chiropracticforward

Big Ideas On Marketing Evidence-Based Practices (Part Two)

CF 099: Big Ideas On Marketing Evidence-Based Practices (Part Two)

Today, you’re going to hear Part Two of our two-part series about marketing. Specifically, marketing an evidence-based chiropractic practice. How do you do it and do it right?

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research. It’s like we’re talking about research over beers. Which is NOT like talking about research in a classroom or an institution of some sort. Accessible research if you will. I could be more professional but I’m not. 

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. 

If you haven’t yet I have a few things you should do, like our facebook page, and go to our Store link at chiropracticforward.com and check out the goods. That’s it. Not bad right?

You have shimmied into Episode #99 and I hope you’re enjoying the Marketing series. 

Now, if you missed last week’s episode, it was Part I of this marketing an evidence-informed practice series. Stop now and go back and listen to Part I first. Then come back here and devour Part II. 

Because….make no mistake…..we’re serving it up hot and fresh here people. 

On a personal note, nothing special is going on around the office or in my work life balance. It’s just been business as usual. We’ve had a bit of a fall off from the Summer but it’s still busier than this time last year and we’re staying busy busy busy. 

So, nothing of signifigance to report here but, before we get too deep, it’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

OK….now, back to Part II of our marketing series. We covered some general marketing thoughts and we covered internal marketing last week. We were just about to get into External Marketing and the idea of the first big three means of external marketing which can be thought of as shotgun marketing. 

So, let’s pick back up where we left off last week. Here we go. 

#2 External Marketing

Now, let’s move on to External Marketing. This is the traditional marketing we think of. Things like:

  • TV
  • Radio
  • Billboards

Let’s talk about those three first. We can call that shotgun marketing because you are hitting random people with random pebbles. You can’t laser focus marketing with a cannonball this way. You can only hope that someone that would be interested in you happens to see your message. Some will. Most probably won’t. 

Don’t worry if you’ve fallen for some of this crap. I spent $19k one year to have the front page corner of the yellow pages. Now, that was years ago when everyone actually used the yellow pages but, trust me, I’ve done stupid crap too. 

Back to TV, no matter how smooth the sales reps are, more and more are unplugging. They’re using streaming services like Netflix or Amazon. Disney and Apple are jumping in with both feet too so sooner rather than later, I think the majority will not see a message on traditional TV. 

Same goes for radio. Hello, every heard of Sirius radio? Or, if you’re like me, I’m listening to a podcast as soon as I get in my truck to go anywhere. I don’t even listen to traditional radio anymore. If you do, I think you’re quickly becoming the minority. 

Billboards may make sense if you’re right off the highway and it leads people to your front door. Otherwise, I think it’s probably mostly a waste of money. Don’t get too tied up in whether or not you see your face or your name up on a big board or up on TV. It’s not real. It didn’t happen organically because you’re awesome. You put it there with your money. And you may have just wasted that money. 

Shotgun marketing can make sense but only after all of the base coat has been painted and now you’re just going for exposure and saturation of the market. I really don’t care what the sales reps say and how many graphs they show you. Those are manipulated to take your money. 

Another negative about shotgun marketing is that it is hard to track. Marketing needs to be traced and tracked. Either through computerized means or on a simple spreadsheet. Better believe I know where every single new patient comes from, who to thank, and where my bread and butter lies. 

Unless you’re really tracking well, many times you won’t know if someone comes in from a billboard, TV, or radio. Sometimes they’ll tell you straight up but sometimes they just don’t remember. 

But what about other means of external marketing?

What about things like:

  • BNI
  • Chamber of Commerce
  • Charity and philanthropy. 
  • Social Media
  • Sponsoring teams and events
  • If you want to do personal injury, wouldn’t you figure out how to attract and market that demographic?
  • If you wanted more pain patients, where do they hang out? Where do they go? Wouldn’t you want to figure out how and who to market for those people?
  • Direct mail – yes, it can still work and you can target it like a laser
  • Brochures
  • Marketing representative
  • Creating authority – talks, appearances, book, podcast, content creation, etc…

I have so much on external marketing. The options are endless and we could talk about them for ever. I’ve tried them all. Trust me. 

Something I forgot to mention in the beginning is the fact that marketing is always changing. It’s not a set it and forget it endeavor. You have to be on it all of the time. Yellow Pages anyone? Hello….Bueller. 

#3 Who You Are

As I said before I add this third one because we are in a personal business. You’re not a big brand like Coca Cola. Coca Cola doesn’t have a face. It doesn’t have a name behind the brand. While some would argue that it does, in the context I mean it in, Coca Cola does not have a personality and it damn sure doesn’t have a relationship with it’s drinkers. 

You could say that #3 really has more to do with internal marketing but I think it’s a cross-over thing. Who you are, your vibe, how you carry yourself….that all goes into making your business what it is and makes your reputation what it is. 

For a smaller community, this is even more vital. For a city, still vital. You are attracting people or you are repelling them. It’s not very often that you have not effect or neutral effect on people. Right? Do you ever leave a conversation or a personal encounter with someone with absolutely zero feel about it? You get the point. 

So, what if you spent on average $150 per each new patient that gets on your schedule? There are some pretty good stats you can keep on this stuff. What if you invested $150, they come to your door, you’re having a bad day, rush through their exam, are a bit of a jerk about them doing exactly what you recommend, and then maybe there’s a snafu at the front desk when they pay out because you were too lazy to get the staff trained appropriately?

You may have made the $150 back up but you’re probably not going to profit on that patient because of YOU. Your vibe was crap. You didn’t want to be there. You didn’t want that patient there. You didn’t train your front desk right. And now YOU probably won’t have another visit with that patient. 

What if you are at an event, you woke up that morning and stepped in dog crap, and that just set the tone for the day. Now you’re at this event you don’t really feel like being at and everyone can tell. Mr. Sourpuss chiropractor over there sucking on a whiskey sour with his sour face. 

These are dumb simple little examples but who you are, how you are able to talk and communicate to people, and communicate what you do can make all of the difference in the world. If you’re positive, energetic, smart, and capable…..Boom. The battle is won. 

Eyore from Winnie The Poo on the other hand gets no patients. Only your mom is coming to see you. #66 in town, #1 in mama’s heart. 

More than personality though, you MUST be a real person. Don’t pretend. Don’t sell. Patients smell that garbage a mile away. Be AUTHENTIC. That’s a key concept in marketing. 

It’s the stuff you learned in kindergarten. Treat others the way you want to be treated. Honesty, ethics, forthright, stand up, and gentlemanly or lady like. Professional. These are so important. What about loving? Of course. You better love your patients and you better love your staff. 

Our practices are made up of lots of relationships and if you aren’t interested in people and relationship building, I’m afraid no amount of marketing will make it OK or will make you succeed. No amount of money. 

When you’re providing quality care with responsible recommendations, and you salt and pepper that delicious brew with a little love and personality, you got a winning recipe on your hands. I like cajun food so I add even more personality to my spicey brew!!

Boom snap pow!

I mentioned this earlier but, I think the biggest key to anything business related is keeping and tracking stats effectively. Do you know the exact number of new patients you got last month from Google or Facebook or Instagram or from referrals from your existing patients? Do you know how many new patients you got from your own staff referring people to you?

Do you know your PVA? Do you know how much you make per patient encounter on average and how much it costs you in marketing dollars to get a new patient in your doors? Do you know what your average profit per patient visit is each month or what it averages over the course of the year?

If you can’t answer these questions, you have to figure out how to answer them and you need to do it yesterday if you get my drift. 

These numbers and metrics aren’t only important to your marketing efforts. They’re important to your business in general. How can you possibly know your return on investment for anything you do in your business? It sounds crazy to say it, right? For so many of us, record keeping and stats are just second nature. But, I wasn’t always there. I had no idea where I’d been and not a clue where I was going.

I was like a drunk pin balling off of the walls trying to get somewhere and falling down every so often. 

I’m not just trying to relate to you on some level. That’s real talk. I was on an island for so many years. No colleagues to bounce ideas off of or to ask for help. No association involvement, no network. No real continuing education. I came late to the party. But, with knowing I was coming late to the party, I jumped in with both feet, man. 

Gimme the bottle of tequila, the bottle of vodka, and throw in some fireball on top of that. Let’s get there as fast as possible. 

That’s what I did with being a chiropractor. 

Now, as far as the stats keeping, I’m working on a solution for those of you that might be interested in getting some help with keeping stats. Something that will make it easy and fast. Yes, it’ll have a monthly cost but it won’t be ridiculous and you can only pay for what you think you need. Different levels…that type of deal. But, it’s in the works and I’ll let you know more about it when we get it up and running. You numbers nerds will love it. 

Some other random thoughts and musings:

  • Having something to talk about is always important. Especially on social media. If you’re talking, people are typically listening. Even when you think they aren’t
  • Make sure your website is doing what it’s supposed to do for you. IF you can’t do it, hire it out. It really is that important. 
  • IF you can learn YouTube videos, learn it and do it. Even if you think you suck on screen. It’s important. 
  • Eliminate the risk. Do what you can to remove any and all obstacles to coming to see you. Is your insurance staff making the payment process a little bumpy? Fix it. Are people wanting to fill out paper work online but you don’t have that? Fix it. Does the majority of your population want to come in from 5-6 and you’re closed at 5? Fix it. Not for just one or two people but if the majority needs that time block, give it to them. Just remove the obstacles. 
  • Be the expert that you are and be the expert everywhere your market will allow you to be the expert. Clubs, associations, boards, etc…
  • The secret to referrals is the difference between satisfaction and enthusiasm. 

Things NOT to do pretty please for the love of all that’s holy. 

  • Do not put your office and profits above your patients for any reason ever. 
  • Do not scare patients into care. It’s rude and it’s unethical
  • Do not use curve correction as a reason to manipulate patients into setting up 70 visits. It’s rude, it’s borderline unethical, it makes all of us look bad, your actions really do reflect on the rest of us, and there’s no good, non-biased research backing the notion that curve correction matters at all. 
  • Don’t do dinner with the doctor unless you truly are simply trying to build authority in your community. If you are using them as bait and switches where you get someone in for a $29 initial treatment and then scare the crap out of them to make them sign a contract for $3500 over the course of a year, then YOU are the problem with this profession. 
  • Oh yeah, contracts between doctors and patients do not belong in healthcare. It’s embarrassing. Please stop if you do it and never start if you don’t. 

Just be honest, ethical, put the patient first, behave in a manner that would make the chiropractor next door be proud to be a chiropractor, and take care of your patients by following industry standards for treatment. Keep learning and expanding your knowledge. Be the smartest in your town. The more real, research-backed education you get the better you’ll understand things in the profession and the better you’ll understand how to carry yourself. CCSP, Diplomates, etc. 

Basically, have a moral compass which sums it up.  

So, there’s the quick form of a marketing seminar.  We could spend an hour on each one of these little nuances to marketing and could go on and on and on. 

Again, if any of you want me to put together a more robust marketing talk and have me present it for your group or association, let me know and we can see how we can make it work. 

If you have any questions or ideas, shoot me an email at dr.williams@chiropracticforward.com

I hope you’ve enjoyed my marketing talk. I literally sat down and just started typing. Yes, I’m sure I didn’t cover everything as thoroughly as you’d like but, if you’re really paying attention, I gave you some good solid cement to build a base out of. 

Key Takeaways

  • Have a USP
  • Have a marketing meeting regularly
  • Set goals
  • Be honest, ethical, loving, authentic, and don’t sell people
  • Don’t push people and scare care is crap care. 
  • If it takes you 100 visits to help someone, you could get better at what you do
  • Internal marketing means as much as external marketing which means as much as who you are and how you communicate and carry yourself. 
  • Track EVERYTHING

Store

I will hopefully have something in place to help you track metrics soon enough. Also Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Big Ideas On Marketing Evidence-Based Practices (Part One)

CF 098: Big Ideas On Marketing Evidence-Based Practices (Part One)

Today we’re going to talk about marketing. Specifically, marketing an evidence-informed chiropractic practice. How do you do it and do it right?

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research. It’s like we’re talking about research over beers. Which is NOT like talking about research in a classroom or an institution of some sort. Accessible research if you will. I could be more professional but I’m not. 

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  If you haven’t yet I have a few things you should do, like our facebook page, and go to our Store link at chiropracticforward.com and check out the goods. That’s it. Not bad right?

