Cover Stories

X-Ray In Motion
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Cover Stories
Written by Dagmar Arce   
Friday, 24 September 2010 11:28

Where other chiropractors were eager to open up their practice, Dr. Postlethwaite had different plans...

Thinking About a Problem While Getting Adjusted?
Cover Stories
Written by TAC Staff   
Friday, 24 September 2010 10:28

Thinking About a Problem While Getting Adjusted?


Scott Walker, D.C., has been a chiropractor for over forty-three years. Frustrated with uneven results in practice, he developed the Neuro Emotional Technique (NET). In addition to having written numerous magazine articles, he has authored many technique manuals, charts, audio and video recordings and also formulated specialized mind-body homeopathic remedies. While teaching internationally with his chiropractor wife, Dr. Deborah Walker, he has also done radio and television interviews and conducted research. He is the founder of the ONE (Our Net Effect) Research Foundation, a non-profit multidiscipline research organization dedicated to doing scientific research on NET.

In the United States, the NET Basic seminar is approved for twelve hours of continuing education hours for chiropractors in most states.

Dr. Walker is credited with a good sense of humor and making learning a fun experience.

In an interview with The American Chiropractor (TAC), Dr. Scott Walker talks about NET’s past, present and future.

TAC: What is NET?

Walker: NET is a simple mind-body stress reduction intervention aimed at improving behavioral and physical problems, such as in chronic injuries, subluxations, pain, worry, anxiety, depression, etc.


TAC: How did you develop this technique?

Walker: In a state of frustration, insecurity and, thankfully, curiosity, NET was eventually developed. Initially I felt frustrated because some patients got well, while others didn’t. I also felt insecure because I didn’t have a satisfying answer for myself or my patients who asked as to why their conditions didn’t respond or why they kept coming back. I was curious, however, and my search took me to "stress" and the body’s conditioned emotional reaction to stress. The interesting thing was I, through reading neuroscience articles, found the emotional response to be physiologically based and not psychologically based! That was lucky, because I don’t know very much about psychology, and I was not about to make a career out of talking, talking, and more talking to patients about their problems! Please save me from that! On the other hand, we, as chiropractors, are well versed in dealing with physiology. In a nutshell, NET works by having the patient think-feel about their pain/issue while a special vertebral adjustment is given. They do 90 percent of the work.


TAC: Could you tell our readers a couple of the most prominent studies that have been published regarding NET?

Walker: NET has many interesting studies on a surprisingly wide variety of conditions. But, then again, that is what one might expect if there were a truly effective mind-body technique. We have a Randomized Control Trial (RCT) study on Low Back Pain through Macquarie University, which was presented to the International Congress of Complementary Medicine this year, and we are just finishing a much larger study (it will be the most comprehensive yet in all of chiropractic) on low back pain, complete with urine and blood immune markers. In chiropractic, I guess we would expect that. But more surprising perhaps, NET has RCT’s (one out of Oxford) on phobias, trigger point resolution, and we have other studies on polycystic ovary, ADD-ADHD, hypothyroidism, separation anxiety, hypercholesteremia, etc. We also did an interesting survey/treatment study on anxiety/depression (using the DRAM instrument) that was remarkably favorable. And, in addition, this study had the shocking finding that, in the random (188 consecutive patients) chiropractic pre-treatment group population, 34 percent were "at risk" and only 23 percent were normal. This finding strongly suggests, in our regular chiropractic patient populations, over a third of our patients are in deep emotional trouble. Fortunately, however, there was significant improvement after the NET intervention.

This reminds me of a published study I did (it was international in scope) which demonstrated that 90 percent of DC’s feel the emotional component of health to be important, yet less than one-third of them had a technique to intervene. Perhaps, for outright interest in studies, maybe the most prominent study is the one we are presently doing on the body stress/trauma related to a patient who receives a diagnosis of cancer (the pronounced diagnosis, itself, is often as shocking as PTSD). We already did a pilot study at Thomas Jefferson University’s Myrna Brind Center of Integrative Medicine and Hospital. This pilot study has been published and, although the blood sample was too small to include, we were delighted to see the immune markers, especially Interleukin 10, dramatically improved, which is also what the preliminary results in the large low back study are now showing. We are now doing a larger study and, who knows, we might have THE profession with the most influence on the immune system.


TAC: What does it take to really understand the core concepts of NET?

