Take an inventory of your practice-stabilizing, once-a-monther patients and you’ll discover that most of them have had two, three, four or more chiropractic episodes prior to embracing chiropractic as a long-term lifestyle adjunct. If this is true (research your own patients and see), then it takes a lot of pressure off trying to find the magical words or the seal-them-in-for-life procedures that so many chiropractors seem searching for.
But what about the chiropractor who thinks they somehow permanently “fix” patients? Even more concerning are patients who think they were “fixed” after a dozen or so visits with you? Have you created an "echo chamber" that has misled you into believing that you make permanent, lasting change because patients rarely return?
Here's how the perception gets started, and what you could do about it.
Chiropractors who believe they fix spines face several challenges. Among them is the simple clinical reality that if there is going to be any “fixing” the patient’s body (which a chiropractor can’t control) will do the fixing. Even if it were true that thrusting on the spine puts the bone “back,” it would only take one adjustment.
But that’s rarely the case.
Naturally, it takes more than one adjustment. Especially since most patients have neglected their problem for years, maybe decades, before consulting a chiropractor. With years of longstanding subluxations, and the accompanying scar tissue and muscle atrophy, thinking that you can make significant, lasting changes because the patient shows symptomatic improvement after a dozen visits or so is a pipe dream bordering on delusion. Especially, if the patient is unwilling to do little more than to passively show up three times a week for a month or so to receive your skillful, precise and carefully-targeted chiropractic adjustments.
True, the patient’s symptoms seemed to resolve (at least for now), but the inevitable relapse (months or years later, brought on by a period of stress) is often not apparent because the patient doesn’t feel comfortable returning to the practice that didn’t deliver lasting results. Or from the bad taste left by the way the practice attempted to compel the patient to continue their care beyond symptomatic relief.
As a result, the amassed trophy case of inactive patient files is often seen as proof of countless permanent successes! This “echo chamber” effect may be affirming, but advances a false notion that you’ve somehow permanently fixed patients, an unhelpful self-deception.
“I tried chiropractic. Once.”
By the time a patient is desperate enough to try chiropractic they have had countless bouts with medical doctors. Many, if not most of these encounters were, at least in their minds, “successful.” However, their most recent episode probably wasn’t. Thus, their availability to explore something outside the mainstream medical model. You.
This is important. Not the frustration with medical solutions, but their previous success from medical interventions! Why? Because their brushes with medicine created the illusion that health problems can be “fixed.” Infection? Take this prescription of antibiotics and you’ll be cured. Broken wrist. Wear this cast for six weeks and it will be fixed. Headache? Take this pain reliever and it will go away. The entire symptom-treating model is based on making the symptoms go away. Until it doesn’t. And then they’re available to try chiropractic. And while medical treatment has failed them, they still have this notion that their problem can be “fixed.” And that’s the problem. In fact, it’s a huge problem if you have any hope of inspiring patients to equate ongoing chiropractic care with brushing and flossing, good nutrition, aerobic exercise and other long-term life-enhancing habits.
The point? You can fix a flat. You can fix a cat. But fixing patients is an entirely different problem, exacerbated by the guilt and shame that many chiropractors induce that prevents patients suffering a relapse to return to the practice. The result promotes the incorrect illusion that you fixed them.
What if you concluded your report of findings with an explanation about the likelihood of a subsequent relapse should they discontinue their care immediately upon the cessation of their symptoms? (Here’s a wall poster that helps make the process visual.)
“Most of our patients show steady improvement with each visit building on the ones before. At some point (which I can’t predict because everyone heals at their own pace), you’ll be feeling better, even before muscles and ligaments have been retrained and strengthened to support your spine properly— something that happens with continued care after symptoms subside.
“So, if you discontinue care as soon as you feel better, you’ll be susceptible to relapse. When that happens, please don’t blame me or chiropractic! Simply give us a call, and we’ll start the process over again. In fact, it’s after two or three of these relapses that a lot of our patients, depending upon the level of stress in their lives, see the value of some type of ongoing supportive care. But you don’t need to decide that now.”
If you can’t fix their spine, at least fix their expectations!