Travel Medicine Business

TCAAs I am nearing the end of my residency and getting a chance to see what exists outside the world of training, I am finding myself looking more and more at different ways to practice medicine.  Obviously, travel medicine is a great passion of mine and I plan to eventually open my own clinic.
I may be good at helping travelers decide which vaccines they might need, discussing safe and healthy travel and diagnosing travel related ailments, but that is only part of the equation.  How do I open my own clinic?  Where do I get travel medicine clients?  How should I advertise?  Fortunately, I have met some very knowledgeable people who help do exactly this! 
I have been fortunate enough to meet many great people involved with travel and expedition medicine and wanted to share some information about some new friends.  The doctors I have met at Travel Clinics of America (TCA) are like-minded practitioners of travel health and offer a service that increases travel medicine clients.  In fact, they not only offer great advice, they even help bring in new clients to an existing practice.
The TCA service also seems to be “minimally invasive” to a practice pocket-book, as well.  Through taking a small percentage of profits from only the clients that are involved with travel medicine, they will not interrupt the money generated from an existing practice such as a primary care or urgent care business.  Thus, using the service from Travel Clinics of America will only generate additional revenue.  Plus, the existing practice gets to offer travel health services to their patients!
For physicians that have not yet had the opportunity to study travel medicine, TCA even offers to educate physicians!  Educational modules are available and cover the basics that travel medicine practitioners need to know.  Obviously staying abreast of global health and disease spread is a key component and their blog is taking steps to help both travelers and practitioners keep up-to-date with this very dynamic field. 
This type of a post may be a little different than my usual writing but my goal with this is to help other health care practitioners become involved in a field of medicine that I dearly love.  Additionally, more travel providers means healthier travelers, overall.  That is one of the goals of my life and one of the goals of the Travel Clinics of America.
For healthcare providers looking to learn more about either starting a travel clinic of their own or incorporating travel medicine into their existing practice, I think a stop by their website would be time well spent.

Forest Fires and Outdoor Athletes

Wildland fireSummer is a perfect opportunity to spend more time in the forests and outdoors pursuing your favorite activities.  Unfortunately, the warmer climates and increased activity outdoors increases risks for wildfires.  Hikers, bikers, climbers and all athletes who get their adrenaline fix off paved roads needs to know a bit about wildfires and how to avoid them, protect themselves and fire safety in wildfire situations.

I was lucky enough to spend a summer as a wildland firefighter and found it to be one of the coolest and most challenging jobs I have ever had.  The science and study of wildfires is a very complex matter and most of the elite wildland firefighters I met always referred to themselves as “students of wildfire science” because they were always trying to learn more about this very large and always evolving discipline.  A few basics about wildland fires will be discussed here, as well as some links and information on where to learn more.

Perhaps the most important things that should be learned from experienced wildland firefighters are the basics.  To me, the basics include the “10 standard wildland firefighting orders” and the “18 watch-out situations”.  These are memorized and drilled into the heads of all new wildland firefighters simply because they save lives.

Watchout Situations:

  • Fire not scouted or sized up
  • In country not seen in daylight
  • Safety zones and escape routes not identified
  • Unfamiliar with weather and local factors influencing fire behavior
  • Uninformed on strategy, tactics and hazards
  • Instructions and assignments not clear
  • No communication link with crew members or supervisors
  • Constructing fireline without a safe anchor point
  • Building fireline downhill with fire below
  • Attempting frontal assault on fire
  • Unburned fuel between you and the fire
  • Cannot see the main fire, not in communication with anyone who can see main fire
  • Weather is getting hotter and drier
  • Wind increases and/or changes direction
  • Getting frequent spot fires across line
  • Terrain and fuels make escape to safe zones difficult
  • Taking a nap near the fireline

Fire Orders:

  • Fight fire aggressively but provide  for safety first
  • Initiate all action based on current and expected fire behavior
  • Recognize current weather conditions and obtain forecasts
  • Ensure instructions are given and understood
  • Obtain current fire information and status
  • Remain in communication with crews, supervisors and adjoining forces
  • Determine safety zones and escape routes
  • Establish lookouts in hazardous situations
  • Remain in control at all times
  • Stay alert, keep calm think clearly and act decisively

These orders and plans are the basics that are designed to keep those with training safe and alive when fighting wildland fires.  For the recreational outdoor person who encounters a fire in the wild, seeking safety should be the number one priority.  Once safe, contact should be made with the local fire department to inform them of the following information on the fire:

Incident Type: vegetation fire, vehicle accident, hazardous material involved, etc

Incident Status: fire behavior such as smouldering, running, creeping, etc

Location:be as exact as possible using landmarks, or latitude/longitude if possible

Incident size: rate of spread and potential for growth

Fuel type: trees, ground cover, trash

Wind speed and direction

Slope steepness and direction slopes face

Best access points: nearby roads the firefighters may use to gain entry

Special hazards and concerns

Cause:if known such as campfire, vehicle accident, lightening strike, etc

Values threatened:  houses and property involved

Weather:  raining, temperature, etc

Resources at scene:  who else is there

Perhaps the best advice for a non-trained person who is confronted with a wildland fire is to simply get out of the area.  Fire behavior is to move up-hill and caution should be used when walking on ridges or slopes with fire burning below.  Fire has a tendency to move up-hill at a frightening speed and the best bet is to not be in that position.  Smoke inhalation can be a problem and a simple bandanna tied around the face can help reduce inhalation of smoke particles and flying debris.  Eye protection should also be used, if available. 

When leaving the area of a fire, ensure that you are not moving into more danger and sometimes the most direct route to safety may be blocked.  Ensure that all of your party remains together and within eyesight of each other, keeping good communication along the way.  Take care of each other and move at the pace of the slowest member.  Remember that material items such as tents and campsite gear can be replaced. 

For more info:

H1N1 and travel: it takes a whole village to raise a virus

GlobeThe recent events of the H1N1 influenza virus and its simultaneous grip of the media and public attention as well as rapid spread may have been the best thing that could happen to travel health.  Further, I hope the virus has shown that international borders and cultural differences were not factors in this illness and its transmission.

Following the Virus

The real-time updates, global tracking maps, use of twitter and other social media sites and various other media sources served to rapidly spread the information about H1N1, even if the information was not always accurate.  Fortunately, use of social media and ease of communication allows for information to travel around the world at a rapid rate.  Almost as fast as the virus did.  I personally found the use of these social media sites very useful for receiving and sending information and am glad to see medical and public health professionals making use of these services.

Everybody at risk

As people watched the number of suspected and confirmed cases pop-up on maps, along with infection rates and death tolls on the nightly news, they were united with others around the world who shared similar concern.  Most viruses do not care about religion, race or social standing, they just infect.  This was truly a “global uniter” of fear and risk of illness.

Traveler’s role

Travelers have long know that they are capable of acting as the perfect vehicles to spread things around the globe.  Travelers can spread cheer, wisdom, passion and illness.  As seen by the rapid spread of the virus, airlines were a major factor in global disease spread.  The intense media attention and global effect of the recent H1N1 virus should have shown that all people of the world are interconnected, especially by international travelers.  Exaclty like the “six-degrees of seperation” game, epidemiology is showing the world is frighteningly small and closely linked.  Travelers need to realize their position in the global health chain and the responsibility of international travel, especially when it comes disease spread.

Personal Note!

Beer :)Finally a post about something other than H1N1 influenza, outbreaks of diseases and things that can hurt travelers.

I am very relieved that I passed my last medical board examination.  I am done.  Residency ends in 6 weeks and a team is already being assembled to help complete some “upgrades” on the website.  Lots of excitement!