Walker: For actually doing the technique, it takes twelve hours of training in a seminar setting with hands-on workshop. Pretty straight forward. But to actually understand NET in depth, one has to be ready to throw out most of the outdated neurophysiology that was learned in school. For example, we may have learned that emotions are psychological, but now we know they are not; they’re physiologically based. We need to see the inter-relatedness not only between the emotional response and the immune system as in psychneuroimmunology, but also the digestive, cardiovascular, dermatological, and hormonal systems, to name a few. A few basic primers are the books Molecules of Emotion by Candace Pert and the excellent Biology of Belief by Bruce Lipton. Then follow all the incredible advances in neuroscience—advances that are validating chiropractic.


TAC: What would be the ideal patient for NET? Is there an ideal?

Walker: Anyone who is experiencing a stubborn physical problem, or anyone is experiencing stress or who has been under significant stress in the past, or has the manifestation of behavioral or health issues with no apparent cause, or someone who has a health challenge that is not resolving with standard chiropractic care, or someone who has emotional blocks to success in their life or health.


TAC: What type(s) of diagnostic testing procedures do you use (i.e., X-ray, etc.) and why?

Walker: We encourage our practitioners to retain all of their present techniques and diagnostic instruments and to use NET as a supercharger to make their present techniques work even better. Our present chiropractic techniques work three to four times better when a compromising emotional factor is neutralized. Although it’s not essential for doing the technique, we recommend peer-reviewed validated questionnaires, and any of the standard clinical and lab tests for the hypothalamic-pituitary-Adrenal (HPA) axis. While these are not essential for actually doing NET, they can give interested practitioners confidence as they monitor the progress.


TAC: What other therapeutic modalities do you include when treating a patient?

Walker: We use the metaphor of the four bases of a baseball diamond, calling it the Home Run Formula to Health. Doctors need to make sure the patient is safe at each base by 1.) providing good structural work, 2.) addressing toxins, 3.) balancing biochemistry, and 4.) de-stressing conditioned emotional responses that are affecting the body. NET practitioners are encouraged to use their structural techniques, as well as specifically formulated homeopathics to detoxify the body and nutritional support to balance biochemistry. Of course, NET practitioners use NET to address the physiology of unresolved emotional stressors.


TAC: Tell us two of your most amazing patient success stories.

Walker: We, all of the NET instructors, have seen many, MANY cases at NET seminars where chiropractors come with their own unresolved low back pain of twenty-plus years and are immediately resolved after a five-minute NET intervention. It’s amazing in that chiropractors have low back pain in the first place, and it’s really amazing that they can resolve on the spot. The same can be said for other afflictions on these sophisticated DC health-care consumers. I’d tell you of others, but risk losing credibility!


TAC: What has really impacted your growth as a chiropractor and that of your practice?

Walker: For me it’s not what, but rather who. My heroes have been Drs. George Goodheart, Jimmy Parker, Major DeJarnette, Ray Nimmo ("Muscles move bones, bones don’t move muscles"), and Robert Riddler. I also love to read DD Palmer and BJ. These guys are all gone now. Presently, I also look up to our chiropractic researchers who are laying the scientific foundation for a whole new exciting era in chiropractic.


TAC: Dr Walker, what have you been able to accomplish with your work that you are the most proud of?

Walker: I am proud of our 6,000 plus NET practitioners in over thirty countries around the world delivering cutting edge chiropractic every day. I’m proud because they were forward thinking and saw the value of NET before the scientific research validated it. They cared that much about their patients, and they donated money for research based on what they saw clinically. I am proud to be in the same profession.


TAC: Explain the relationship between psychologists and chiropractors. Is there a creative exchange of information, etc?

Walker: Yes, although we like to smile and say the "issues are in the tissues," there are often psychological aspects of some problems we encounter which need talk-it-out reasoning and counseling. And, with the emergence of the mind/body or biopsychosocial model, these psychotherapists are very ready to refer to NET practitioners to get their client’s nutrition balanced, structurally adjusted, etc.


TAC: Who/What has been the greatest influence on the way you practice?

Walker: Aside from my heroes I mentioned, I am ever grateful for being raised way out in the country where I learned from nature, my greatest teacher. I also went to school in a two-room schoolhouse where I was unhurriedly able to absorb the fundamental building blocks of knowledge. My father, a mechanic, patiently taught me how things work and my mother, a nurse, taught me how to care—combine those two and you get a chiropractor.


TAC: Throughout the ages, there have been many great healers. Whose approach would you like the most?