You have collapsed into Episode #98 which means I’ve been doing this thang of ours for a r solid 98 weeks now without missing a single one. It hasn’t always been easy to pull off either but I’m committed. I hope you are committed to listening and helping grow this thing as well. 

Now, if you missed last week’s episode, it was Part II with Dr. James Lehman and, if his episodes didn’t get you to thinking and didn’t get your wheels turning, you just don’t have the entrepreneur mindset about you and that’s OK. But, if you do, you need to make sure you don’t miss those two episodes!

make sure you don’t miss that info. Go listen now. Keep up with the rest of the class won’t you?

I usually do a personal section here but I’m just going to say that our topic today is huge. Marketing is absolutely multifaceted and they have college degrees on the topic so it’s big and we’re just going to dive right in. 

ChiroUp.com

Before we get too deep though, it’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Marketing Authority

OK….marketing evidence-based practices. Where to even start? Isn’t it fascinating that just changing the color of a girl’s shirt from black to red to blue can get more attention and can invoke different emotion in a potential buyer? Blue is healing. Red is emergency and urgent. Green is money. Black is executive. Orange is just stupid. Lol. 

Let’s start with authority. What on Earth makes me a person that is qualified to talk about marketing. Well, most people that actually know me or have watched me over my career probably don’t have that question in their minds. They’ve seen what I do day to day. It’s pretty obvious. 

For those that don’t know me or my practice, let me say these things in an attempt to show authority and NOT in an attempt to sound like a big shot or to brag. That’s not the intention here. 

I’ve been at it almost 22 years and, to an extent, I gave everyone else a 7 year head start. If you are more than just a casual listener of the show, you probably know that I was a traveling musician for the first 7-8 years of my time in practice. I didn’t market. Learning more and educating myself was off the table. I didn’t pour my heart and soul into chiropractic and building my practice. I made all I could Monday – Thursday and then hit the road with the band to go play music. Where energy goes, attention flows. 

It’s a fact. So, while I gave everyone a big head start on me, I believe I have caught up and passed a whole bunch of them. On average, as a solo practitioner, I get about 80+ new patients per month. That’s vital to practice health. If I’m not going to scare care people into a million visits, then I’d better have a steady stream of new ones. 

If you like the stat we call PVA, patient visit average, mine is about 9 or 10. Which means, on average, I see patients over the course of their lifetimes about 9 or 10 times. To put that into perspective, the more philosophy, subluxation based, vitalistic, holistic practitioners will see PVA’s of 40, 50, even 100 in some offices. 

That is probably the key difference between evidence-based and philosophy-based practice. If you get people better and back to their lives honestly and ethically and in 10 visits, and research doesn’t support the construct of correcting curves and seeing people 100 times, then why on Earth would you do that? Other than for financial means, of course?

Now, marketing….yes….I see roughly 80+ new patients per month and that turns into about 180-220 patient encounters per week. Yes it can be done because I do it. Yes you have to have a big, well-trained staff to pull it off. That’s a whole other episode. The point is, for an evidence-based practice, I think we can agree that we’re doing something right in regard to marketing in order to make it all happen. OK? OK….

Seminar

Now I have considered putting together a short weekend seminar on this so, this may just form the framework to it. If any of you have an organization or association that you’d like me to build this talk for, shoot me an email at dr.williams@chiropracticforward.com I’d love to see how we can work together on it. 

Introduction To Marketing and Patient Expectation

Let’s dive in. First thing you have to know is that, in your marketplace, trust is #1. How do we build trust? I’d argue you build trust through a consistent history and track record of making smart, factual posts on Facebook. Pumping out marketing, talks, or material that sets you up as the authority when it comes to smart, responsible, reasonable options and alternatives to what your patients see everywhere else. 

Patients are not dumb for the most part. They do not want to be sold to. Let me repeat that. They do not want to be sold to. Trust me, they smell a snake from a mile away. Outside of scaring the crap out of them, you cannot get them to see you a million times. They didn’t come to you for that, they don’t want that, and you can’t talk them into it either without making a fool of yourself and out of other chiropractors. 

So, the 50-100 PVA……throw that out the window. That’s not real world stuff if you are doing what is real, reasonable, and responsible. Most of the docs using that out-dated construct use information from one or two guys that is over a century old or they’re using questionable research done to prove a system. A system that the ‘researcher’ sells and makes money from. Bias maybe? Um….yes. Muy biased as they say in Texas. 

So, for me, that practice construct is out the window. I focus on pain, disfunction, movement, and strengthening. If I were Joe Blow off the street that hurt like hell, what would I find more appealing and more respectable? Would it be ‘let’s correct that curve through 50-100 visits or you’ll be in pain and be sick your whole life, especially in 30 years’? 

Or would it be “research shows we can usually do something about that pain you’ve been having and we can usually do it in anywhere from 3-20 visits or so depending on the patient. We’ll use strengthening, exercise, we’ll use chiropractic adjustments, we may use some massage and muscle work, we could use some balance training, and maybe acupuncture to accomplish it but we can usually either make it better or get it knocked out completely.”

Well, my money is on the last one and I’d be bold enough so suggest that your marketing should reflect this way of practicing. Yes, it’s focused on pain. And isn’t that OK? Pain affects almost everyone in the world so why on Earth would focusing on pain limit our reach and limit the pool of potential patients? Hell, I think there are more worried about getting our of pain than are interested in wellness care honestly. With that  being said though, you can treat patients for their pain but you can certainly market and treat wellness patients as well. The more lures you have in the water, the more fish you catch. No doubt. They’re not mutually exclusive. 

Dan Kennedy

One of my all time favorite marketing sayings is from Dan Kennedy. He calls it “YCDBSOYA” and that stands for ‘you can’t do business sitting on your ass.” So, if you think you’re going to sit behind your desk and post a couple things a week on your Facebook page that has like 250 likes on it and that’s going to make the difference for you…..I have some disappointing news for you. You’re wasting your time. 

I think the next steps in marketing would be to define your market and your demographic. Get very clear on who they are and how you should best communicate with them. 

For example, if you’re a sports chiro, you better be marketing athletic trainers, coaches, PTs, soccer moms, off-campus sports programs, and other sports experts in your market that may be sources of referrals. 

But, make sure you REALLY are a sports chiro. Go get your CCSP or your CSCS or a Diplomate in Chiropractic Sports. Don’t just have a passing interest in sports so you decide to call yourself a sports chiro. Otherwise, your house of cards WILL fall and it’ll fall in a way that embarrasses you and gives other chiropractors a bad name. 

Market what you are. Not what you’d like to be someday. Now that you know who you’re marketing, where do they hang out? What do they do? How do they think?  How would their lives be easier if you’re in it? what makes you the best option above and beyond anyone else in your market? When you answer these questions, you have a head start on finding these people and getting your message to them. 

Now that you’ve defined your market and where they hang out, you need to define your service. You need to be crystal clear on what it is you do and how you want to communicate that message. No confusion. No chiro speak. Simple, relatable terms. It’s called a unique selling proposition or USP for short. 

USP

A USP could be something similar to ‘We help everyone from Moms to top-notch athletes solve short term and long term pain in as few visits as possible, based on what the research shows is effective and safe, so that they can live their lives with less complication and more enjoyment.”

Bam snap pow

Could that use a little work? Well hell yeah but what do you expect for something that I just took 3 seconds to think up and type down? Come on man. Cut a brutha some slack. 

But that’s a quick example of a USP and that should be the over riding message that you are communicating to your chosen target demographic. 

The next thing that’s important is goal setting. What is the goal of your marketing? New patients? long-term treatment plans? Pain resolution? Mom’s this month? Sports people this month? 

Not just goal setting but mostly meetings with either yourself or with your marketing representative. Did we accomplish our goals? Why did we or why did we not? What could we have done better? What are we going to focus on this month? 

If you are not setting time aside to evaluate goals and you are not tracking your marketing efforts as well as your marketing results, you are driving in the fog without a map people. 

The old saying will hold true until the end of time. If you can measure it, you can improve upon it. When things are quantified and recorded, you now have a number. A number to chase and a number to improve. A more quantified goal if you will. 

Now tools that are important to disperse and build on that message…. My view of marketing may differ a touch than some other. I believe You need a three-pronged approach to marketing. Most focus on #1 and on #2 but I think there are three points to be made here. They are:

  1. Internal marketing – inside your practice
  2. External marketing – billboards, in the public
  3. Your vibe – who you are – everywhere

Let’s start with #1

Internal marketing. Did you know that people that have already done business with you before, assuming you treated them right and they’re happy, those people are the cheapest and most fulfilling to market to? 

They’re easy to reach because you already have their info. People like this are more eager to help you. They’re happy to refer but most of us just don’t ask. If they don’t know you need their referrals, they won’t think about it. It’s nothing against us. We’re just all busy and, many times, if we’re not told, we just don’t think about it or know about it. 

Most of the really really busy practices are so busy because they are actively marketing internally as much as externally. 

Some of the most effective internal marketing techniques consist of simple things like:

  • The first and most important aspect of internal marketing is patient experience. What does your office look like when they come in and when they walk around the place? How do you treat patients? What are they thinking when you’re explaining things to them? What are they thinking when they’re walking back to their cars? I’ve had patients that I could have been meaner to just to give them that pop that we all love but, would they be walking to their cars feeling like they just got crapkicked in the alleyway? Shouldn’t a visit be something a patient looks forward to rather than a visit they are happy they survived? Did you greet them with a smile and a handshake? Did your front desk staff greet them by their first name? Was your rehab staff knowledgeable and understanding of their specific challenges? Were you a pushy jerk about your recommendations or were you firm with recommendations but understanding of finances, travel concerns, and things like that? The real world does exist ya know. All of these things go into a patient’s experience and you better believe they make up their mind VERY quickly whether they like you and your place or not and, if not, you start behind the 8 ball and had better put on your charming pants if you want to turn that tide around. 
  • An email list – cheap and easy. And yes…..still effective. Just ask Kevin Christie with the Modern Chiropractic Marketing podcast. He just did an episode on it. 
  • A testimonial book in the lobby – Think that’s an out-dated idea? Go read Influence by Cialdini and check out the section on group think or peer influence. 
  • What about office flyers for some new information you just discovered?
  • Brochures? Well, you know I’ve created evidence-based brochures for my office and for yours if you want to purchase some. So you know I’m all about brochures. 
  • Music
  • Smell
  • In-house events – talks, patient education
  • What about encouraging online reviews and Facebook check-ins? Patients don’t think of these things so you can’t be shy about telling them what you need from them. 
  • How about thank you letters to your patients when appropriate. What if one leaves you a Google Review? Wouldn’t it set you apart if you sent them a handwritten note? Of course it would and I promise a lot of you have plenty of time to do it. 

These are just a few of the things you can do with internal marketing but there are a lot more things. We could dive into specific tactics on each of these but, again, that could be its own seminar down the road and doesn’t necessarily fit into the podcast format. 

Store

I will hopefully have something in place to help you track metrics soon enough. Also Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

w/ Dr. James Lehman (Pt. 2) – National Scope, Chronic vs. High Impact Chronic Pain, Coordinated Care/Medicaid, DACO to DIANM

CF 097: w/ Dr. James Lehman (Pt. 2) – National Scope, Chronic Pain vs. High Impact Chronic Pain , Coordinated Care/Medicaid, DACO to DIANM

Today we’re going to be talking with Dr. James Lehman. This is Part Two of the interview. If you are just now joining us and did not get to hear Part One, make sure you do so. When Dr. Lehman speaks, you don’t want to miss a word. We’re going to cover topics like implementing a national scope of practice, chronic pain vs. high impact chronic pain, and topics like should a chiropractor own rural healthcare clinics and chiropractors working in coordinated care and medicaid integrated settings. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research. It’s like we’re talking about research over beers. Which is NOT like talking about research in a classroom or an institution of some sort. Accessible research if you will. I could be more professional but I’m not. 

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  If you haven’t yet I have a few things you should do, like our facebook page, join our private facebook group and interact, and then go review our podcast on iTunes. We have a youtube channel and twitter too but those are the main things. 

You have collapsed into Episode #97

I always do a little update on my personal practice and life in the trenches. In the real world if you will. Instead of that, I want to say that last week, I was scrolling through my Facebook page and Dr. Lehman and I are friends on Facebook. 

