Hall of Famers Metallica Swear by Chiropractica

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What do rock stars and Olympic athletes have in common? No, this isn’t the lead up to a punchline.

Both share a need or desire for chiropractic care to enhance their demanding performances. Having been a team doctor for six Olympic competitions, my latest “gig” with Metallica has shown me that intense activity, endurance and strength are sought by both kinds of performers, be it on stage in front of thousands of fans or competing for a gold medal at an Olympic event.

For the last nine years and more than one thousand tour dates, I have been providing Metallica’s band members with almost daily care.  Going on thirty years of making music and more than 100 million albums sold, Metallica’s rock and roll habits of decades ago have simply been replaced with more conservative routines, as they prepare for their two-hour-plus concerts.

Pre-concert care, deep tissue work and rub-downs between songs are just a few of what Metallica’s band members have required on the road.

Voodoo doctor

Vocalist and rhythm guitarist James Hetfield has called me a voodoo doctor and bass guitarist Robert Trujillo says my treatments resemble acupressure.  I’m counted on by drummer Lars Ulrich and Kirk Hammett, who happens to be my cousin.

At the end of the day, all of the band’s members are finely tuned into the idea of how they can best prepare for demanding concerts to please their fans of many ages.

Odd as it seems, treating rock stars and competitive athletes have a lot in common.  Trujillo needs constant attention to his guitar-strumming arm and its speed-demon fingers, even between songs backstage.  Deep tissue work before shows has also become a Metallica tradition.

Metallica’s band members must individually maintain cardio-vascular endurance, an exercise and stretching regime and a balanced diet and nutrition.  With the bands’ intense concert schedule and travel itinerary, Metallica members must be at a peak performance state both physically and mentally.  Subsequently, their qualitative longevity deserves and requires preventative and maintenance healthcare on a daily basis.

To me, Metallica brings harmony to their fans as the band roams the jungle of a world filled with chaos and insanity.  Helping Metallica bring their music to the world has been my own rock and roll dream come true. It has been a privilege to work and tour around the world living in the mad, mad world of Metallica.

Almost Famous

I’ve been a huge fan since my cousin Kirk invited me to a Metallica concert in San Francisco in the early 1980’s, not long after the band formed in 1981.

metallicawcaptionMy family had always been chiropractic-oriented family and believed each of our innate abilities flourished throughout our lives whenever the life force was made to flow freely with chiropractic care. That was our gospel, and one that Metallica eventually tuned in to.

During the early 1980’s,  Metallica released hits with fast tempos and instrumentals, fast becoming well known as one of the top four thrash metal bands, alongside Anthrax, Megadeath and Slayer.  Because of their aggressive musicianship, Metallica gained a loyal fan base in an underground music community.

In 1986, Metallica’s album, Master of Puppets was described and acclaimed as one of the most influential metal thrash albums of all time.  In 1993 onward, Metallica achieved substantial commercial success with the Black Album, which debuted at number one on the Billboard 200.  With the release of the Black Album, Metallica shifted and expanded its musical direction resulting in an album that appealed to a mainstream audience.

It was Kirk who was convinced of the power of chiropractic and insisted that his spine is adjusted regularly.  His sister, Jennifer Hammett also plunged into the world of chiropractic in the 1990’s.

As an Australian/American citizen, I would meet and work with the band on a part-time basis when I lived in Australia.  It was at the time, in 2000, that Metallica released St. Anger, an album that seemed to have alienated a number of fans. Nevertheless, the band created a documentary describing and exposing the bands most inner hopes, fears and turmoils.

After given them adjustments a number of shows, by 2002, they appointed me as Metallica’s full-time touring band doctor.

Diehard fan

The diehard Metallica fortress that had grown through nearly 30 years was becoming much more stable and solid. It didn’t
matter if fans had come and gone during the last 29 years, Metallica music had been a great source of love and support for many fans to lean on.

They have been through a lot that some fans criticized, from signing on to  a major label, to doing a ballad, to cutting their hair, to fighting Napster, as well as to create a documentary that brought on their most intimate fears to the public. Yet the Metallica fortress stood solid and unshakable.

Releasing nine studio albums, three live albums, two EPs, 24 music videos and 45 singles, Metallica has won nine Grammy Awards.  Metallica has also had five consecutive albums debut at the top of Billboard 200, the first band to do so.

Metallica was inducted into the Rock and Roll Hall of Fame, Cleveland, Ohio in April 2010. When they accepted the new title, it was one of the best moments of my life.

After having worked behind the scenes at concerts in cities around the country and the world, adjusting the band to keep on playing for fans, I can definitely say, it’s only rock and roll, but I like it.

 

Dr. Don Oyao is a six-time Official Olympic Team Doctor in Seoul 1988, Barcelona 1992, Lillihammer 1994, Atlanta 1996, Sydney 2000 and Beijing 2008.  He now works as Metallica’s touring band chiropractor and one of their biggest fans.

What’s Your Solution? The Real Skinny on our Obesity Epidemic— No Pun intended

Is there any one contributor to chronic health conditions more prevalent and dangerous than obesity? National obesity rates among adults has doubled since 1980 alone, yet it seems to be overlooked and misunderstood more often than any other disease catalyst. The explosion of weight loss products and the plethora of theories behind weight gain have seemingly done nothing more than water down this issue, leaving the public confused and indifferent. In this article, we delve beyond the turmoil surrounding the obesity issue and offer new insight into what obesity means for you and your patients.
The fact is this problem is not going away and, yet, people continue to attend their weight loss meetings, eat their tiny out-of-the-box meals, drink their shakes and work out like crazy. We have worked with people who have stuck to these protocols for years, losing very little and gaining it all back plus some. Then, either by design or misconception, they blame it on themselves. And so, for years, we have been banging our heads against the wall with this “calories-in-versus-calories-out” solution. No wonder this is a billion dollar industry!
Diet and exercise have long been touted as both the problem and the solution. If the real solution is that simple, and completely free, then why are so many people walking around dangerously overweight in a country known worldwide for its ambition and persistence? It may be because diet and exercise do not always work! In fact, some experts are finding that diet and exercise alone work a very low percentage of the time.
Still, fitness enthusiasts and “health freaks” will talk all day about self control and the like, but evidence is building against a new culprit. The fact is, these overweight people are often deemed weak minded, lazy and lacking in self control, but may possess a very real and unfortunate cause for the fat they cannot lose and the cravings that simply will not go away.
People suffering from hypothyroidism and adrenal fatigue are great examples. These individuals tend to carry excess fat and have an extremely difficult time taking it off. In addition, a variety of mental and emotional circumstances come to mind including uncontrollable appetite and abnormal satiety. The probable reason?

