Posts Tagged ‘Practice Members’

Do Something Different

Thursday, February 21st, 2013

It’s time to talk about my “Life Rule” Number 3.

Hang on just a minute I can hear you think: You haven’t told us about Rule Number 1 and 2 yet?

Well to summarise; Rule Number 1 is “Breathe”. Doesn’t sound too difficult as it is one of the most basic life reflexes, and after sitting by the bedside of a dying person I can tell you just how innate and strong that reflex is. My kid’s got sick of me teaching this Rule at a very young age – Every time they had a fall or fright, and as a parent you watch that “hold” of the breath, and sense that rising of the anxiety and panic in their physiology, I would place a reassuring hand on their shoulder and firmly say “Breathe!” Breath control is a key to controlling our internal homeostasis but it’s not what I want to highlight today.

Rule number 2 is “Keep Moving” or as it was chanted in Finding Nemo “Just Keep Swimming”. Some of my practice members look a little bemused when they present in an acute inflamed state and ask – “should I rest?” And my standard response is “you need to keep moving, but gently!” Perhaps they are secretly craving a few days flat on their back in bed, with a small bell to ring to beckon their spouse to bring more fluids? Rule number 2 is a critical ingredient to any endeavor in life but it is not today’s topic.

So that gets us up to Life Rule Number 3: “Do Something Different” – I think I also learned this principle as a young parent. As your children begin to explore and attempt new milestones but at times reach a point of frustration when trying to do something new, by repeating the same unsuccessful steps. As a “mentor” it would be quick and simple to step in and show your “student” the correct way to do it – but a better life application lesson will come if they discover the solution – so instead we can summarise the best possible advice as “Do Something Different”. This doesn’t mean we turn a blind eye and leave them to figure it out, it would be better for us to make an alternative single suggestion, “reach your hand over a little further this way”, “why not try turning that block over on its side instead?”

Let’s jump for a moment into practice life and hear the Life Rule again – “Do Something Different”. Think of the practice member that appears to be responding poorly or too slowly to your care plan: This is a simple one – “Do Something Different”. Change the technique, change the schedule, change the home advice – makes obvious sense? The worst cases of over-servicing that we hear of in our profession are nearly always a case of a person with a complex health concern who is signed up for a long program of care, and then subjected to the same recipe book visit regardless of the course of their concerns. Having said that I do not believe that over-servicing is a widespread problem in our “culture”. Actually I strongly believe that under-servicing is the most serious negligence which exists at epidemic proportions in our society – there are very few people in our world that are suffering from too many adjustments – but there are far too many suffering from too few!

But this essay is not quite as simple as this – what about the person who is a loyal customer that might potentially see you on an ongoing basis for years to come? “Do Something Different!” Now I may ruffle some chiropractic feathers at this point. But the warning is to avoid the “if it ain’t broke then don’t fix it” philosophy. We supposedly reject this philosophy on the basis that prevention is better than a cure. When someone is out of pain we beseech them to continue with care, but if that care is the same neurological encounter on each and every visit from that point forwards then is that really any different – You see Maintenance is not Wellness?

Look at this from a few points of view:

1) The nervous system adapts and evolves based on its perception and response to every stimulus: So if the stimulus that you provide each week/fortnight/month is the same again and again then what evolution is going to occur as a result of your input? Let me simplify it this way – does your “technique” allow you to perform a live analysis of someone’s state right there and then so that you can provide an adjustment that is responsive to their neurological needs on that given day? Sorry to say but too few techniques truly offer this.

2) If the body is a self-healing organism, then why are you still correcting the same Subluxations that you chose on the first visit? I hear the arguments about scar tissue and degeneration, and “patterns” – but if your adjustment is initiating change, and healing and progression, then surely something has to change therapeutically at some point? In Torque Release Technique we argue that this should be occurring on every visit…

3) Chiropractic is about maximizing human potential: Doesn’t this mean that a person who is in their fifth year of care will probably need more advanced care than someone in the first? As an elite masters’ athlete, my training program develops in intensity and complexity within a short term and long term time-frame. I made my comeback to competitive athletics in 2008, and training methods have changed somewhat since my former aths career in the 80s. Even though I am approaching the 50 milestone, the training that I am doing in 2013 is more advanced than the training I was doing in 2008. And the training that I am doing in February 2013 is higher quality and more technical than the training I was doing in December 2012, as I approach my peak for state and national championships. This is contemporary sports science: But, I’m not convinced that this has pervaded contemporary chiropractic science.