I noticed a picture he posted laying in a hospital bed watching his beloved St. Louis Cardinals play on TV. 

It turns out that just last week, Dr. Lehman suffered a myocardial infarction. I normally wouldn’t mention this but, I figure if it’s posted on Facebook by the man himself, he’s OK with it. 

Anyway, the main reason I mention it is to ask you all to say a prayer for Dr. Lehman if you are the praying kind, which I most certainly am. If you are not, then please send some positive vibes, energy, or thoughts his way through the ether. Whatever it is, let’s give it to him because Dr. Lehman certainly has given us chiropractors a lot. 

Dr. Lehman, from what I can tell through Facebook and text, Dr. Lehman is doing well and on the mend. From me to Dr. Lehman, you have my prayers and thoughts and please get well my friend. 

Now, before we dive into this interview that we did a couple of weeks ago with Dr. Lehman, we have to pay the bills. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Introduction of Dr. James Lehman

Now, let’s go ahead and get on with the reason we’re all here. Before we speak with Dr. James Lehman, I want to go through a little background information on him for you so you are well aware of who he is and where he is coming from. 

Dr. James Lehman is an Associate Professor of Clinical Sciences at the University of Bridgeport/College of Chiropractic and Director of Health Sciences Postgraduate Education (HSPED). 

Dr. James Lehman completed his MBA at the University of New Mexico and a doctorate in chiropractic medicine at the Logan College of Chiropractic in St. Louis, Missouri.

Dr. James Lehman is a board-certified, chiropractic orthopedist. He teaches orthopedic and neurological examination and differential diagnosis of neuromusculoskeletal conditions. In addition, he provides clinical rotations for fourth-year chiropractic students and chiropractic residents in the community health center and a sports medicine rotation in the training facility of the local professional baseball team. 

As Director, Dr. James Lehman developed the three-year, full-time resident training program in chiropractic orthopedics and neuromusculoskeletal medicine. The program offers training within primary care facilities of a Federally Qualified Health Center and Patient-Centered Medical Home. While practicing in New Mexico, he mentored fourth-year, UNM medical students. We could go on and on. 

In your article, you include a section titled “Modernization of Medicare and Medicaid Coverage” which will lead us nicely into one of the main topics of our episode today. In this section you mention how Article 2706 of the Affordable Care Act is supposed to prevent discrimination against chiropractors but, for whatever reason, it hasn’t. I’ve been hollering about this through my position with the Texas Chiropractic Association for years. You talk about this a little in the article but…..why do you think nobody is forcing 2706 down people’s throats and what would it take to take a stand against insurance companies with 2706 as the basis?

OK, coordinated care and Medicaid: a topic you are very knowledgeable. In fact, we have discussed the integration of chiropractors into the FQHC’s around the nation. FQHC, for those that don’t know means Federally Qualified Health Centers. One of our former podcast guests is Dr. Kris Anderson from North Dakota who just happens to be the first in his state to work in an FQHC. 

Can you tell us more about coordinated care and Medicaid and the initiative to get chiropractic care integrated more into that setting?

Alright, last on our list of things we must talk about is the topic you have done a ton of work on. I remember one of the DACO classes I had with you as the instructor. In the class, I recall you mentioning that we as a profession do not diagnose chronic pain syndrome nearly enough. It’s a big problem, and one I’ve become more and more engaged in through the DACO program, so let’s dive into the topic of Chronic Pain Syndrome vs. High Impact Chronic Pain. 

I’m just going to turn it over to you on this. The way I want to start is for you to just tell us what you think we as a profession need to know and we can take it from there.  Chronic pain is a huge topic that really can be it’s own year long topic of chiropractic forward podcasts. Chronic pain affects a huge number of patients.

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

w/ Dr. James Lehman (Pt. 1) – National Scope, Chronic vs. High Impact Chronic, Coordinated Care/Medicaid, DACO to DIANM

Today we’re going to be talking with Dr. James Lehman. Yes, THE Dr. James Lehman and we are fortunate to have him with us. The experience and the common sense Dr. Lehman brings to the table is immense and I can’t wait to dive into it today. We’re going to talk about national scope

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #96

Now if you missed last week’s episode on chiropractic and opioids, on anti-inflammatory diets, and on screen time for kiddos…. make sure you don’t miss that info. Go back and listen. I think there were some good information there within so make sure you’re up to date and not falling behind the rest. 

Advertisement

We can’t get started without mentioning the sponsor of the show, 

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Introduction of Dr. James Lehman

Now, let’s go ahead and get on with the reason we’re all here. Before we speak with Dr. James Lehman, I want to go through a little background information on him for you so you are well aware of who he is and where he is coming from. 

Dr. James Lehman is an Associate Professor of Clinical Sciences at the University of Bridgeport/College of Chiropractic and Director of Health Sciences Postgraduate Education (HSPED). 

Dr. James Lehman completed his MBA at the University of New Mexico and a doctorate in chiropractic medicine at the Logan College of Chiropractic in St. Louis, Missouri.

Dr. James Lehman is a board-certified, chiropractic orthopedist. He teaches orthopedic and neurological examination and differential diagnosis of neuromusculoskeletal conditions. In addition, he provides clinical rotations for fourth-year chiropractic students and chiropractic residents in the community health center and a sports medicine rotation in the training facility of the local professional baseball team. 

As Director, Dr. James Lehman developed the three-year, full-time resident training program in chiropractic orthopedics and neuromusculoskeletal medicine. The program offers training within primary care facilities of a Federally Qualified Health Center and Patient-Centered Medical Home. While practicing in New Mexico, he mentored fourth-year, UNM medical students. We could go on and on. 

Welcome to the show Dr. James Lehman, it’s an honor to have you on the Chiropractic Forward Podcast this week. 

Let’s start with the topic that immediately impacts me. I have been telling our listeners for a year or more that I’m going through the DACO program. DACO stands for the Diplomate of the Academy of Chiropractic Orthopedists. Very recently, as in just a few weeks ago, I received notice that the designation has changed to DIANM which stands for the Diplomate of the International Academy of Neuromusculoskeletal Medicine. 

What was the impetus for the change and what all went in to making the decision, deciding on the name, and then moving forward with the decision?

You wrote an article recently that Dynamic Chiropractic published in their September 2019 issue. The title of it was “What Is Chiropractic? We Need A National Practice Act.” We are in a profession that seems to me to bristle at the idea of standardization. How has this article been recieved or is it still a bit too early to tell?

In the article, you say, “Limited Medicare and Medicaid scopes of reimbursement and individual state scope-of-practice restrictions reduce access to chiropractic wervices for patients in pain.” Can you explain how you think limited scopes reduce access and how a broader scope can help us? And how broad of a scope do you advocate for?

I would assume a national scope would be something the ACA would be in the driver’s seat for, which is something you mention in the article as well. Is this something the ACA is looking at? Other than resistance within our own profession, what hurdles would you see in the way of a national scope?

You say it’s not impossible to accomplish and offer 6 essential charactieristics which include:

  1. Chiropractic Physician designation. 
  2. The scope being determined by Doctoral and Post-Doctoral education, trainng and experience 
  3. Full management, referral and prescription authority commensurate with contemporary chiropractic education for patient examination, differential diagnosis, working diagnosis, and health assessment
  4. Full evaulation and management, referral and prescription authority commensurate with contemporary chiropractic education for the care and treatment of neuromusculskeletal and other health conditions or issues. 
  5. Full authority for the delivery of information, advice, recommendations and counseling regarding general health matters, wellness, and health optimization. 
  6. Full authority and adaptable requirements fo the management and training of health care teams and the participation in collaborative or integrative health care groups. 

When I read through that list, does anything jump out at you as being particularly radical or provocative to some chiropractors?

In your article, you include a section titled “Modernization of Medicare and Medicaid Coverage” which will lead us nicely into one of the main topics of our episode today. In this section you mention how Article 2706 of the Affordable Care Act is supposed to prevent discrimination against chiropractors but, for whatever reason, it hasn’t. I’ve been hollering about this through my position with the Texas Chiropractic Association for years. You talk about this a little in the article but…..why do you think nobody is forcing 2706 down people’s throats and what would it take to take a stand against insurance companies with 2706 as the basis?

OK, coordinated care and Medicaid: a topic you are very knowledgeable. In fact, we have discussed the integration of chiropractors into the FQHC’s around the nation. FQHC, for those that don’t know means Federally Qualified Health Centers. One of our former podcast guests is Dr. Kris Anderson from North Dakota who just happens to be the first in his state to work in an FQHC. 

Can you tell us more about coordinated care and Medicaid and the initiative to get chiropractic care integrated more into that setting?

Alright, last on our list of things we must talk about is the topic you have done a ton of work on. I remember one of the DACO classes I had with you as the instructor. In the class, I recall you mentioning that we as a profession do not diagnose chronic pain syndrome nearly enough. It’s a big problem, and one I’ve become more and more engaged in through the DACO program, so let’s dive into the topic of Chronic Pain Syndrome vs. High Impact Chronic Pain. 

I’m just going to turn it over to you on this. The way I want to start is for you to just tell us what you think we as a profession need to know and we can take it from there. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

An Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies

CF 095: An Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies

Today we’re going to talk about the relationship between chiropractic and opioids, we’ll talk about anti-inflammatory diet ideas, and a little ditty about screen time and dumb butts. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have slinkied into Episode #95

Now i you missed last week’s episode on my trip to St. Louis for the Forward ’19 seminar, decompression research, and young baseball pitchers, make sure you don’t miss that info. I’d like to think that all of our episodes are such that you walk away better than before you hit the play button. That’s my goal anyway. 

I usually am not at a lack of words when it comes to the personal side of what’s been going on lately. I have to say though, not much is going on around the office these days. It’s slower this week but not much slower. I’m just trying to get everything done. 

For a chiropractor, what exactly does that mean? Well, I’ve created two or three new graphics for social media posts and loaded them into the hopper for realease later this week. 

I proofread two blog articles my writer sent to me for two websites. I’ve gotten those posted after making corrections. 

I’ll be proofreading and scheduling my patient weekly email as soon as my staff member finishes it. 

I met with our marketing staff member to go over what marketing we are doing and want to do before she headed out onto the town this morning. 

It’s 1 pm and I’ve already seen two new patients and my fair share of established patients. 

I’ve dealt with a roof leak, a staff member that ended up with a migraine that required us to take her to be treated. Taht’sAn Inverse Relationship With Chiropractic & Opioids, Anti-Inflammatory Diets, & Screen Time Might Make Dummies a whole different crazy story. 

I get off early on Tuesdays to go home and study for the DACO part II test so I’ve got that going for me today. 

So…..my point is, even when we are a bit slower, we don’t slow down. Hell, that’s when we are actually able to ramp it up. 

If you are not doing external AND internal marketing consistently, you are behind your colleagues. Wake up. Dan Kennedy has a saying I follow. It’s YCDBSOYA. That stands for you can’t do business sitting on your ass. 

I hate a liar but I love a hustler. I mean that in the ethical manner. Not hustling someone as in lying and cheating for financial gain. I mean hustling as in constantly busy getting the word out about how amazing your office is. The more you hustle in that manner, the more business you see. It’s magical like that. 

You want a slow practice, sit on your butt in your office playing games on the computer. That’s exactly how you can accomplish that. 

You would have a hard time coming up with any form of marketing that I either have not tried or am not currently doing. I’m probably doing some marketing you’ve never even thought of. 

So, here’s your pro tip. When things get a little slower in the fall when the kids get back to school, that’s when you have the time it takes to really market effectively. So do it. 

I may end up doing a marketing epsiode. I should totally do that. If I forget in the next several weeks, y’all send me an email or two and I’ll do it. 

The first paper we’ll breeze across is a brand new one about the association between chiropractic use and opioid use. 

First, It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

OK, back to the research. As I mentioned, this first paper is called “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis” Now remember, systematic reviews and meta-analyses are at the top of the research pyramid. It was authored by Corcoran, et. al(K 2019). and published in Pain Medicine on September 27, 2019…whoa….that’s like last week. Scorching hot off the presses, watch out, don’t burn your finger prints off….

Why They Did It

They wanted to investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt. 