Toxicity.
Whether it be from various heavy metals, including mercury or copper, perchlorate, BPA, food additives, prescription drugs, plastics, bromide, fluoride, or any of the thousands of chemicals used in pesticides, evidence on the causes of obesity is mounting on a much deeper issue, much more complex than the calories-in-versus-calories-out theory.
These toxins, and many more, are becoming virtually unavoidable. Take drinking water, for example. Runoff adds pesticides and perchlorate (rocket fuel), and various prescription drugs are tossed into the mix by unsafe disposal methods. The water is then treated with chloride and fluoride before it finally ends up in your glass. If you do the research on these chemicals, you will find that there is something very wrong with this formula and that’s just one limited example.
Exposure is happening through the consumption of everyday products that are trusted to be safe. Scarier yet is alarming evidence that mothers have a great capacity to pass such toxic substances to a fetus. In this situation, the issues will be present throughout development, resulting in potential problems deeper than science has currently explored.
A perfect illustration of these points is the use of diethylstilbestrol (DES) by expecting mothers to prevent miscarriages during the 1950’s and 1960’s. The consequences were a wide range of devastating birth defects, all from a product deemed safe for consumption.
New evidence is continually surfacing supporting this cause and many experts agree that increased toxicity can lead to any number of imbalances which manifest themselves as excess fat. In addition, some hypothesize that, as a direct result of greater exposure over a prolonged period, the youngest generation of Americans will have even greater health issues than those of their parents.
It is plausible to assume that a wide range of imbalances could be caused along these same lines. In May, the Government even released a piece titled: Solving the Problem of Childhood Obesity within a Generation. In it they reveal that “scientists have coined the term “obesogens” for chemicals that they believe may promote weight gain and obesity. Such chemicals may promote obesity by increasing the number of fat cells, changing the amount of calories burned at rest, altering energy balance, and altering the body’s mechanisms for appetite and satiety. Fetal and infant exposure to such chemicals may result in more weight gain per food consumed and also possibly less weight loss per amount of energy expended. The health effects of these chemicals during fetal and infant development may persist throughout life, long after the exposures occur.”1
These “obesogens” are some of the exact same substances mentioned earlier in this piece. They are found in various everyday products and we are no doubt exposed to them frequently.
To have the science community finally becoming skeptical of these everyday chemicals is both alarming and refreshing.
The bright side to all of this? The living cell is an incredibly resilient structure. It will work very hard to remove these toxins from its being and return to homeostasis. The body has proven very capable of exercising this power with many less powerful intruders and illnesses; however, strong evidence supports the idea that, in most cases, it has great difficulty removing the more harmful substances all by itself.
This problem presents a remarkable opportunity for health professionals. Experts are finding that giving the body a little bit of help can be incredibly beneficial to the body’s healing process. Clinical, nonprescription detoxification of these toxins has been found to produce the needed fuel for bringing balance to the body. For this, we recommend you look to homeopathic remedies for their unparalleled safety, effectiveness, ease of use and affordability.
Where weight loss is concerned, it is vital to find programs that provide the ability to uncover a wide range of imbalances which may be causing weight gain and retention. Notice the use of the word “program.”
Successful programs will produce quality, lasting results, while providing the patient with lifestyle education for successful, back-to-everyday life. It is imperative that a program involve the consumption of real food as opposed to shakes or meals in a box. Meal replacements and those that come in boxes tend to represent a set of perpetual diet programs which produce poor results, a low quality of life and do not give the patient any basis for living a healthy life outside the diet.  
In addition to being results-driven and including each element previously mentioned, you will be best served selecting a turn-key program which is easily implemented into an existing practice. However, the amount of clawing and scratching you want to do is totally up to you, as developing a clinically tested successful program on your own takes years and a lot of money. Finally—an end is in sight to the era of ball and chain diets as you, the practitioner, now have the power to provide real results.

Susan Blackard, R.N., N.D.C, M.H.A., F.N.P.C, is an expert on obesity and detoxification at the Rejuvenation Institute of Natural Health. For more information, download the free e-book on clinical weight loss at www.dc-weightloss.com or call 1-877-942-4669.
Reference
White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation. May 2010.

Nutritional Alternatives to Prescription Drugs

by Dr. Howard F. Loomis, D.C.

Prescription drugs are used to treat disease. They WORK by blocking a human enzyme system or by filling specific receptor sites, thus directing the body’s biochemistry. Their specific need and even dosage can be pinpointed by the use of various laboratory testing.
However, nutritional supplements (whether protein, lipids, carbohydrates, vitamins, or minerals) do not, by themselves, perform WORK. They must be put to work by specific enzyme action. Nevertheless, the concept of considering nutritional alternatives to prescription drugs is well worth the effort.  I must point out (with tongue in cheek) that it is too late for rose hips when you have just fallen off the top of a ten story building. In other words, nutritional supplements find their best use for maintaining health—not treating disease.
With the above in mind, it would seem advisable to incorporate enzyme supplementation into one’s nutritional recommendations. There are many different enzymes that can be safely used for nutritional use, but similar to prescription drug use, one must be certain to use the correct enzyme or combination of enzymes for each individual patient’s needs. Shotgun approaches to nutritional supplementation, while easy and convenient, are seldom successful in the long term for restoring normal function.
I use food enzymes to improve digestion and to nourish the body when signs of inflammation appear; that is, increased heat or fever, redness, swelling, pain and muscle contraction. I generally do not use enzymes derived from beef and pork (marketed under the name of pancreatin), since they are only useful in inflammatory conditions, and not for improving digestion. In this article, I will be pointing out a very useful physical finding that chiropractors can use to determine when a patient requires food enzyme supplementation—namely, loss of normal thoracic kyphosis in cases of indigestion, metabolic syndrome, and restless legs.
An important part of every case history, and even ongoing case notes, should be knowledge of the patient’s prescription and over-the-counter drug use. This has always been important, because drugs mask symptoms and physical findings that are important in making an accurate assessment of the need for chiropractic care. In fact, it could be recommended that you set aside time to review prescription drug use with each patient at least every 3 to 6 months. Most of your patients will appreciate the effort.
It is important to remember that any visceral dysfunction produces contraction(s) in the muscles that share spinal innervation with the stressed organ(s). This occurs not only in the periphery but at the spine as well. Thus, we have the occurrence of spinal subluxation contaminant with visceral dysfunction.
When prescription drugs are used to alter visceral function, muscle contractions and subluxation patterns change. Thus, it is imperative that a patient’s use of prescription medications and any changes that are made in their medications be carefully noted by the clinician.
Your patients should be informed that prescription drugs are used for the treatment of disease and they do not restore normal function, nor can they maintain health. Since all prescribed drugs interfere with normal body functions, by either blocking receptor sites or interfering with a human enzyme system, they all cause side effects that can be recognized very early by changes in muscle contraction and subluxation patterns.
Let’s now consider some of the more common conditions you see in your practice for which the patient is using prescription medication. Recall that all symptoms are caused by the inability of an organ system to fulfill its role in maintaining homeostasis, either because it is nutrient deficient or there is excessive waste accumulation. Since we are making nutritional recommendations, we’ll begin with digestion.

Proton Pump Inhibitors for Digestive Symptoms
These drugs block the production of stomach acid to reduce symptoms of heartburn, indigestion, gas and bloating. Unfortunately these drugs are recommended solely based on symptoms, since there are no laboratory tests to specifically identify whether the problems are caused by stomach, biliary or pancreatic dysfunction.
Proton Pump inhibitors reduce symptoms but do not affect the muscle contractions, loss of range of motion, and chronic subluxation patterns associated with compromised digestion.
Invariably, since the digestive organs receive sympathetic innervation from the mid-thoracic area, these patients will exhibit a loss of the normal thoracic kyphosis. It is important to remember that this is not an osseous problem, but rather is caused by muscle contraction.
Very often this is the underlying cause of chronic headache complaints and non-traumatic shoulder complaints.

