Hear as Dr. Carlson talks about being a family physician and wellness expert. You can find Dr. Jim at www.drjamescarlson.com and on his Twitter feed found in the sidebar of this interview.
What do you do for a living?
How would you describe what you do?
Aside from treating a multitude of medical diseases from Asthma to Zygomycosis, my main focus is in treating patient’s disease processes through the use of proper nutrition. As a result of my nutritional approach, the main diseases I treat on a daily basis are obesity, heart disease and related cardiovascular disorders and diabetes.
What does your work entail?
Seeing patients on a daily basis, both existing patients and new patients; evaluating symptom complaints, analyzing blood work and diagnostic studies, and formulating treatment plans based on my thorough review of all the data. I also review whether or not dietary manipulation can play a role in the treatment of my patient’s disease process.
What’s a typical work week like?
I work 5 days a week, 4 of which I spend in direct patient contact, with two ½ days spent reviewing all the labs and diagnostic studies that are received by my office.
How did you get started?
I started at the community college level as my grades in high school only earned me a C at best. In high school, my main focus was on bodybuilding, not the requisite academic studies, therefore the C average. Interestingly enough, instead of studying what I was supposed to be studying, that is, my courses in HS; I was deeply involved in reading voluminous textbooks on nutrition, anatomy & physiology, kinesiology as well as keeping up with the workouts of the Mr. Olympia’s of my day.
Yes, Arnold Schwarzenegger was one of my idols during this time and I honestly thought I would pursue a career in competitive bodybuilding, until I found out that I would need to use steroids to remain competitive. Since I am anti-drug (even as a physician), I realized quickly I would never have a real career as a bodybuilder.
When I started at my local community college, I took a math course (intermediate algebra I thought was a safe bet as I had failed trigonometry in HS), the introductory English course, a basic chemistry and psychology course, and a gym class. My first semester started off pretty much like high school, I was pulling C’s and low B’s up to the middle part of that semester. I was actually very diligent in my studies, studying every day and night and found myself submerged in whatever course I was studying at the time; I remember having 3 tests on one day, one in math, psychology and chemistry.
It just so happened that all 3 test grades were revealed to me on the same day. First was chemistry. As was customary at the time, the professor would write on the blackboard all the grades and the number of students who had achieved that grade. The first grade written was a 97 with only one student obtaining that grade…turned out it was me. Then I ventured on to my math class where the same process occurred, only one student had obtained a 98, and that was me; then I journeyed on over to my psychology course where I had also obtained the highest grade of 97, with no one else even close.
It was on this day that I realized that I could excel academically and excel I did. I didn’t receive a grade less than 90 from that day on at the community college level, often getting the highest grade in the class and I became somewhat of an academic guru in my own right. Not only did I eventually take trigonometry again, receiving a high A (average was 98 %), my overall GPA became a 3.9, I was inducted into 2 honor societies and won 2 mathematical scholarships (which was interesting as I was not even a math major, go figure. As an aside, my average in all the calculus courses, I, II, III was about 99 %, with calculus III I had received a perfect 100% until the final where I received a 99%, yes, my fellow students chided me big-time on that one J
So I spent 3 years at the community college and eventually I had to leave/transfer as I had no more math or science courses to take. Demonstrating my strong and persistent academic ignorance, I applied to 2 universities to pursue my BS degree, Johns Hopkins and Cornell University.
I really wanted to go to Johns Hopkins and I chose Cornell as my back-up school. Yes, you read that right. Even though I was kicking academic butt with my grades at the community college level, I had no idea, not the slightest, that Cornell was an Ivy League university. So much to my chagrin I had chosen an Ivy League University as my backup choice. Good thing too, because Johns Hopkins wasn’t interested in me. So off to Cornell I went.
My majors at Cornell was/were biochemistry and molecular cellular biology. I did so well academically that not a single professor believed I had started at the community college level. My fate was sealed as soon as I stepped foot onto Cornell’s campus.
After I graduated from Cornell, I didn’t decide on possibly going to medical school until that June when I came to the stark realization that, even at 23, I wasn’t ready for the real world. So I signed up and sat for the MCATs, the admission test for medical school, without preparing or studying in the least bit. I did OK, good enough to actually have the cajones to apply to a medical school, and apply I did. Now, because I guess I am unconventional on almost every level, instead of applying to fifteen thousand schools like everyone else (just kidding, most medical school hopefuls apply to at least 10 schools), I only applied to one. That’s right, just one. It was the NY College of Osteopathic Medicine.
I remember my medical school interview like it was yesterday. There I was dressed in a suit, which was weird for me as I had never owned a suit before so this was unfamiliar attire for me; strangely enough, I wasn’t even the slightest bit nervous, just waiting until I could get the darn suit off so I could be more comfortable; unbeknownst to me that I was going to be accepted to the only medical school I applied to and that the wearing of a suit would become my newly found appendage, kinda like Spiderman’s suit or superman’s cape). Now if you’ve been reading up to this point you may get the impression that I never got below a 90 on a test or something like that, but my time at Cornell saw me getting 2 of my lowest grades. I actually received a D in both Botany and Physical Chemistry.
