The Reality

I just finished my sixth month in practice yesterday.  I cannot say that it has been easy trying to establish my name in town, but I can say, the reward of helping patients overcome their musculoskeletal problems with non-invasive therapies and treatments is amazing.  Saving people from surgery and unneeded invasive treatments is a real joy.

The past six months have had some glitches.  Some cases have trickled in that I have had to do major research to figure out what the source of pain is.  I've ordered blood work, MRI's, CT studies and X-ray radiographs to rule out serious disease.  At times, the studies come up negative and others, it is quite fence-straddling.   That said, with uncertainty minus pathology, creativity is sparked for an interesting approach to the patient's dilemma.

What I have found is that nobody understands what I do until I tell them or show them.  I have also found that medical doctors in my town are largely anti-chiropractic even if the approach is along the lines of physical medicine.  I've approached patient care from the physical medicine methodology from day one and I've yet to obtain a patient referral from a medical doctor or medical provider.  I do communicate with the doctors I refer patients to and they keep me updated as well, but they are reluctant to refer patients to me.   The lack of trust in what I do and in the chiropractic profession as a whole, makes it very challenging to grow my practice.

I've often wondered how easy it would be to build a PT practice or a medical practice.  I can only imagine more doors would be open for professional referrals if the credential I worked my booty off to obtain started with an M and ended with a D.  With that said, I can breath a sigh of relief when I can use creativity to my advantage and solve stagnant musculoskeletal issues that have faded through the medical system's rigorous tests and treatments.  When an MRI shows no reason whatsoever for a patient's chief complaint and their blood work is within normal limits, what is the reason for their pain?  Is it all in their head?  My answer is that medical tests do not solve all the answers and being that medical therapies are largely dictated by the results from these tests, nothing can be done except nerve blocks and inflammatory control.

Anecdotally, I have a patient who has suffered from thoracic pain for over 4 years who has had every test in the book to diagnose the issue.  When all the tests came up short, they prescribed her anti-anxiety medications.  This, in my opinion, is a very wasteful system and a failure of intuition and knowledge of musculoskeletal imbalance.  After treating her with IFC, scapular distraction and Graston Therapy, she is now 90% pain free and is no longer taking anti-anxiety medication.

Anecdotes are anecdotes and they are not at all scientific truth and they can be skewed in many ways to promote bias.

With that, in the past 6 months, I've also had cases that have not responded to my conservative approach and have responded to epidural injections and invasive therapies.  It really comes down to respecting your scope of practice and other practitioners who have training in the more invasive treatment options.  Fine tuning our skills in diagnostics and implementation of conservative care is the most important development we can do, because it intervenes when appropriate either when a patient has exhausted all options or when they start fresh with us.

My issue after 6 months of practice is this:  Medical providers largely do not understand anything other than THEIR approach to care and when you approach them they push away.  If they were scientists who believe in empirical evidence which drives implementation of care, then they'd seek to understand procedures and therapies that are effective no matter what.  But when bias absorbs objectivity, poor decisions are made that lead patients to treatments that are risky, wasteful and purely for the ego boosting satisfaction the overseeing doctor personally needs.  Does this sound like science?

Trust your intuition, understand your orthopedic and neurologic tests and order tests if no answers are prevalent.  If there is still no answer, then treat the condition from a layered perspective; fascia, muscles, then joints.  Measure your performance by the results your therapies obtain and then boast from rooftops what you have done!

All for now,

Dr. Spangler
www.trailheadclinic.com