Walker: That’s easy, Hippocrates, for separating healing from magic; the Yellow Emperor emblematic for the East’s wisdom about nature and healing forming a great basis; and then the brilliant medical heretics, Paracelsus, Semmelweis, Hahnemann, and DD Palmer.


TAC: What are your goals for the chiropractic profession?

Walker: To make DD Palmer’s paradigm, "The determining causes of disease are traumatism, poison, and autosuggestion," and "moving thots (sic) produce disease—malice, revenge, remorse, grief, worry, spite, etc."—into a rock solid, scientifically validated, pragmatic and prosperous profession. DD saw it from afar. The 19th century biomedical model has failed miserably; the biopsychosocial (BPS) model is now the predominantly acknowledged viable model. Essentially the BPS was, and is, DD Palmer’s paradigm. But we are catching on. The stress factor is there and it is now being acknowledged. There are other techniques besides NET which, depending on the DC’s predilections, can help practitioners and are helping with stress. Such examples are Bio Energetic Synchronization Technique (B.E.S.T.) and Network Spinal Analysis. In addition, Applied Kinesiology and Total Body Modification (TBM) and, John Amaro’s International Academy of Medical Acupuncture (IAMA) have unique approaches.


TAC: Any final words for our readers?

Walker: It’s been a hard fight, but we DC’s have done well. We have kept vitalism alive in the face of medical and legislative persecution and commercial discrimination. We have fought with them and, of course, being chiropractors, fought with each other, but we have not given up on fighting for our patients’ welfare, for what we have seen helps them. I encourage everyone to financially support our colleges’ scientific research departments. Science is the only currency that spends these days. It better, as we enter into ever more evidenced based third party pay, including a looming federalization. As you know, we are usually at the very end of the Medicare line with our hands out. We are going to beat traditional medicine using the very weapon they have used against us, science—only better. It used to be the medical establishment would say they had research and that we did not. Now, we can say to them, we have research demonstrating that pathophysiology can be eliminated through natural drugless means, thus restoring true health. Furthermore, we can say, "Your medical research may show a certain drug has the ability to force a certain effect; however, that particular medical mechanical paradigm has nothing to do with the patient actually healing." Medicine, indeed, has a science of sorts, but a puny unworkable philosophy of health. Outside of emergency and heroic life saving measures, medicine has even been deadly at times. Not so with chiropractic. I will be speaking at the World Federation of Chiropractic in Montreal in April, 2009. Please come hear what NET science through The O.N.E. Research Foundation has provided us, and learn what other top-notch chiropractic researchers in the various colleges have also achieved in other realms.


You may contact Dr. Scott Walker at N.E.T., Inc., 5651 Palmer Way, Suite C, Carlsbad, CA 92010, by calling 1-800-888-4638, emailing This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or visiting

Real Marketing from the Experts
Cover Stories
Written by Market Review   
Thursday, 23 September 2010 17:03

Real Marketing from the Experts

Michelle Geller

Dr. C. J. Mertz

MGV Marketing, Inc

Team WLP

William D. Esteb

Dr. Mark Sanna

Patient Media

Breakthrough Coaching

Dr.Daniel T. Drubin

Dr. Timothy J. Gay

ProPractice Partners

Ultimate Practice

Dr. Mark Studin

Dr. Eric Plasker

CMCS Management

The Family Practice


Market Review


We’ve gathered eight top experts in the Chiropractic field, just for you, to provide you with fundamental methods of marketing that can be integrated right now, on a shoe string, and keep your practice thriving years into the future.



Michelle Geller VinoThe most cost effective way to attract new patients is through relationship building. Relationship building costs virtually nothing and is simple! My analogy is, if the doctor wanted to become the mayor of his/her town, what would be the best way to become known? The answer is to meet as many people as possible.

One of the easiest ways to attain this goal is for the chiropractor to go out into the community and offer to do educational workshops in schools, corporations and organizations on health, wellness and safety topics, as part of his/her community awareness program. That doctor will become the most well-known very quickly. Especially in this economy, employees in the workplace should be educated to stay healthy and be as productive as possible.