How They Did It

  • The study was as systematic review and meta-analysis
  • The databases mined for information were Medline, pubmed, embase, amed, cinahl, and web of science.
  • The search was through April 18 of 2018
  • They identified 874 articels 
  • Those were whittled down to 6 articles
  • 5 studies focused on back pain while one focused on neck pain

What They Found

In a random-effects analysis, chiropractic users had a 64% lower odds of receiving an opioid prescription than nonusers. 

Bam pop snap!

Come on MDs, DOs, and all of your flock. It’s time to start turning the back and neck pain folks over to the profession that continually proves, through research I might add, that we can get them better safely, effectively, non-invasively, non-pharmaceutically, with better outcomes assessments, and better patient satisfaction than any other healthcare practitioner in the world. 

If it’s really all about the patient, and you all REALLY mean that, then start referring these patients to evidence-informed chiropractors. Like yesterday. 

If you want to try PT first, OK. Do that. Then, when PT isn’t as effective as the patient was hoping it to be, send them to an evidence-informed chiropractor. 

That’s if it really is all about the patient. 

Item #2

Item 2 is from Harvard Health Publishing from Harvard Medical School and is called “Foods that fight inflammation.” (2014)They published it in June of 2014. It’s an older study. Old Man River, that old man river….

They start by asking what does an anti-inflammatory diet do? Your body creates inflammation in response to anything it recognizes as foreign. Things like microbes, plant pollens, and chemicals. That’s great obviously but sometimes inflammation persists right? The article goes on to state that many major diseases like cancer, heart disease, diabetes, arthritis, depression, and even Alzheimer’s have been linked to long-standing, chronic inflammation. 

Dr. Frank Hu, professor of nutrition and epidemiology in the Dept. of Nutrition at Harvard School of Public Health says, “Many experiemental studies have shown that components of foods or beverages may have anti-inflammatory effects.”

Wouldn’t it be nice if we can reduce our risk of these deadly serious diseases just by eating more of the right stuff?

First they list foods they have identified as CAUSING inflammation so that you can stay away from them. Take a deep breath, this is going to hurt a little bit. OK, it’s going to hurt a lot. 

  • Refined carbohydrates – yes, white breads, pastries, noodles, yep I know
  • French Fries – no real loss there. 
  • Soda and other sugar-sweetened drinks. Honestly, if you’re still drinking soda as an adult, you’re behind the curve. 
  • Red Meat – like burgers, steaks, and processed meat like hot dogs and sausage. Although I saw a report this morning that red meat isn’t as bad as they thought. 
  • Margarine – shortening, and lard

The anti-inflammatory foods they highlight are:

  • Tomatoes
  • Olive oil
  • Green leafy vegetables – spinach, kale, and collards
  • Nuts – almonds and walnuts
  • Fatty Fish – like salmon, mackerel, tune, and sardines
  • Fruits – strawberries, blueberries, cherries, and oranges. 

That would be a brief overview of the article but I’d encourage you all to go read the whole thing. Very interesting stuff. I just wanted to give you the short version of it. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Item #3

On to our last item here. It doesn’t have anything to do with musculoskeletal issues but might be a little something you could print up and put in your lobby for your patients to look over and think – Dayum. 

It’s called “Association Between Screen Media Use and Academic Performance Among Children and Adolescents A Systematic Review and Meta-analysis” by Adelantado-Renau, et al and published in JAMA Pediatrics on September 23, 2019(Adelantado-Renau M 2019). 

Why They Did It

They were trying to find out if there was any association between screen-based activites and academic performance areas among children and adolescents. 

How They did It

  • They took 58 cross-sectional studies, television viewing and video game playing were inversely associated with academic performance. 
  • In addition, it was more profound in adolescents than it was for the smaller children. 

Wrap It Up

  • Television and video games were the worst of the screen time culprits. 
  • This study suggests that education and public health professionals should consider screen media use supervision and reduction as strategies to improve the academic success of children and adolescents.
Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • (2014). “Foods that fight inflammation.” Harvard Health Publishing https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.
  • Adelantado-Renau M, M.-U. D., Cavero-Redondo, (2019). “Association Between Screen Media Use and Academic Performance Among Children and Adolescents A Systematic Review and Meta-analysis.” JAMA Pediatr.
  • K, C. (2019). “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis.” Pain Med.

Forward ’19, Decompression Research, Curveball or Pitch Count?

CF 094: Forward ’19, Decompression Research, Curveball or Pitch Count?

Today we’re going to talk about my Forward ’19 experience, we’ll talk about decompression research, and we’ll cover some new research on whether it’s the curveball or the pitch count that injures young players on the baseball diamond. 

But first, here’s that sweet sweet bumper music 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have rattled and rolled into Episode #94

Now if you missed last week’s episode on the bigger the disc the better and what early improvement in treatment tells you, make sure you don’t miss that info. Every episode offers some good take-aways so make sure you’re up to date and not falling behind the rest. 

I like to look at this podcast as an ongoing, fun way of learning and making each other just a little bit better every week so don’t just hop in for one episode. Stack them up one after another and, before you know it, you’re going to start retaining the info and you’re going to start recalling something we talked about down the road when you’re interacting with a patient and they ask you a question. 

You’ll see. Even though I’m the host, it happens to me. Someone will ask me a question and I’ll remember an episode we did on that topic and BOOM!! Pow!! There it is, the answer comes to me. Pretty cool. 

Forward ’19 – For you newbies here you’re probably wondering what the hell Forward ’19 is. A quick rundown is that it is a yearly seminar/conference that was born from an online Facebook group called the Forward Thinking Chiropractic Alliance aka FTCA. They have a website as well. 

The group is very much evidence-based or evidence-informed. Whichever is your preferred verbiage. The group has about 7800 or so doctors in it and they are interacting on a daily basis mostly to try and make each other better. Overall, it’s a good group. I’ve heard people griping because they see griping here and there in the group but, in general, it’s a very positive, very smart, and very helpful group. I encourage you joining it if you’re a doctor or student. 

Anyway, Forward 19 – What an event. The group puts on several events through the year but this is the key event put on by the FTCA every year. This is year #2. It was in St Louis at the campus of Logan Chiropractic College.

First thing is, holy smokes what a campus man. I bet they pay a fortune just to mow the grass. Just wow. The landscaping, the tower in the middle, and Purcer Center where it was all held. Just gorgeous. Having gone to Parker, that was the Chiro campus I’d been on and don’t get me wrong, Parker is impressive. I’d say Logan most definitely is as well. Kudos.

Speakers:

Gray Cook SFMA – SFMA stands for Selective Functional Movement Assessment – I have to admit that this was my first exposure to Gray Cook but it won’t be my last. I had heard of SFMA but was not all that familiar with it. I really enjoyed his talk and some of the concepts he puts forward. I can’t wait until I get through with my Diplomate program – hopefully in November – so that I can dive into Gray Cook’s stuff and just keep building on the knowledge pile. 

Greg Kawchuk – He is the Research Chair for the World Federation of Chiropractic. 

So, outside of the FTCA, I had little knowledge of Greg Kawchuk. But, Greg gave a speech at the World Federation of Chiropractic last year in Berlin that got some people a little fussy and some people elated. It definitely got the attention of chiropractors around the world to say the least. He gave the same speech last weekend in St. Louis and it had people on the edge of their seats. 

Backing up a bit, Greg is a dynamic speaker. One of the more humorous and engaging speakers I’ve seen in maybe forever. He’s immediately like-able and that make for a good speech from the top. The talk was all about putting the ACT back in Chiropractic. A play on the way the philosophy guys use the TOR and the TIC garbage. You know….the principled vs. un-principled hoohah. 

I happened to think that evidence-informed docs are the principled ones and if you need more info on why I think that, just go back about 3-4 episodes and listen to my podcast on the topic of Closing Patients. A principled, ethical person doesn’t carry themselves in that manner and the philosophy folks are much more likely to be out there closing patients than offering responsible treatment plans that are based on commonly accepted guidelines. In my experience at least. It’s always made me a bit hot under the collar when someone asks whether another chiropractor is principled or not. 

Makes me want to principle them in the forehead…..with a mighty slap. 

Anyway, putting the ACT back in chiropractic: he asked what are we doing right now? What are you doing right now to move the needle forward? To bring chiropractic into this current century we are in? He suggests we do a lot of sciencing and consume at least 1 science per day and I agree with him. 

Hell, here at the Chiropractic Forward podcast, we distribute about 3-4 sciences per episode so we almost got you covered for the whole week if you’re a regular listener. 

I think the part of his presentation that some took exception to was the part where he feels the evidence group may, at some point, consider a divorce from the philosophy geared group. He said it may not be an official divorce but could be very much a divorce in the way we act, carry ourselves, communicate with our patients, and things of that nature. 

He says, at the end of the day, it could be something similar to….. we went out for a pack of smokes and…..just never came back. 

Now, as you sit in your car or truck or your office hearing me say that, you can take that all in as you will. I’m going to tell you that, as a doctor that considers himself very much on the research end of things and very little on the philosophy end of it, and as a doctor that does everything he can to be ethical, honest, and all that…..it is so hard to sit and hear patients talking to me about being forced to sign of on a contract for thousands of dollars for a year long schedule for umpteen visits based on a curve correction that research suggests isn’t that big of a deal. 

It’s hard to hear about the knuckleheads in Oakland claiming they can reverse degenerative spurring by seeing someone 3x/per day for 3 weeks. It’s hard to watch Mr. man bun top not from the coffee house talking about fixing kids with no research to back his claims. 

It’s hard to hear about chiropractors scaring the crap out of patients with x-rays and convincing them that they are somehow damaged and in a dire circumstance unless they undergo 60 visits and another 3 sets of x-rays….

These are just a few of the stories. There are so so so many of them and at some point, I just don’t want to be associated with that anymore. At all. If that’s not understandable and that makes no sense to you and that makes you mad at me, well….I’d say I’m sorry but I’m just….I’m just not. 

Even though I don’t smoke in the physical meaning of the word, I think I went out for a pack of smokes and never came back about 15 years ago. 

Christine Goertz – If you are a regular listener of our podcast, you know Dr. Goertz has been on our show before and you know I’m a nerdy fan of her and her contribution to our profession. Any chance to listen to Dr. Goertz is a chance that should be seized upon. She’s a giant in our industry. 

Annie O’Connor – World Of Hurt – OK, I’m admitting something again. I wasn’t familiar with Annie O’Connor. Annie is fun and vivacious and really another very dynamic speaker but she is full of knowledge nuggets. The kind that you can really put to use. She spoke on how words can harm so how key communication can be for some patients. She talked about yellow flags and she talked about classifying pain patients so that we can help them with more efficiency. You can believe that World Of Hurt is on my reading list after Forward ’19. 

Greg Friedman – documentation  documentation. Greg is Greg. Smart, laid back, fun, and just likable immediately. It was great to get to meet him in person and share a good discussion prior to his documentation class. He’s full of excellent information and not just on documentation so, if you get a chance and you need the hours, search out a class. He’s flying all over the nation every weekend. 

Mike Massey – he shared teaching duties with Greg on the documentation class. He told me he’s a listener of our podcast and he’s an active member of the FTCA so I’ve been a fan of his for a while now. It’s always a cool deal to put the online world into a 3D context and it was sure nice to meet Dr. Massey. Hopefully next time I’ll get to sit and speak a while with him. I think our personalities probably match up pretty closely from what I can tell. 

Some of the others I got to see and speak with are Brandon Steele

Kevin Christie

Jon Morrison

Robert Jones, President Of The ACA was there the whole weekend sitting in on the classes himself. What a super guy.

Budweiser tour

Meeting people

Kris Anderson

Chris Howson

Rob Pape

Bobby Maybee

Bobby Mozafari

Mike Massey

Greg Friedman

Dale Thompson

Kevin Christie

Anne Maurer

My biggest regret is that I didn’t get any real one on one time with very many of these folks but That’s OK. All’s well.

If I didn’t come up and speak with you but you saw me there, please don’t take it personally, believe it or not, I have a bit of a shy streak. Once I’ve had a conversation with someone, it’s all good. But, if I don’t know you yet….ugh….I have a podcast. I was a traveling musicians for 7 years. Why would a guy like me be shy at all? Yeah I don’t know. I’m in control in those other situations. Maybe it’s when I’m not in control or I’m a newbie….who knows?

Anyway, if you ever see me at an event, regardless of the event, please come say hi. I’d love to meet you.

We are about to get to our two articles. One is new research on traction/decompression information for low back discs and the other is on young baseball pitchers and how the curveball isn’t the culprit. 

