Strengthening the weak areas of your practice will add enthusiasm and income

Life and practice success equates equally to adaptability. The daily joy and grind of managing and maintaining a healthy practice requires your ability to fine-tune the ebb and flow of patient and community demands. Therefore, it behooves the doctor and staff to maintain their level of knowledge and either tweak or overhaul practice and patient management as needed. This article will outline three areas that often get overlooked due to complacency or poor practice habits.

Many chiropractors generally learn a technique or two and then cling to them. As DCs see more and more patients with diverse symptoms, they soon realize their limitations of skill, equipment, and knowledge. This leads to unnecessary emotional stress, and may have kept their practice stale. Diversity and newness of technique and skill will often keep things fresh; therefore, it should be encouraged.

The purpose of this article is to stimulate you to keep an open mind to new ideas while taking advantage of various techniques, professional diagnostic and treatment protocol vendors, and practice-management and educational seminars. So many of these are available within various philosophical comfort zones, that to maintain the status quo when change would help is foolish.

Learning something new, such as a new technique, is a common practice for reducing chiropractic professional burnout. Burnout is an insidious crawl of malaise leading to disgust and withdrawal. The worst-case scenario is a practice that has no rudder and is floundering because patient management is out of control and the DC has lost faith in his or her skills. Patients often resist the DC’s recommendations, and the benefits obtained by the treatments are often hit and miss. As the practice either slides downward or is stale at best, the DC gets further discouraged and watches the clock rather than anticipating the next patient or getting excited by any new approach to get others.

As is often the case, renewed study as well as enthusiasm for learning and using a new technique or practice skill often helps sustain a practice career while giving the doctor a new lease on his or her professional life. Rather than waiting for your professional candle to flicker, incorporating new ideas should always be on your plate.

Conduct a review to determine whether any weak areas exist within your practice and patient management. These weak areas might include your adjusting or diagnostic skills, attending to sport or personal injury cases, rehabilitative and nutritional services, insurance relations, or patient and community communication. Once you strengthen these areas, they will add enthusiasm and income to your practice and reduce the emotional ups and downs of daily practice life.

Curiously, the other day a patient asked me if I was up on everything new in chiropractic. I asked her why she even asked the question, and she said she was just curious if I was staying attuned to the advances within our profession.

She had every right to question me, and my response stimulated me to realize that we never know enough. Reading journals and attending postgraduate license-renewal courses are one thing, but implementing the latest and greatest within the realm of adjusting, diagnostic, or educational techniques is yet another.

Keeping abreast of what’s new keeps your enthusiasm and skill level up for the benefit of all. Let’s explore a few areas in which your practice might have room for improvement.

Adjusting Techniques
Colleges provide a great base of biomechanical study. The course curriculum follows guidelines set by the Council on Chiropractic Education (CCE), leaving little room for innovation.

Table and equipment vendors often provide educational seminars for the novice and established doctor. Another avenue is to attend a state convention or seminar where various tables and adjusting styles and techniques are usually displayed. Keeping an ear and eye on the adjusters and those being adjusted helps you visualize and decide if the technique is well-suited for you. Keeping up with the advances keeps you afloat within the evolution of chiropractic.

As chiropractors, our concern is with the biomechanical components of posture. The body’s ability to adapt to its harsh external environment is crucial for a free flow of energy to sustain homeostasis and health. Considering that the alternative for the public is drugs and more drugs, or more likely doing nothing, we have a great role to educate them about the wonders of chiropractic and to meet their needs by providing the best-quality care we can offer.

The technique du jour may not appeal to you, but to others, it may be the answer to their pieces of the adjusting puzzle.

Today, along with the manipulative adjusting approach, many elective technique alternatives are available. These include creative tables, handheld adjusting tools, computer-assisted adjusting instruments, blocking, stimulating soft tissue, decompressing discal derangement, using rehabilitative exercises to promote normal posture or reduce scoliosis, and using low-level lasers. Your choice depends on what best fits your practice parameters and personality. For doctors using therapeutic adjunctive therapy, equipment and education also evolves and requires your ongoing attention.

