Bio-cranial therapy as the primary adjusting method contributes to the success of two New York offices.

It undoubtedly strikes some new patients as odd that their chiropractor, Stuart C. Marmorstein, DC (left), is as interested in the condition of their cranium as he is in the condition of their spine. Marmorstein is a big proponent of bio-cranial therapy, a method of treatment premised on the notion that the membrane within the skull exerts a powerful influence over the integrity of the spine. With it, the entire spine and pelvis can be adjusted simply by working on the cranium, according to Marmorstein.

"I find it a good noninvasive technique for getting people quickly back into alignment, and to be able to hold better onto alignment once I get them there," says Marmorstein, who runs a solo practice, the Universal Health Foundation, out of his home on 24 acres in the Catskill Mountains, about 9 miles from the small town of Ellenville, NY. "Basically, this type of osteopathic cranial work can cause the spine and pelvis to self-adjust and the whole system to dramatically relax."

Marmorstein explains the concept (pioneered by Robert Boyd, DO, in Ireland), "The inner lining of the skull attaches to the spine in the upper neck; if there is a contraction in this membrane, it is similar to having someone pull on the strings of a puppet."

He says chiropractors are trained to think of the spine as cause and illness as effect. "What Dr. Boyd asserts is that, often, spinal subluxations and the tendency to get them is something we may have brought with us from the birth process onward because of this underlying background tension that is present in the cranium all the time," Marmorstein says. "Then, we superimpose onto that already existing layer of tension that never goes away precipitating factors like falls, lifting objects that are too heavy, bad food, and emotional stress. We start out already set up for trouble."

A Heady Effect
Marmorstein typically employs bio-cranial therapy as his primary adjusting method. However, he often uses it in conjunction with other techniques, including one he developed—Chiropractic Repatterning.® "This is not a form of treatment, but a means of analysis—to show patients the before-and-after differences of, for instance, bio-cranial therapy," he says. "It mainly gives chiropractors the means to establish their expertise and credibility in the eyes of patients and, at the same time, elicits a ‘wow’ effect since patients can observe from one minute to the next that there is a recordable basis for the improvement in the way they feel.

"People do not want to hear [chiropractors] tell them that, since it took many years to get in this bad condition, it will take many years to get you out. We live in an age of instant this and instant that. As such, patients expect quick but good, solid improvements—results here and now. If you can’t deliver, you’re not going to keep them as patients. Chiropractic Repatterning helps satisfy this expectation for demonstrating quick results. In fact, there’s nothing like it for stimulating referrals and repeat business."

Marmorstein performs bio-cranial therapy adjustment on patient Dana L. Williams.

Marmorstein came up with the idea after years of observing various factors that cause people to lose some of the benefits of a good adjustment. "A serious problem for chiropractic is that there are many patients who receive treatment, feel better as a result, and then go on about their business, but soon, it starts to unravel," he says. "The factors that contribute to this tendency for some to not be able to hold an adjustment include specific muscle weaknesses leading to structural imbalance, as well as patterned abnormal responses to all kinds of normal, everyday stimuli. This abnormal reactivity causes destabilization."

A key element of Chiropractic Repatterning is muscle testing, which Marmorstein approaches in two ways. The first involves isolating individual muscles to find out which ones are working and which are not. The second revolves around learning which vertebrae are misaligned. "There isn’t," he says, "a better technology available for being able to demonstrate both to the patient and the doctor that a subluxation exists. Patients in particular need to have it credibly demonstrated that there is a problem and then be shown that improvements are occurring as a result of treatment.

"For example, if one side of the latissimus dorsi muscle is strong and the other is weak, the ramification is a constant pull on the spine; if that specific muscle imbalance is never addressed, adjustments of the vertebrae will not hold. I use the insights gained from muscle testing to develop ways of strengthening the weak musle and get it working properly again."

By Marmorstein’s tally, some 90 chiropractors around the country have incorporated Chiropractic Repatterning into their practices—most taught by Marmorstein himself.

Tale of Two Cities
Since launching his New York City practice in 1991, Marmorstein has accumulated files on about 3,000 patients (all of whom pay cash for his services; Marmorstein refuses to accept insurance payment of any kind). He customarily sees 20 to 25 patients per day, or about four per hour—a pace he likes. And he sees them at two offices: in addition to the in-home office outside Ellenville, he has a second facility about 100 miles south in a busy Upper Westside neighborhood of New York. "Having the two locations gives me a nice balance in my life," says Marmorstein, who grew up in suburban Philadelphia. "It gives me the opportunity to enjoy the best of what the city and the countryside have to offer."

