way and insist on no vaccines.  They don’t want me to try and persuade them.  And I don’t.  In their minds, they already know what makes sense to them.  They’ve made their choice.  The risks are theirs to bear.  Other people uncommitted to a path, may choose to follow an onerous schedule without consideration of the trauma of a vaccine injection visit.   This does not make sense to me at all.  Make a decision.  Commit one way or another.  Trust MDs or trust DOs.  Make a choice.  What makes sense to you?

Bunions, Left and Right

September 19, 2010

Like manna from heaven.  I am getting bunions, left and right, literally and figuratively.  I am now supremely confident that osteopathic manipulative treatments is the best non-surgical alternative for BUNION CURE.  I have concluded that treating the causative strain will resolve the forces that cause the great toe to bend in.  Once the joint is freed up, there is more range of motion and it articulates well and initially will even crack by itself.  This patient was treated today.  We were all suprised how well she responded, she, her husband and I.  I do believe that the causative strains for men and women differ.  These sets of photos are before and after.  Note that only after 30 minutes the bunions look better; the angulation of the great toe is much improved.

My Big Fat Bunion IV

September 18, 2010

my yucky bunion

Wait till you see this.  I let my toenails grow just to show you that it really is a few weeks later.  Same foot.  Same toes.  My feet feel great.  The toe does not ache.  But I can not take it any more.  I have to cut the toenails, the length is driving me crazy.  As a reminder, I treated the big fat bunion and it was amazing the stuff, the strain letting go, I kept yammering on about it through the posts.  Then I decided to treat the other toe because my history of wearing 3 inch clunky heels would affect even the better foot.  I was disappointed that there was no tingling sensations.  This is understandable because it was not in pain or even discomfort.  To my suprise, even the angulation on the good toe is improved.

So here you have it – proof that bunions do not require a surgical solution.  It was gentle.  It was amazing.  I believe I may call this a CURE FOR BUNIONS.  If you opt for surgery, just beware what you will be getting into.  Read my blog on Bunion and Valgus Knee – Carla’s foot looks curled in.  Of course! Surgery causes scarring and the tissues tightens, contractures and turns in.  Weight bearing becomes altered and callouses form on different places on the foot.

There is Something Wrong with My Baby – update #3

September 17, 2010

Regan is now almost seven months.  All that old head trauma birth strain is behind her.  Her head shape is beautiful and symmetrical.  The veins are gone.  Her fontanelle is soft and open.  Unfortunately, she is now starting to teeth.  I start to suspect that I will never catch up on my sleep.  This is a person who gave up a surgical residency to do pediatrics.  My husband says that I don’t have beauty sleep.  I have nice sleep. 

Because of her early sleep issues, Regan abhors that car seat.  She absolutely hates it.  She is so unpredictable now.  She is rarely on schedule.  Sometimes she naps well.  Sometimes she doesn’t.  It varies.  Last night we planned something different and she slept for four hours straight.  Which means mommy slept for four hours straight.  It was so nice.  I think that might have been the fifth time in seven months that I slept more than 3 hours straight.  Thank goodness.  I am so grateful for those four hours.  Who knew one could be so thankful for such little sleep?

Mommies…if your child has sleep issues, your child has mechanical cranial strain.  Children do not know they hurt.  Consequently, they manifest health issues in the form of behavior.  Remember, any deviation from our most Natural State, will leave us at risk to be lion lunch meat.  That means that it is a problem.  If a child, person, anyone is sleep deprived they cannot function.  Searching for food, catching food, cooking food and running away from predators is very important.  If you are too tired for that you would be gone.  If a child sleeps heavily while mom is out searching for food and a predator is around, they will be lunch.

When a patient has cranial strain, they will always have disturbed sleep.  A good osteopathic manipulative treatment will always resolve this.  Do not settle for less.  Any other forms of ‘manual treatment’ will only be second rate.  Only and osteopathic physician can render OMT.

Insurance Hell

September 16, 2010

Okay.  Here it is.  This may be one of my most important posts yet.  Why?  you ask, (all three of you).  Because I am sick and tired of it and I am biding my time.  I will speak  the truth because I am fed up.  Done.  Then in a couple of  months I will feel the pressure to take this post and delete it.   So, share it with your friends and pass the link around because it will not last long…I will share with you the low down and dirty…