I didn’t really care too much as I abhorred botany but had to take it as I wasn’t allowed to take Genetics as the powers to be at Cornell feared I’d upset the curve (I had taken Genetics at the community college and had received an A so I guess their fear was somewhat justified) and I was actually tickled pink that I had actually ‘passed’ physical chemistry, aka p-chem, even if it was with a D. As a side noted, my college counselor or whatever they’re called, vehemently implored me to NOT TAKE P-CHEM AS IT IS SO SO HARD AND I WILL SCREW UP MY GPA!!!!!!!!!!!!!!!!!!!!! Oh yeah, I thought, I heard the same crap before I took calculus but I went on to do well quite well with that. Anyway, I had received straight Ds in p-chem and was really proud of it. I knew I had studied and worked my hardest so the fact I passed was enough for me. This fact of the Ds in p-chem actually came up in my medical school interview and my interviewer was (I think) shocked to learn that I was very proud of my Ds. I probably shouldn’t have asked this on a medical school interview, but I did; when he started discussing the D’s I nonchalantly asked how he did in p-chem with the comment back “Well, um, I never took it.” Which ended that line of inquiry and can we say hello to medical school, which I eloquently refer to as my ‘missing’ 4 years, where I disappeared from the human race only to re-appear as a medical school graduate; unable to carry on a conversation with anyone but a fellow medical student graduate and/or my dog…but the worst was yet to come…my dark year of medicine….my internship….
OK, so my internship year was hell, pure, living, fire-breathing, cannot-believe-this-is-actually-happening-to-me-while-I’m-still-awake-and-now-I-believe-Freddy-Kruger-is-real….HELL! Now I need to emphasize that when I did my Internship there were no laws governing how long an intern could work. I would routinely work a 36 hour shift, up the whole time and working the whole time. I never really had a problem with this, actually kinda liked it, and I’m pretty sure I became addicted to the adrenaline rush working these hours. As a side note, I would actually laugh at people who couldn’t make it through a 40 hour work week without complaining; heck, I was working 36 hours STRAIGHT every third day, I mean really, I became pretty cynical with typical work weeks. As a side note (and yes, I do happen to like side notes) the longest shift I ever worked straight through was 60 hours when I was doing an OB/GYN rotation, pure adrenal rush on that one! Except for the fact I fell asleep in bumper to bumper traffic on the way home, hey, at least it was bumper to bumper so I only hit a bumper J No, don’t try that at home. Oh yeah, now they have laws preventing that….
So my next step was residency. I was accepted to Delaware Valley Medical Center’s Family Medicine residency program which was a 2 year stint. In about 6 months I was voted in as Chief Resident, which was weird because I didn’t even know I was a candidate. In any event, I became the Chief Resident of family medicine which basically means I gave a lot of lectures to the med students, interns and fellow residents; but it really meant that nobody really kept an eye on you and you could basically do whatever you wanted; I actually read medical textbook after textbook (yes, I am a real, true, medical geek) and watched just about every minute of the OJ trial, shhhhh, don’t tell anyone.
After residency, I found my way into my first family medicine practice, but didn’t realize my true potential as a clinical biochemist until about 6 years into the private practice of medicine. At that point I was 70 pounds heavier, had a horrible lipid panel, was a ticking time-bomb of death, and then finally realized if I ate the ‘correct’ way, not the ‘accepted’ way, I could cure all my disease processes…and so I did. Seven years after that, I sat down and wrote a book espousing the correct way to eat. And along the way also obtained an MBA with Honors in physician practice management/healthcare economics and a Juris Doctorate in Healthcare Law/Medical Malpractice.
Today, I have become an International Leader on proper nutritional biochemistry as it relates to medical care (still not sure how that happened, it just did over the years), and I attribute my success to strict adherence to the scientific method and fervently rebuking any and all studies laden with anecdotes and improper scientific methodology.
What do you like about what you do?
Everything. Well, almost everything….
What do you dislike?
Insurance companies denial of claims. See next question J
How do you make money/or how are you compensated?
Mainly through what is known as third party payors. AKA, insurance companies. The problem is that they don’t like to pay you for services that were rendered and you have to fight for money that is rightfully yours.
How much money do Health and Wellness experts make?
The sky can be the limit with proper marketing, just look at Atkins or even the billion dollar a year Weight Watcher’s.
How much do Family Physicians make?
General ranges of income for a Board Certified Family Doc all depends upon where you work. If you get into a large group practice or work with hospital support, income ranges are from 120-150,000 depending upon the region you are working in. If you are a solo self-employed doc, like myself, that income sharply reduces to under 6 figures a year.
How much money did/do you make starting out as a Health and Wellness expert?
Not much. It takes a while to become recognized as an industry leader and even though I’ve attained that status, I don’t even come close to the six figure mark annually. This is one field where you really have to ‘love’ what you do.
What education, schooling, or skills are needed to do this?
I have a Bachelor of Science and an Osteopathic Medical Degree along with a Board Certification in Family Medicine; my MBA and JD were obtained due to my love of the academic challenge…and the fact I must be a little insane…
What is most challenging about what you do?
Trying to relay to people, especially my colleagues, as to the correct way to eat.
What is most rewarding?
Seeing the realization in people’s eyes when they realize what I say is true.
What advice would you offer someone considering this career?
Read the right books about nutrition i.e. Protein Power, all the Atkins books….and don’t believe the hype!
How much time off do you get/take?
Not much. As a self-employed physician, it is very difficult to take time off; especially when few in your field understand the correct way to eat and you’re worried about people getting the correct dietary advice.
What is a common misconception people have about what you do?
That I make a lot of money…
What are your goals/dreams for the future?
I’m living it.
What else would you like people to know about your job/career?
Even though I do not make a million dollars a year, I am saving lives and preventing morbidity on a daily basis in my practice. There is no price tag on that, what is the price of one good life saved I ask?!