Justifying the Adjustment

As I finished my second month in practice last week, I began thinking about a topic worth writing about that may stir the pot a bit and provide insight into what it's like trying to build my reputation on results.

In school, we are thoroughly taught how to adjust every joint in the body.  They teach us that adjusting is the best method to use in practice and they raked us over the coals heavily to conform.  The dogmatic approach they used, builds a complex, as if we have to adjust people no matter what and that is what patients are seeking when they come into our practices.  I am here to say, this is a mindset of the past.  People want results, not adjustments.

What has been eye-opening is how many people fear getting adjusted.  Most say it is because they remember seeing some bad guy getting his neck snapped in the movies.  They tense up and protect the area from any harm.  So even if an adjustment is given, the soft tissues absorb a ton of the force and the joints do not get a therapeutic manipulation.

If you step back and forget about their fears and actually assess the physical issue, the specific tissues in need of manual therapy display themselves.  Is it a capsular end feel or a spongy end feel?  Are there sore origins and insertions of muscle groups?  What's the history?  Could there be fascial adhesions?

Now if you go and adjust them without assessing things thoroughly or explaining things logically, there is a lack of trust built and a negative viewpoint of chiropractic is planted in the patient's head.  You don't have to adjust people just because you are a chiropractor.  If they need it, that's another story.  I personally look at chiropractic adjustments as an aggressive/last resort therapy that should only be used if absolutely necessary.  If other less aggressive therapy fails to give relief or restore motion, then I reassess and adjust the patient.  People seem to really respect this approach and they trust it because they feel I am taking their condition seriously and do what is necessary.

It comes back to why are we doing what we do.  Are we trying to get people to come back over and over for meaningless therapy that doesn't affect specific tissues?  Or are we trying to help people get over their specific condition with tissue specific therapy?  The ethical answer is the latter.  You can do just as well and even better if you are honest about what the patient really needs versus approaching patient care with dogmatic/engrained thoughts.

Too often, chiropractors adopt the mold of businessmen/women first and doctors second.  Trust is key with running/building a practice and if you depict specifically what issue the person is dealing with and apply your therapy directed at specific tissues in need, business will flourish.

If you use one tool for every job you'll fix 10% of the issues and screw up or mildly help the other 90%.

Food for thought,

Dr. Spangler
Trailhead Chiropractic