How can we as chiropractors set the tone for patients to go beyond recovery and into optimizing health and performance? Can we take the spine-based model chiropractic is uniquely positioned for and build a platform for other health care decisions? How do you foster confidence and certainty with patients to make significant change?
The educator, on the other hand – even when true to their own message, tends to have to work hard for each audience. For every patient you encounter, there are countless additional opinions questioning your services: family, friends, insurance companies, social media and online review outlets.
Not everyone, including prospective patients, has had the benefit of seeing you in practice and living your lifestyle, leaving you to explain why you do what you do.
Establishing the Narrative
As individual practitioners and groups, we have the liberty to craft our own message (brand) and choose the ways in which we communicate with the public within our respective scopes. We all face the same challenge of sharing our thoughts with each audience with minimal effort.
It seems simple, but what inspires a patient may not satisfy their spouse; and the person reviewing your claims doesn't rubber-stamp them when the patient's dog sits during an adjustment in quiet approval.
Can we speak and write in a way that resonates with each group? My suggestion to you, the healer, is to share a vision of health care that goes beyond any of their minimal requirements. The right point in time to make that vision clear is in the formation of the treatment plan.
Patients, often driven by discomfort, present with short-term goals and a quick-fix pain management mindset at first. Their attention could come and go with pain, and your opportunity to educate them about what they can achieve under ongoing care may be short-lived.
When someone understands the more functional aspects of their improvement, we can ground them to more important and measurable gains like:
- How long can I sit, stand or walk?
- How much exercise can I do?
- What kind of resistance can I handle?
- How much faster can I move?
- When and how could I see improvement?
Communicating the Treatment Plan
Think of the treatment plan as a disclosure statement of how you will help your patient achieve the why. Clearly state how you intend to help them so they can set fair expectations of what's possible from the beginning. Transparency fosters the trust needed in care management and decision-making. This is important not only in the case of rapidly improving patients, but also for those who do not get the immediate relief they seek and may require more support before they have a satisfying experience. These are two scenarios that a doctor can be well-prepared for with a thorough treatment plan.
It's at the beginning, when explaining complex ideas to the patient – like the neurology and biomechanics of the subluxation, and how their spine could be affecting overall healthy function – that we should clarify how and why we address areas related to the spine. These less-obvious contributing factors are all very difficult to ignore when the end goal is for the patient to be weight-bearing, moving and exercising more (for all their well-documented and scientifically established benefits).
It's critical to have the feet, spine and brain function optimally as a unit. The role of foot alignment is especially important, and this is an opportunity to explain it at a level that's on par with spine care.
That may be difficult for some of u,s as it's already a challenge to explain neurology of the spine. But once you've accomplished that, some of these relationships are obvious whether you use proprioception to convey it or you look at basic gravity-based posture principles (e.g., standing on your feet). It doesn't have to be complex, but to include this explanation as a doctor's priority creates a higher standard.
Initiating the Spinal Care Conversation
When we explore function (another opportunity within the treatment plan), we now start to give people a better idea of how we envision health; and what resilience based around spinal care would look like. When we wait for late opportunities (e.g., waiting for the re-examination 12 visits out) to introduce additional ideas and new concepts, for the patient, it can feel like we're changing the game on them.
Consider providing all of the possibilities during the visit where you share the report of findings; anything you can predict can be shared at the beginning. When you refer back to that ROF, you are presenting with a confidence and consistency patients look for. In the office, after laying out the landscape of their health, we draw a possible map to the end goals, but we trust patients to understand that we'll adapt as needed and set the pace for each case individually.
The value of whole-body posture correction and changing people's behavior around posture and their spine is too important to leave out. Explaining the role of healthy foot function is another critical opportunity for us to demonstrate what's possible in care and part of our formula for maintenance and wellness.
I believe my responsibility is also for me to say, "Here's how I'm getting it done." Many people look to the doctor as a leader of the right way to do things. Part of my job is to tell them all the spine-related decisions I make: how I sit, how I stand, what kind of support I use, how I perform exercise, how I approach sleep and posture supports such as orthopedic pillows, bedding, quality shoes, and custom, flexible orthotics that support all three arches of the foot to align and stabilize the body.
All those things fit into this care plan. To put it in writing is an even higher standard, and the treatment sheet is the perfect opportunity to do so.
The benefit of this approach is in what can follow. The future of health care is definitely not in the pursuit of physical or mental health. The future of health care is to re-imagine The Renaissance in the modern world, and to get them both right.
The way neuroscience has advanced, we know a significant part of modern health care is about learning. We know recovery is a re-education process; we know the spine's role in communication is neither to be taken for granted nor chosen; for instance, over movement and range of motion. They are both complex functions that are related and intertwined.
If we're going to grasp the opportunities, reach the full potential of chiropractic, and get to a place where we don't have to justify our care by the presence of pain, we would be wise to begin with critical steps like the treatment plan.
Dr. Anish Bajaj is a 2000 graduate of Life University and the owner of Bajaj Chiropractic in New York City. He serves on the executive board of the New York Chiropractic Council and is the chair of its Neuroscience and Research Committee. As a member of the Foot Levelers Speakers Bureau, he travels extensively, sharing his chiropractic knowledge and expertise with audiences around the country. He can be reached at
.