This is a proven way to attract new patients into any practice! There is no cost. All that is involved is putting aside consistent time each week to make the calls. Michelle can be reached at 1-561-392-5206, by visiting her website at or by emailing her at   This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

William D. EstebThe biggest marketing problem for chiropractors these days is the inclination to cut back and turn inward when things tighten up, often considering patient education as a needless luxury. Simply put, getting new patients is about effectively telling the chiropractic story to as many people as possible. Patient Media helps chiropractors communicate chiropractic clearly, concisely and persuasively with state-of-the-art, visually-based patient education resources, informative videos, report documents and reactivation tools. What makes Patient Media unique is that we help chiropractors see their practices and their internal and external marketing procedures from a patient’s point of view. We offer free blog posts at, Monday Morning Motivation, magazine articles, books and audio recordings to help chiropractors understand today’s patients, focus their communications and stay on message.

For more information, call 1-800-486-2337, visit, or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Dr. Daneil T. DrubinThe number one challenge that practitioners in the market place appear to be experiencing is in the area of patient retention. At ProPractice Partners, we work with our clients on the quality of their communication. We know that the quality of patient compliance can be directly related to the quality of communication. The more the doctor is prepared to "give direction, and hold the patient accountable," the more the patient connects with the doctor.

Here are 4 strategies that, when applied properly, will increase patient compliance:

1. Work diligently at the end of the new patients’ first visits, to have them return for the results of their tests with a spouse or significant other. Remember, any time that you speak with only one member of the family, 50% of the time you have the decision maker with you and the other 50% of the time the decision maker is at home. Patient compliance is always improved when the patient’s partner is 100% behind the doctor’s recommendations.

2. When you provide patient recommendations, consider the following...the patient only hears the lowest number of visits that your recommend as you present your program of care. Make certain that you and the patient are clear about what it is going to take to maximize results during their experience at your office.

3. Patient education increases patient compliance! Our clients provide their patients with an entire series of patient education programs. These programs are designed to educate and motivate the patients as the doctor builds value about the benefits of chiropractic care as a lifestyle choice. The more time and energy the doctor invests into patient education, the more the patients will follow through with their care and the more referrals that will be generated.

4. Make sure that the patient always has something to look forward to. If the patient is properly prepared, whether it is for their next re-examination, an exercise program, or nutritional support, the patient will be more compliant.

If you incorporate these 4 essential patient protocols into your office, your compliance will increase as will the patient’s response to care.

For more information, call 1-520-575-0207 or visit


Dr. Mark StudinGet out of your office and introduce or re-introduce yourself to the community by visiting one shopkeeper at a time. It is a numbers game and the goal is to double the people who know you, not the number of people you know.... It is that simple. Don’t forget to write them thank-you letters after you return to your office, adding your business card so they are reminded of whom you are and where you practice.

As for what CMCS Management does, we help guide doctors through a process of becoming the best-of-the-best through information provided or recommended and also work with you on how to approach a patient from a triage perspective. We then share with you how to look as great on paper as the consummate professional you really are. In the medical-legal world, the written word carries weight and all else is non-admissible rhetoric. Once that is accomplished, we give you a system to get the lawyers to come running after you because, the second you ask for a referral, the game is over and you have lost. The lawyer has to understand that you are the solution to their cases in an honest and ethical environment and that is the easiest part, once you have created an infrastructure of clinical excellence.

Dr. Studin can be reached at 1-631-786-4253 or visit


Dr. C.  J. MertzThe biggest problem most chiropractors face is the inability to produce "overlapping" in their marketing efforts. New patients come from one of four actions: Energy on the inside, energy on the outside, money on the inside or money on the outside of your practice. Increasing new patients is always the result of proper overlapping of all four marketing actions organized in six to eight week programs. This process is known in WLP as periodization.

The solution has five phases. Phase One is to always create a personal environment in your belief which builds upon your love, passion and energy to serve. Phase Two is to develop a budget (up to 10% of your monthly gross collections), so that you can determine those marketing actions that best serve the next level of growth for your practice. Phase Three is to organize a six to eight week period of overlapping marketing that includes daily, weekly and monthly actions. For Example: hand out five referral packets per day, schedule six awesome weekly titled workshops, place a monthly ad in the newspaper and schedule three screenings over six weeks. The fourth phase is hiring or training a Chiropractic Assistant with passion and skill to partner with you and turn your marketing campaign into practice success. The final phase is to carefully track your results so that you can improve as you prepare your next marketing periodization.

Chiropractic works, we just need to get the message out loud and clear; let’s make it happen!

Dr. Mertz can be reached at 1-512-347-1895 for further explanation of marketing periodization.