First though, we have backed off and rather than having two show sponsors, we have one and it’s a company you all know how much I love. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

The first article today is called “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis” by Cheng, et. al(Cheng Y 2019). and published in Clinical Rehabilitation in August 28, 2019. Smoking hot folks. Stand back. Watch your eyebrows!

First thing, recognize in the title there, this is a systematic review and meta-analysis. That’s at the top of the research pyramid. 

Why They Did It

To evaluate the effectiveness of traction in improving low back pain, functional outcome, and disk morphology in patients with herniated intervertebral disks.

How They Did It

  • They did a big time search PubMed, Scopus, Embase, and the Cochrane Library and they did this search from the earliest record all the way up to July 2019. 
  • They included RCTs that involved adult patients with low back pain associated with herniated disc confirmed by MRI or CT
  • RCTs that compared lumbar traction to sham or no traction
  • RCTs that provided quantitative measurements of pain and function before and after intervention. 
  • The initial search came up with 3,015 records which they whittled down to 7 involving 403 patients.

What They Found

Compared to the control group, the patients that had traction showed significantly greater improvements in pain and function in the short term

The differences were not significant enough to support the long-term effects on pain and function, nor the effects on herniated disc size. 

Wrap It Up

Compared with sham or no traction, lumbar traction exhibited significantly more pain reduction and functional improvements in the short term, but not in the long term. There is insufficient evidence to support the effect of lumbar traction on herniated disk size reduction.

Here’s where I’m at on that. I use decompression. I just need to know more about this study. Did they do simple traction? Did they do a cycling pull phase from a pull to a rest phase? How much weight was the pull? How long did they do each treatment and how many treatments did they do?

There’s also patient preference and clinical experience factoring into using decompression.

Reading down through this sucker, it’s just too varied to make any assumptions. The intervention programs differed among the studies from 10 sessions to 60. The treatment protocols varied from 2 weeks to 10 weeks. Some of the studies included had no information on the weight of the pull while a handful went up to 50% of the body weight. Some of the studies used continued traction while others had intermittent traction. Some even used self-suspended, inversion table type traction. 

Are you getting a whiff of what I’m dumping here? 

Out of the 7 studies they included, only 2 measure the disc height and one measured the disc ratio. 

Overall, when you read through the paper, these authors freely admit, this is a tough one but they wanted to start somewhere. They suggest several ways to go forward and say that there are a couple of studies out there that show a trend toward long-term decompression reducing the size of a disc herniation but no longer papers have been done to investigate it. 

It’s anecdotal as hell but I’m going to go ahead and anecdote the hell of you. Right to your face. Or….to your ears as it may be. I’ve been doing decompression for about 7 years and I’ve yet to see anything as effective. Including exercises, McKenzie, all of it. In some cases, it has absolutely amazed me. But, like I said, that is anecdotal but I hope some of these really super smart researchers out there in the profession start to dial down into it and figure it out. Mostly because I know it works. I’ve just seen it too many times. 

Item #2

This last item is called “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers” by Oliver et. al(Oliver G 2019). and was published in Journal of Pediatric Orthopedics in September of 2019. Wait, it’s September of 2019 right now right? Steaming pile of fresh knowledge nuggets, big platter, sizzling. 

Why They Did It

The purpose of this study was to examine differences in pelvis, torso, and upper extremity pitching mechanics and muscle activations between the fastball, change-up, and curveball pitches in youth baseball pitchers following a simulated game.

How They did It

  • 14 youth baseball pitchers with no history of injury were included
  • All major muscles and mechanics were measured
  • The pitchers were instructed to throw with max effort during a simulated game that provided random game situations
  • They were limited to 85 pitches
  • Data from 3 fastballs, curveballs, and change-ups thrown in the first and last innings were selected for analysis

Wrap it up

The principle findings of this study revealed that pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches. These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown. This is supported by the pitcher’s ability to maintain a proper arm slot during all 3 pitches and indicates that they are obtaining the spin on the ball from their grip and not by altering upper extremity mechanics.

So….it is not the curveball it seems but, rather, it’s the pitch count in young pitchers, it’s treating them like professionals when they’re still developing, it’s that they tend to play only one sport aka specialize, and that they need to be treated like developing children and human beings rather than the Dad’s lost glory or a future paycheck for the whole family. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Cheng Y, H. C., Lin Y, (2019). “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis.” Clin Rehabil.
  • Oliver G, P. H., Henning L, (2019). “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers.” J Pediatr Orthop 39(8): 387-393.

Big Discs Can Disappear, Chronic Pain & Chiropractic Success, The First Week Says A Lot About The Fourth

CF 093: Big Discs Can Disappear, Chronic Pain & Chiropractic Success, The First Week Says A Lot About The Fourth

Today we’re going to talk about the resorption of lumbar disc herniations (Hint: lots of the big ones don’t need surgery at all!), we’ll talk about chronic low back pain and the success of chiropractic, and we’ll talk about how, after the first visit, you might can tell how well your patient is going to do in the long-term. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have tippy-toed quietly into Episode #93 and I do appreciate your keeping it down for me. I’ve been a little tired here lately. 

Now if you missed last week’s episode on the history of chiropractic, you need to  make sure you don’t miss that. It was really fun episode to put together. Especially for a history junkie/nerd like myself. I believe here recently September 18 to be exact, it was the anniversary of DD Palmer inventing chiropractic. We talked a little about whether he invented it or borrowed it or whatever. We talked about that in that episode. Pretty interesting. 

Other more recent episodes you need to be aware of would be the Closing Patients episode. Go learn more about that garbage please. It’s important. 

Also waaaayyyy back (old man river) episode 13 was on Debunking the Myth that chiropractors cause strokes. Enough of that trash. It’s not true and you need to know why, how, when, and how to tell others that it’s bunk info. 

For you older chiros, bunk means bad info. 

One other I think new listeners should go back and find would be about 6-8 weeks ago, episode 90 I believe. It was our mini-class basically on Decoding Chronic Pain. What priceless info. It’s like you went to a seminar and got all of the information for free straight from Dr. Anthony Nicholson. He’s crazy smart. 

Or the way they say it in Boston….he’s wicked smaht. 

I’m currently getting ready to head to St. Louis for the Forward ’19 seminar. It’s all a part of the FTCA Facebook Group and website group. By the time this episode airs, it will already have come and gone but you know I’ll tell you all about it next week. 

I’m looking forward to meeting a lot of the folks from the group that I see interacting with each other all of the time. I’m looking forward to networking and bouncing ideas off each other as well. 

There may be some cocktails in the mix as well so, you know, there’s that too. 

I’m still going through the DACO studying. I have part II coming up on November 9th. Wouldn’t it be nice if you could just get a Diplomate because you took all 300 hours and passed all of the tests and quizzes along the way? 

If you ask the older guys that did the DABCO several years ago, they’ll tell you I’m whining and I need to just shut up because they had it way worse. And you know what? They’d be right. They DID have it way worse. Still, I have a very busy practice, I have a 47 year old brain that doesn’t retain the amount it once did, and I’ve been studying for the part I and the Part II during my free time since probably May. And you know what? I’m tired of studying. Lol. 

I’m ready for it to be over and done with. Geez. Stress, studying, sustained over a long period of time….there’s absolutely a reason that we don’t have a large number of doctors getting the specialization diplomates. It’s carried out over too long of a period. But that’s just fussing. The hours of actual class have been amazing learning. I have stood under the niagara falls of knowledge nuggets people. I swear. 

I’m all in. I’m ten times better than I ever thought I was and for some things, I thought I was pretty put together. I spent a lot of years putting together and taking apart different aspects of a low back exam. I was already coming into it very much up on lumbar differential diagnosis. I’m still better than I was. 

I knew jack squat in regard to the shoulder compared to what I now know. Same goes for the hip, knee, and on down the line. 

If you need some help getting some info and starting down the track of that Ortho Diplomate, let me know. Send me and email at dr.williams@chiropracticforward.com and I’ll be glad to do what I can to get you going. 

We’ll get to the paper on whether discs can resorb in just a sec but first, It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

https://www.ncbi.nlm.nih.gov/pubmed/28072796/

Let’s start the research part of the show with one called “Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis” by M Zhong, JT Liu, H Jiang, et. al(Zhong M 2017). and published in Pain Physician in 2017. Not new enough to play the Hot stuff sound byte and not old enough to sing old man river to you. Just somewhere in between so we’ll just play some random sound byte for you here. Lol. 

You know me…..heavy on the entertainment part here. 

Anyway, here’s Why They Did It

the wanted to analyze the incidence of spontaneous resorption after conservative treatment of low back discs using CT and MRI imaging. 

How They Did It

This paper was a meta-analysis, meaning they took information from a whole bunch of previously done papers and compiled the best information that could be extracted from them to come up with their findings. 

They used a search of the literature from 1990 all the way through 2015. That’s 15 years for those of you that didn’t take mathematics in school. They used very common databases called PubMed, Embase, and the Cochrane Library to find these papers for inclusion. 

What They Found

The overall incidence of spontaneous resorption was 66.66%. Oddly enough they say that the incidence in the UK was a whopping 82% while in Japan it was only 62%. What the hell gives there? I’m not worldly enough to know the significant differences in lifestyles of those two countries to figure out why that would be. Maybe one of you world travelers can offer us some suggestions. Email me. I’d love to hear it. 

Wrap It Up

Wrapping up this paper the authors conclude, “The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH.”

Now what do I personally know about this? I know that was your next question that was just on the tip of your tongue so I’m going to answer it for you. 

We know, and this comes through the DACO teaching, that a couple of things can give you  clue to whether or not a herniation will eat itself. That sounds like will ferrell doing harry carry on saturday night live. If you were a hot dog….would you eat yourself? I know I would. Lol. 

Anyway….Lord help me. Anyway, a couple of things:

The make up of the herniation

The extent of migration

If there has been endplate damage / modic changes, with that, you might see some trash or garbage inside the herniation on MRI. It may look speckled. When it looks speckled, it is more stubborn and less likely to go away on its own.

On the other hand, if it’s made up of more nuclear material, it’s smoother in appearance and more likely to be able to be reabsorbed. 

On top of that, when a herniation has more than a 4mm migration, it’s further out there and the body is more likely to recognize it as an issue and more likely to do something about it by breaking it down and getting rid of it. 

This is EXCELLENT news for people with these big discs that you may have at one time thought were most certainly surgical. I used to think they were. I think a lot of surgeons probably still think they are. But not all of them are. That’s a researched fact at this point. 

Item #2

https://www.ncbi.nlm.nih.gov/pubmed/12214186/

This one is called “Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain?” by I Axen, A Rosenbaum, and T Wren, et. al. and was published in Journal of Manipulative Physiological Therapeutics in 2002(Axen I 2002). Old Man River….

Why They Did It

To investigate whether 3 distinct patterns of reactions to chiropractic care predict early favorable treatment outcomes in patients suffering persistent low back pain. 

What They Found

OF the 115 patients int eh most favorable prognostic group, 84% reported to be definitely improved but the 4th visit vs. 63% of the 384 in the intermediate group, and 30% of the 116 in the least favorable prognostic group. 

Wrap It Up

“Among chiropractic patients with persistent low back pain, it is possible to predict which patients will report definite improvement early in the course of treatment.”

Basically, if you’re getting good response in the first week or so, game on. That patient is likely to have an excellent outcome. 

On to the paper on chronic low back pain patients being referred form a spine surgeon it just a second. Let’s try our best to pay the bills first. 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

Item #3

https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0225-8

This last item is called “An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment” by Brigitte Wirth et. al. and it was published in Chiropractic & Manual Therapies in 2019(Wirth B 2019). There it is fresh outta the oven and slapped on your plate for gobblin’ purposes. 

Why They Did IT

The aim of this study was to describe the trajectories and outcomes of patients with chronic LBP referred from the spine surgery division to the chiropractic teaching clinic.

