Monday, October 7, 2013

Does It Really Take 6 months To A Year To Heal?

There are many protocols out there that have patients come 3x a week from 6 Months to a year. What I have found is this: If you are doing that protocol, for some patients they may require it. It may actually take that long. But, there are problems that do occur with that protocol that most often make this system ineffective.
1) Most patients don't start holding their adjustment  for 2-3 days with that protocol until the middle of month 2. Most patients, if they come in with pain, aren't going to wait that long before they START to see results. 

Let's go with the facts first.
A) We know that "healing is by momentum". You can't come once a week and expect any type of substantial results,....if any. Sure, it feels good, and you are there to remove the pain. But, what happens is the patient and doctor have delved into the same allopathic philosophy that chiropractors have been longing to avoid. That being: "treating the symptom not the cause". With many patients, they will try to control the situation of coming to the clinic regularly due to: (financial restraints, laziness, boredom, etc...), but if the doctor doesn't fully explain this, they will lose all patients to this allopathic way of: Treating the symptom, not the cause.

B) No matter how well a patient thinks they are, if they have never been adjusted, a first adjustment never holds for more than a few hours. Sometimes less than that. Why? Well, first of all, half the patients that come in are often resistant to an adjustment, thereby the adjustment falls back quickly. Many patients have moderate to severe postural distortion,...and nothing has been done to correct that, so is the patient going to be corrected overnight? Not even close. Lastly, an adjustment needs to be "trained" in order to hold it's position.

So, let's go back to this 3x a week adjustment mode of thinking. If an adjustment barely lasts, then by the 3rd week, the patient starts to get thoughts of "doubt". Wouldn't you? I would. I go in to see the chiropractor and the pain continually returns? Ah....this stuff doesn't work.  So, what needs to be done is what I am doing in my clinic now.

2x > 1x > 2x : 5x a week for 3 weeks. (2x on Monday, 1x on Wednesday, 2x on Friday) For most patients, in fact, for all the patients that I have done this with in the past 4 months, I've NEVER had it NOT work.
1) Patients start seeing immediate results.
2) Doctor is able to properly score the patient and see how long the adjustments hold, and what muscles need to be worked on, what ligaments need to be stretched, what postural work needs to be focused on, and what part of the body tends to be subluxated the fastest.

1x > 2x > 1x: 4x a week for 3 weeks. Patient has already started to show improvement, and now the doctor and patient can work cohesively together to get the posture correct, and work on exercises and training that will allow the adjustments to hold even longer.

1x > 1x > 1x: 3x a week for 3 weeks. Patient has seen the results extremely quickly. It doesn't matter if the patient has a radiculopathy, scoliosis, low back pain, neck and intrascapular pain and stiffness. They're all seeing results.
One of the things a patient needs to see is POSITIVE RESULTS. I have on occasion skipped step #2 and gone straight to this step if the patient is really progressing quickly. It depends on the patients progress, however,

!x > 1x: 2x a week for 3 weeks. This is the final step in a 3 month process that gets a patient better in a more timely manner than 6 months or a year.

After this, the patient has the choice. They can come 1x/weekly, 1x/two weeks,  1x/ 10 days, or 1x/monthly. It depends on many factors, usually these factors are decided upon by the patient do to their desire to continue with their health. But, that isn't the doctors decision. They did their job.
a) Got the patient well
b) educated the patient on how to prevent their pain/stiffness to return.
c) educated the patient on how to maintain their spine and the importance of chiropractic.
d) educated the patient on how to minimize pain if it does return.
e) educated the patient on the CAUSE of their problem and the reason for the problem in the first place. (This doesn't mean we have a crystal ball,... this simply means the doctor did a good enough diagnosis and treatment plan, that the patient was able to understand completely what was going on with their body).

Back to why 3x a week is "old school ".

2) Patient impatience: Many patients to this day believe that chiropractic is a "pain relief" system of therapy,...until they come in my clinic. Many believe it even after they are told repeatedly, otherwise. So, the way they remember is by seeing results. You can preach to the choir, but if you get no results, then when preach? A doctor MUST remember that even when they educate, they MUST remove the problem (chief complaint of the patient) first!. IT'S AN ABSOLUTE MUST! Patients will be more patient with you and your teaching if this occurs.

3) No patient in their right mind can clear their schedule for 6 months to a year for chiropractic care. A chiropractor would be insane to think that. Patients have business trips, vacations, sickness, kids, family obligations, non-expected emergencies.......way too many to even write down.  This is why most never complete the 6 month - 1 year/ 3x week process. I have been fortunate that most of my patients will give me 3 months. Even the ones that cannot, when they return from their obligations, they return without any issues because they saw the results, and they feel the need for an adjustment once they've been away. They are starting to recognize their own body.

4) WLP: Waiting List Practice: a C.J. Mertz program in keeping a successful practice. I remember a chiropractic practice in Singapore that ran this program to a tee! SO much so, there were "memorized" scripts that were told to every patient, regardless of the issue the patient came in with. The problem with this way of practicing is the practice turns into a duplication of the "car salesman industry". When a person buys a car, often what they fathom is the whole process of buying a car and dealing with the car salesman, and gnarling back and forth between themselves and the salesman. It has NOTHING to do with the car. They love the car. The car is what they came in for, but it's the bullsh*t they have to deal with while trying to make a purchase that makes them cringe. Same with this WLP system. Nothing wrong with chiropractic, but it's the bologna they have to deal with and not knowing what is truthful and what is not, that turns the patient against chiropractic completely. I COMPLETELY AGREE. This form of chiropractic doesn't keep a patient longterm. 

In my clinic, we are upfront in what they need,.....every patient is treated differently. From the style of adjustment, to the treatment plan, to the observation method, to the exercises given. All of it. And guess what? Patients often return and many have been my patients for a long long time. Many giving referrals. Think about it,.......if you bought a car from a place and you HATED the service or sales department, would you recommend that place again? HELL NO! Same here. You may get well, but you won't recommend the place again, and you'll bow out as soon as possible. So, there are clinics in America, Canada, Europe and Asia that are running this system. (Including Singapore and Indonesia).

I talk about "momentum in healing" quite a bit. I want you to picture a bunch of people pushing a car. When does it take the most energy? When does it take the most force? When does it take the most momentum? At the beginning when there is little results or when the car is finally rolling?

In this image above. The asserted energy is used while the car is stuck in the snow. Once the car gets rolling, everyone hops back into the car and rides along the road with ease. Same thing for chiropractic. The momentum is at the beginning. The most adjustments, the most work is in the first 12  weeks. Once that momentum is built, then simple maintenance is all that is needed. Simple as that!!!!!

Good Health,

Dr. G

1 comment:

  1. Really interesting article Giovanni. Thank you for your cogent analysis.
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