Dr. Mark SannaRoll the Video! Online communications are changing. Chiropractors are now sharing information about their practices using podcasts, online video and, now, live video streaming. With the web evolving to include these richer media channels, the savvy marketer must learn how to listen, understand and use the same media. Broadband penetration is 70% in the US, making streaming video a "must" marketing tool for your practice. One hundred twenty-three million Americans watch at least one video a month, and three-quarters tell a friend about one. Video provides you with an enormous opportunity to engage, educate and entertain (yes, entertain) your patients: the "Three E’s" of successful marketing. Chiropractors are producing specialized videos to help their patients get the most from their chiropractic experience. These video messages include everything from virtual tours of the practice, welcome messages from the doctor, new patient orientation sessions and even customized home exercise programs, all streamed over your practice’s website.

For more information, visit or phone 1-800-7-ADVICE (1-800-723-8423).


Dr. Timothy GayThe single biggest barrier that is ongoing in practice is to stay motivated and not get discouraged in the marketplace.

There is a lot of competition in health care and, with all of the marketing trends changing, many doctors will start a program and become disheartened if there are no immediate results.

Speaking engagements, screenings, and networking, from an overhead stand point, are the most economical ways to get new patients. Many doctors have an inability to go outside of their offices and communicate the chiropractic message in a sharing—not selling—way.

Along with thinking and doing, taking an action step is what is needed in any marketing endeavor. It is extremely important to keep the right attitude to accomplish the most in your practice. Selling the public on your definition of chiropractic is done only by creating reasons for patients to participate in their health care. Buying motives are more important then selling motives. The public has a what’s-in-it-for-me-attitude towards everything. Give information away—not services—and remember that negativity is a misalignment from achieving your goal.

Dr. Gay can be reached at 1-866-797-8366, or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Dr. Erick PlaskerImplement a Healthy Generations Campaign in your practice and begin attracting the families of the people that are already coming in. This includes the traditional family members such as the moms, dads, children and grandparents as well as the inner circle families of your patients, which includes their friends, co-workers and community relationships. Put up a Generations Board with pictures of any traditional or inner circle families who are under your care. When you do this, instead of getting one new patient at a time, you will begin to get 5, 10 and 15 new patients at a time. I know this may sound too simple, but that is the brilliance of it. Focus your report of findings, daily visit procedures and marketing efforts to produce these types of results and you will experience substantial growth with minimal to no expenses, even in this crazy economy.

Dr. Plasker can be reached at 1-866-532-3327 or visit

“Nerve First” Approach
Cover Stories
Written by David Fletcher, D.C., F.C.C.S.S.(C)   
Thursday, 23 September 2010 16:57

“Nerve First” Approach

by David Fletcher, D.C., F.C.C.S.S.(C)


 Dr. Fletcher is a 1980 graduate of Canadian Memorial Chiropractic College with a Fellowship in Chiropractic Sport Sciences. He trains and teaches thousands of chiropractors to interpret and communicate the power of chiropractic care, using CLA’s Insight scanning technologies. He continues to practice daily, while developing new strategies for coaching chiropractic offices towards excellence.

"Like most patients, I began seeing a chiropractor for some spinal pain and sports related injuries. This was in the early seventies, and my parents and I used chiropractic as one would use dentistry or medicine. A chiropractor was just another doctor you went to; in this case, for spinal care. Our family DC had little interest in teaching the "Big Idea" and would tell us to come back if it hurt. When I chose to become a chiropractor, I had no idea that chiropractic was a healing system based on vitalistic principles and the powerful science supporting it. That was until I heard Reggie Gold speak, off campus, of course. His signature lecture, ‘The Chemistry of Life’, struck me between the eyes. Here I was, already in a chiropractic school and I was being trained to heal people, not just spines! I was ecstatic! All we needed to do was tell the story often and properly."

And so the journey began that has led Dr. Fletcher around the world, teaching chiropractors that the hip bone is connected to the universe, because of the neurology that lies within. The American Chiropractor (TAC) caught up with this dynamic communicator in his office outside of Toronto, Ontario, Canada.

TAC: You’re a busy man with your speaking and coaching programs. Tell us what you have been doing to spread the message of chiropractic.

Fletcher: I do teach, train and coach chiropractic teams to excel; but what I still love to do is practice chiropractic. I call my office a "living laboratory" for developing new and innovative teaching and communication strategies. I think that this adds a relevancy to what I teach. I am always amazed at how a subtle shift in the message can be so powerful at getting that "Ah Ha" from the patient. Being in practice allows me to refine and simplify the message.

