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Written by William D. Esteb
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Saturday, 28 February 2004 00:00 |
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Most patients don’t “get” chiropractic on their first exposure to it. So, if you’d like to increase the likelihood of subsequent reactivations, even referrals, create a safe place for new patients to “fail.”
Failing, is when a patient begins chiropractic care, enjoys symptomatic relief, discontinues their care and suffers a relapse months or years later. Failure is an essential ingredient of true patient “education.”
Failure is underrated in our culture. Yet, it’s how we really learn. Most of us were “taught” not to touch the hot stove, and were “educated” when we did. While the painful burn might have been seen as a failure by your parents, it was all part of the plan. That’s why, these days, you don’t have to be told not to touch a hot stove. You and I have learned much more from our failures than our successes.
If a patient must fail on their first (and probably their second or third!) exposure to chiropractic, then consider creating an environment in which a patient can receive chiropractic care, discover its implications and discontinue without shame or fear of judgment. (Something difficult for many chiropractors who care about a patient’s health more than the patient does.)
What would a “successful” patient failure look like? A patient who has a positive chiropractic experience discontinues care, has a relapse, knows not to blame you or chiropractic, returns to your office without an “I-told-you-so,” resumes care and after a couple of these episodes (possibly spanning years!), comes to accept regular chiropractic care as they do bathing, teeth brushing, eating healthy foods and other healthy habits.
Ready to play the “long game” and plant the seeds necessary to perhaps, possibly, maybe, someday enjoy a harvest of appreciative, stable, cash-paying patients who see chiropractic as a way of life? Then create a safe place for patients to fail.
Begin by assuming a healthy detachment about how much chiropractic care patients opt to receive. Acknowledge their sovereignty and appreciate the fact that they have the freedom to abuse their bodies, reject your suggestions and value other things more than their health.
Second, make sure patients understand that they are likely to feel better before muscles and soft tissues supporting their spine are fully healed. Set the stage during your report of findings to “future pace” each patient: “We had a patient in here a couple of months ago who got great results and then dropped out of care as soon as she felt better and later suffered a relapse. Fortunately, I had explained that she would be susceptible to a relapse and she didn’t blame chiropractic or me, and came back in. Of course, how long you benefit from chiropractic care is always up to you.”
Make sure every patient knows that you’re genuinely interested in serving and honoring their health goals. (Remember, they have to fail first.) Help each patient see that they won’t be “letting you down” or disappointing you by discontinuing their care early or won’t be judged for not doing what “good” patients do. (That’s the hard part!)
Even more daring, at your report of findings, while the relationship is still being established, discuss the “office disengagement process” when they’ve had enough chiropractic care.
“We have a little ceremony my staff and I like to conduct when patients reach their health goals, so please let us know when you’ve had enough so we can celebrate.” It may seem counterintuitive to celebrate when the patient is seemingly sabotaging their health, but, remember, they still have to have a relapse or two before they’re likely to appreciate the lifestyle benefits of periodic chiropractic care.
Some might criticize this as actually putting the “premature dismissal seed” into a patient’s brain. Hardly. Most patients have heard that “once-you-go-you-have-to-go-for-the-rest-of-your-life” anyway, so most patients are plotting their escape from the first visit!
Take a quick inventory of those wonderful “once-a-monthers” who are a delight to serve. You rarely have to force-feed them chiropractic. In fact, on most visits you rarely even talk about health! How did these individuals acquire their healthy habit? Many observe that these special patients have usually had a couple of previous chiropractic experiences—often in someone else’s office!
Yours? TAC
William Esteb is the president and creative director of Patient Media, Inc. His new company provides state-of-the-art, visually-based patient communication tools from a patient’s-point-of-view. Request a free copy of his 64-page catalog and subscribe to Monday Morning Motivation, his free, weekly emailed practice tip or patient communication idea by visiting www.patientmedia.com or calling (800) 486-2337.
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Written by TAC Staff: National Association News
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Saturday, 28 February 2004 00:00 |
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American Chiropractic Association
ACA Ranked High Among Washington’s Elite Lobbying Groups
The ACA runs one of the most influential advocacy operations in Washington, DC, according to a new listing of the 25 “most effective grassroots lobbying organizations for health care in the United States.” The ACA is number 19 in a ranking compiled by an official of the American Political Science Association and reported in the Washington Times on November 26, 2003.