Let me illustrate this with a scenario that I know we have all seen in practice: A person comes in to see you and they are in a bad way. You perform whatever analysis you do, go to work with your healing hands and send them home with some tips to keep them occupied till they next see you. They come back next time and praise you for your majestic healing powers and share their testimonial of retracing and insight. Now you have a quandary – you want to give them the same amazing experience each and every visit – so you rush back to your notes to try and discern what it was exactly that you did last time? And you attempt to reproduce that exact same adjustment. You eagerly await their next visit only to find that it just was not quite as dramatic, or worse they actually took two steps back after the last visit. What happened? You forgot Rule Number 3 – You adjusted them based on your analysis from days before, and not on the day that they presented: You didn’t “Do Something Different”!

Or you may have observed in the past that when a practice member saw your locum or perhaps visited another practitioner, all of a sudden they got a positive shift in their healing progress that had seemingly halted under your regular care. Was it that the other practitioner was better or more gifted, or smarter than you? No, they just did “Something Different”. Now I know you are thinking that you have seen the opposite scenario whereby a locum or alternative practitioner has done more damage than good – if you are thinking this then make sure you read the postscript below…

So how does Life Rule Number 3 change practice? If you want to maximize the physiological response to each and every adjustment follow these simple steps:

1) Find a technique that gives you certainty that you can discern exactly where and how to adjust on any given visit: If you don’t possess this certainty then please join us at a Torque Release Technique program to share what is perhaps the most consistent educational outcome – confidence in your competence. An adjusting technique that progresses in pace with the person’s response is pivotal to successfully implementing Life Rule Number 3 as a principled Chiropractor.

2) Build into each practice member’s care plan variety, change and progression – make every visit a new experience – not random unpredictable and hence stressful – but evolutionary and intelligent (like their nervous system).

3) Never stop learning new tricks: If you left college and have avoided attending any PD unless coerced to find the cheapest and quickest shortcut program to maintain your registration then shame on you. Commit your time, energy and money to developing yourself – for your patients’ sake if not for your own longevity in practice.

4) Incorporate objective functional assessments into your progress examinations – if you rely on how your practice members are feeling to determine their progress in care then you are at the mercy of anything from the weather, to the economy, even perhaps to astrology. People are going to feel good sometimes and be sick, and feel crook at times but be healthy. But the only thing that improves function is a management plan that works.

5) Cooperatively develop a micro plan and macro plan for your practice members: What do you both want to achieve from the next 6-12 adjustments. What will be the benefits to them if they follow your plan for the next 6-12 years? Conduct regular progress exams and celebrate the small and big steps.

6) If you are feeling somewhat fatigued or jaded in practice then remember Rule Number 3 one more time: “Do Something Different”!

P.S. If  you are now pondering how this can really play out in your consulting rooms then there are some tips I have learned from elite athletics training that I find apply to “Doing Something Different” in practice:

A) Don’t try to do everything in one visit: You can’t get fit in one training session, and as much as you may want to be a miracle healer, you won’t fix most people in one visit. So keep some tricks in your bag for subsequent sessions so that variety is easy to achieve – whoever made the rule that every chiropractic consultation should consist of the same experience – but in general it does? Dr Jay Holder teaches a key TRT principle of “Less Is More” – and this can be a hard but life changing principle to implement in the real world, especially when that 50 year old male walks in the room with extreme antalgia and demands for you to crack his back into alignment.

B) Have a plan for a series of sessions versus a plan for each single session. When I start coaching a new athlete, I have a fairly standard progression of drills and activities over a series of sessions that then has to fit and adapt with the athlete’s level of response and completion. Think through a progression of care that you would like to be given yourself if you were just starting out under your own program. I remember hearing of some old-timer therapists in Perth who had a three visit progression: On the first visit you had a hot-pack placed along your spine for a few minutes. On the second visit you had the hot pack, plus a tennis ball was then rolled up and down your paraspinal muscles. On the third visit you received the hot pack and the tennis ball care, and then had your spine manipulated so severely that the noises could be heard in the next suburb. And that was it – you were done! Hopefully you can come up with a more contemporary version of a more ongoing wellness based program?