Fibrates Used with Statin Drugs
Fibrates are used in combination with statins for a range of metabolic disorders, including high cholesterol and high lipid levels in the blood. Although less effective in lowering LDL, fibrates increase HDL levels and decrease triglyceride levels. They also seem to improve insulin resistance and other features of the metabolic syndrome, in particular hypertension and diabetes mellitus type 2.
Fibrates are able to penetrate cell membranes and block fatty acid receptors within the cell. They stimulate a class of intracellular receptors that modulate carbohydrate and fat metabolism. Fibrates are agonists, that is they replace fatty acids as well as prostaglandins and leukotrienes at the receptor sites within the cells of muscle, liver, and other tissues. Of course, there are side effects to all this:
The most obvious is myopathy—muscle pain with CPK elevations.
T5 to T9—most fibrates can cause mild stomach upset and, since they increase the cholesterol content of bile, they increase the risk for gallstones.
T10 to T11—in combination with statin drugs, fibrates cause an increased risk of rhabdomyolysis (idiosyncratic destruction of muscle tissue) leading to renal failure.    

Dopamine Agonists for Restless Legs
There are no laboratory tests to diagnose RLS and no physical examination findings are indicated for determining the presence or cause of RLS. Recommendations for the drug are based solely on symptoms. Since movement relieves the symptoms,  it is commonly reported that the symptoms only occur or are worse at night.
Orally administered dopamine agonists are being widely advertised for symptomatic relief of RLS. In pharmacology, an agonist is a substance that binds to a specific receptor and triggers a response in the cell. It mimics the action of a neurotransmitter or hormone that normally binds at that site. Since agonists are useful in replacing the neuron-transmitter dopamine, these drugs are also used in the treatment of Parkinson’s disease. Of course the patho-physiology of both Parkinson’s and RLS is unknown.
Studies have shown that these drugs have helped some people control or improve their symptoms. Although they may seem to help at first, later these medicines may make symptoms worse by a process called augmentation.
The most common side effects in clinical trials for RLS were nausea, headache, and tiredness. Studies indicated the drug has little or no effect on blood pressure or pulse rate when lying down. But, upon standing, they produce a drop in blood pressure, both the systolic and diastolic. These changes are accompanied by lightheadedness upon arising, general fatigue, inability to tolerate stress, and a slow, weak pulse rate. Based on the above, it is reasonable to assume you will again find loss of normal thoracic kyphosis in these patients due to muscle contraction.
Increased urinary potassium losses also become significant when dopamine agonists are used for symptoms of RLS. Symptoms of potassium deficiency include stiff, sore joints, constipation, inability to think clearly, and cardiac arrhythmias.
In my practice, I used nutrition to maintain health and give support to those patients taking medications.  Food enzymes are the key to improving digestion and nourishing the body when signs of inflammation appear.  The loss of normal thoracic kyphosis is an easily recognizable sign warning you when a patient requires food enzyme supplementation.
Again, your patients should be informed that prescription drugs are used for the treatment of disease and they do not restore normal function, nor can they maintain health.

 

Dr. Howard Loomis can be reached by mail at 6421 Enterprise Lane, Madison, WI 53719 or by phone at 1-800-662-2630.  
Visit his website at: www.loomisenzymes.com.

Decompression… Where it all Began

Dr. Allan Dyer has a Bachelor of Science degree in Pharmacy and is a doctor of Internal Medicine. He was also awarded a Ph.D. for his graduate studies and pioneer work in Transthoracic Cardiac Defibrillation.

During his career as a senior administrator and Deputy Minister of Health, he instituted the hospital services quality assessment, generic drug substitution program, prescription drug benefit, emergency air ambulance and paramedic programs for the government of Ontario.

On retirement from government service, he pursued research leading to the development of spinal decompression technology

He coined the term Vertebral Axial Decompression and registered the first medical device to administer this procedure with the Food and Drug Administration. He has been awarded three US patents on the equipment and the procedure for non-surgical spinal decompression .

In an interview with The American Chiropractor (TAC), Dr. Dyer….

 

 

TAC: Could you tell our readers about the VAX-D table. How did the idea evolve?

Dyer: The recognition that chiropractic manipulation does help relieve low back pain coupled with the fact that research had shown discogenic lesions to be the main pain generator led to investigation to develop technology that could be programmed to modulate intervertebral discs beyond that possible with manual methods.

Many years ago, a pioneer in the back pain field named Cyriax hypothesized that, if we could find a method to distract the spine that would not elicit trunk muscles’ contraction, we should be able to produce negative intradiscal pressure, which, if strong enough, could suck a herniated disc back in.

We started the search with standard traction devices like the Tru-Trac device, but found that linear traction (whether applied statically or intermittently) did not bypass trunk muscle contraction.

We discovered that tension applied to the spinal column using a logarithmic time force curve bypassed the muscle guarding reflex, and lowered the disc pressure to negative levels.

Recently, we have made significant advances in motion control technology that incorporates physiological biofeedback to control and perfect the decompression procedure.

 

 

TAC: There are a certain amount of doctors out there that would say there is no difference between decompression and traction. How would you respond to this assertion?

Dyer: Because there are commonalities with traction superficially, some people equate the procedures. The same superficial attitude would state that a CT scan is nothing more than an X-ray. The difference in both cases is the inclusion of computer technology that significantly impacts the outcome of the procedure.

Traction has been in use for many years as an unsupervised physical therapy modality. Traction has not been shown to lower intradiscal pressures, and has had a dismal track record with chronic low back pain. Anderson and Nachemson placed pressure transducers in four subjects in the lumbar spine during traction procedures. They found that the intradiscal pressures went up dramatically in both cases. They concluded that at no time was negative intradiscal pressure observed and, therefore, the disc could not be sucked back in as proposed by Cyriax. They suggested that, in order to produce a relative reduction in disc pressure, traction must be administered in such a way as to allow trunk muscle relaxation. Traction can be expected to increase intradiscal pressure and can, therefore, aggravate a protruded, herniated or extruded disc. It is, therefore, contra-indicated for patients with herniated discs.

Technological advances, along with our research, led to the development of VAX-D Treatment. The computer control of the equipment allows controllable, effective axial distraction to be applied to the lumbar vertebral column without eliciting trunk muscle contraction. We found that distractive forces must be applied and released in a progressive logarithmic fashion.

 

 

TAC: Can you please explain what is meant when you say that it is a logarithmic pull pattern?

Dyer: VAX-D incorporates computer programmed technology that applies the tension according to a logarithmic curve. Essentially, as tension is increased, the time function is progressively slowed. This is a critical difference between VAX-D and traction and is the reason VAX-D was issued a US patent #6,039,7376. This patent describes the complex computer program and illustrates the logarithmic time/tension curve.

Traction applies tension on a linear time rate; e.g., if you plot the strength of tension (lbs.) vs. time (secs.), the plot is a straight line. The biological response to traction causes reflex muscle guarding. This is a homeostatic protective response that prevents traction from decompressing discs. When the procedure is governed by a logarithmic time rate, reflex guarding is averted, and the disc pressure can be decreased to negative levels.

 

 

TAC: What would you say is the percentage of tables sold to chiropractors versus those sold to other professions?

Dyer: About 65 percent of our devices are utilized by MD’s and DO’s. The remainder are used by chiropractors and PT’s.

 

 

TAC: What kind of research has been done on the VAX-D and/or decompression in general?

Dyer: It should be noted that VAX-D is the only device proven to achieve spinal decompression through direct recording of negative pressures in intervertebral discs in living subjects. No other device has been shown to lower the disc pressure. In addition, independent clinical research has demonstrated neurodecompression following VAX-D. No other product has ever published comparable research studies. Therefore, practitioners using any other devices cannot legally substantiate spinal decompression claims.