Out of thousands of groups that lobby Congress on health care issues, the ACA and just 24 other organizations are singled out for their effectiveness in communicating with Capitol Hill and recognized for being “highly successful in building connections between their members and Congress on a wide geographic basis.”
“This ranking confirms that the ACA and the chiropractic profession have a place at the table when health care policy decisions are made in Washington, DC,” said ACA President Donald Krippendorf, DC. “Very simply, elected officials know that the ACA is a force to be reckoned with. When our members speak out on health care issues, they’re listened to and heeded.”
Michael T. Heaney, a research fellow with the American Political Science Association and the author of the ranking, conducted anonymous interviews with 77 health care aides to U.S. senators and congressmen/women between April and July 2003. The result has been several significant legislative victories for the chiropractic profession in recent years, the most recent being the inclusion of a Medicare Chiropractic Demonstration Project in the newly signed Medicare reform bill.
International Chiropractic Association
Continued Coverage of Discredited “Stroke” Article Raises Serious Questions of Journalistic Responsibility
The re-appearance of a news report on WNBC New York, based on a thoroughly discredited article that appeared months ago in the medical journal Neurology, has raised serious questions about the motives of the broadcast agency carrying the story. Entitled “Study: Chiropractic Adjustments May Increase Risk of Stroke,” the piece appeared on November 6, 2003. Presented by the station’s “health” reporter David Marks, MD, the issue of chiropractic safety was once again raised, but offered no additional evidence, no credible data and no new perspective, other than the opinion of a medical neurologist, whose experience on the issue of chiropractic procedures is completely unknown.
ICA Board Calls for Profession-Wide Dialogue on Chiropractic Education and Accreditation
The Board of Directors of the International Chiropractors Association (ICA) has issued a call for a serious profession wide dialogue on the challenges and needs of chiropractic education, in light of the current intense controversy surrounding the educational accreditation process. During their Mid-Year Board meeting on February 25, 2003, the ICA Board adopted a statement that expressed concern over the state of chiropractic accreditation and called for a national dialogue on how this process might be improved. This resolution is meant to voice the concerns of the many thousands of individual doctors of chiropractic and the dozens of chiropractic organizations that have contacted the ICA regarding the nature and direction of the operations of the Council on Chiropractic Education (CCE).
For more information, go to www.chiropractic.org.
World Chiropractic Association
WCA Announces Annual Awards
The World Chiropractic Alliance is proud to announce the following recipients of its annual Chiropractic Awards to be presented during the WCA International Summit in Washington, D.C., April 29-May 1, 2004:
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Chiropractor of the Year: Leona Fischer, D.C. A member of the WCA International Board of Governors, Dr. Fischer served as a U.S. Navy Special Operations medic assigned to the Explosive Ordnance Disposal unit. She showed true courage under fire in 2003 as one of only two members of the Veterans Affairs Chiropractic Advisory Committee to vote in favor of direct access for chiropractic.
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Outstanding Service: Jerry Hardee, Ed.D., president of Sherman College of Straight Chiropractic. After the Association of Chiropractic Colleges (ACC) passed a statement on diagnosis that all but gutted the "Chiropractic Paradigm" that had won nearly unanimous applause from the profession, Dr. Hardee was the first college president to stand up to the group in opposition.
- Researcher of the Year: Madeline Behrendt, D.C. By countering the medical and drug industry propaganda with hard scientific evidence, Dr. Behrendt has been able to gain attention and respect for chiropractic. In 2002, she was named Associate Editor of the Journal of Vertebral Subluxation Research.
- Humanitarian of the Year: Bobby Doscher, D.C. For 26 years, Dr. Doscher has dedicated herself to providing service to severely sick and handicapped children at Oklahaven Children’s Chiropractic Center. Expanded under her leadership, the Center’s current home allows room for future expansion to serve even more children, to conduct research and to educate people about the benefits of a natural, drug-free health care and the chiropractic way of life.
For more information, see
www.worldchiropracticalliance.org.
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Written by Daniel P. Dock, D.C.
