From Dr. Karen Para (kparadc@doctor.com) 4-8-03 Practicing in Valencia, Venezuela After attending the Palmer seminar in Las Vegas in Jan,, I decided that it was time for me to return to the States to study nutrition and get updated in chiropractic. I have a practice of 13 years here in Valencia, Venezuela. There are 2 chiropractors in Valencia, a city of over 2 million. Because there are so few chiropractors in the country, I do not want to leave the populace without chiropractic care. Therefore, I am searching for an associate who is interested in maintaining an ongoing practice with the possibility of moving into their own practice eventually. It is an opportunity to get started. The growth potential is very great. It would be a person who likes challenges, adventure, seeking the growth of chiropractic world-wide. How long is your program? Indefinite. I am doing independent study. The chiropractor that comes, if they like living here, could start up their own practice after a time, or could continue working in this clinic. Since most cities in Venezuela are without chiropractors, the field is wide open for locating anywhere. I would be willing to help someone get started after a year of working in my clinic during which time the Dr. could establish a patient base. When would you like the position filled? As soon as possible. What are the housing arrangements? Single women, or a couple could rent a room in the back of the clinic. A couple with children, needing more space, would be able to rent or buy an apartment in the neighborhood. What are the qualities of the person you want to hire? Honest, straightforward, open, a desire to learn, courteous, well-adjusted, good sense of humor, ability to work in a group, takes initiative without taking over, consults with others, ability to give praise and encouragement to others. Description of the duties, what conditions you are looking for in this associate position The associate would be adjusting the patients, of course, educating the patients about health and chiropractic, consulting in a regular meeting with the three assistants/office employees, consulting with other health care associates, working as a team, learning how to manage a chiropractic office in a foreign country. The running of the clinic, administratively, is handled by the assistants. Any changes are made through group consultation in the weekly meetings. The clinic is old-fashioned, furnished comfortably and casually. The adjusting tables are either portable or made to specifications, with simplicity in mind. One could bring their own Hi-Lows. The reason for not having electrical tables is that the electricity goes off for several hours at least once a month mostly due to the present drought conditions at this time. It used to be more frequent, so I have become accustomed to the stationery tables. There are no x- ray machines (there are plenty of places that do that, some quite good, one or two who understand the chiropractic x-ray.), no modalities of any sort, again mostly out of necessity. One would have to bring his/her own. The clinic is plain and simple and has been very effective for me. Amenities This is a well-established clinic of 13 years with a base of hundreds of patients. The files are regularly updated, very good patient referral system, and call-back program. There are no malpractice suits to worry about, no malpractice insurance to pay, cheap cost of advertising, many opportunities for radio publicity, many opportunities of expansion and growth. It is a cash basis only practice. Patients pay for each visit at the time of the visit, some pay in advance. . The clinic is in a residential district, in a one-level house. The massage therapist rents a room in the back for her residence. There is another room reserved for my regular visits of every two or three months for a month¼s stay. There is a kitchen, laundry facilities, and three full-baths and 2 half-baths (in the clinic). The rest is used for the clinic, which has space for three adjusting rooms, large reception area, work area, office, two massage rooms, and three more rooms presently not in use. The house is quite large. There is a maid who cooks and cleans five days a week, Mon ‚ Fri. Salary, terms being offered Essentially one would be renting space ‚ to cover one¼s portion of the fees in operating the clinic. The chiropractic patients at present number 75-100 patients a week. The above costs could easily be covered by 50 patients per month. The remaining income from the additional number of patients would be what the associate would earn personally. Arrangements here are somewhat different than in other parts of the world. So if a Dr. is ambitious, having around 200 patients a week, he/she could earn quite a bit in a month. Although, in dollars the amount would be moderate, there would be enough income to pay on student loans, take two three-week vacations a year, and have a modest savings. In local currency the income is in the high income bracket ‚ but in terms of exchange, it would not be fair to compare the income with what one would expect by working in the US. (For those who are interested) Short term acceptable? Two weeks to three months. It is something that I had not considered, but which, I think, could be workable even if I would not be here. What is the situation in Venezuela like? Because the socio-political climate has been somewhat stressful and tense recently, more people are feeling stressed which increases the patient load. Of course, living in any foreign country requires someone with an adventurous nature. The country is normally quite pretty, very beautiful in parts. For over a year there have been drought conditions, getting worse with each month. There is much to see in Venezuela and nearby islands. The ABC Islands, Aruba, Bonaire, and Curacao, are quite close, easy to visit, as well as Margarita Island, Trinidad and Tobago. One can drive to the shore across from Margarita and then ferry over. From Valencia one can go to the beaches anywhere from a hour to 2 hour drive. Caracas, the capital, is 2 to 3 hours away. If one observes the culture and respects the social differences, one can live here quite comfortably. Chiropractic is still in a limbo state legally, or what I consider to be a limbo state. Although occasionally there are advances in getting chiropractic legalized, essentially, chiropractors are to be associated with a medical doctor, but in practice, aren't; and while it is illegal to practice chiropractic if one is not graduated from a chiropractic college, many medical doctors "do" chiropractic. Establishing chiropractic is a great challenge. There is in the making the possibility of working toward having a chiropractic school associated with a private university here in Valencia. This is through one of my patients. The first project that the university is undertaking is to get government approval to have courses in alternative medicine. That part of the project has already begun. There are exciting things happening for chiropractic here if one wants to pursue all the opportunities. We as chiropractors need to do this immediately before the doctors take over chiropractic in this country, to prevent what has happened in other countries in Europe. It is essential that we have many more chiropractors in the country. This is an opportunity for a chiropractor to get established in a foreign country where chiropractic is so vitally needed.