VAX-D also has a number of clinical studies that have demonstrated significant efficacy. That fact that these clinical studies have shown consistent levels of success also provides practitioners with research evidence of efficacy.

In a recent internet search (January 2008) using PubMed, Medline, and Embase, we could not find any clinical research on any of the other so called decompression tables published in “peer reviewed” medical journals. Yet they all claim success rates in excess of 85 percent.

 

TAC: What is the biggest difference between the way the way MD’s approach the use of the decompression, versus how a DC initially approaches it? Is it any different to that of a DO?

Dyer: MD’ and DO’s are able to utilize the complete VAX-D protocol in the treatment of back and neck pain. Many patients have a large inflammatory component to their spinal disorder. The VAX-D protocol includes the use of certain prescription pharmaceutical agents in conjunction with the mechanical therapy. In addition, particular diagnosis, such as Internal Disc Disruption, require the concomitant use of Matrix Metalloproteinase Inhibitors (MMPI’s) along with an oral steroid such as methylprednisolone.

DC’s and PT’s are unable to prescribe so they are not able to take advantage of all of the treatment adjuncts unless associated with a multi disciplinary practice.

Also, many DC’s (and some DO’s) add spinal manipulation to the procedure. We caution all practioners not to add any adjunct that has the potential to increase the intradiscal pressure.

 

TAC: Are there any threats to the use of this technology as a form of improving low back pain in the future?

Dyer: There are several unrelated answers to this question. One threat has been the use of fraudulent and illegal marketing techniques. Some practitioners have already been subject to fines for making false claims.

The other threat to the availability of the treatment is improper denial of claims for the service by insurance providers and third party payers. The treatment is often denied on the basis that the treatment is “investigational and experimental” in nature. In fact, the treatment does not have an investigational regulatory status with the US Food and Drug Administration, whose mandate is to make such determinations. Investigation devices must be utilized under an Investigational Device Exemption.

Several landmark class action lawsuits against a number of managed care companies have concluded that they have engaged in a conspiracy to improperly deny and delay claims, in whole or in part, and/or reduce payment to physicians based upon improper use of definitions of Experimental and Investigational status of treatments.

We believe that “evidence based medicine” should be a determining factor in whether a drug or device should be recognized and reimbursed by the health insurance industry.

VAX-D is the only device with a long history of studies published in peer reviewed journals, including a recent study, in February 2008, that showed short- and long-term outcomes after VAX-D treatment in a large sample of patients with activity-limiting low back pain that had failed at least two previous, non-surgical treatments. The study showed that patients had significantly improved pain and disability scores at end of treatment, at 30 days and at 180 days post-discharge.

 

TAC: Can you tell our readers about the cervical component? What kind of conditions have demonstrated improvement?

Dyer: Anatomical differences and enhanced proprioceptor reflex sensitivity, compared to the lumbar spine, dictate the use of higher precision and special adaptations to successfully treat discogenic lesions in the cervical spine.

Research found that the application of tension needed to be strictly controlled in the horizontal plane and the vertical plane in order to avoid triggering muscle guarding and spasm in the cervical spine. The cervical collar component is also critical for distracting the head and neck, because it allows the required mobility of a circumferential lift system, while providing the necessary support and immobilization for patients in the post treatment period when the muscle guarding reflexes have been reduced. Without the protection of the collar, head and neck movements will trigger muscle spasm, increased intradiscal pressure and neck pain.

We have many of the new Genesis Cervical systems in the field now, and they all report success with herniated and degenerative disc disease cases. We will need to do properly designed clinical studies in order to determine the overall success rates with different conditions.

 

TAC: How do post surgical patients respond to decompression?

Dyer: Post surgical patients respond positively to VAX-D treatment, although the reported success rate in the literature is lower. An outcome study on 778 patients wrote: “Thirty-one patients had previous lumbar disc surgery. Eighty-four percent of this group’s pain scores, 71 percent of their mobility scores and 61 percent of their activity scores improved by one unit or more with therapy, and 65 percent of their pain scores were reduced to 0 or 1. Vertebral axial decompression was well tolerated.”

 

TAC: While there are many different types of decompression tables available with varying degrees of research to support it, what’s your advice to our readers who may be using any type of “decompression” table in their practice?

Dyer: Look to purchase equipment that has clinical support published in peer reviewed medical journals. Don’t base the purchase on marketing hype. Look for at least Level II evidence of efficacy.

 

TAC: Is there an issue that doctors using decompression along with cash prepayment plans should be aware of? (Ie, Is the patient paying for something that they’re not getting??) Can you explain this concern?

Dyer: Yes, there is an issue when a practitioner is charging a patient for decompression, using a traction device. In addition, a patient should be treated with equipment that has clinical support for its efficacy.

 

TAC: When it comes to decompression, there are many concerns and/or rumors about the government or insurance companies giving doctors problems when utilizing this new technology. Who are these people/organizations? And why do you think they are giving doctors such a hard time?

Dyer: The Department of Justice has an obligation to protect the public against false advertising. The DOJ and some insurance companies have initiated investigations into fraudulent claims made by decompression device manufacturers, and then repeated by practitioners in promoting the service. Patients cannot be induced to take a treatment based upon fraudulent claims.

The spinal decompression industry is full of misinformation, unsubstantiated claims and marketing hype. Many manufacturers have been quoting research done on VAX -D as though it applies to their device. That is illegal. It is disconcerting that the industry has grown so large, when a search of the medical literature reveals there are no studies published in peer-reviewed medical journals on devices other than VAX-D.

Many device manufacturers claim that their equipment will lower the intradiscal pressure. To this day, VAX-D is the ONLY device shown in clinical research to decompress the disc to negative levels (Ramos & Martin, Journal of Neurosurgery).

 

TAC: Any final words for our readers?

Dyer: We at VAX-D have always been more interested in the outcome for the patient, rather than the marketability of the equipment. One of our mottos is, “Real Science, Real Studies, Real Results”.

I would advise purchasers to make their decisions on clinical evidence rather than on marketing hype, and to make sure that they can substantiate any claims that they make regarding the treatment and its success rates.

 



Inspiring Millions to Become More Fulfilled and Successful

Inspiring Millions to Become More Fulfilled and Successful

 

Dr. John F. Demartini earned his Bachelor of Science degree while majoring in Biology and Biochemistry at the University of Houston in 1978 and was accepted at Texas Chiropractic College earlier that year. In 1982, Dr. Demartini acquired his Doctorate Degree and graduated Magna Cum Laude, as Salutatorian of his class. In addition, he earned a Special Achievement Award in Clinical Practice. Throughout his clinical training, he specialized in somatopsychic and psychosomatic health disorders while undergoing curricular and extracurricular studies in clinical psychology.

Continue reading “Inspiring Millions to Become More Fulfilled and Successful”

Thinking About a Problem While Getting Adjusted?

Thinking About a Problem While Getting Adjusted?

 

Scott Walker, D.C., has been a chiropractor for over forty-three years. Frustrated with uneven results in practice, he developed the Neuro Emotional Technique (NET). In addition to having written numerous magazine articles, he has authored many technique manuals, charts, audio and video recordings and also formulated specialized mind-body homeopathic remedies. While teaching internationally with his chiropractor wife, Dr. Deborah Walker, he has also done radio and television interviews and conducted research. He is the founder of the ONE (Our Net Effect) Research Foundation, a non-profit multidiscipline research organization dedicated to doing scientific research on NET.

In the United States, the NET Basic seminar is approved for twelve hours of continuing education hours for chiropractors in most states.