Helping someone through a pain or symptom crisis is honorable. At the spinal-mechanical level, we can assist a lot of people; but that is only the entry point for people to experience chiropractic. The real story of healing energy and potential lies in the connections of neurology within the spinal-neural-dural array. Our role is to show people how to care for this amazing system and coach them to live life fully. I practice and coach the benefits of an invitational approach which allows the doctor to become the trusted advisor, leading patients along their path to wellness.


TAC: Wellness seems to be the most popular message amongst chiropractors today. Tell us your thoughts on the link between wellness and spinal care.

Fletcher: Seven years ago, I was brought in to consult with an international health and safety board that was comprised of government and business leaders to whom I introduced this "bizarre" notion of wellness being included in corporate health programs.

They just couldn’t get their heads around this idea of something bigger than prevention; but they took a leap of faith and we created "The Wellness Way" at their annual convention. Eight thousand attendees got a glimpse of a new perspective in employee health. We used Chiropractic Leadership Alliance’s Insight Scanning technology to show how stress and nerve interference were present in almost everyone, whether they had back problems or not. This allowed us to show how stress was interfering in employee health and performance and, of course, tell how chiropractic was the natural starting point for a wellness program. The organizers were amazed at the interest and desire of business groups to learn about the natural management of stress in the workplace. Fast forward to the present and the Wellness Way is sponsored by all levels of government and big business. In these organizations, wellness is seen as a necessary message and funded protocol. Our challenge now, as chiropractors, is to bring the full message of healing and health forward and to be seen as relevant players in these programs. If we limit the story to back and neck care, we miss out on telling the wellness story, which mires us in the competitive spinal therapeutic marketplace. Our philosophy, science and the artistic brilliance of an adjustment, positions us perfectly as leaders of the wellness culture.

The link between Wellness and spinal care
really comes down to one word:certainty


TAC: So, if the time is right to see chiropractic breakout on the international health and wellness stage, what’s holding chiropractors back?

Fletcher: Well, it really comes down to one word: certainty. On a practical basis, I teach that you get paid at the level that you perform with certainty. If you are certain that you can manage acute care, you develop a terrific acute care practice. If you are certain that wellness lifestyles and lifelong chiropractic care are essential foundations for your community to thrive, then the sky is the limit for your practice.

Unfortunately, doubt and insecurity are rampant within the profession. If you can believe it, we see that the greatest uncertainty is around the role of the chiropractor. In seminars, we ask the question, "Are you acting as an over qualified physiotherapist, an under trained medical doctor or a perfectly capable chiropractor?" This is where coaching and mentorship is necessary. A capable coach can really help to teach the principles, while training congruent procedures. Most of all, a coach can mentor and unleash the hidden potential while refining the raw talent.


TAC: You mentioned earlier the importance of the nervous system in telling the chiropractic story. Tell us more about this.

Fletcher: I attained my Fellowship in the Sport Sciences in the mid 90’s. I wanted to learn more about performance and apply that to the chiropractic care I was delivering. What I came to respect and understand was the absolute importance of neural competency and efficiency. I started to investigate surface EMG as a reliable indicator of spinal nerve function and came across these two chiropractic pioneers named Patrick Gentempo Jr. and Christopher Kent of the Chiropractic Leadership Alliance. They had a terrific technology that included spinal range of motion, thermal scanning and the sEMG. I realized that this would be the perfect combination to show how the spine and nerve function were so intimately related and I immediately made this the hub of my practice.


TAC: How did you make this technology work for you?

Fletcher: Examinations, reporting, and even marketing were based upon the principle of identifying subluxations and tracking the changes with this technology. My practice changed dramatically and, years later, continues to thrive based on this principle. The most measurable change was in the retention of patients. A care plan was now relevant, as it addressed the issues that brought the patient in and laid the foundations for wellness and stress management. I developed a new practice paradigm known as the "20-80 practice." This is a reversal of a traditional practice where 80% of patients in a practice are there for the 2-4 months while only 20% stay a bit longer.
This traditional style of practice demands a tremendous effort to acquire new patients to replace those that leave. I teach and train my clients that the "20-80 method" takes a "Nerve First" approach to examining and reporting. Although we always recognize the necessity of spinal alignment and function, our first goal is to identify patterns of unmanaged stress affecting the nerve centers along the spine. By introducing how daily stress can eventually "stain" the nervous system, a care plan using neural scanning and spinal function allows the patient to be actively involved in their care and progress. This creates long term relationships and, hence, the "20-80 practice" where 80% of the patients are under wellness care and 20% aiming to get there.