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Saturday, 28 February 2004 00:00 |
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VBI Test (George’s Test) is positioning of the neck to screen for who is at risk of dissecting (tearing) of the vertebral artery during a neck adjustment, and/or who is at risk of having a stroke due to a neck adjustment. It is not supported by science.
Continue to do this test until your State Board of Chiropractic, the malpractice insurance companies, and the risk management firms state you can stop. This is a legal standard, but not a clinical standard of care. The odd side of this is that, in the right patient, just doing this test could dissect (tear) the vertebral artery.1
Before the VBI Test, studies were done by medical doctors. About fifty years ago, medical researchers injected a contrast dye into the vertebral arteries of cadavers. When the neck/head was faced straight ahead, the dye flowed through the cadavers’ arteries. When the head was turned to either side, the opposite vertebral artery was pinched off. Based on these findings, medical doctors came to the conclusion that patients should not have their necks adjusted by chiropractors, as patients may suffer strokes as a result.
One can see that this makes as much sense as the statement, “Did you walk to work, or did you take your lunch.”
Turning the head to one side, causing the vertebral artery to be physically occluded by an upper vertebrae in a cadaver is different than in a live person, as a live person has blood flow and “collateral circulation”; therefore, the blood can flow in from other arteries and make up for the temporary occlusion. Medical science supports this. Surgeons can even surgically close a vertebral artery (in the correct patient) and a stroke will not occur, due to “collateral circulation.” Thus, medical doctors’ comparing of the cadaver studies to human ones is not even supported by their own medical practice.
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VBI risk factors
based on: http://www.soc-ortho-med.org/vba.htm
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The following are VBI (Vertebro-basilar insufficiency) risk factors.
Special questions relating to these symptoms or signs , should be asked and the results recorded, as part of the VBI Test.
- drop attacks, black outs, loss of consciousness
- nausea, vomiting and general unwell feelings
- dizziness or vertigo, particularly if associated with head positioning
- disturbances of vision (e.g., decreased, blurred, diplopia)
- unsteadiness in the gait (ataxia) and general feelings of weakness
- tingling or numbness (especially, dysaethesia i.e., tingling around the lips, hemianaesthesia or any alteration in facial sensation)
- difficulty in speaking (dysarthria) or swallowing
- hearing disturbances (e.g., tinnitus, deafness)
- headache
- past history of trauma cardiac disease, vascular disease, altered blood pressure, previous cerebrovascular accident or transient ischaemic attacks
- blood clotting disorders
- anticoagulant therapy
- oral contraceptiveslong term oral steroids
- a history of smoking
- immediately post partum
(Kleynhans & Terrett, 1985; Grant, 1988; Hutchinson, 1989; Chapman-Smith, 1994; Kunnasmaa & Thiel, 1994; Rivett, 1994; Carey, 1995; Rivett,1995; Grant,1994; Kuether et al, 1997; Rivett, 1997; Kesson & Atkins, 1998; Di Fabio, 1999).
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Using our own life experience, we know that, even on a common sense basis, the medical doctors’ conclusion of comparing the cadaver studies to human ones is flawed. We all turn our heads to either side, and may even hold them in the turned position, yet we do not have strokes as a result. Also, consider neck movement when driving cars, backing up cars, checking the blind spots, and turning our heads to look to the side. By using the medical doctors’ logic, there should be a high frequency, or at least a regular occurrence, of vertebral artery related strokes. We all know this just does not happen. Shouldn’t the medical doctors warn the general public, “Do not turn your neck when driving; in fact, do not turn your neck at all!” But, the medical doctors do not; they just say, “Do not have your neck turned in a chiropractor’s office!”
The medical research states there is an unidentified weakness in certain people’s vertebral arteries and they can dissect (tear) spontaneously or with simple neck motion.
Will the VBI Test help identify who is at risk to dissect an artery with the neck motion during a chiropractic adjustment. No, as it does not identify the patients who have unidentifiable weaknesses in the arteries. But, the VBI motion could actually dissect the vertebral artery in a patient that has this unidentifiable weakness of the artery.
Will the VBI Test help identify a patient that will have a stroke from the chiropractic adjustment? The stroke can occur due to a thrombus (clot) or emboli (clot that breaks loose and goes further in the blood vessel before it gets stuck).
