Hero Or Villain?
by DeDe Van Riper
Have you ever wondered about the strange phenomena that exists in the spectrum of chiropractic public opinion? How is it possible that such extreme differing views can exist? You have one group of people who swear by Chiropractic. They bring in their families. They tell their friends. And when challenged about their views, they are the strongest possible advocates for the Chiropractic profession. Yet strangely, equally as passionate are the doubters… and the down right haters. They range from the people who have “heard” about Chiropractic… to the people who simply say that Chiropractic doesn’t work… to the far extreme who believe that Chiropractors are a bunch of quacks… or charlatans… or thieves.
The easy answer is to attribute all the bad PR to those who are… well… bad Chiropractors…or charlatans… or thieves. If you wanted to we could debate the value of this technique or that technique, this college or that college, straight versus mixer, tonal versus segmental… the list goes on. Yet the reality is quite different. And for many of us, the answer is possibly more disturbing. Because at times we are all the bad chiropractors or the charlatans or the thieves. How is that, you ask?
Whether you have identified the feeling yet or not, you probably realize that to one degree or another these two extremes exist right in your own practice. Take Mrs. Johnson for example (or any of the many patients in your practice who fit the profile). She has been living with headaches for as long as she can remember. The pain is so severe at times that it is completely debilitating, She has been through all of the standard medical channels to address her condition but to no avail. On the advice of a friend, she decides to give Chiropractic a chance. Just a few adjustments into care she begins to get some relief. A week or two later she starts to believe that there really is something to this thing called Chiropractic. And after just four or five weeks you are a hero and she is telling the world about the miracle of Chiropractic. You can count on her to bring her family in to get checked. And you may rest assured that her friends and coworkers are tired of hearing about her experience. You are a hero. And you feel great.
Now comes the other side of the coin. For our example lets use Mrs. Smith. She has almost the exact same story as Mrs. Johnson. Yet Mrs. Smith doesn’t respond well to the first few adjustments - if at all. You try to comfort her - and yourself -by telling her that it is normal for things to take a little while. After all, she has lived with this for years. Can anyone expect that she will get better that quickly? Be patient. On the third or fourth visit you can tell that she is getting disappointed or annoyed with the process. She is beginning to believe that maybe there really isn’t anything to this thing called Chiropractic. Finally on the fifth visit - and most likely her last - she wants to know what you did the last time you adjusted her because now she feels worse than ever before. You are anything but a hero. And you feel terrible.
Similar patients. Identical history and complaints. Completely different outcomes. One patient becomes your biggest fan and goes out into the community to tell them the great news. The other patient joins the League-of-Doubters and goes out into the community to tell everyone the bad news… repeatedly… forever.
If you have been practicing for any length of time, you probably have more of these scenarios than you care to think about. Most may not be quite as extreme as this example, but the nagging feeling you have in the pit of your stomach should tell you that its not far off either. The questions that beg to be asked are these. Was your analysis different from one patient to the other? And was your care different in any way? The answer to both - most likely - is no.
This is not a fun situation for anyone: patient or doctor. Experienced repeatedly and soon a doctor’s confidence may wane. They develop a sense that they have little to no control over the outcomes of their patients. This weight - this quiet sense of dread - often motivates doctors to seek the Chiropractic Holy Grail: certainty. For some doctors this means learning a new technique. Yet speak with doctors of any technique and - if they are honest - they will admit that this patient-outcome-dichotomy is a universal experience. The discussion may open the door to a technique debate - and you may argue over the extent of the experience - but the bottom line is the same; they have the same situations, the same doubts, the same questions, and the same lack of answers.
Other doctors will turn to some form of outcome assessment technology such as surface EMG or thermography. Yet think about where this might lead in our current scenario. These technologies are wonderful tools at assessing and communicating a patient’s outcome. For the money, they are second to none. Yet as wonderful as they are when patients get better, where does it leave you with patients like Mrs. Smith? She is in pain. She is complaining that she is getting worse. You ask her to stick with her care plan for at least twelve visits so that you can do a proper re-exam. Then guess what. The magic day arrives and that wonderful technology does its job perfectly. It confirms for Mrs. Smith what she suspected all along - and she has a beautiful, high-tech report to prove it. Not only did she not get any better. She may - in fact - be worse than before. Ironically, it is not the certainty you were looking for.
So where does that leave us? Are we willing to write off a portion of the world as Chiropractic non-responders? Are we - as a profession - destined to live forever with that Chiropractic Love-Hate relationship? Hero to some. Villain to others. Before you accept this situation as your fate, you should know that there is another option. I am not talking about certainty. Certainty is not a reasonable thing to promise to deliver. What I can offer you, though, is insight into your patients like you have never seen before.
To begin with, try to envision what is at the core of our profession: stress. Physical, chemical and emotional stress. They are the cause of subluxations. They are the cause of nerve interference. And ultimately, that is what we - as Chiropractors - deal with. Now lets go back to our example of Mrs. Johnson and Mrs. Smith. We have previously agreed that everything about the two appeared identical… except the outcome. Yet if you had to guess, do you think that their nervous systems handled stress in the same manner? Do you think that their response to stress - and ultimately their recovery from it - was the same? Not a chance. Look back over a couple of the Mrs. Johnson’s and Mrs. Smiths in your practice and see if you had any hint of a difference in how they coped with stress.
You won’t see it with an X-ray. You won’t see it with an EMG. You won’t see it with a thermograph. Why is that? Because all of those exams are a static look at one system or another taken at a singal point in time… under very controlled situations. They can show if there are any abnormal alignments, abnormal muscular asymmetries, or abnormal readings. When you do a re-exam you can see if these conditions have improved. And if they have, you can quantify for the patient how much they have improved… and possibly show that there is more to be done. All wonderful things unless you are Mrs. Smith. Not only is she not better, she is probably gone.
Now imagine if things had gone a little differently for Mrs. Smith when she first came into your office. Rather than taking a static look at her nervous system, imagine what insight might be gleaned from watching how her nervous system responded to stress - and possibly more importantly - how it recovered - or didn’t recover - from stress. Is the picture starting to become more clear? What would it be worth to you to know up front that Mrs. Smith is likely to be one of those patients who never seems to “hold an adjustment”? What would it be worth to you to know up front that your care plan for Mrs. Smith will need to be a bit more comprehensive than the rest?
The technology that can provide this level of detail - this resolution as it were - has existed for years. Though predominantly used by psychologists, scientists, and researchers for biofeedback and neurofeedback, its application to Chiropractic is providing an exciting and powerful view of patients that has never been seen before. These insights are the result of a 12 minute stress assessment using technology from the largest biofeedback manufacturer in the world (they have dealers and equipment in over 85 countries around the world). Working closely with them we have developed this stress test to monitor and analyze 7 different components of the nervous system; brain function (EEG), heart rate, heart rate variability, respiration, galvanic skin response, temperature, and muscle tension (EMG).
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Videos and Webinars
Dr. Richard Barwell discusses the scientific verification of Neurologically Based Chiropractic. He delves into the
Law of Hormesis and why it is essential to have more than one adjusting technique in your chiropractic tool kit. He shows you
how changing the Frequency, Duration, and Intensity of your adjustment can forever change the outcomes of your patients.
Dr. Joe Demyen discusses the effects of the NeuroInfiniti on communication in his practice.
Collection of previously recorded CEO Call Series Webinars.
A list of suggested reading for those looking to expand their knowledge in areas
related to stress, the stress response, neurologically based chiropractic, biofeedback, neurofeedback, or the
future of health care.