Posts Tagged ‘Dcs’

Practice Tip - INCREASE COMPLIANCE WITH EXERCISE PRESCRIPTION

Tuesday, November 27th, 2007

Perceived indifference is the number one reason for patient drop out - AND - the number one need of each of your client’s is the perception that you have heard and understood their biggest concerns. A major shift in consumer power is the demand for self-help advice. While most MDs THINK that their patients come to them for a prescription; and most DCs THINK that their new patients have come to get their backs cracked; One of the first questions in your patient’s mind/s is “what can I do to help myself?”

I still remember one particular new patient who consulted me. He was wanting help with his chronic recurrent Low Back condition and had already seen his MD for an “expert” opinion. The GP had given him a sheet full of exercises as his prescription. This sheet had actually convinced the man that he was in the wrong place! You see, the copyright symbol at the bottom of the page was 1965! The guy said to me - “if that’s how up to date the MDs are then I figured I needed to find another profession”.

A lot of chiropractic treatment programs are very “front-ended” - That is the new practice member gets a lot of attention and information in the first 1-2 weeks of care: And then they become part of the daily schedule - Arrive, wait, guided into the adjusting room, face down, adjustment, “powers-on, see you next visit”, pay and make an appointment, leave. And as each visit passes they develop a growing dis-ease that they might just be a number.

Here’s one technique to help your practice members feel like you continue to see them as individual, important and cared for: It’s called drip-feeding. People respond and comply much more effectively to your educational inputs when they are in small bite-size chunks, instead of a huge plate full of stew that exceeds the appetite. You can apply this to any aspect of your ongoing systems and procedures but let’s use the example of exercise prescription:

Many DCs have given up on prescribing exercises because of perceived poor compliance and persistence. The primary cause of this poor outcome is the way in which the exercises are taught, delivered and reviewed. Instead try these guidelines…

1) Only teach 1 and never more than 2 exercises at any one visit.

2) Demonstrate the exercise by assisting the person to perform the exercise there and then - it’s fine to give a sheet but these are just visual reminders - NEVER expect a client to perform an exercise from a still picture without demonstration, and DVDs will rarely make it into the player more than once.

3) Let them know that you will be teaching them another exercise next week, and that you will be reviewing their progress.

4) When you teach them the next exercise, get them to quickly show you how they are doing the last one you taught them.

This process should only add 1-2 minutes to that consult if you do it effectively - if this is too long, this can be delegated to a tech CA who you should have assisting you if you are seeing high volume anyway.

This process achieves a number of things - implementation because they will remember the exercise, compliance because they know you will be checking on them, persistence because they have been made accountable.

When we teach the Super Posture program I show a set of 12 simple exercises which are very effective for improving postural habits, and can also be used to improve response to your adjustments. Click Here To Learn More About Super Posture…

Now the challenge for you is to review the information that you currently bombard your new patients with, and take some time to trim it down into smaller bite size pieces, to mix into your drip-feeding recipe…

WHAT IF YOU WERE ONLY ALLOWED TO MAKE ONE ADJUSTMENT?

Wednesday, October 17th, 2007

Imagine if every Australian was allowed to receive one adjustment per week, and that adjustment was covered under Medicare? But here’s the condition: You can only deliver one adjustment per week, per person, and you have to demonstrate the measure benefits of those adjustments every three months using impartial objective outcome tools. I guess there would be a minority of DCs who would think they had found easy street and delivered any old adjustment, in any old fashion, without much consideration for where or how they delivered that adjustment - just so long as the cheques kept rolling in. But for the rest of us, we would want to be completely diligent in ensuring that this one adjustment was a good one, a really good one, and that we adjusted the segment which most needed to be adjusted, and in the right direction because you can’t just hit it on both sides - you only get one shot!!

Think about this in the context of how you currently prioritise how you deliver your adjustments each and every day:

1) Do you start at the bottom and work your way up, or some other variation of this theme? Check and adjust the low back, check and adjust the thoracics, then roll them over and check and adjust their neck? Most DCs have an order in which they adjust everyone. It may not be the order I mentioned, but in most cases it will be a “routine” based on the practitioner’s habit as opposed to some patient-centred findings dictating where you start and finish. STOP IT: Take an extra few seconds to analyse your patients’ spines and make a decision about which is the most important adjustment to make on that visit.

