ByTAC D r. Robert Fencll graduated from Palmer College of Chiropractic in Davenport. Iowa in 1997. He has been in practice in Tulsa. Oklahoma since the summer of 1997. During his education at Palmer College, Dr. Fenell became very interested in adjusting the upper and lower extremities. His passion for extremity adjusting encouraged him to attend dozens of extremity seminars and receive training from multiple instructors. Dr. Fencll has spent thousands of hours researching the cause and effect relationship of cxtraspinal subluxation as it pertains to a myriad of upper and lower extremity conditions. Because of his persistence and passion, he has developed his extremity adjusting techniques and skills to an extraordinarily high level of proficiency. Dr. Fenell has been touted by many as "the leading expert on chiropractic hand and foot adjusting." Dr. Fencll has developed a system of manual manipulation techniques that allows the chiropractor to manipulate carpal, tarsal. and other cxtraspinal regions with case and efficiency. He has helped hundreds of practicing DCs take their extremity adjusting skills and know ledge to a completely new level of expertise. In September 2011, Dr. Fenell founded Chiropractic Hand & Foot Clinics Of America™ (CHFA™). CHFA™ offers a private fellowship program through which Dr. Fenell mentors and trains an exclusive group of chiropractors in applying his advanced extremity adjusting techniques and case management protocols. In addition to the training, his marketing team manages a done-for-you marketing campaign for each doctor, which generates new patients and builds referral relationships w ith other health professionals in their communities. Dr. Fencll took time out of his busy schedule to share-some of his exprience starting out as well as well as what he has been able to achieve today. The American Chiropractor (TAC): What inspired you to become a chiropractor? Do you have a specific story? Dr. Robert Fenell (Dr. F): I suffered a lowerback injury when I was 10 years old. My brother, who is 12 years older than me. would often roughhousc and wrestle with me. One day, he grabbed both of my ankles and lifted me upside down. He swung me back and forth and from side to side. Of course, my brother didn't mean any harm, but these movements injured my lower back causing it to become increasingly painful tliroughout the rest of that afternoon. The symptoms became so severe tliat I wasn't able to cat dinner that evening due to muscle spasms involving my abdominal region. I had a difficult time sleeping that night and awoke the following morning with severe low back pain. My father took me in to his chiropractor to receive an exam and my first chiropractic adjustment. I was absolutely amazed! After just one chiropractic adjustment. I experienced nearly complete relief from my back pain. Before that adjustment. I didn't even know what a chiropractor was or did. and with just one quick thrust to my fifth lumbar vertebra. I knew exactly what I was going to be when I grew up. At the ripe young age of 10.1 decided right then and there that I was going to become a chiropractic physician. All throughout middle school and high school, my focus never veered to anything else. I was extremely motivated as an adolescent and young man to help as many people discover the same value and benefit of chiropractic as what I had experienced as a young boy. TAC : What type of patients do you generally treat or attract? What are the top live conditions you most often treat in your office? (i.e., wrist pain, foot pain, knee pain, etc.) Dr. F: "Attraction" is exactly the way tliat I receive the majority of patients who arc referred to my chiropractic practice. Patients have often tried numerous options including chiropractic. For example. I recently had a patient fly in from Salt Lake City. Utah to my Chiropractic Hand & Foot Clinic™ in Tulsa. Oklahoma after having sought treatment for his wrist condition from three different chiropractors in his town. He eventually researched his treatment options online and found my website. As a patient motivated to regain his health, he recorded a seven-minute video demonstrating his hand dysfunction and e-mailed it to me for review. After watching his video. I consulted him over the phone and he then decided to make the flight to Tulsa where we were able to successfully treat his condition and provide the relief he had been hoping for. It's not uncommon to have new patients drive in from another state and stay a few nights in a hotel in order to receive chiropractic care for their hand or foot at my clinic. There is currently an unmet need in the chiropractic marketplace involving specialized hand and foot care, and that is exactly what my practice has become known for in the Tulsa metro area. Some of the most common symptoms that patients present for care at my clinic include hand pain or numbness, foot pain, knee or shin pain, and shoulder problems. The most common conditions involving those body regions that we treat include plantar fasciitis. bunions and hammcrtocs. first carpometacarpal arthritis, dc Qucn ain's tcnosynovitis. carpal tunnel syndrome, and thoracic outlet syndrome. Mam of my patients are referred to me by other local chiropractors. I have formed the reputation in my community as the "hand and foot chiropractor." That of course didn't happen by accident, rather it was something that I planned as I positioned myself strategically