Again, without the dissection, or vasospasm, the clot would probably not form. If the patient walked into the doctor’s office with the dissection and clot already, which is likely the occurrence, the collateral circulation (blood flow from other areas) would keep the neurological symptoms from happening. The patient would have been turning the head in their every day activities. The fact that there had been no identifiable neurological symptoms when the patient came to the office shows the VBI Test would not have made a difference.
Dr. Daniel P. Dock is a Board Certified Chiropractic Neurologist and a Board Certified Chiropractic Orthopedist. He has written four books: A False Claim: Stroke From Manipulation; Whiplash Trauma; Records Documentation; and The Orthopedic Spinal Examination. The recipient of the Minnesota Chiropractic Association-President’s Award, Washington State Chiropractic Association’s Volunteer of the Year Award, Georgia Chiropractic Association’s Honorary Life Time Membership, Dr Dock lectures at over sixty continuing education seminars per year. He also maintains an active practice in Minnesota.
For more about Dr. Dock call 218-525-2033 or e-mail
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
References
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Dock, DP. Stroke & Chiropractic Adjustments. The American Chiropractor, V25, I6, p.52.
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Written by Daniel P. Dock, D.C.
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Sunday, 30 November 2003 00:00 |
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When I was in chiropractic school, a teacher stated that, as chiropractic grows in popularity, we will be attacked by our competitors.
Recently, chiropractic was on the receiving end in the national media with regard to the relationship of stroke and chiropractic neck adjustments, even though it is also reported so rarely that it occurs only once in forty-three chiropractic professional careers.
What I do not see in the media is that the medical research documents vertebral arteries can dissect (tear) spontaneously or with simple neck movement. One can get these articles at the hospital libraries of the medical doctor that tells the patient to avoid chiropractic adjustments. In the interest of public safety, shouldn’t these medical doctors inform the general public and their patients that the vertebral arteries can dissect spontaneously or with simple neck movement, not just movement of the neck in a chiropractic office? Shouldn’t these medical doctors tell the general public and their patients that they should avoid all neck movement, not just the movement in a chiropractic office? Doesn’t it seem that the medical doctors’ public safety notices are lacking? Their alerts seem to give a false sense of security to the public and their patients. Their message seems to indicate that avoiding a chiropractor can avoid the spontaneous dissection (tear), the dissection that can occur with simple neck movement. We all know that, for the unidentifiable population at risk, this is simply not true.
Some would state that it is the force of the adjustment that is the reason and cause of the vertebral artery dissection (tear). This ignores the medical research and common sense. We have all treated patients hurt in car collisions. They had their head turned to either side and the car was hit from behind. Look at the forced rotation and hyperextension that happened to your patient. But, I doubt the doctors reading this have seen a case of a dissected (torn) vertebral artery with stroke in the car collision cases they have seen.
Are the medical doctors stopping the physical therapists from adjusting (mobilizing) patients?
The patient most likely walked into the chiropractic office with the vertebral artery dissection—the secondary stroke occurring due to the pre-existing vertebral artery dissection, not due to the chiropractic care.
Do these vertebral artery dissections (tears) and secondary strokes occur without the patient seeing a chiropractor? Of course they do and there are medical articles to show this. Yet, if the same person did see a chiropractor, would the chiropractor get blamed as the cause? Of course they would.
Dr. Daniel P. Dock is a Board Certified Chiropractic Neurologist and a Board Certified Chiropractic Orthopedist. He has written four books: A False Claim: Stroke From Manipulation, Whiplash Trauma, Records Documentation, and The Orthopedic Spinal Examination. The recipient of the Minnesota Chiropractic Association-President’s Award, Washington State Chiropractic Association’s Volunteer of the Year Award, Georgia Chiropractic Association’s Honorary Life Time Membership, Dr Dock lectures at over 60 continuing education seminars per year. He also maintains an active practice in Minnesota.
For more about Dr. Dock e-mail
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
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Written by Frank J. King Jr., N.D., D.C.
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Sunday, 30 November 2003 00:00 |
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Jim Collins most recent business book, Good to Great, shares some key components that have distinguished great companies from good companies over time. This exhaustive five-year study offers those of us who have chosen chiropractic as our profession some strategic—and surprising—long-term insights, contrary to conventional wisdom, that can help us grow into greatness, both individually and corporately, as a profession.