Dr. Walker is credited with a good sense of humor and making learning a fun experience.

In an interview with The American Chiropractor (TAC), Dr. Scott Walker talks about NET’s past, present and future.

TAC: What is NET?

Walker: NET is a simple mind-body stress reduction intervention aimed at improving behavioral and physical problems, such as in chronic injuries, subluxations, pain, worry, anxiety, depression, etc.

 

TAC: How did you develop this technique?

Walker: In a state of frustration, insecurity and, thankfully, curiosity, NET was eventually developed. Initially I felt frustrated because some patients got well, while others didn’t. I also felt insecure because I didn’t have a satisfying answer for myself or my patients who asked as to why their conditions didn’t respond or why they kept coming back. I was curious, however, and my search took me to “stress” and the body’s conditioned emotional reaction to stress. The interesting thing was I, through reading neuroscience articles, found the emotional response to be physiologically based and not psychologically based! That was lucky, because I don’t know very much about psychology, and I was not about to make a career out of talking, talking, and more talking to patients about their problems! Please save me from that! On the other hand, we, as chiropractors, are well versed in dealing with physiology. In a nutshell, NET works by having the patient think-feel about their pain/issue while a special vertebral adjustment is given. They do 90 percent of the work.

 

TAC: Could you tell our readers a couple of the most prominent studies that have been published regarding NET?

Walker: NET has many interesting studies on a surprisingly wide variety of conditions. But, then again, that is what one might expect if there were a truly effective mind-body technique. We have a Randomized Control Trial (RCT) study on Low Back Pain through Macquarie University, which was presented to the International Congress of Complementary Medicine this year, and we are just finishing a much larger study (it will be the most comprehensive yet in all of chiropractic) on low back pain, complete with urine and blood immune markers. In chiropractic, I guess we would expect that. But more surprising perhaps, NET has RCT’s (one out of Oxford) on phobias, trigger point resolution, and we have other studies on polycystic ovary, ADD-ADHD, hypothyroidism, separation anxiety, hypercholesteremia, etc. We also did an interesting survey/treatment study on anxiety/depression (using the DRAM instrument) that was remarkably favorable. And, in addition, this study had the shocking finding that, in the random (188 consecutive patients) chiropractic pre-treatment group population, 34 percent were “at risk” and only 23 percent were normal. This finding strongly suggests, in our regular chiropractic patient populations, over a third of our patients are in deep emotional trouble. Fortunately, however, there was significant improvement after the NET intervention.

This reminds me of a published study I did (it was international in scope) which demonstrated that 90 percent of DC’s feel the emotional component of health to be important, yet less than one-third of them had a technique to intervene. Perhaps, for outright interest in studies, maybe the most prominent study is the one we are presently doing on the body stress/trauma related to a patient who receives a diagnosis of cancer (the pronounced diagnosis, itself, is often as shocking as PTSD). We already did a pilot study at Thomas Jefferson University’s Myrna Brind Center of Integrative Medicine and Hospital. This pilot study has been published and, although the blood sample was too small to include, we were delighted to see the immune markers, especially Interleukin 10, dramatically improved, which is also what the preliminary results in the large low back study are now showing. We are now doing a larger study and, who knows, we might have THE profession with the most influence on the immune system.

 

TAC: What does it take to really understand the core concepts of NET?

Walker: For actually doing the technique, it takes twelve hours of training in a seminar setting with hands-on workshop. Pretty straight forward. But to actually understand NET in depth, one has to be ready to throw out most of the outdated neurophysiology that was learned in school. For example, we may have learned that emotions are psychological, but now we know they are not; they’re physiologically based. We need to see the inter-relatedness not only between the emotional response and the immune system as in psychneuroimmunology, but also the digestive, cardiovascular, dermatological, and hormonal systems, to name a few. A few basic primers are the books Molecules of Emotion by Candace Pert and the excellent Biology of Belief by Bruce Lipton. Then follow all the incredible advances in neuroscience—advances that are validating chiropractic.

 

TAC: What would be the ideal patient for NET? Is there an ideal?

Walker: Anyone who is experiencing a stubborn physical problem, or anyone is experiencing stress or who has been under significant stress in the past, or has the manifestation of behavioral or health issues with no apparent cause, or someone who has a health challenge that is not resolving with standard chiropractic care, or someone who has emotional blocks to success in their life or health.

 

TAC: What type(s) of diagnostic testing procedures do you use (i.e., X-ray, etc.) and why?

Walker: We encourage our practitioners to retain all of their present techniques and diagnostic instruments and to use NET as a supercharger to make their present techniques work even better. Our present chiropractic techniques work three to four times better when a compromising emotional factor is neutralized. Although it’s not essential for doing the technique, we recommend peer-reviewed validated questionnaires, and any of the standard clinical and lab tests for the hypothalamic-pituitary-Adrenal (HPA) axis. While these are not essential for actually doing NET, they can give interested practitioners confidence as they monitor the progress.

 

TAC: What other therapeutic modalities do you include when treating a patient?

Walker: We use the metaphor of the four bases of a baseball diamond, calling it the Home Run Formula to Health. Doctors need to make sure the patient is safe at each base by 1.) providing good structural work, 2.) addressing toxins, 3.) balancing biochemistry, and 4.) de-stressing conditioned emotional responses that are affecting the body. NET practitioners are encouraged to use their structural techniques, as well as specifically formulated homeopathics to detoxify the body and nutritional support to balance biochemistry. Of course, NET practitioners use NET to address the physiology of unresolved emotional stressors.

 

TAC: Tell us two of your most amazing patient success stories.

Walker: We, all of the NET instructors, have seen many, MANY cases at NET seminars where chiropractors come with their own unresolved low back pain of twenty-plus years and are immediately resolved after a five-minute NET intervention. It’s amazing in that chiropractors have low back pain in the first place, and it’s really amazing that they can resolve on the spot. The same can be said for other afflictions on these sophisticated DC health-care consumers. I’d tell you of others, but risk losing credibility!

 

TAC: What has really impacted your growth as a chiropractor and that of your practice?

Walker: For me it’s not what, but rather who. My heroes have been Drs. George Goodheart, Jimmy Parker, Major DeJarnette, Ray Nimmo (“Muscles move bones, bones don’t move muscles”), and Robert Riddler. I also love to read DD Palmer and BJ. These guys are all gone now. Presently, I also look up to our chiropractic researchers who are laying the scientific foundation for a whole new exciting era in chiropractic.

 

TAC: Dr Walker, what have you been able to accomplish with your work that you are the most proud of?

Walker: I am proud of our 6,000 plus NET practitioners in over thirty countries around the world delivering cutting edge chiropractic every day. I’m proud because they were forward thinking and saw the value of NET before the scientific research validated it. They cared that much about their patients, and they donated money for research based on what they saw clinically. I am proud to be in the same profession.

 

TAC: Explain the relationship between psychologists and chiropractors. Is there a creative exchange of information, etc?

Walker: Yes, although we like to smile and say the “issues are in the tissues,” there are often psychological aspects of some problems we encounter which need talk-it-out reasoning and counseling. And, with the emergence of the mind/body or biopsychosocial model, these psychotherapists are very ready to refer to NET practitioners to get their client’s nutrition balanced, structurally adjusted, etc.

 

TAC: Who/What has been the greatest influence on the way you practice?

