Most of the time, a positive outcome happens. The patient sings you praise and a deserving pat on the back occurs. Other times, things don't go as planned and you must direct patient care as taught in school - such as, refer for medication or a surgical consult. Of course, we do all we can before referring, but under law, we must keep the patient's wellbeing in mind and decide when they have maximized our abilities.
I've had a few cases that have required challenging decisions. Two of which, made me decide to purchase an ultrasound/electric stimulation machine because I was limited with my approach of using moist heat, PNF stretching and soft tissue therapies. Sometimes you need a powerful tool to calm tissues down prior to manual therapy. I am excited to add this equipment to my practice!
On the upside, there are a lot of patients that respond favorably to conservative manual therapy and traditional chiropractic adjusting. They thrive under this approach and they are a real joy to treat. Others take forever to respond to therapies we know work for most patients suffering from identical symptoms. The trick is being flexible and open to changing the game plan. We must be willing to order additional tests, refer for cortisone shots or buy equipment able to handle the cases. Do whatever it takes to help the patient.
When they get results, even if it wasn't due to your direct care, they will feel comfortable referring their friends and family to you because they know you made the right decisions to get them appropriate care. If you did all you can do and they still aren't better, they will respect you if you send them to a practitioner with a wider scope of practice who is able to provide relief.
It really is all about results.
All for now,
Dr. Spangler
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