Great companies used technology as an accelerator, not as a creator of momentum. None of those companies began their success transitions by pioneering technology, but rather understood that they could not make good use of technology until they realized which technologies were relevant to their primary mission. They disciplined themselves and waited until they found appropriate technologies capable of fulfilling their primary focus. Surprisingly, 80% of the great company executives didn’t even mention technology as one to the top five factors in their transition. Instead, they were motivated by a deep, creative urge, and inner compulsion for sheer, unadulterated excellence; fear of being left behind technologically never entered the equation. Great companies avoided technology fads and bandwagons. They carefully selected technologies only when they strategically fit their primary focuses.
We live in a world of constant change. Each new day brings some new scientific or technological breakthrough. If we chiropractors are to fulfill our great destiny as primary healthcare providers, we need to use discernment regarding which technological advances truly make a difference to our bottom line purposes and avoid being misled by the ones that don’t.
As chiropractors, we need to be careful of technological pitfalls that can be costly and cause us to stray from our true mark. The bottom line key to our success is to more effectively and efficiently help sick people get well. Society is plagued with chronic recurring health problems. Doctors who can best help these people will be the most successful doctors of the future.
Chiropractic’s founders were visionaries able to see beyond the mediocrities and accepted practices of their day and shape new paradigms of healthcare. If we are to carry this tradition forward, we must have a strategic vision for the future—how to best transform and enhance our abilities as healthcare providers to meet the healthcare needs of our society.
To meet the healthcare challenges of today, we must be innovative. We should be willing to think “out of the box” and apply new approaches that provide better results fulfilling our purpose of getting sick people better naturally.
It is difficult to find someone in our society who doesn’t have some unresolved health problem. Many well-meaning chiropractors have sought costly time- and labor-intensive techniques in sincere attempts to help the many patients with chronic, recurring health problems in our society. And, while these techniques might be good, they can quickly impair the chiropractor’s ability to help the most people when these labor-intensive techniques become our primary techniques.
It is far wiser and more prudent to first apply those techniques that are the most efficient, expedient, and cost effective. Basic chiropractic techniques, combined with our contemporary homeopathic techniques, can help 80% of the health problems people presently face and save the more costly and labor-intensive techniques for the 20% who might require them.
Homeopathy has the greatest time-tested ability of all adjuncts to more effectively and efficiently help the broadest spectrum of chronic, recurring health problems. The doctor who helps people with health problems other doctors cannot is the doctor everyone wants to see. The doctor who helps people more efficiently and cost effectively will eventually be the doctor insurance companies—as well as the public—will reference.
The contemporary procedures we have developed in homeopathy have turned this once complex healing art into an easy and effective approach for the high volume chiropractic office. These breakthrough procedures allow the chiropractor to help the most people with a broad scope of health problems in less time and less expense. Our procedures can be applied to any homeopathic company’s products and still enable the chiropractor to see 50 to 100+ patients per day!
The key to our optimal success is to most proficiently and efficiently help the most people. Homeopathy empowers the chiropractor to fulfill this purpose better than any other adjunct. Homeopathy equips the chiropractor to correct nerve interferences throughout the whole nervous system, and works bio-energetically to correct nerve interferences deep within the brain and its periphery, where the hands of the chiropractor cannot reach.
Our focus, as chiropractors, must be to offer the most straightforward, uncomplicated, individualized, as well as cost-effective therapies available to each patient. As long as we maintain this focus, chiropractic will abound with the greatest opportunities above all other health professions. Homeopathy permits us to fulfill our charge as chiropractors.
Frank J. King, Jr., is a nationally recognized researcher, author and lecturer on homeopathy. In addition, Dr. King is the founder and director of King Bio Pharmaceuticals, a registered homeopathic manufacturing company dedicated to completing chiropractic destiny with the marriage of homeopathy. Dr. King offers, complimentary to all Doctors of Chiropractic, his turnkey procedural system for the high volume practice called, The Chiropractic Enhancer systemÔ (CES). It is so easy to use that you can successfully apply homeopathy in your practice using any company’s products in one day. Call King Bio Pharma-ceuticals, Asheville, N.C.1-800-543-3245 or e-mail:
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