Posts Tagged ‘Exercises’

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…

Practice Tip - CLOSING THE GAP BETWEEN WHAT PEOPLE THINK AND WHAT THEY DO

Wednesday, October 17th, 2007

There is compelling scientific evidence that what people know about diet and how they eat are in many cases two different issues? I’m sure you have observed that this void between knowing and doing crosses over into all health behaviours?

1) The acute antalgic low back or torticollis crisis patient who promises you that they will keep seeing you forever for maintenance care if you can only help them get out of agony; who then discontinue somewhere between visit two and six because “they are fine now and will ring if they have any further problems”.

2) The reactivating patient that confesses that they were feeling great while they were doing the exercises that you taught them, but then they just forgot about them because they didn’t have any pain. And then they ask you “why does this problem keep coming back?”

3) The osteo-arthritic retiree that starts complaining of increased aching and stiffness, and when you ask them if they are still taking their Glucosamine, they respond “Oh I finished the bottle and thought I’d see how I’d go without them for a while”.

4) You meet an old regular practice member who discontinued 1-2 years ago, and when you ask them how they are going they give you the long list of ailments, diagnoses and prescriptions that they now take, and then pass comment “you know when I used to see you I didn’t have any of these problems”.

There’s a push in our profession right now to adapt us into risk-factor screening machines, who then pass appropriate educational brochures to those at risk, and warn them of the dangers of not changing their ways. Think about this: Most people who are overweight already know they are overweight; most people who are unfit already experience the effects of it; most people experiencing symptoms of Diabetes are aware of the symptoms… They don’t need you to identify the symptoms of their condition. They need help closing the void between their awareness and their behaviour!

If you want to be a wellness practitioner let me tell you a major paradigm shift you are going to have to make - It’s not about you, it’s about them. Wellness is a personal journey of lifestyle choices leading towards better life and health outcomes. You can’t make the decisions for them - if you try to then its not wellness - it’s medicine.

Here’s four questions that you must ask your practice members to make massive changes in your wellness relationship:

1) “What is your biggest health priority right now?” Their choice not yours.

2) “What are three things you think you could do to improve this area of your life?” Their choice, not yours. But this may be the point where they ask you for your educated opinion.

3) “What information do you think you need to help you make this change?” This is the point where they will most likely give you permission to feed them with resources.

4) “What would you like me to do to make sure you follow through on your plan?” This is where you help them to make some commitments, set some goals for them to achieve, define some measures for monitoring their progress, and set a time-line for review.

Click Here To See How Wellness Coaching Is Done…

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…