How They Did It

  • The patients filled in an 11-point numeric rating scale (NRS) for pain intensity and the Bournemouth Questionnaire (BQ) (bio-psycho-social measure) at baseline and after 1 week, 1, 3, 6 and 12 months.
  • The Patient’s Global Impression of Change (PGIC) scale was recorded at all time points apart from baseline
  • The data was analyzed using linear mixed model analysis and repeated measures ANOVA

What They Found

  • Between June 2014 and October 2016, 67 participants (31 male, mean age = 46.8 ± 17.6 years) were recruited, of whom 46 had suffered from LBP for > 1 year, the rest for > 3 months
  • At baseline, mean NRS was 5.43 and mean BQ was 39.80 points
  • NRS significantly decreased to 4.05 after 12 months but a significant reduction was not observed BEFORE 6 months after treatment start. So….it took time to see the difference. But don’t a lot of our evidence-informed crowd give you the poo face stink eye if you see patients more than just a couple of weeks? Food for thought judgy judgers!!
  • Now, the Bourneouth Questionnaire – it significantly diminished to 29 points after 12 months and showed a significant reduction in just the first month after treatment started. 
  • Also, the proportion of those showing overall improvement significantly increased from 23% after 1 week of treatment up to 47% after 1 month of treatment. 

Wrap It Up

“Chiropractic treatment is a valuable conservative treatment modality associated with clinically relevant improvement in approximately half of patients with chronic LBP. These findings provide an example of the importance of interdisciplinary collaboration in the treatment of chronic back pain patients.”

That’s some great info right there folks. Ingest it. Roll it around. Not everyone on Facebook has all of the answers. Not even your mentors have ALL of the right answers. We all have to find our own way don’t we? I know I did. 

And we all have to keep learning. Neuroplasticity is real. We keep learning. We keep growing and hopefully we keep altering our perception of what is and what can be. Research helps us do that don’t you agree?

This week, I want you to go forward with…..

Key Takeaways

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Axen I, R. A., Robech R, Wren T, Leboeuf-Yde C, (2002). “Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain?” J Man Physiol Ther 25(7): 450-454.
  • Wirth B (2019). “An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment.” BMC Chiro Man Ther 6.
  • Zhong M, L. J., Jiang H, (2017). “Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis.” Pain Physician 20(1): E45-E52.

The History of Chiropractic (Do You Know What You Think You Know?)

CF 092: The History of Chiropractic (Do You Know What You Think You Know?)

Today we’re going to talk about the history of spinal manipulative therapy and the history of chiropractic. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #92

Now i you missed last week’s episode on the 10,000 Steps Myth, the neuro aspect of an adjustment, and sodas kill, make sure you don’t miss that info. 

Keep up with your colleagues and listen. Also, don’t miss Episode #13. I systematically debunk the myth that we chiropractors cause strokes. I’m not having it, y’all. It’s just not reality and I show you how to fight the myth. 

Also, a few episodes back we talked about Closing Patients and my opinion on that. It may not be what you think it is. 

This week has been more of just catching up. My new schedule I mentioned last week either has my world screwed epically or it’s working beautifully. Lol. Time will only tell but I’m pretty confident we’re doing just fine. 

If you missed last week, I talked about implementing a firmer policy of having patient time and new patient/paper time. 

Since doing that, we have been a bit lighter on the schedule that in recent weeks past but I am getting so much more done right now and it feels good. I have more energy at the end of the day. And doesn’t it feel good to feel good?

It’s cool. For now. If it gets much lighter on the schedule, I’ll hit the WTF? Button and switch gears. WTF….that stands for Why The Face right?Lol. 

Kidding!! I know what it means but I run a mostly clean business here!! But, the point was….. I’m not worried at all right now. 

We are about to get to all things History here but I saw an interesting thing on Facebook this week and it made me want to punt a kitten. I thought I’d share. 

I was on Facebook and saw a couple of knuckleheads coming live from a coffee house. They do it once a week. Doesn’t sound too miserable just yet, does it? It’s actually a decent idea. Get the coffee shop in on it and Facebook live it once a week from the coffee shop talking about certain issues and what your solution to the certain issues might be. Maybe take questions from the crowd there too. Not a bad idea honestly.

Hell, I’d do that myself. Problem is that I’m too damn busy to do it and I’m not a morning person so I’m not getting up early enough to do it before work. Just forget it. Freaking forget it. 

These guys are there at like 10 am on a specific day and I’m like….why aren’t you at work working on people in your work place where people work at 10 am on a work day? Lol. 

They say build it and they will come and Maybe they haven’t built it just yet so the crowds are not coming just yet. I don’t know. Maybe they just make this coffee shop thing a priority for now and choose to not be working on a work day. Either way, one day the one dude wore a cap in the video and the next week he wore a tight little top knot man bun. 

YESSSS I’m old. Yess I think it looks unprofessional. Yes…it makes me crazy like so many other things of his generation tend to do,  and yes…..I’d rather take a kick in the nuggets than to allow someone that looks and talks like him work on me or my kid. 

But…..Yes….there’s a chiropractor for everyone so…..what the hell do I know. Look the way you want I suppose. I’ve heard they have chiros in Florida and California that dress in flip flops and shorts so….when it Rome I guess. 

Here’s my deal, they target kids and parents. Nothing wrong with that. But, they are busy talking about kids that can’t concentrate at school and how there’s just a disconnect in what God meant them to be capable of and what they are currently doing and, if the parents just bring them in to the chiropractor, these guys can help the kids make the connection back and lead that kiddo to the awesome shining light of a life that God intended for them. 

Ummmm…..no you can’t. Is that judgy? Yup. Sorry, whether you admit it or not, we make snap judgements of each other. Rightly or wrongly. IT’s a fact of life. My snap judgement is…..son of a mother. Son of a motherless goat. 

There are so many great chiropractors engaged in research, engaged in diplomat programs. Engaged in taking themselves and this profession to the next level. And this crap trashes all of it. Chunks it all in to the garbage immediately. 

 They chunk it in the garage with their ‘truth’. You hear that crap all of the time now. Speak YOUR truth. We all have our own truth. When did that start exactly? There’s the truth and that’s it. There’s not your truth, my truth, my dog’s truth, some talking head on TV’s truth…..none of it. There is only THE truth. 

And the truth is I’ve seen nothing convincing about this sort of stuff. Absolutely 100% nothing to the level allowing people to get on Facebook touting the ability in a voice that says “You’re great parents. You’re doing everything for your kiddo and we know that. You just need the right kind of help.” Srsly? I you could just get the parents on your brogram…..err…I mean program. 

Come on bruh. Bro. Broseph, I can see it now, they sell brotein shakes at their office and it’s part of the brogram that Billbro Baggins and his buddy Chillbro Swaggins put together after a night of hitting the hookah. 

Show me the support for chiropractors resolving ADHD, autism, and all of that other stuff they claim to help with. Show me it in systematic trials. Maybe randomized controlled trials. Hell, just something peer reviewed and published in a reputable journal? 

But DON’T show me a damn case study or pilot study. Don’t do it or I’ll name you publicly. Lol. I can’t handle people that think case studies hold up to proper scrutiny. They do not. They’re interesting and, for the most part, that’s it. 

They could be doing these in business suits and ties and start spouting unsupported claims like this and they would still look like space cadets claiming they have been to the moon, looked back at Earth, and it is indeed flat despite all evidence to the contrary. Seriously. Srsly. 

I can’t stand this sort of gibberish. It’s a waste of time and talent. 

I’m getting to Item #1 in just a second but we can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

Item #1

Now we know a little about our more recent history like chiropractors used to go to jail for treating patients. We know that the AMA has wanted us banished form Earth since our inceptions. Most chiropractors know this stuff. And you should know this stuff. 

But, I remember Dr. Anthony Nicholson, on one of his guest spots with us, I remember him mentioning that spinal manipulative therapy was actually one of the mainstays of treatment before the explosion of the physician/medical complex. I honestly did not know that. 

So, when I stumbled across this paper called “A History fo Manipulative Therapy.” I started reading. It was written by Erlan Pettman(Pettman E 2007) who is actually a PT and published in the Journal of Manual Manipulative Therapeutics in 2007, Old man river…..it’s an oldie but goodie, people. 

So, the author is a PT and this is basically his devotion to getting spinal manipulative therapy under the scope of physical therapists. Or to get more PTs to utilize it. I don’t know but, he says that the earliest reference to its use is in 400 BC back in Europe. 

Interestingly, he says that spinal manipulative therapy rose simultaneously in cultures from Indonesia, Hawaii, Japan, China and India, to Central Asia, Mexico, Nepal, Russia, and Norway. All things I did not know. He also mentions that historical reference to Greece show the first direct evidence of its use and that it was well-established at the 400 BC mark so certainly predated that time going even further back. 

Get this: Hippocrates who lived from 460-385 BC and who is referred to as the father of medicine….you know….the whole hippocratic oath thing….anyway, even back then he wrote a book on joints and described using spinal manipulative therapy. He even noted that the treatment should be followed by exercises. That’s sort of being ahead of ones time wouldn’t you agree?

This is such an interesting paper that I do hope you’ll check it out. I’m linking it in the show notes right here at this point in the text of the podcast. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565620/

While it’s very interesting, it is also very long and you’re not going to stick with me through it. There’s enough here that I may need to do an entire episode just on this paper because it’s THAT fascinating. 

Briefly, he says that as common as spinal manipulative therapy was throughout the origins of mankind, it appears that physicians and surgeons began to abandon the acceptance of it in the 18th century. Though he can’t say exactly why, he offers that it could conceivably be from using the technique for the wrong candidate or potentially the perceived danger in manipulating a spine weakened by tuberculosis which was ravaging the population at that time. 

So that’s where the downturn started for spinal manipulative therapy and, as he says, by the 19th century, a significant part of the medical establishment has a true disdain for bonesetters and their practices. 

While there were many throwing the proverbial poo at spinal manipulative therapy, there were others with the power to recognize the obvious. Robert Jones, the founder of British Orthopaedics, wrote, “We should mend our ways rather than abuse the unqualified. Dramatic success in their hands should cause us to enquire as to the reason. It is not wise or dignified to waste time denouncing their mistakes, for we cannot hide the fact that their successes are our failures” INDEED Mr. Jones. Indeed….

Were you told that DD Palmer invented chiropractic? Of course you were. I was too. And, in as far as ‘chiropractic’ is an industry or a profession, he did. But, he did not invent the idea of ‘bonesetting’ through some magical discovery. At least it doesn’t appear that way in this article. 

The author talks about Andrew Taylor Still. Still was also a magnetic healer. He suffered from chronic headache and took note one day. He had fallen asleep with his neck wedged between the roots of an oak tree. Upon waking, he had no more headaches. From there he began conceiving a theory about health and how it could only be maintained and, therefore, disease defeated, through normal function of the musculoskeletal system. This was all in 1874. Still went on to create the practice of Osteopathy. Did you know that Still’s practice was only about a day’s drive from DD Palmer’s town?

An astute listener will see the parallels of where osteopathy WAS and originated very similar to where chiropractic was and originated. And very astute listeners will make note of where osteopathy is now and where some in the chiropractic profession wish to keep us…..right back where we started. No progress. No learning. No breakthroughs. Nothing. It’s dumbfounding to say the least. 

The author also talks about DD Palmer in the article. How could you not? He says that he was not the first to use the word subluxation nor was he the first to describe the use of the spinous and transverse processes as levers to adjust said subluxation. Those honors go to Johannes Hieronymi, William and Daniel Griffen, and Edward Harrison. 

Did you know that in the 1920’s chiropractic was on life support but that the GI Bill after WWII was what enabled returning soldiers to go to chiropractic college and really bolster the numbers? I didn’t know that. Pretty cool. 

Also of particular note is that in 1958, the National New from the National Chiropractic Association warned about the rising numbers of PT’s training in manipulative procedures. So…..that’s been a thing for a long time it seems. Lol. 

Just a fascinating read for us chiropractors. Go give it a look see and see what you think. I’d love to hear your impressions. Email me at dr.williams@chiropracticforward.com and let me know what you thought. 

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
The History of Chiropractic (Do You Know What You Think You Know?)

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Pettman E (2007). “A History of Manipulative Therapy.” J Man Manip Ther 15(3): 165-174.

10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust

CF 091: 10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust

Today we’re going to talk about the 10,000 Steps Myth, Is An Adjustment Neuro Too, Soft Drinks, & It’s OK To Not Adjust 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #91

Now if you missed last week’s episode on Healthcare, the Days Of Old,  make sure you don’t miss that info. It was a bit of a brain dump. The week before that was on Decoding Fibromyalgia and we had a great episode before that one called Closing Patients…..we’ve had a lot of beneficial discussion on Facebook come out of that episode and it’s definitely worth checking out. 