as the hand and foot expert here locally and it has been a huge success. Becoming known as "The Hand & Foot Chiropractor™" is exactly what I teach the doctors in my CHFA™ fellowship program how to successfully accomplish. TAC : How did you develop your skills? Dr. F : Passion, persistence, and practice. These three characteristics allowed me to become an extraordinarily proficient upper and lower extremity adjuster. Yes. I took a few dozen seminars on extremity adjusting, but that was not what caused me to become proficient. In addition to the training I received. I spent thousands of hours honing my skills, researching upper and lower extremity conditions, biomcchanics. and then developing new. biome-chanically correct and efficient ways to adjust the extremity regions. I came to realize that many, if not most, carpal and tarsal adjusting techniques can be rather uncomfortable or painful to the patient. Because of tliat. I worked diligenth over several years to develop a manual extremity adjusting methodology that is bioniechanicallv correct, moves the bone/joint through a complete range of motion, and most importantly, is virtually pain-free to the patient. TAC: What percentage (in estimated numbers) of your practice is made up of the following: Dr. F: Men: 40% Woman: 60% Children: 5% Families: 20% Elderly: 30% TAC: What types of techniques do you use? Dr. F: I work with a toolbox full of the necessary techniques to get sick patients well and keep well patients functioning at their optimum potential. The most common techniques that I use include diversified. Gonstcad. Thompson, and Fcncll Extremity Adjusting Technique (FEAT™). The majority of my patients are referred for some type of hand. foot, or other extremity-related condition. Many of those patients become spinal patients as well. A large number of my extremity patients are referred by other chiropractors in my local area. In that case. I only adjust the extremity regions that the chiropractor referred them for. and refer the patient back to their original DC for spinal care. TAC: Arc there any chiropractic vendors that stand out in your mind? Dr. F: Although there are several chiropractic vendors that I feel are worthy of praise. I will mention just two that I recommend to the doctors that attend my extremity workshops. For modalities. I prefer Rich-Mar. I especially appreciate their hands-free ultrasound/auto-sound technology. I would also like to make mention of Thera-Band and Synergy Therapeutic Systems. They both offer a reasonably priced, full-body system that DCs can purchase and implement as a beneficial adjunct to the chiropractic adjustment. I am a big fan of low -tech rehab and I believe that any DC who wants to provide optimal care will offer at least some form of rehabilitation. TAC: What type(s) of diagnostic testing procedures do you use and why? Dr. F: I use plain film radiographic imaging on most of my patients. I believe that it represents the current standard of care and provides high value and sen ice to the patient. I realize that there is some disagreement among chiropractors where some DCs dont believe that imaging is necessary to get the patient well, and I understand that point of view. However. I have seen my fair share of patients who. if I did not order the necessary radiographs, may not have received the best care possible. I also commonly refer patients for MRI. I was a partner in a local MRI center for several years. That was a great experience and it taught me about the value and benefit of referring patients for MRI studies with certain injuries. Again. I believe that if more DCs referred patients with certain conditions out for these types of diagnostic procedures, it would enhance overall patient care by allow ing the chiropractor to become a more objective and thorough case manager. TAC: Do you use orthotics on all of your patients? Dr. F: I use orthotics selectively on certain patients who I feel would most benefit from them. Mam of the patients I attract have already tried orthotics and they have not helped them with their foot condition. My primary goal with each foot patient is to restore health} function to their feet by adjusting the tarsal subluxations that arc causing their dysfunction. I use a highly effective, manual adjusting technique to improve alignment, increase range of motion, and restore healthy tarsal joint function. Most patients receive specific rehabilitation training to improve proprioception and strength. Orthotics arc definitely a valuable tool and I cast them for a significant percentage of my patients after they have completed their treatment plan; however, there are large number of patients who respond favorably enough with tarsal joint manipulation and rehabilitative protocols alone for whom I do not prescribe orthotics. I believe that it is a mistake to cast orthotics arbitrarily on patients without first adjusting their feet for a period of time in order to restore optimal tarsal joint function and alignment. Just as a back brace cannot correct spinal subluxations. orthotics cannot correct tarsal joint subluxations. but they can support feet that have already been corrected through proper and complete treatment using specific chiropractic tarsal manipulation. TAC: What single piece of advice would you give a new chiropractor just starting out? Dr. F: Hire a coach or mentor to guide you in making sound business decisions in your practice. Starathletes