Sorry, I need to get political for just a little bit.  When President Obama insisted on the need for healthcare reform he showed himself to be hostile to doctors.  We are the enemy.  We put ourselves through minimum 11 years of education (4 years college, 4 years med school and minimum 3years training) at a heavy financial cost.  He wants to subjugate us and enslave us to his idea of what he thinks is right.  After all that debt and schooling, he wants us to do less for patients and see more patients (increase our volume) and decrease our charges; a consequence that would put us at increasing risk for lawsuits so that his buddies can sue us. Great.  Common sense tells you the quality will decline, to the quality of government cheese.  Then, when he stated as a fact that pediatricians make money taking children’s tonsils out, I was personally offended.  Why didn’t anyone stand up to him and defend us?  (I have to say only Rush Limbaugh did). He showed himself to be just another ignorant politician.   First, we are not surgeons.  We do not actually take a scapel and cut out the tissue.  This is a procedure.  You have to be trained to do this kind of thing.  Then you have be licensed for it.  Then you have to be insured for it.  If you are a renegade, you might just do it without all these pesky in between steps but that would put those 11 years and a quarter million in education at risk.  Doctors aren’t known to be risk takers.  Second, the government is all up in our business.  If I accepted money for referring my patients to a surgeon, that is illegal, that is called a kickback.  So, the nitwit lawyer does not even know what he is talking about (didn’t all his aides warn him?) In my area, all the ENTs are good decent people.  They are not friends.  I do not socialize with them.  We are not buddies.  I like that the relationships are professional.  They are easily severed if there is any hint of nonsense.  I refer and when I get feedback I then change my referral pattern or not.  Most often we refer, at least I do, to other doctors who are philosophically similar. 

The government sets rules for payments, after all it is the biggest of all payors.  MediCare.  How does this affect pediatricians?  The bean counters crunch their numbers and figure out what a disease is worth, essentially.  How difficult is a visit?  How much time was spent?  How much was done?  They set the payment for visits.  Insurance companies follow suit.  If the government pays 1 dollar, some insurances set their rate at between 70 -80 cents on the dollar.  The government is a big fat teat.  Many take succor from it.  There is fraud.  The government can audit.  If the i is not dotted or t’s cross, the documentation weak, then there is fraud.  Prosecution can lead to fines and imprisonment.  Insurances do the same – with the exception of the jail part.  I chose to not have the government involved in my business, I do not wish to suckle on the government teat.

Because they (govmt and insurance) generate volume and numbers, doctors offices should generate  patterns.  If you deviate from that pattern then something is fishy.  Everything is standardized and people are herded like cattle in numbers.  The problem is that is statistics.  Remember the bell curve?  Most of us fall smack dab in the middle.  We can take pills and injections, no problems.  The ones who get screwed up are the outliers.  Sorry guys, your bodies don’t act like everyone elses, but you are subjected to the same rules.  You know who you are.   You too are fed up with the system.  You are the ones who need the tailored medicine services of the traditional osteopath.

For pediatricians, those suckling on the govmt teat, to pass inspection you  need a $20K crash cart.  Once you pass inspection, then they will ship you vaccines for free (because they purchase it).  You hard working middle class people need to hear this.  Federal mandate states that all children regardless of economics should get vaccines for free.  So children walking into any free health clinic, no charge.  For insurers, they are mandated to cover vaccines in part.  So you might have a coinsurance.  If it doesn’t bother you because can afford it, no problem.  If finances are tight, you still have your share, tough luck.  Those whose offices, like mine, are private, we have to pay out of pocket for our vaccines first.  Yes, buy the vaccines first and store them in our refrigerator.   Then when we administer them, then we get to bill for them, to recoup the loss.  But the law allows the insurers 90 days to pay.  How do you like that?  You go to McDonald’s to buy a hamburger.  They make you pay right then and there.  Imagine that!  There are other issues and incentives that I should probably talk about, but it is too much for now…

Those of you who choose to use insurance, you get what you pay for.  Insurance pays for the orwellian double plus ungood CMS misthink.  It is okay if you fall within the statistical norm.  The Conventional Medical System is a biostatistical model.  To get that bell curve, you have to treat the population in mass numbers, like cattle.  Again, it is okay to think this way to cover the mass immigrant influx, to protect for the greater good and if it is all you can afford.  It is only when you fall outside of the norm, and I am beginning to suspect that those of you who do, number in the 20% of the population range; that is, of 300 million Americans, 240 million of you people can go to any board certified doctor in any area and can pretty much ignore us DOs.  That leaves 60 million who need us.  With only (high gross estimate) 5,000 DOs doing traditional osteopathic manipulative treatments, well, your odds of finding one of us is pretty slim…

What am I going to do about this insurance hell?  Ha.  I will be teaching soon.  Clinically.  I am going to teach new young doctors to be good DOs.  I will teach them not to bother with insurance.  I am getting good enough now that in this last month, patients who come to me, I have already figured out their mechanical strain and am able to deliver 90% results in less time.  I am excited for the next 30 years.  When I get busy, I will start to cut off insurances.  Ha.  The truth is those of us who are good enough to work hard to deliver results should not be constrained by nonsense.  I have heard of DOs who are so good, they just work out of their homes, treat for 15-20 minutes and charge $50.   That will be my longer term goal.  Go under the radar. Go underground.  Drop insurances.  Drop malpractice.  Just word of mouth.  Line up first come, first served.  Yahoo!  I look forward to my future liberation.