We can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

In personal practice, I have to say I’m testing. What I mean is that you never have everything as cookie cutter as you’d like do you? I used to have patient time and paper time and life was good. i got plenty done but never seemed to break through as far as patient load. 

I had a new front desk scheduler come on board and she basically ignored my paper time patient time dynamic and, after some time, my practice blew up and went crazy as hell. 

Now, the key is, did the roof blow off because she put the patient preference in regard to the schedule…..did she put their wants first? So they loved it because it was so convenient? Or, was it a natural progression of practice and it happened to simply coincide?

Who the hell knows? I think we do a lot of things right so I don’t know. Here’s what I’m certain of though. If we continued putting patients wherever they wanted to be on the schedule rather than forcing them into a formatted schedule that still takes advantage of peak and most requested times…..if we continue to allow patients to run our practice rather than us running the practice….I’m quitting!! Lol

Here’s the thing, I don’t want to brag about numbers and things of that sort. I’m just telling you that it’s been at a point where, when the patients run the schedule, I have zero time to produce a great podcast, zero time to collect thoughts on anything at all, hell I don’t have time to go to the bathroom. 

So, a couple of weeks ago, I decided it was time to put a foot down. A foot down outfitted with a  steel-toed boot! We will have paper time and we will have new patient time. Period. 

Here we are with week #2 of the schedule playing out and you know what? We are a little slower today than normal. I’ve been in practice long enough to know that is not a big deal. Sometimes, it’s just that way. But there still is that part of me that wonders what in the hell? Is it the new schedule? Is it this is it that? 

Blah…. So, even 21 years later, it can be a rollercoaster. It can be a day to day, week to week, month to month thing and that drives me crazy. Mostly because I believe I have an anxiety disorder. 

Again, I share these more personal problems or issues with you all because I know some are going through the exact same thing and some younger docs WILL. 

I’ve been making plans on being at the Forward Thinking Chiropractic Alliance’s conference called Forward ’19 in St. Louis, MO….actually Chesterfield, MO but had I said that first, you’d have no damn clue where I was talking about and you’d have to get out your Google machine and waste time looking for the damn place and I don’t want to do that to you. OK?

It’s the little things I do for you all right? Anyway St. Louis on the weekend of September 20-22….it’s that weekend. They have Gray Cook as the headlineer. They also have , Greg Kawchuck, Annie O’Connor, Christine Goertz, a guy I got to know a bit through the DACO program and a great speaker and doctor, Dr. Brandon Steele, and several more. It’s a time to not miss. Plus, hell, I’ll be there. 

I’ll be staying at the Drury Inn there in Chesterfield and it’s right next door to a Cheesecake Factory so, honestly, what’s not to love about this weekend that’s coming up on us rather quickly?

They aren’t paying me to tell you about it. In fact, nobody associated with the FTCA has even asked me to mention it. But, I think it’s important and I think attendees will walk away as better doctors. That’s why I’m going. 10% better every day, week, month, and year. 10% better. 

go to https://www.forwardthinkingchiro.com/convention if you’re interested.

Item #1

We have a short one to kick this off with. It’s called ‘For Mortality, Busting The Myth of 10,000 Steps Per Day” by Jennifer Abbasi and published in the Journal of the American Medical Association in July of 2019 (Abbasi J 2019), hot cakes, hot stuff. 

Jennifer says the goal of reaching 10,000 steps every day has been a thing for a while now but, in truth, that may not actually be necessary. She said that older women who walked more than their peers and lower death rates in a recent study in JAMA Internal Medicine but….here’s the gotcha part….but the mortality benefit was seen with as few as 4400 steps. 

She says the recommendation of 10,000 steps may be disinclusive – is that a word?I think you know what I mean. She says 10,000 steps can be daunting to many. Especially older people and can actually keep them from walking any more. Whereas 4,400 is much more realistic and the that’s where the benefit is actually seen. 

Interesting stuff right there and definitely worth mention. I’m taking that to my practice. You should too. 10,000 steps may not be the gold standard.

Item #2

This is one called “Spinal manipulation therapy: is it all about the brain? A current review of the neurophysiological effects of manipulation” by Giles Gyer, Jimmy Michael (don’t trust someone with two first names), and James Inklebarger, et. al(Gyer G 2019). It was published in the Journal of Integrative Medicine in September of 2019. Hell, it’s September of 2019 right here right now. Hot potato, hot potato…..

They start out by saying that the the mechanisms underlying the pain modulatory effects of spinal manipulative therapy remain elusive. And although biomechanics and neurophysiological phenomena have been thought to play a role in the effects we see, more and more studies are showing improved outcomes suggesting peripheral, spinal, AND supra spinal mechanisms are playing a part. 

If you listen to our episode with the esteemed Dr. Christine Goertz, she was very clear in saying that we are currently a long way away from being able to say exactly how adjustments get the amazing results they get. That’s frustrating in a way isn’t it? It is for me. I want to know exactly how. 

In describing the article, she says, “The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability, increase in cortical drive and many more.”

I have cited this article in case you want to go and find it. It’s in the show notes at chiropracticforward.com so go check it out. But I couldn’t find the whole article. At least not yet. Not until one of you awesome listeners sends it to me at dr.williams@chiropracticforward.com I would be grateful. 

But it is good for discussion. I actually did an episode dedicated to this topic. It was Episode #56 and I’m linking right here at this spot in the show notes so you can hear it. I actually had several people emailing me with some thanks on that one. 

The first reason this one was a big episode is because there were some knucklehead wannabe chiropractic gurus out in California claiming to have reversed spinal arthritis after two weeks of draining a patient’s bank account….errr. cough…I mean….of treating the patient 4x/day for 3 weeks. Which quickly adds up to a whole pile of steaming fresh hot brown….BS.

That episode came with pictures and illustrations in the show notes even. I was really fired up there. Lol. 

Anyway, the main reason I’m talking about that episode right now is that I provided a pretty solid description of the latest research and ideas on what an adjustment just may actually be doing for our patients. 

Basically, 

A recent paper by Anderstt et al. (2018) confirmed that cervical manipulation results in facet gaping.  This force also improves regional motion across multiple spinal levels during and post-manipulation.

“This study is the first to measure facet gapping during cervical manipulation on live humans. The results demonstrate that target and adjacent motion segments undergo facet joint gapping during manipulation and that intervertebral range of motion is increased in all three planes of motion after manipulation. The results suggest that clinical and functional improvement after manipulation may occur as a result of small increases in intervertebral ROM across multiple motion segments.” 

And according to the DACO learning

It appears that manipulation relies upon signaling properties of the muscle spindles that lie embedded in the paraspinal tissues. As the spindle registers rapid lengthening of the muscle it transduces this into a large proprioceptive barrage. 

The unique nature of a manipulation seems to alter the responsiveness of second-order neurons in the dorsal horn and make them less sensitive to incoming nociceptive signals from injured tissues.”

Adjustments are gapping the facets, improving proprioception and sensorimotor function, helping the body and brain know better where everything is and know better how it’s supposed to move thus, improving that movement and function. 

So, until new research comes out that makes us throw all of our best information out the window, that’s what I’m going with and, for evidence-informed practitioners, would suggest you adopt as well. 

Short break here….

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Now, Item #3

This one is an obvious one and is called “Association Between Soft Drink Consumption and Mortality in 10 European Countries(Mullee A 2019)” by Amy Mullee, PhD, Dora Romaguera PhD, and Jonathan Pearson-Stuttard, BMBCh whatever the hell that is. 

Brand new info here. They took 451,743 individuals from 10 countries in Europe consuming more sugar-sweetened and artificially sweetened soft drinks. 

What they found was that those drinking more of either of those had a higher risk of all-cause mortality. Consumption of artificially sweetened soft drinks was positively associated with deaths from a circulatory disease while those consuming sugar-sweetened soft drinks suffered more deaths from digestive disease. 

So, why not cut them all out? I think water rules the day and NOT tap water by the way. I drink a lot of coffee and tea but I’m doing my best to drink more water. I know I’m supposed to. I get it but dammit it has no umph to it so water just sort of pisses me off and leaves me wanting. Lacking. And basically bitchy. 

Anyway, Item #4

This one is called “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada” by Rivka Green, Bruce Lanphear, and Richard Hornung, et al and published in JAMA Pediatrics in August of 2019(Green R 2019). Look out hot stuff everywhere, steamin’ plate…

The question they wanted to answer was, is maternal fluoride exposure during pregnancy associated with childhood IQ in a Canadian cohort receiving optimally fluoridated water?

Their conclusion was as follows “In this study, maternal exposure to higher levels of fluoride during pregnancy was associated with lower IQ scores in children aged 3 to 4 years. These findings indicate the possible need to reduce fluoride intake during pregnancy.”

Interesting stuff. Especially for those of you that make pediatrics and prenatal care such a big part of your practice. Knowledge nuggets all over the place today. You can’t listen today and avoid getting hit in the head with at least one of them. It may slap some sense into the recipient. At least that’s the goal. 

OK, last thing I have on tap today is Item #5

It’s called “Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students” by Guillaume Goncalves, Marine Demorier, and others. I say and others because I’m not even about to try to pronounce the next name. There would be a verbal murder of probably a perfectly good name and I don’t want to play any part in that. 

It was published in BMC Chiropractic and Manual Therapies in 2019. Once again, too hot to handle, step back one….no two steps…

In the background section of the abstract, they start by saying “While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative ‘subluxation’ model. The main goal of this study is to determine if chiropractic students with such conservative opinions are likely to have a different approach to determine contra-indications, non-indications and indications to chiropractic treatment versus those without such opinions.”

What They Found

  • They had 359 student respond out of 536.
  • They generally recognized a number of contra-indication as well as indications for treatment
  • What the problem was was in identifying non-indications for treatment. 
  • The subluxation students were much more willing to treat someone even when there was nothing relevant wrong
  • For example, they were much more willing to treat a 5-yr-old kid with no history of back pain or disease to prevent future back pain and to also prevent non-musculoskeletal disease. 

Wrap Up

Their conclusion was “It is concerning that students who adhere to the subluxation model are prepared to ‘operationalize’ their conservative opinions in their future scope of practice; apparently willing to treat asymptomatic people with chiropractic adjustments. The determinants of this phenomenon need to be understood.”

I can help them understand it. It’s BS passed on by wannabe gurus and colleges like Sherman and Life and was once shoveled in large amounts by Palmer and my alma mater, Parker. Although, to my understanding, those discussions are fewer and further between at Palmer and Parker these days. 

Look, I’ve made no secret, I’m not a Subby, a TOR, or a TIC. I’m an evidence-informed chiropractor. Just like Subbys and other evidence-informed chiropractors…..I too get great results for my patients. 

Unlike SOME of my Subby counterparts….not all of them….but certainly SOME of them…….I communicate with the medical field in effective ways that make sense to them, I do not take advantage of my patients, I do not use techniques and recommendations not back in part by evidence and research, I run a patient-centered practice, and don’t treat when I shouldn’t and treat when I should, and I do not try to see how many times I can run a patient through my doors based on the idea that I’m going to prevent some sort of mythical loss of curve issue 30 years in the future. Folks, we’re highly educated. It doesn’t happen that way and in 2019, we damn well know it doesn’t happen that way.

Your bank account might not like it but your patients will and they’ll know you care and they’ll know you’re different than the rest when you’re worried about them and NOT their wallet or their purse. 

The golden rule isn’t just for kiddos. IT’s for everyone regardless of age. Treat others the way you want to be treated. If you want to be treated a million times through your life because you may lose some degree of curvature in your neck, then 10/4, rock on with your bad self. 

I for one have no interest in that for myself so I’d never recommend it to anyone. Why would I? Other than financial motivation of course.

I wouldn’t.  

Before we sign off here, I made some awesome evidence-informed brochures and posters for your offices. Go check them out at the store link at chiropracticfoward.com 

While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Abbasi J (2019). “For Mortality, Busting the Myth of 10 000 Steps per Day.” JAMA Open 322(6): 492-493.
  • Green R, L. B., Hornung R, (2019). “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada.” JAMA Pediatr.
  • Gyer G, M. J., Indlebarger J, Tedla JS, (2019). “Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation.” J Integrative Med.
  • Mullee A, R. D., Pearson-Stuttard J, (2019). “Association Between Soft Drink Consumption and Mortality in 10 European Countries.” JAMA Open.