would not rise to high levels of success if they continued past high school without a coach. I have never understood chiropractors who make statements against hiring a chiropractic coach or mentor. It just doesn't make good business sense! Certainly, you can be good on your own: however, you can be great with the right coach. Earlier in this interview I shared with you that I collected a measly $11.000 my first year in practice and over $750,000 during my third > car. I hired a chiropractic coach during my second year in practice. Yes. it was my unique niche that caused me to soar to high levels of success in such a short period of time, but my coach helped me to create the strategics that I used to market my unique niche. One of the worst things that can happen to a new chiropractor is to open a practice and grow it quickly to a mediocre but comfortable level. These doctors often do not grow much beyond that initial plateau. However, new doctors who become involved with a good chiropractic coach early on will often experience more consistent growth and continue to move beyond the plateaus in practice. Ever since my second year in practice. I have never been without a business coach or mentor. Every dollar that I have invested has been well worth it. and it was like a seed that I planted for future growth. The least that I"vc invested in one year on coaching was a little over $8,000 and the most was over $100,000 (yes. in one year). As a new doctor, do not allow yourself to focus on the money you arc paying your coacli/mcntor. but rather, keep your focus on your practice vision and on working your plan for success. Your investment will be returned to you multifold. TAC: What general advice would you give an established chiropractor whose practice might be struggling? Dr. F: I realize that its not fun and it may be embarrassing to be in such a difficult position. First of all. you need to realize tliat others have stnigglcd and others have moved beyond tliat low point to become a success. Believe me when I say. "I completely understand what it is like to struggle in practice." The first tiling that I would recommend to an established DC who is stniggling is to look for the most successful chiropractors in your town and in neighboring communities. I mean the ones who arc adjusting over 75 to 100 patients or more per day. Go visit those doctors and ask them to lunch. These doctors will oitcn take a fellow chiropractor who has been struggling "under their wing" and offer sonic guidance and support. You would be amazed by how much you will learn when talking to these successful doctors and business owners. Learn to keep an open mind and allow yourself to soak in everything that these doctors share with you. Then you can process that information and make a decision on what you would like to implement. Then begin to take action on what you learn. Taking action is a key to success. I sec a lot of struggling doctors who sit inside their clinics all day and play solitaire or surf the internet while they wait for the phone to ring. This is a sure recipe for failure, or at best mediocrity. Asa new doctor or as an established one who lias been having a difficult time, you should first create a vision for your practice. Once you have a clear vision, you can begin to set goals and create an action plan for success. Then you should take action and begin working your plan. Persistence and consistency will take you a long way in practice. Of course, as soon as you can afford it. you should find a good chiropractic coach and hire him or her to help you in creating the best strategies for consistent practice growth. TAC: Where do you see the future of chiropractic headed? Dr. F: We certainly have experienced some changes in the healthcare industry and it will most likely continue to change with the looming national health insurance reform and uncertainties that lie ahead. However, even with all the fears and doubts that surround us. I believe that chiropractic will continue to be a mainstay in the healthcare industry. Whether there is health insurance coverage or not. I believe that a similar percentage of people will continue to enjoy the health benefits of chiropractic care. I do feel like continued and strategic education of the masses is paramount in order to sec an increase in the utilization of chiropractic. In 2011. the pharmaceutical industry spent in excess of $4 billion marketing directly to consumers and $25 billion marketing to physicians. It is no wonder so mam people seek dnigs over conservative alternatives such as chiropractic. Since we cannot compete with the pharmaceutical industry's marketing budget, we need to be strategic with how we educate the public about the value and benefits of chiropractic. TAC: Any final words for our readers? Dr. F: I would just like to say thank you to all of the readers and supporters of The American Chiropractor! Its been my pleasure and a real honor participating in this interview process. I encourage each and every chiropractor to continue to support this wonderful profession and to do their best in working together in collaboration with other doctors of chiropractic. There is a lot of negative influence looming out there in society and it is up to us to work together to strengthen our profession as a whole so we can serve a greater number of people. ► You may contact Dr. Robert Fenell at 888-505-9606 or by e-mail at robert(a)Jiandandfootexpert.com