Walker: Aside from my heroes I mentioned, I am ever grateful for being raised way out in the country where I learned from nature, my greatest teacher. I also went to school in a two-room schoolhouse where I was unhurriedly able to absorb the fundamental building blocks of knowledge. My father, a mechanic, patiently taught me how things work and my mother, a nurse, taught me how to care—combine those two and you get a chiropractor.

 

TAC: Throughout the ages, there have been many great healers. Whose approach would you like the most?

Walker: That’s easy, Hippocrates, for separating healing from magic; the Yellow Emperor emblematic for the East’s wisdom about nature and healing forming a great basis; and then the brilliant medical heretics, Paracelsus, Semmelweis, Hahnemann, and DD Palmer.

 

TAC: What are your goals for the chiropractic profession?

Walker: To make DD Palmer’s paradigm, “The determining causes of disease are traumatism, poison, and autosuggestion,” and “moving thots (sic) produce disease—malice, revenge, remorse, grief, worry, spite, etc.”—into a rock solid, scientifically validated, pragmatic and prosperous profession. DD saw it from afar. The 19th century biomedical model has failed miserably; the biopsychosocial (BPS) model is now the predominantly acknowledged viable model. Essentially the BPS was, and is, DD Palmer’s paradigm. But we are catching on. The stress factor is there and it is now being acknowledged. There are other techniques besides NET which, depending on the DC’s predilections, can help practitioners and are helping with stress. Such examples are Bio Energetic Synchronization Technique (B.E.S.T.) and Network Spinal Analysis. In addition, Applied Kinesiology and Total Body Modification (TBM) and, John Amaro’s International Academy of Medical Acupuncture (IAMA) have unique approaches.

 

TAC: Any final words for our readers?

Walker: It’s been a hard fight, but we DC’s have done well. We have kept vitalism alive in the face of medical and legislative persecution and commercial discrimination. We have fought with them and, of course, being chiropractors, fought with each other, but we have not given up on fighting for our patients’ welfare, for what we have seen helps them. I encourage everyone to financially support our colleges’ scientific research departments. Science is the only currency that spends these days. It better, as we enter into ever more evidenced based third party pay, including a looming federalization. As you know, we are usually at the very end of the Medicare line with our hands out. We are going to beat traditional medicine using the very weapon they have used against us, science—only better. It used to be the medical establishment would say they had research and that we did not. Now, we can say to them, we have research demonstrating that pathophysiology can be eliminated through natural drugless means, thus restoring true health. Furthermore, we can say, “Your medical research may show a certain drug has the ability to force a certain effect; however, that particular medical mechanical paradigm has nothing to do with the patient actually healing.” Medicine, indeed, has a science of sorts, but a puny unworkable philosophy of health. Outside of emergency and heroic life saving measures, medicine has even been deadly at times. Not so with chiropractic. I will be speaking at the World Federation of Chiropractic in Montreal in April, 2009. Please come hear what NET science through The O.N.E. Research Foundation has provided us, and learn what other top-notch chiropractic researchers in the various colleges have also achieved in other realms.

 

You may contact Dr. Scott Walker at N.E.T., Inc., 5651 Palmer Way, Suite C, Carlsbad, CA 92010, by calling 1-800-888-4638, emailing [email protected], or visiting

Real Marketing from the Experts

Real Marketing from the Experts

Michelle Geller

Dr. C. J. Mertz

MGV Marketing, Inc

Team WLP

William D. Esteb

Dr. Mark Sanna

Patient Media

Breakthrough Coaching

Dr.Daniel T. Drubin

Dr. Timothy J. Gay

ProPractice Partners

Ultimate Practice

Dr. Mark Studin

Dr. Eric Plasker

CMCS Management

The Family Practice

 

Market Review

 

We’ve gathered eight top experts in the Chiropractic field, just for you, to provide you with fundamental methods of marketing that can be integrated right now, on a shoe string, and keep your practice thriving years into the future.

 

 

Michelle Geller VinoThe most cost effective way to attract new patients is through relationship building. Relationship building costs virtually nothing and is simple! My analogy is, if the doctor wanted to become the mayor of his/her town, what would be the best way to become known? The answer is to meet as many people as possible.

One of the easiest ways to attain this goal is for the chiropractor to go out into the community and offer to do educational workshops in schools, corporations and organizations on health, wellness and safety topics, as part of his/her community awareness program. That doctor will become the most well-known very quickly. Especially in this economy, employees in the workplace should be educated to stay healthy and be as productive as possible.

This is a proven way to attract new patients into any practice! There is no cost. All that is involved is putting aside consistent time each week to make the calls. Michelle can be reached at 1-561-392-5206, by visiting her website at www.mgvmarketing.com or by emailing her at  [email protected].


William D. EstebThe biggest marketing problem for chiropractors these days is the inclination to cut back and turn inward when things tighten up, often considering patient education as a needless luxury. Simply put, getting new patients is about effectively telling the chiropractic story to as many people as possible. Patient Media helps chiropractors communicate chiropractic clearly, concisely and persuasively with state-of-the-art, visually-based patient education resources, informative videos, report documents and reactivation tools. What makes Patient Media unique is that we help chiropractors see their practices and their internal and external marketing procedures from a patient’s point of view. We offer free blog posts at www.patientmedia.com, Monday Morning Motivation, magazine articles, books and audio recordings to help chiropractors understand today’s patients, focus their communications and stay on message.

For more information, call 1-800-486-2337, visit www.patientmedia.com, or email [email protected].

 

Dr. Daneil T. DrubinThe number one challenge that practitioners in the market place appear to be experiencing is in the area of patient retention. At ProPractice Partners, we work with our clients on the quality of their communication. We know that the quality of patient compliance can be directly related to the quality of communication. The more the doctor is prepared to “give direction, and hold the patient accountable,” the more the patient connects with the doctor.

Here are 4 strategies that, when applied properly, will increase patient compliance:

1. Work diligently at the end of the new patients’ first visits, to have them return for the results of their tests with a spouse or significant other. Remember, any time that you speak with only one member of the family, 50% of the time you have the decision maker with you and the other 50% of the time the decision maker is at home. Patient compliance is always improved when the patient’s partner is 100% behind the doctor’s recommendations.

2. When you provide patient recommendations, consider the following…the patient only hears the lowest number of visits that your recommend as you present your program of care. Make certain that you and the patient are clear about what it is going to take to maximize results during their experience at your office.

3. Patient education increases patient compliance! Our clients provide their patients with an entire series of patient education programs. These programs are designed to educate and motivate the patients as the doctor builds value about the benefits of chiropractic care as a lifestyle choice. The more time and energy the doctor invests into patient education, the more the patients will follow through with their care and the more referrals that will be generated.

4. Make sure that the patient always has something to look forward to. If the patient is properly prepared, whether it is for their next re-examination, an exercise program, or nutritional support, the patient will be more compliant.

If you incorporate these 4 essential patient protocols into your office, your compliance will increase as will the patient’s response to care.

For more information, call 1-520-575-0207 or visit www.ProPracticePartners.com.

 

Dr. Mark StudinGet out of your office and introduce or re-introduce yourself to the community by visiting one shopkeeper at a time. It is a numbers game and the goal is to double the people who know you, not the number of people you know…. It is that simple. Don’t forget to write them thank-you letters after you return to your office, adding your business card so they are reminded of whom you are and where you practice.