Diagnostic Techniques
Our colleges have also done well preparing us to sit and pass national and state boards while offering a facility to probe, question, and learn. The school clinic is also straddled by the confines of CCE regulations that often provide a restricted environment toward a more thorough diagnostic workup.

Depending on the doctor’s philosophical and treatment protocols, the diagnostic analysis may differ drastically. For the doctors interested in a subluxation-based or broader-scoped analysis, radiographs, heat reading, and graphing programs often serve them well. Surface electromyography, thermography, and range-of-motion studies can be purchased from several vendors. Along with typical radiographic studies, digital palpation, and postural analysis, an individualized subluxation or biomechanical diagnosis can be obtained. Several doctors are incorporating various on-site diagnostic programs.

Further studies may incorporate electrodiagnostic and ultrasound testing. Referrals to medical specialists or outside facilities for magnetic resonance imaging or computed tomography studies require your ability to interpret the reports, read these films, and explain the findings. Postgraduate classes discussing the use of these services and the analysis are given nationwide and often during state association license-renewal programs.

To add a diversified approach to patient analysis, many doctors choose posture-oriented programs such as PosturePro or a strategic asset-management system unit. Sophisticated software programs will calculate the level of postural distortion and provide a report for the patient. Comparative muscle testing and range-of-motion analytical units help with insurance and attorney reports while helping educate the patients.

The more tools used to pre- and postevaluate the patient only adds further criteria for your treatment-and-release protocol. Take advantage of these tools for the purpose of assisting your patients and increasing patient management and compliance. It all begins with a clear evaluation, a report of your findings, and your criteria-based recommendations.

Educational Techniques
A stagnant practice often leaves little room for patient education. Many excuses are used to offset the frustration of a lackluster practice, but the key to changing this dynamic is education and more education. Patient awareness is as important as the adjustment. Every patient is interested in knowing that you have pinpointed his or her problem and wants to know how best to assist you in getting them well.

Over the years, a cottage industry of chiropractic vendors has grown around our desire to educate our patients and community. These have run the gamut from wall charts, concept posters, PowerPoint lecture programs running continuously on an LCD screen, and touch-and-tell kiosks, to computer-generated interactive spinal health programs, lecture charts, videos, and DVDs. Community programs allow you to meet and greet potential patients while helping them with proactive ergonomic classes, spinal screenings, and the like. Patient orientations are very successful and useful to bring guests to the office and solidify your rationale for care. The doctors that regularly provide spinal care classes find the time spent preparing for these programs well worth it.

Rehabilitation and nutrition protocols are areas that should be explored. Patients benefit most from a “wholistic” perspective. In addition to adjustments and adjunctive therapy, patients usually cooperate best when they can participate in their care. In-office or at-home rehabilitative exercise instructions are imperative for their sustained results. Nutritional advice and protocols must be learned. These two service areas have a dual role in every office. They add to patient results and add income to the practice.

Success will follow the doctors who are comfortable with the level and manner of their adjusting skills and their patient and practice management. The doctors who educate each patient will also share their enthusiasm and purpose of chiropractic, which in turn will help the patients share it with their friends and neighbors. The doctors who have the tools to reach out to their community with various educational programs outlining the proactive approach of chiropractic will see their practice grow. Therefore, the successful doctors set aside a portion of their working budget for patient and practice management, doctor and staff education, and updating equipment and skills. CP

Joel E. Margolies, DC, has been in practice for 25 years in Atlanta and is the author of four books: Smart Start, Workshop Workbook, Chiropractic Marketing and Public Relations, and Personal Injury Workbook. He sends a free weekly chiropractic e-newsletter concerning practice management, public relations, and philosophy to more than 10,000 DCs in 31 countries. Margolies can be reached via email: joel3639@aol.com, or Web site: www.chirosmart.net.