Essential Patient Education
by William D. Esteb
If the depth of chiropractic understanding exhibited by experienced patients is any guide, most veteran chiropractic patients are woefully ignorant of the most basic chiropractic principles. No wonder delighted patients haven't catapulted chiropractic into first place in the healing arts! They don't have the foggiest notion of what happened to them or why. It is essential that each chiropractic office convey basic chiropractic information to each patient. Without this understanding and appreciation chiropractic will remain a secret or limp along in oblivion.
The diverse types of businesses that hold trade shows and conventions in the hotels where I conduct seminars intrigue me. I like to walk down the aisles, look at the booths and learn how other industries communicate with their customers. The pharmaceutical industry is especially interesting.
Many in chiropractic see the drug marketeers, medical doctors and pharmacists as their enemies. Walk down the row after row of booths and see the commitment, passion and well-intentioned purpose of helping people and it's hard to imagine that these individuals are the source of chiropractic's inability to suppliant or replace medicine. Within their model of health and their range of understanding (which they don't perceive as limited), they care deeply about patients. They don't even see chiropractic on their radar screens!. It seems the only thing worse than being ostracized is good old-fashioned indifference.
Without the assistance of the drug-influenced (literally and figuratively) media, the responsibility of turning around widely-held opinions and perceptions of chiropractic should be a major concern of every chiropractor and staff member. The first step is to identify the most essential chiropractic concepts that every patient should know and understand. How these notions are communicated to each patient is another matter. However, a recent seminar audience produced this list of essential topics:
The nature of true health. Most patients have a misguided notion about what health is. What passes as "health care" is actually sickness care. You may never be able to totally divorce patients from using symptoms to judge their health, yet, without this most basic understanding, chiropractic will forever be misjudged and mischaracterized. Patients need to know that doctors--regardless of the initials after their name, don't heal, can't heal and have never healed. Only a patient can do that.
The nervous system controls everything. We live in a blood culture. We're fixated on blood chemistry. Do you have iron poor blood? HIV? High cholesterol? The entire drug industry is based on blood as a transportation medium. Chiropractic patients need to know that the nervous system, not the circulatory system, is the master system. Without this simple reframing, patients can't fully appreciate your interest in the spine--housing the most accessible (and vulnerable) part of the nervous system.
The chiropractic adjustment is a powerful thing. If patients are to take chiropractic seriously, there must be reverence attached to the adjustment. This starts with the chiropractor. Talking during the adjustment, distracted by other concerns or assuming a casual attitude can diminish the patient's perception. More subtle, since most adjusting procedures are the same from visit to visit, without enlarging each patient's appreciation of the incremental changes you're detecting, the value of the adjustment can be easily dismissed.
Results take time. Everybody wants instant gratification. Television commercials claim "fast, fast relief" and who wouldn't want that? However, the sometimes slow process of healing and its expectant symptomatic relief is especially challenging for chiropractors unable to build patient rapport or communicate the previously mentioned points. Patient expectations need to be properly addressed so patients aren't disappointed or tempted to blame chiropractic in the likelihood of a relapse if patients discontinue care prematurely. Healing is a process, not an event.
Chiropractic is scientific. The last 100 years of "progress" has bred a generation of patients who want assurance that their health care is "scientific." This lack of understanding about the scientific basis for chiropractic results in patients who get great results, but say they don't "believe" in chiropractic. Do they also "believe" in aspirin and tonsillectomies? Since most chiropractic procedures appear "low tech" and repetitive, many patients believe that chiropractic is nothing more than an elaborate massage.
The sound adjustments make are not bones rubbing on bones! Patients who experience chiropractic from chiropractors whose adjusting technique produces cavitation often think the sound is produced by bones rubbing on bones. This and many other incorrect notions are rarely mentioned by patients in the presence of their chiropractors. Yet, focus group research indicates this perception is widely held by even the best, most compliant chiropractic patients.
Chiropractic is for everyone. Many patients are given the impression that the only people suitable for chiropractic care are men and women ages 21 through 55 who have headaches or low back pain. Seniors are often thought of as having bones that have grown too brittle for chiropractic adjusting procedures. Children are too young to suffer from a bad back, plus, the force of the adjustments is likely to injure young spines.
Spinal problems get worse with neglect. Every patient needs to understand the relentless degenerative process that occurs to spinal joints. While they may always judge their health by how they feel, patients need to be aware of what their bodies do to joints that aren't moving properly.
The patient is always in control. Countless people could be helped with chiropractic care, yet are afraid to begin care for fear they will fall under the spell of something or someone that will keep them coming back for life. While those of us who understand chiropractic, want it for the rest of our lives, most newcomers to chiropractic are fearful of becoming dependent upon chiropractic (or pain pills for that matter). Make sure every patient understands that how long they decide to benefit from chiropractic is always up to them.
If the millions of chiropractic patients since 1895 knew these simple truths about chiropractic, the profession would have made a considerable impact on our culture. Instead, patients have sought out chiropractors, gotten great results and yet remained ignorant of basic information critical to advancing the profession through the word of mouth process. Like patients who seek a one-visit cure, there will always be chiropractors hoping a yellow page solution, or a state association solution, or a public relations solution or a powerful TV documentary solution will once and for all level the playing field for chiropractic--which is about as likely as you winning the lottery.
Striking a Nerve
Originally published in 1997
Not a reader? Bill reads his favorite chapters
from all 10 books on Bill's Best.