Chiropractors are so lucky that they have aligned their careers with the Universal principles of healing and


TAC: How do you teach and train doctors to include this Nerve First approach in their practice?

Fletcher: I have become a leading authority on neural scan interpretation and the integration of scanning into a practice. Each year, I train hundreds of doctors how to interpret a full array of neural scans, including surface EMG, Thermal scanning, Inclinometry, Algometry and Heart Rate Variability. The real challenge is to ensure that a proper report is given by the doctor and I believe that is where my greatest skills shine through. Over the years in practice and while coaching doctors, I have developed powerful, yet simple, communication methods that take complex concepts and present them in practical and inspiring terms for the patient. A 7-10 minute Report of Findings really can connect the hip bone to the Universe!

I created the GAP Coaching program for doctors searching for that individualized training and mentoring. GAP stands for Greatness Action Plan. I believe that there is an untapped greatness in all of us that can be coaxed out and allowed to shine. Chiropractors are so lucky that they have aligned their careers with the Universal principles of healing and greatness. They are the perfect clients to coach with the GAP program.


TAC: What does Gapping mean in those contexts?

Fletcher: Besides the first meaning, we also use GAP as a communication and patient education concept. It’s a bit contrarian to the concept of "bridging the gap" and that’s what gives it an edge and gets people thinking outside the box. We teach the patient that GAP stands for General Adaptive Potential. It follows Selye’s work on stress and adaptation. In the nerve first approach, we teach the patients, very early in their care, the importance of identifying and modifying daily stress. Once we get them to understand the role that stress plays in their pain and health, we then introduce "widening the GAP." Gapping is the process of releasing the innate healing response while we collaborate with the patient to reduce the stress load that is narrowing the GAP.


TAC: What do you see as the practice of the future?

Fletcher: It’s hard to envision what chiropractic will look like in another 100 years but, in the next 5-10 years, I see a return to basic business fundamentals where a cash practice dominates. The rapid decline in insurance contributions is obvious and, as we all know, it’s a mess dealing with paperwork and receivables. To make a cash practice work, all systems have to be ultra efficient and cost managed: a simple fee schedule, convenient hours, simple care plans that allow restorative healing and, of course, an inspired doctor and team that are expecting a miracle with each adjustment.

We can learn a lot from the masters at cash-based, long-term care…the orthodontists. I have taken some of their finest practice strategies and adapted them to work in a wellness centered chiropractic office. Linking stress, wellness, lifestyle and structural integrity in an organized care plan allows us to widen the gap over months and, eventually, years of care.

I think it is also very wise to take the time to "know" your ideal patient. Chiropractic impacts everyone, but there are certain groups of people that we just resonate better with. Focus on these patient clusters and become passionate about adjusting this group’s perspective and behavior towards wellness.

The other side of the practice profitability equation is managing overhead. We coach and train our doctors in efficient procedures that inspire and educate at the same time. Imagine a 3 or 4-day workweek, high intensity, high profitability, cash dependent and low, low overhead. Lofty intentions delivered with a high degree of certainty, blended with compassionate care and brought by a doctor who respects his own health and well being, are the foundations for the future, successful practice.


TAC: What single piece of advice would you give a new practitioner?

Fletcher: Meet people. There’s an old adage that states, "The more people you meet and greet, the more you treat." When I started practice, I always had a stack of business cards in my pocket and handed them out to everyone I met. People, months and even years later, would remind me that I had passed along a card. In today’s technology based environment, meeting people can also be done via the internet. Joining networking sites, using Twitter, and sharing blogs allows you to meet a more diverse group of potential patients.


TAC: Thank you Dr. Fletcher for taking the time to share your story. Any last thoughts?

Fletcher: We are most powerful when we define our strengths and go for it! Above my desk is Aristotle’s quote," We are what we repeatedly do. Excellence, then, is not an act but a habit." Learning to be great and to act powerfully is a habit worth exploring.

You may contact Dr. Fletcher at This e-mail address is being protected from spambots. You need JavaScript enabled to view it ,  by calling 1-905-831-9696, or visit

CLEAR Scoliosis: Case Study
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Written by Dennis Woggon, DC, B.Sc.   
Thursday, 23 September 2010 14:15

CLEAR Scoliosis: Case Study

by Dennis Woggon, DC, B.Sc.