Marmorstein explains a foot adjustment procedure to patient Rochelle Aruti.

To minimize the time spent shuttling between offices, Marmorstein works Upstate on Mondays and Fridays only. He stays in the city Tuesday through Thursday, staying with friends or family. Marmorstein sublets his New York City office (consisting of two treatment rooms and administrative and reception areas) to a physical therapist who uses it on Mondays and Fridays. "This cuts down on my overhead," he confides. "I’m, in effect, only paying for the space on the days I’m actually using it."

Universal Health Foundation is the third practice Marmorstein has operated since graduating from Texas Chiropractic College in 1979. That same year, Marmorstein opened a small office, which he sold in 1987 after a steep decline in oil prices soured the Houston economy. With proceeds from the transaction, he then set up shop in upstate New York, not far from the world headquarters of an organization that taught a type of meditation, which he and his wife, Gitesha, embraced.

In 1989, Marmorstein closed that practice for 2 years to live in India where he worked as a volunteer at the Gurudev Siddha Peeth clinic and aboard the Shree Muktananda hospital bus. After returning from India, he made plans to practice chiropractic once again. This time, he chose to hang out his shingle in New York City. "I figured that New York City would be the best place to practice," Marmorstein recalls. "New York was where people were always seeking a higher quality of life and where they have the means to pay a reasonable amount out-of-pocket for quality care."

Initially, Marmorstein situated himself in a friend’s apartment and made house calls whenever patients needed treatment. "I carried around a portable table to each appointment," he says. "The problem with house calls was that I couldn’t see as many patients as would be possible if I was in a fixed location."

Eventually, Marmorstein found a facility where he could establish a permanent clinic. In 1997, Marmorstein decided to open an additional office in the Upstate region, his previous location. "Many of my patients were coming from there—a trip that took close to 3 hours, one way," he says. "When a good deal on a property in that area materialized, I bought the place, which made a lot of people there happy."

Marmorstein uses auriculotherapy treatment method on patient Stephen Hoffman.

Marmorstein’s patients hail from all walks of life. One thing in common is an appreciation of Marmorstein’s willingness to speak freely as he works, explaining to them what he is doing and why. Many of them come for advice about nutritional supplements and diet. "I offer," he says, "reflex-based muscle testing analysis for nutrition, and also a sophisticated approach involving the use of standard BP equipment, urine, and saliva test sticks, and a device for measuring urine surface tension, as well as calculating types of metabolic imbalances, generating a report of findings, and offering dietary and nutrition recommendations."

A Profitable Byte Idea
Computers play a big role in Marmorstein’s practice. "I’ve been working with computers since I was in high school," he says. "All of the software I use to manage my office are programs I wrote by myself. I’ve also got a website, which I put together—coding it entirely by hand using HTML language and JavaScript. Since it is my own programming, it makes it easy for me to maintain the site."

His new-patient volume has increased appreciably because of his efforts. "The website makes it easier for patients to explain to their family and friends what goes on here in my practice," he says." Many patients trying to encourage family and friends to see me have trouble communicating technically detailed chiropractic concepts. All they have to do is give prospective patients my business card with my website address."

Visitors can peruse posted studies and reports about their health conditions. "They’re able to read at their leisure many articles on common issues such as TMJ problems and carpal tunnel syndrome, bio-cranial therapy, and the chiropractic and nutritional techniques I use in practice," he says. "I make this available because I want prospective patients, chiropractic colleagues, and other health care professionals to have access to reliable material about the work I do and why it is important to them."

The website even allows patients on maintenance to schedule themselves to receive email or telephone appointment reminders. "I tend to establish strong, meaningful, and respectful relationships with my clients, and this is one way to support that," he says. "I also like a relaxed relationship with my patients—a relationship built on mutual appreciation and one that can last for many years.

"I’m not the type to tell my patients, ‘This is the way I do things here; do it my way or you’re outta here.’ I don’t get into hype, plans, or trying to control anyone’s life. I simply recommend, teach, and occasionally urge, but I never take an authoritarian approach with my clientele."

Currently, Marmorstein is considering adding some square footage to his Ellenville-area home to accommodate a larger treatment area, which would allow him to purchase more equipment.

"As long as I run a practice that is both credible and incredible, day in and day out, I can’t help but grow."

About the Author
Rich Smith is a contributing writer for Chiropractic Products.