As for what CMCS Management does, we help guide doctors through a process of becoming the best-of-the-best through information provided or recommended and also work with you on how to approach a patient from a triage perspective. We then share with you how to look as great on paper as the consummate professional you really are. In the medical-legal world, the written word carries weight and all else is non-admissible rhetoric. Once that is accomplished, we give you a system to get the lawyers to come running after you because, the second you ask for a referral, the game is over and you have lost. The lawyer has to understand that you are the solution to their cases in an honest and ethical environment and that is the easiest part, once you have created an infrastructure of clinical excellence.

Dr. Studin can be reached at 1-631-786-4253 or visit www.TeachChiros.com.

 

Dr. C.  J. MertzThe biggest problem most chiropractors face is the inability to produce “overlapping” in their marketing efforts. New patients come from one of four actions: Energy on the inside, energy on the outside, money on the inside or money on the outside of your practice. Increasing new patients is always the result of proper overlapping of all four marketing actions organized in six to eight week programs. This process is known in WLP as periodization.

The solution has five phases. Phase One is to always create a personal environment in your belief which builds upon your love, passion and energy to serve. Phase Two is to develop a budget (up to 10% of your monthly gross collections), so that you can determine those marketing actions that best serve the next level of growth for your practice. Phase Three is to organize a six to eight week period of overlapping marketing that includes daily, weekly and monthly actions. For Example: hand out five referral packets per day, schedule six awesome weekly titled workshops, place a monthly ad in the newspaper and schedule three screenings over six weeks. The fourth phase is hiring or training a Chiropractic Assistant with passion and skill to partner with you and turn your marketing campaign into practice success. The final phase is to carefully track your results so that you can improve as you prepare your next marketing periodization.

Chiropractic works, we just need to get the message out loud and clear; let’s make it happen!

Dr. Mertz can be reached at 1-512-347-1895 for further explanation of marketing periodization.

 

Dr. Mark SannaRoll the Video! Online communications are changing. Chiropractors are now sharing information about their practices using podcasts, online video and, now, live video streaming. With the web evolving to include these richer media channels, the savvy marketer must learn how to listen, understand and use the same media. Broadband penetration is 70% in the US, making streaming video a “must” marketing tool for your practice. One hundred twenty-three million Americans watch at least one video a month, and three-quarters tell a friend about one. Video provides you with an enormous opportunity to engage, educate and entertain (yes, entertain) your patients: the “Three E’s” of successful marketing. Chiropractors are producing specialized videos to help their patients get the most from their chiropractic experience. These video messages include everything from virtual tours of the practice, welcome messages from the doctor, new patient orientation sessions and even customized home exercise programs, all streamed over your practice’s website.

For more information, visit www.mybreakthrough.com or phone 1-800-7-ADVICE (1-800-723-8423).

 

Dr. Timothy GayThe single biggest barrier that is ongoing in practice is to stay motivated and not get discouraged in the marketplace.

There is a lot of competition in health care and, with all of the marketing trends changing, many doctors will start a program and become disheartened if there are no immediate results.

Speaking engagements, screenings, and networking, from an overhead stand point, are the most economical ways to get new patients. Many doctors have an inability to go outside of their offices and communicate the chiropractic message in a sharing—not selling—way.

Along with thinking and doing, taking an action step is what is needed in any marketing endeavor. It is extremely important to keep the right attitude to accomplish the most in your practice. Selling the public on your definition of chiropractic is done only by creating reasons for patients to participate in their health care. Buying motives are more important then selling motives. The public has a what’s-in-it-for-me-attitude towards everything. Give information away—not services—and remember that negativity is a misalignment from achieving your goal.

Dr. Gay can be reached at 1-866-797-8366, or [email protected].

 

Dr. Erick PlaskerImplement a Healthy Generations Campaign in your practice and begin attracting the families of the people that are already coming in. This includes the traditional family members such as the moms, dads, children and grandparents as well as the inner circle families of your patients, which includes their friends, co-workers and community relationships. Put up a Generations Board with pictures of any traditional or inner circle families who are under your care. When you do this, instead of getting one new patient at a time, you will begin to get 5, 10 and 15 new patients at a time. I know this may sound too simple, but that is the brilliance of it. Focus your report of findings, daily visit procedures and marketing efforts to produce these types of results and you will experience substantial growth with minimal to no expenses, even in this crazy economy.

Dr. Plasker can be reached at 1-866-532-3327 or visit www.thefamilypractice.net.

“Nerve First” Approach

“Nerve First” Approach

by David Fletcher, D.C., F.C.C.S.S.(C)

 

 Dr. Fletcher is a 1980 graduate of Canadian Memorial Chiropractic College with a Fellowship in Chiropractic Sport Sciences. He trains and teaches thousands of chiropractors to interpret and communicate the power of chiropractic care, using CLA’s Insight scanning technologies. He continues to practice daily, while developing new strategies for coaching chiropractic offices towards excellence.

“Like most patients, I began seeing a chiropractor for some spinal pain and sports related injuries. This was in the early seventies, and my parents and I used chiropractic as one would use dentistry or medicine. A chiropractor was just another doctor you went to; in this case, for spinal care. Our family DC had little interest in teaching the “Big Idea” and would tell us to come back if it hurt. When I chose to become a chiropractor, I had no idea that chiropractic was a healing system based on vitalistic principles and the powerful science supporting it. That was until I heard Reggie Gold speak, off campus, of course. His signature lecture, ‘The Chemistry of Life’, struck me between the eyes. Here I was, already in a chiropractic school and I was being trained to heal people, not just spines! I was ecstatic! All we needed to do was tell the story often and properly.”

And so the journey began that has led Dr. Fletcher around the world, teaching chiropractors that the hip bone is connected to the universe, because of the neurology that lies within. The American Chiropractor (TAC) caught up with this dynamic communicator in his office outside of Toronto, Ontario, Canada.

TAC: You’re a busy man with your speaking and coaching programs. Tell us what you have been doing to spread the message of chiropractic.

Fletcher: I do teach, train and coach chiropractic teams to excel; but what I still love to do is practice chiropractic. I call my office a “living laboratory” for developing new and innovative teaching and communication strategies. I think that this adds a relevancy to what I teach. I am always amazed at how a subtle shift in the message can be so powerful at getting that “Ah Ha” from the patient. Being in practice allows me to refine and simplify the message.

Helping someone through a pain or symptom crisis is honorable. At the spinal-mechanical level, we can assist a lot of people; but that is only the entry point for people to experience chiropractic. The real story of healing energy and potential lies in the connections of neurology within the spinal-neural-dural array. Our role is to show people how to care for this amazing system and coach them to live life fully. I practice and coach the benefits of an invitational approach which allows the doctor to become the trusted advisor, leading patients along their path to wellness.

 

TAC: Wellness seems to be the most popular message amongst chiropractors today. Tell us your thoughts on the link between wellness and spinal care.

Fletcher: Seven years ago, I was brought in to consult with an international health and safety board that was comprised of government and business leaders to whom I introduced this “bizarre” notion of wellness being included in corporate health programs.

They just couldn’t get their heads around this idea of something bigger than prevention; but they took a leap of faith and we created “The Wellness Way” at their annual convention. Eight thousand attendees got a glimpse of a new perspective in employee health. We used Chiropractic Leadership Alliance’s Insight Scanning technology to show how stress and nerve interference were present in almost everyone, whether they had back problems or not. This allowed us to show how stress was interfering in employee health and performance and, of course, tell how chiropractic was the natural starting point for a wellness program. The organizers were amazed at the interest and desire of business groups to learn about the natural management of stress in the workplace. Fast forward to the present and the Wellness Way is sponsored by all levels of government and big business. In these organizations, wellness is seen as a necessary message and funded protocol. Our challenge now, as chiropractors, is to bring the full message of healing and health forward and to be seen as relevant players in these programs. If we limit the story to back and neck care, we miss out on telling the wellness story, which mires us in the competitive spinal therapeutic marketplace. Our philosophy, science and the artistic brilliance of an adjustment, positions us perfectly as leaders of the wellness culture.

