We have written in the past about what we call "the modern chiropractor." This concept was based on a JMPT article by Dr. David Seaman.1
Adjustments
Chiropractors are quite concerned about other practitioners, particularly PTs, DOs and MDs, learning how to do manipulation and "moving into our territory." Our response is simply that other practitioners are going to learn how to do manipulation whether we like it or not. Physical therapists are now becoming doctors of physical therapy and will have a broader scope. The evidence for what is a very powerful method for helping patients, the chiropractic adjustment, is not a secret any longer. Others want what we do and want to use it in their practices.
The bottom line is that other practitioners are going to be doing manipulation, and our job is to be better at it than them. We are not going to worry about other practitioners performing manipulations since we feel they will never be as good at it as we are. We don't mean that from a standpoint of arrogance, but because we have been doing adjustments for 25 years on a full-time basis and have dedicated ourselves to becoming very good at it. Our advice to other DCs is to become good at doing adjustments, and that threat will be much less of a threat.
Stretching
Stretching the shortened muscles as taught originally by Janda goes hand-in-hand with adjustments. Shortened muscles perpetuate the joint dysfunction and subsequent degenerative changes, especially with our sedentary, flexion-dominant work settings. It takes some time to develop a touch for these postisometric relaxation stretches, but they are a great adjunct to our adjustments.
Rehab
Low-tech rehab can be simple and inexpensive, yet quite effective. Our adjustments, along with low-tech rehab, is the best combination for long-term success with musculoskeletal patients. There are some great books written on low-tech rehab such as Liebenson's book Rehabilitation of the Spine or Murphy's Conservative Management of Cervical Spine Syndromes. Those books have enough rehab information in them to make you quite proficient in a clinical setting.
Soft Tissue
Soft-tissue approaches to patient care has been growing in the profession with the Graston and active release techniques. There are chiropractic offices that do these techniques almost exclusively, and this gives them a clinical focus. DCs have built great practices based on these approaches as their primary treatment. While the classes are expensive, the information is excellent and clinically valuable. From a standpoint of the vertebral subluxation complex, these soft-tissue techniques are quite good for addressing the myopathology component.
Nutrition
Nutrition practices can be stand-alone. If you want to focus on nutrition, you have a huge amount of information to study, learn and apply to your patients. Alternatively, you can do a relatively small amount of nutrition, such as we do in our practice.
Define Your Practice Focus
One of the things that has been going on in health care over the past several years is patients are becoming more and more responsible for their chiropractic treatment costs. This means they have a greater interest in results. If you want to build a successful practice, then focusing on giving your patients outstanding chiropractic care is key to this success. Mediocre is not going to be good enough anymore. Chiropractors who are not as passionate, not as focused or interested, and not providing excellent care are dropping out. It has become much more of a Darwinian environment as compared to when we started our practice.
Take a step back and think about what you are doing in your practice. Do you need to take a class to sharpen your clinical skills? Do you need to learn how to do proper coding and documentation of your work? Do you need to prioritize organizing your office? Step back, look at your situation, and then take action. Focus will lead to results, and if your focus is on helping people and building the ultimate practice, you will do that.
- Seaman DR. Joint complex dysfunction, a novel term to replace subluxation/subluxation complex: etiological and treatment considerations. JMPT, 1997 Nov-Dec;20(9):634-44.
Dr. Mark King graduated from Life Chiropractic College in 1986. He is a clinician at Mt. Lookout Chiropractic Sports & Injury Center in Cincinnati; president and lead instructor of the Motion Palpation Institute; and a coach and co-founder of Cutting Edge Chiropractic Consultants.
Dr. Steve King is a 1996 graduate of Life Chiropractic College. He is a coach and co-founder of Cutting Edge Chiropractic Consultants and has provided consulting services for several companies including Proctor & Gamble and the Cincinnati Bengals professional football team.