Posts Tagged ‘Progress’

IMPROVEMENT IN HEARING AFTER CHIROPRACTIC CARE

Saturday, April 12th, 2008

The first chiropractic adjustment given in 1895 was reported to have cured deafness. A new research study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care.

Fifteen patients were thoroughly assessed with audiometry, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. All patients were classified as hearing impaired though greater on the right.

At 40 dB six had hearing restored, seven improved and only two had no change. At 25 dB using the Speech-frequency criteria, none were restored, eleven improved, four had no change and three missed a tone.

A significant percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system leading to improvement in their hearing.

Click Here To Read The Research Abstract At PubMed…

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…

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…