C) Make each change a gradual progression from the last: In training my rule is only change one variable at a time – up the intensity or up the quantity or up the complexity, but don’t vary any combination of the above. This is a little hard to apply directly to chiropractic care but with some thought you should get what I mean? Let’s go back to the example I mentioned before of the practice member that sees your locum or another practitioner and suffers a significant setback – I guarantee that the other practitioner has either erred on point A (they did too much and tried to fix the person in one go in an attempt to prove how inferior you are and how superior they are) or this point C (the care they provided was too large a jump from what you were doing and the person’s body suffered a shock response).

I have a simplistic point of view to practice design and management: I try my very hardest to design a practice environment, policies and procedures that I would be highly impressed and compliant to pay good money for myself… Would you be happy to visit your own practice on a regular basis, and wait for however long you make people wait, and receive the care that you supply, and pay whatever fee you expect your own customers to pay? If not then it is definitely time to apply Life Rule Number 3 and “Do Something Different”…

To find out more about Torque Release Technique Training and access a big saving go to www.torquerelease.com.au/Torque-Release-Discount.htm

BETTER RESULTS FOR 90% OF YOUR PRACTICE

Thursday, June 2nd, 2011

A recent survey conducted following a Torque Release Technique program has shown that TRT delivers dramatic benefits to those that attend:

  1. Chiropractors were able to use the methods taught to effectively determine the primary subluxation and how to best adjust it in 80-90% of their practice immediately upon returning to their office.
  2. When asked if TRT had been useful in practice a 9/10 rating was achieved.
  3. When asked if TRT had improved their confidence in practice a 8.5/10 rating was achieved.
  4. When asked if TRT had increased their belief in chiropractic a 9.1/10 rating was achieved.
  5. When asked if TRT had made them a better chiropractor a 8.8/10 rating was achieved.
  6. When asked if TRT had improved their clinical skills a 8.8/10 rating was achieved.

This means that what is learnt at the program is immediately useful. We’ve all been to great sounding programs that when the rubber hits the road on Monday morning and you want to offer something better with your new skills, to be honest, they turn out to be too time consuming, or too fiddly, or are only useful for a small percentage of our practice members. It’s nice to know that TRT is easy to implement and relevant to the needs of nearly every practice member.

And don’t underestimate the power of becoming a better clinician and technician when it comes to adjusting. I think sometimes we get sidetracked looking for new ancillary procedures to somehow improve our clinical outcomes - when the real truth is that we can all hone and upgrade our adjusting skills - and as a result become better Chiropractors.

After running seminar programs for 15 years, I have noticed that Chiropractors are more likely to attend a motivational, practice management seminar than they are to attend a technique program - and I believe this is partly due to this perception of spending hours in a technique class to learn something that you will never use. It’s nice to learn that there is a technique program that delivers measurable benefits immediately upon returning to practice. Sounds like a worthwhile investment with great returns to me.

But you are probably sick of hearing this from me so here is what some of the participants had to say:

  • “Great Seminar - Taught really well. Since finishing Uni, have lacked in confidence - But this technique has allowed me to be more sure of what I’m doing. Thanks!” Chloe Whiting, Australia
  • “This is a great foundation chiropractic technique. It is simple to implement and improves my efficiency at finding and adjusting subluxations. It is an enjoyable seminar.” Penelope Seuren, Australia
  • “Amazingly good seminar with excellent research based outcomes. Combines neurology and technique as an excellent presentation. I have been to many seminars but these CPD points are my most valuable!” Matthew Bailey, Australia
  • “TRT makes more sense than anything else I’ve learned in chiropractic. I want to learn more!” David Schaller, Australia
  • “It’s great. Surprised, Amazed! Thanks Nick for teaching me TRT.” Yi Ping Gu, Australia
  • “TRT is a very elegant technique which reflect its origins in the triad of the Art, Science and Philosophy of Chiropractic. I look forward to exploring it further.” Anda McMillan, Australia
  • “Thank you for the generosity and knowledge/wisdom. Other courses promise you will be able to confidently apply the technique on Monday morning. Well I beat that and took my table over to family members on Sunday night. Miracles are happening in my practice and I feel as if I am honoring the body’s innate wisdom through the checking system and finally not over-treating. THANK YOU. :-)” Clare McCardel, Australia
  • “Thank you so much for the seminar last weekend, it was Awesome!!!! I have a new passion for Chiropractic, Neurology, Outcomes and using Low Force Techniques. This has re-lit my fire within! Your passion & honesty & knowledge was appreciated throughout the seminar & this has a flow on effect.” Matthew Bailey, Australia

The lead researcher and co-developer of Torqe Release Technique, Dr Jay Holder, will be in Australia in August for a rare appearance - don’t miss this amazing opportunity to learn from one of the great minds in Chiropractic. Go to this link to find out more: http://www.torquerelease.com.au/Jay-Holder-Discount.htm

YOUR ATTITUDE IS CONTAGIOUS!