2) Do you adjust the same segments in the same order, any three visits in a row? I thought your practice members were supposed to be getting better and progressing to a new level of health - why then would they continue to have the same subluxations? If you are activating retracing in their body then surely the next layer of subluxation should appear and need to be corrected? And, since they last saw you a lot of different stresses have presented, so they may have a new and different layer appearing on the next visit. Why do we say that the body is a self-healing adaptive organism and then fail to adapt and change our adjustments to keep up? BEWARE: If you check your notes and see that patients are getting the same mix of adjustments on every visit then there’s only two options - A) you put the stuck pattern there with your repetitive habituating stimulus, or, B) their spine isn’t evolving under your care - either way you need to try a new strategy.

3) Do you have a system that allows you to make a live analysis and differential diagnosis of which subluxation wants to be adjusted at any given moment in time? When we teach TRT we show you 14 different indicators of subluxation and train you in the differential diagnosis technique that gives you absolute certainty and precision in making this vital decision…

Click Here To Find Out More About TRT Training…

An interesting question arising from my hypothetical above is for our profession as wellness providers. I used the weekly example based on the observation that:

1) If I could get adjusted as often as I liked I would probably get an adjustment every week;

2) I conducted a highly informal survey of a group of my practice members when I asked them “if you could get adjusted whenever you liked and it didn’t cost you anything, how often would you get adjusted?” The most common reply was “I’d come every week”;

3) I have been using functional assessment technologies in my practice for over a decade and have observed qualitatively and quantitatively the biggest changes when clients are getting adjusted weekly (go beyond three weeks and you will see a significant percentage of clients start to deteriorate functionally);

4) Many chiropractors I have met who claim to be wellness DCs get adjusted weekly and recommend weekly adjustments.

But, how much would this cost the community if every man, woman and child was adjusted weekly: Using the round figure of 20 million people and $40 per adjustment, that comes to $800 million per week.

Here’s the ultimate challenge: We would have to be able to demonstrate without a shadow of a doubt that we were saving the Australian economy at least $1 Billion per week? Can we do this? Your thoughts are welcome…

Are You Relieving Your Patients’ Emotional Pains And Strains?

Sunday, October 7th, 2007

Are You Relieving Your Patients’ Emotional Pains And Strains?

Whether or not we all agree on the theory that Subluxation is the cause of ALL illness - most DCs agree that there are three primary causes of Subluxation - Physical, Chemical and Mental.

At our TRT programs I ask the participants to rank these factors, and we always get 100% agreement - Emotional factors are by far the most common cause of Subluxation. So how does this revelation impact your every day clinical conversation and your adjusting procedures? Let me put this another way - what system/s do you have in place in your practice to identify and correct the emotional component which is causing most of your practice members, the majority of their problems?

What happens in your practice when someone is responding slower than you would expect, they keep exacerbating their condition, or you keep identifying the same recurring subluxations?

Here’s what it sounds like in most chiropractic offices: “Well Fred, what did you do on the weekend - did you do any gardening or lifting? Tell me about your office chair at work. How many hours do you spend in front of the computer? Are you doing some exercises? What position do you sleep in? Tell me more about that car accident you had 55 years ago.”

Notice something missing? Where were the questions to identify the emotional cause, let alone the second most common cause of subluxation - chemical? Physical, physical, physical…

Do you want to be a wellness chiropractor and not a back doctor? Then you need to connect with your practice members on an emotional level. This has got nothing to do with counseling or psychology, and it’s definitely not about finding new referrals for the Beyond Blue program. But it is about providing your customers with a more holistic service…

Next time you find yourself in the above scenario, stop yourself before you blow the opportunity for a learning moment, and try this instead…

“So Fred, why do you think that your body is having trouble getting better as fast as YOU would like?” Fred’s usual answer will be “well I d’know, your the doctor?”

“Have I told you that there are actually three causes of subluxation? There’s the obvious one, the physical stuff that happens to you and that you do to yourself. Then there’s chemical stuff; you know, all the toxic stuff that we eat and drink, and all the poisons that exist around us in our homes and in the environment, like allergies. Then the one you might not have thought of before, is the mind - this is actually the most common and the most severe cause of subluxation. Fred, can you think of any mental or emotional stuff in your life that might be creating stress inside your body?” Now don’t drop the ball, stay silent until Fred comes up with some ideas… Then adjust him as per usual.

Like I said, this doesn’t have to lead to a psychotherapy or hypnotherapy program; just the therapeutic power of the identification and connection of HIS emotional stuff with his subluxation will astound you….

Click Here To Find Out More About Chiropractic Coaching…