THE PATIENT PRESENTED in 2008 with a 48 degree right thoracic Cobb angle. It was initially diagnosed in 2005 at 25 degrees. The patient had a history of birth trauma. The scoliosis previously was treated with traditional Chiropractic Care. The standard CLEAR Scoliosis examination was performed. Her X-rays revealed a loss of the cervical lordosis and forward head posture (FHP) with left alar ligament damage. There was a primary right thoracic Cobb angle of 48 degrees, with compensatory left cervical dorsal Cobb angle of 35 degrees and a left lumbodorsal Cobb angle of 24 degrees. When the addition of the “compensatory” Cobb angles is larger than the primary Cobb angle (35 + 24 = 59), the scoliosis will advance. Treatment consisted of CLEAR protocols with 11 visits. The Mix, Fix, Set procedures consisted of warm-ups, adjustments and rehabilitation. The Mix phase consisted of cervical traction to improve the cervical lordosis and decrease forward head posture and vibrating traction (VT) to improve the cervical and lumbar lordosis. This mechanical traction (VT) allowed relaxationof soft tissue, specifically ligaments and discs to allow for separation between joint surfaces. Cervical drop traction was used to reduce the forward head posture and increase normal lordosis. The Spinalator allowed mechanical traction to decrease the degree of tension in the soft tissues and also allowed for more separation between joint surfaces. The Eckard Table created mechanical traction with mirror image positioning of the patient's X-ray configuration. The Eckard Table provided motion as well as traction for therapeutic exercises and decreased disc wedging.  The Fix or adjusting phase consisted of specific spinal adjustments based on 8 precision X-rays and the supine neurological leg check. They included anterior thoracic adjustments, lumbodorsal pelvic side posture and drop adjustments, cervical dorsal adjustments using the Arthrostim, long axis traction adjustments, as well as extremity adjustments to the shoulders, 1st ribs and TMJ. To correct the scoliosis, the upper and lower cervical angles must be corrected and the legs must be balanced. The Set phase teaches the spine to stay in position. This included the: LD ball exercise, ball twist exercise, standing strap stretch exercise and vibration therapy and rotatory twist exercise. These exercises are therapeutic and assist in developing strength, endurance, range of motion and flexibilit. Pneumex gait training with spinal weighting is a style of walking including rhythm and speed. The patient also used the Scoliosis Traction Chair (STC), which is a combination of traction and whole body vibration (WBV), with a mirror image placement of the patient and tension straps utilized to pull rather than push the spine towards normal alignment. Tightrope exercises were utilized for gait training with spinal weighting. Next, The VibeTM was used with head, shoulder and hip weighting. This is a vibrating platform for proprioceptive neuromuscular re-education with cervical traction. Spinal weighting with WBV causes the spine to “react” to the unbalanced forces returning the spine to a normal position. The patient’s re-evaluation revealed an improvement of the scoliosis. The right thoracic Cobb angle of 48 degrees decreased to 34 degrees, the left cervical dorsal Cobb angle of 35 degrees decreased to 18 degrees and the left lumbo-dorsal Cobb angle of 24 degrees decreased to 11 degrees. More importantly, the forward head posture (FHP) returned to normal. The patient showed significant improvements in the cervical and lumbar lordosis, correction of the upper and lower angles as well as other spinal units, stabilization of the alar ligament, and a balanced neurological leg check. Lastly, the patient was instructed to continue with home protocols including head weights with limited vision glasses (to improve the cervical and lumbar lordosis, decrease forward head posture, and improve neuromuscular re-education for movement, balance, coordination, kinesthetic sense, posture and proprioception), specific spinal isometric exercises and scoliosis stretching exercises (to develop strength, endurance, range of motion and flexibility), cervical traction, and the Scoliosis Traction Chair (STC), as well as continued chiropractic care and a follow up evaluation every three months. Discussion: The scoliotic spine does not follow what we would consider normal spinal biomechanics. Therefore, normal chiropractic procedures may not be effective in some cases. This patient did benefit from previous chiropractic care symptomatically, but not structurally. The CLEAR hypothesis is that Adolescent Idiopathic Scoliosis (AIS) is caused by a combination of neurological (subluxation) and biomechanical deficits, FHP and a loss of normal spinal lever arms. Additional follow up and research is necessary to improve upon the chiropractic profession’s understanding of the scoliotic spine.


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