Sunday, January 27th, 2008

The number and type of clients you see and draw to your practice are a SYMPTOM of your own attitude towards chiropractic!

1) If your attitude is that chiropractic is great for the relief of any number of aches and pains - then you will have a pain relief and crisis care practice.

No matter how many visits you try to extract from your customers, they will tend to use you only for the relief of aches and pains - you may have a PVA of 20, but this will be 20 visits of crisis care. And because you will see primarily pain relief occurring, you will justify your attitude. In other words, you will either not initiate larger state of wellbeing and general health changes, or even if they are occurring you will be oblivious; because you won’t even ask the questions that might detect that something else is going on. And your patient’s won’t think to mention any other changes that are happening in their lives, because you are the “Back Doctor”, and the other stuff has nothing to do with you.

2) If your attitude is that chiropractic is good for fixing back problems, or straightening abnormal spinal angles - then you will have a corrective care practice.

You could have a huge practice, with people seeing you for a bunch of visits in a relatively short space of time. People will be convinced and even impressed by your level of professionalism, equipment and affluent appearance. But here’s the question: How many families are you seeing, how many of your clients have been seeing you for 5 and even 10 years, how dependent are you on the next bunch of new patients to refill the appointment book and balance sheet?

3) If your attitude is that regular chiropractic helps to prevent spinal problems from progressing to be serious, acute and painful - then you will have a maintenance practice.

How quickly do your patients get to four to six week intervals in their care? Often they get to monthly visits and you haven’t even reassessed them. A couple of times a week for a couple of weeks, then once a week for a couple more weeks, and then before you know what’s happened they are booked in, in 4-6 weeks. They may be out of pain, and they may have experienced some initial health improvements, but have YOU really made any signifiant physiological and functional changes to their global state of wellbeing? Will they live longer and better as a result of an adjustment every 30-60 days, while in between they undo all your good work?

4) If your attitude is that chiropractic is an integral part of a person’s health program, having an effect on their nervous system and releasing the work of the body’s innate intelligence - then you will have a broad scope health and wellness practice.

Their symptoms, state of disease, financial position are even totally irrelevant to your belief that a regular adjustment will do them good… It’s this simple - PEOPLE WHO GET ADJUSTED DO BETTER! And they usually feel and function better too. But you don’t take responsibility for your practice members’ state of health - You didn’t get them into the state they are currently in, and you can but assist them and even coach them towards a more optimal lifestyle… You understand that each adjustment is a positive healing step forwards, and you utilise all your clinical and technical skills to determine how many steps they take backwards in between adjustments to determine the optimal schedule for their care. And this attitude is contagious, because the type of new patient that appears at your door seems to intuitively understand this philosophy, and they seem to be surrounded by a family and peer group that wants to join them at your rooms on a regular basis.

Click Here To Find About Practice Growth Coaching…

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 - HELP YOUR PRACTICE MEMBERS TO FIND ONLINE HELP

Saturday, November 10th, 2007

The Internet has now become one of the primary ways that practice members and prospective customers find out answers.

Do you help to direct them to congruent health related resources?

65% of people report access to the internet. A total of 74% of those with access use the Internet to find health information for themselves or family members. Disease-specific information is most frequently sought, followed by medication information, and then information about nutrition and exercise. Did you know that as a health care professional you can significantly build your relationship and loyalty with your customers by referring them to useful and helpful web sites?

Here are some short cuts to assist you to point your patients in the right direction…

1) Collect your patients email addresses and offer them a periodical email update service: Send out a periodical group newsletter with links to interesting health articles that align with your philosophy and services. Nowadays you can even remind some patients about their appointments via email.

Click Here To Find Out How To Send Powerful and Impacting Emails…

2) Get a web site: Not just an online business card - but one that has significant amounts of health related and even self-help information, which is regularly updated. There are chiropractic specific services that can help you with this.

3) Have a list of health sites that you regularly refer to yourself - link to these from your web-site, and try to set up reciprocal links from their site to yours.

Click Here To Visit My New Health Blog Suitable For Anyone To Read…