Healthcare Of Old – Days Gone By

CF 090: Healthcare Of Old – Days Gone By

Today we’re going to talk about how healthcare has changed – gone are the days of this and gone are the days of that. And there will be plenty of room for me to spread some personality in there too. If you’re a regular listener, you know I’m never lacking an opinion. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #90

We can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

We have some great stuff this week. It’s a short week due to Labor Day so this episode may run a little short and that’s OK. I try to not get too long winded. I think I went on about 45 minutes when we talked about Closing Patients two episodes ago.

But, a little gripe session never hurt anyone. If you’ve ever wondered whether Closing patients is right or wrong, get my take by going and listening to episode #88. I lay it out pretty clearly there. 

And don’t forget, last week’s podcast about Fibromyalgia. New info on fibro and treatment. Good stuff there in episode #89

Item #1

I want to start with an article that kind of struck me as…..huh….interesting. It’s called ‘The Old Days of Medicine Are Gone” by Michael Weiss(Weiss M 2019) and it was published in MedPage Today on January 17, 2019. Hot potato, heads up now. 

Weiss is a cardiologist and I have cited this article in the show notes over at chiropracticforward.com. This article refers to medical doctors specifically but there are a lot of parallels that we doctors of chiropractic can relate to. 

The article starts by saying that in the last 5-6 years, physicians have become less and less powerful. So have their patients. This disempowerment is due to a lot of things according to this article. Chief among them are:

  • Health management organizations
  • Managed care and 
  • The insurance exchange

Mr. Weiss says that all of these factors have taken power from the doctors and put the power into the hands of the large insurance companies and in the hands of the government. Well, that’s been going on for at least a generation. 

I remember a pencil pusher with an insurance company several years ago, a person who doesn’t have any kind of degree other than following prompts on a computer…..I remember them telling me how to treat a patient. What they needed. How many times….I was stunned. I will just say that I had a strongly worded conversation that I’m certain went in one ear, bounced around in that dude’s empty noggin, and fell out the other without making any impact. 

But I remember thinking, we are allowing insurance companies, the guys with a financial stake and a financial bias, we are allowing these people to tell us how and when to treat patients when they’ve never seen them in their lives. These patients are just numbers on a page to these companies and they’re going to tell us how to treat them. 

Same goes for the government. Whether it’s a popular opinion or not, makes not one damn to me. I’m going to tell you that when you put all of your healthcare decisions in the hands of one big fat, red-taped fat bureuacratic entity that has already screwed up Medicare and Social Security for no reason at all, due to both sides of a messed up aisle, well, you are once again numbers on a page and sometimes you get what you deserve. Of course that doesn’t mean everything’s peachy and we don’t need some changes to the healthcare system. We most certainly do. Universal healthcare medicare for all though…..I don’t see how that is the solution. Again, one fat, slow, dumb entity that has a history of screwing up big programs isn’t what I personally want making all of the healthcare decisions for me and my family but to each their own. 

Getting back to the article, Mr. Weiss says this physician disempowerment was basically a money grab on the parts of these powers and on the part of the pharmaceutical industry. Well…..of course. I think all that goes without saying doesn’t it? But I’m glad someone is indeed actually saying it. We should be shouting it out loud but, will it change anything? Politicians won’t do anything about it when big pharma is in their pockets and they’re scared of the insurance companies. 

Anyway, he says that doctors’ incomes have been progressively on the decline for years. Can i get an ‘amen’ on that my people. Testify!!  He says this cash-strapped generation of physicians have been forced out of private practice into working for hospitals and huge conglomerates and that gone are the days of Wednesday off for golf, gone are the days of being called a doctor rather than a provider, gone are the days of being respected, gone are the days when patient’s would say “But what does the doctor say?” rather than “Will the insurance pay?”, gone are the days when a physician could direct care they deemed necessary. Even the prescription pad is becoming useless since insurance doesn’t cover a lot of the scripts written these days. 

He says gone are the days when a physician could sit down and perform a detailed and thorough examination. Instead, we have be busted down to being typists, chaotic clerks, mindlessly clucking away at meaningless electronic health records benefiting only large entities. Hallelujah!! 

In order to make money these days, it has to be quantity and, unfortunately, quality many times suffers. For better or worse. When your income goes down, you see more to maintain the income you have built your life around. Quality of care suffers. Not intentionally. Nobody is morally corrupt typically. It’s just a natural consequence. You have bills to pay and you’ll figure out a way. 

Take a radiologist. They used to get about $35 for reading a neck series. Now, after Obamacare, they make $7-$10. I happen to know a radiologist very well so you can trust what I’m telling you. At least here in Texas. Could be different in your area. What happens when you income gets reduced by roughly 2/3 but you still have a big house and some extra toys you have purchased? 

Maybe you have a big garage sale and get rid of the extra fat? Ah hell no, that’s not what happens. Instead of 5 films read in 30 minutes you read 10. Think you might have an elevated risk of missing something? Of course you do. 

Back to the article….I keep getting side-tracked, he says gone are the days when a physician had the luxury of utilizing their skills of observation. He says now there are cookbook guides that have become the puppet masters of the physicians. I’d like to go on record right now, as part of a profession that has no standardization whatsoever…..I’m all for researched and evidence-backed guides. I love it. Give us some guides. Hell, don’t just give them to us, FORCE us to abide by them. Please? Lol. Just make sure they weren’t generated by a damn insurance company. That’s all. 

He says gone are the days of decent hospital stays and the days of when a patient could be cured of infections from a decent stay at the hospital. Now, he claims that patients are kicked out of the hospital early and take the buggies back to their community and spread them which leads to resistant buggies. I’d argue that commonly prescribing antibiotics when it’s a virus was problematic and the cause of a lot of resistance back in the day as well? He left that out oddly enough. 

He hit on a HUGE one when he says gone are the days of reasonable costs for a doctor visit or a drug co-pay. Now, since Obamacare, we see double and triple premiums, up to $100 co-pays, and double or triple deductibles. 

This sucker continues but, before I get to the rest of it, I need to talk about one of our amazing sponsors here at the show. It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Back to the article, Mr. Weiss says gone are the days of visiting an ER and getting immediate care as if illness is the priority. Instead, we gotta get that co-pay covered first. 

He claims the days of physicians not having to worry about a patients insurance are gone. But…haven’t those days been gone since the 80’s or so? Honestly? That’s not something new. He says though that the insurance companies have encouraged minute clinics where the nurse pracs, and he says soon the pharmacists, will be giving the medical advice. 

He doesn’t seem to like this idea much but he’s OK with people waiting for hours to see a ‘physician’ because there aren’t enough of them. I’m pretty OK with nurse practitioners for the more mundane stuff. Plus, in my experience, NPs are more likely to refer to chiropractors for whatever reason. 

While Mr. Weiss is right to some extent, a lot of this is just whining in my opinion. The traditional physician doctor had their run with all of the power, the glory, and the golden ticket they cash when they get their medical degree. And, to an extent, they damn well still have a certain amount of power, glory, and golden ticket status. Although to a lesser extent currently. Admittedly. 

It’s one of the last quotes of the article that gets my goat a bit. He says, “Physicians’ voices have been drowned out, their plights buried, leaving their patients helpless,,,,”

Well freaking whaaaa Weiss. Yes, chiropractic has the status it has in healthcare right now because a certain portion of its practitioners refuse to progress. In fact, they work to inhibit any progress and cripple any efforts to expand the profession. Yep, it’s there and it’s undeniable but, when we talk about having voices drowned out, plights buried, and helpless patients, let’s go a little deeper. 

I’ve said it a million times but the medical field is going to look back on spinal fusions in 20 years and wonder what the hell they were thinking. I think I heard where lumbar fusion surgery has gone up 500+% in the last decade or so with little to zero hard stats that show any improvement in outcomes. 

Oh looky there, I see a herniation. Let’s cut that out and you should be good as new. We know so much more now. We know you can’t cut out pain. We know you don’t treat an image. You treat the patient in front of you because most of the time, there is little to no correlation between what you see on an x-ray and what the person’s pain generator is. 

We know now that chronic pain is mostly in the central nervous system. Not out in some peripheral part of the body. You cannot typically get rid of chronic pain by cutting something out. We know more and more now that it just doesn’t work that way. 

Yet, I feel confident promising you that right now, several fusions across the country are taking place. As I type this out. We also know that less than half of those fusion surgeries will be successful, right?

We know this stuff. Yet, they continue. Unabated. So, while I agree that insurance, the government, and the whole managed care concept have screwed up our healthcare system, I would say that physicians have played very key parts in their own downfall. Hello….opioid crisis anyone? Unnecessary surgery? Surgeries for the wrong candidates? Super bugs from overprescribing? Any of this ringing any bells? 

Have you heard the podcast called Dr. Death? Basically, a so called spinal surgeon down in Plano, TX maimed several patients and even killed several and the hospitals protected him and enabled him to keep hurting people over and over and over again. 

It’s not just insurance companies and big pharma that has cause any fall from grace. And let’s be clear, I don’t think there’s been a fall from grace. Go to a hospital and see the interactions. Everyone still defers very clearly to the physician and I don’t see that changing. It’s just now they have to work more, follow rules, and get paid less. I think that’s the big gripe. 

And to that I’d say, welcome to my world friend. Welcome to my world. 

But again, it’s not just the system. Medical doctors have done their part. And, as a chiropractor, I’d argue that part of that is they have largely ignored the American College of Physicians’ recommendations to try spinal manipulative therapy, exercise, massage, acupuncture, yoga, thai chi, and heat first for back pain. 

Those are the first-line recommendations and they are in concert with The Lancet papers on low back pain, the CDC, the FDA, the Joint Commission, The White House, and just about anyone else with any sense at all when it comes to non-complicated musculoskeletal pain. Yet, as I said, fusions are going on all over the country right now. As I speak. That’s when only 5% of back pain sufferers truly need surgery. 

When does someone truly need spinal surgery? When they hurt? Nope. Not usually anyway. Remember, you can’t cut pain out. Outside of an obvious case of a spinal fracture, tumor…..the bad bad stuff….I think it’s commonly accepted that surgery is necessary in a loss of bowel or bladder function, saddle anesthesia – cauda equina- type stuff, or a progressive neural deficits. 

So, if only 5% of back pain sufferers truly need surgery, why are so many still happening every day? After all of the research and after all of the updated recommendations?

Well, I’d say it’s financial. Get this, according to the American Medical Group Association’s Physician Compensation Survey says their research spine surgeons make $688,500 a damn year on average. 

Me personally, I’m doing pretty well in practice. But, it took me 16 years before I really started putting the pedal to the metal. Now part of that was my fault because I was traveling around playing music. Part of it was chiropractic’s fault because we have a system that eats its own. 

Either way, check this out, it took me 16 or so years to really build but, for an orthopedic surgeon, during the first two years of employment, bring in $400k and by their third year, $670k. Allied Physicians reported the maximum orthopedic spine surgeon salary was $1,352,000. 

Crazy. We have some chiropractors that make that kind of money but it’s not many and it’s not very likely. 

Anyway, I agree with some aspects of the article. Other aspects make me chuckle because, although it’s to a much lesser extent, physicians of our day are dealing with some of the things we’ve been dealing with for years and years. 

If we could just communicate with them the fact that we evidence-based chiropractors can play such a big part in helping them treat their patients and getting them back to work and back to life, I probably would have more sympathy. 

Hell, people come to us because we’re experts in what we do, because we are safe, and because we’re effective but, a large part of the medical field looks at us like stumbling idiots playing doctor and hurting our patients. While that may be true for some in our profession as well as for some in THEIR profession (hello Dr. Death), for the most part, we are all highly educated, highly capable doctors getting patients well. 

Maybe when they begin seeing us in that light, we start to see some sort of deeper, more meaningful integration. It’s started here and there in some pockets of awesomeness but not in general. It’s still a goal worth chasing. 

That’s assuming we chiropractors can get our of our own way. Otherwise, if I were a medical doctor, I wouldn’t want any part of something I could only explain as pseudoscience. I WOULD however be interested in a healthcare discipline that had the randomized controlled trials backing the meat of their modality. Count me in on that. 

And that’s the way I see it today. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg
This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Weiss M (2019). “The old days of medicine are gone.” Medpage Today – KevinMD.com.