The link between Wellness and spinal care
really comes down to one word:certainty

 

TAC: So, if the time is right to see chiropractic breakout on the international health and wellness stage, what’s holding chiropractors back?

Fletcher: Well, it really comes down to one word: certainty. On a practical basis, I teach that you get paid at the level that you perform with certainty. If you are certain that you can manage acute care, you develop a terrific acute care practice. If you are certain that wellness lifestyles and lifelong chiropractic care are essential foundations for your community to thrive, then the sky is the limit for your practice.

Unfortunately, doubt and insecurity are rampant within the profession. If you can believe it, we see that the greatest uncertainty is around the role of the chiropractor. In seminars, we ask the question, “Are you acting as an over qualified physiotherapist, an under trained medical doctor or a perfectly capable chiropractor?” This is where coaching and mentorship is necessary. A capable coach can really help to teach the principles, while training congruent procedures. Most of all, a coach can mentor and unleash the hidden potential while refining the raw talent.

 

TAC: You mentioned earlier the importance of the nervous system in telling the chiropractic story. Tell us more about this.

Fletcher: I attained my Fellowship in the Sport Sciences in the mid 90’s. I wanted to learn more about performance and apply that to the chiropractic care I was delivering. What I came to respect and understand was the absolute importance of neural competency and efficiency. I started to investigate surface EMG as a reliable indicator of spinal nerve function and came across these two chiropractic pioneers named Patrick Gentempo Jr. and Christopher Kent of the Chiropractic Leadership Alliance. They had a terrific technology that included spinal range of motion, thermal scanning and the sEMG. I realized that this would be the perfect combination to show how the spine and nerve function were so intimately related and I immediately made this the hub of my practice.

 

TAC: How did you make this technology work for you?

Fletcher: Examinations, reporting, and even marketing were based upon the principle of identifying subluxations and tracking the changes with this technology. My practice changed dramatically and, years later, continues to thrive based on this principle. The most measurable change was in the retention of patients. A care plan was now relevant, as it addressed the issues that brought the patient in and laid the foundations for wellness and stress management. I developed a new practice paradigm known as the “20-80 practice.” This is a reversal of a traditional practice where 80% of patients in a practice are there for the 2-4 months while only 20% stay a bit longer.
This traditional style of practice demands a tremendous effort to acquire new patients to replace those that leave. I teach and train my clients that the “20-80 method” takes a “Nerve First” approach to examining and reporting. Although we always recognize the necessity of spinal alignment and function, our first goal is to identify patterns of unmanaged stress affecting the nerve centers along the spine. By introducing how daily stress can eventually “stain” the nervous system, a care plan using neural scanning and spinal function allows the patient to be actively involved in their care and progress. This creates long term relationships and, hence, the “20-80 practice” where 80% of the patients are under wellness care and 20% aiming to get there.

Chiropractors are so lucky that they have aligned their careers with the Universal principles of healing and
greatness.

 

TAC: How do you teach and train doctors to include this Nerve First approach in their practice?

Fletcher: I have become a leading authority on neural scan interpretation and the integration of scanning into a practice. Each year, I train hundreds of doctors how to interpret a full array of neural scans, including surface EMG, Thermal scanning, Inclinometry, Algometry and Heart Rate Variability. The real challenge is to ensure that a proper report is given by the doctor and I believe that is where my greatest skills shine through. Over the years in practice and while coaching doctors, I have developed powerful, yet simple, communication methods that take complex concepts and present them in practical and inspiring terms for the patient. A 7-10 minute Report of Findings really can connect the hip bone to the Universe!

I created the GAP Coaching program for doctors searching for that individualized training and mentoring. GAP stands for Greatness Action Plan. I believe that there is an untapped greatness in all of us that can be coaxed out and allowed to shine. Chiropractors are so lucky that they have aligned their careers with the Universal principles of healing and greatness. They are the perfect clients to coach with the GAP program.

 

TAC: What does Gapping mean in those contexts?

Fletcher: Besides the first meaning, we also use GAP as a communication and patient education concept. It’s a bit contrarian to the concept of “bridging the gap” and that’s what gives it an edge and gets people thinking outside the box. We teach the patient that GAP stands for General Adaptive Potential. It follows Selye’s work on stress and adaptation. In the nerve first approach, we teach the patients, very early in their care, the importance of identifying and modifying daily stress. Once we get them to understand the role that stress plays in their pain and health, we then introduce “widening the GAP.” Gapping is the process of releasing the innate healing response while we collaborate with the patient to reduce the stress load that is narrowing the GAP.

 

TAC: What do you see as the practice of the future?

Fletcher: It’s hard to envision what chiropractic will look like in another 100 years but, in the next 5-10 years, I see a return to basic business fundamentals where a cash practice dominates. The rapid decline in insurance contributions is obvious and, as we all know, it’s a mess dealing with paperwork and receivables. To make a cash practice work, all systems have to be ultra efficient and cost managed: a simple fee schedule, convenient hours, simple care plans that allow restorative healing and, of course, an inspired doctor and team that are expecting a miracle with each adjustment.

We can learn a lot from the masters at cash-based, long-term care…the orthodontists. I have taken some of their finest practice strategies and adapted them to work in a wellness centered chiropractic office. Linking stress, wellness, lifestyle and structural integrity in an organized care plan allows us to widen the gap over months and, eventually, years of care.

I think it is also very wise to take the time to “know” your ideal patient. Chiropractic impacts everyone, but there are certain groups of people that we just resonate better with. Focus on these patient clusters and become passionate about adjusting this group’s perspective and behavior towards wellness.

The other side of the practice profitability equation is managing overhead. We coach and train our doctors in efficient procedures that inspire and educate at the same time. Imagine a 3 or 4-day workweek, high intensity, high profitability, cash dependent and low, low overhead. Lofty intentions delivered with a high degree of certainty, blended with compassionate care and brought by a doctor who respects his own health and well being, are the foundations for the future, successful practice.

 

TAC: What single piece of advice would you give a new practitioner?

Fletcher: Meet people. There’s an old adage that states, “The more people you meet and greet, the more you treat.” When I started practice, I always had a stack of business cards in my pocket and handed them out to everyone I met. People, months and even years later, would remind me that I had passed along a card. In today’s technology based environment, meeting people can also be done via the internet. Joining networking sites, using Twitter, and sharing blogs allows you to meet a more diverse group of potential patients.

 

TAC: Thank you Dr. Fletcher for taking the time to share your story. Any last thoughts?

Fletcher: We are most powerful when we define our strengths and go for it! Above my desk is Aristotle’s quote,” We are what we repeatedly do. Excellence, then, is not an act but a habit.” Learning to be great and to act powerfully is a habit worth exploring.


You may contact Dr. Fletcher at [email protected],  by calling 1-905-831-9696, or visit www.docfletch.com

CLEAR Scoliosis: Case Study

CLEAR Scoliosis: Case Study

by Dennis Woggon, DC, B.Sc.

 

THE PATIENT PRESENTED in 2008 with a 48 degree right thoracic Cobb angle. It was initially diagnosed in 2005 at 25 degrees. The patient had a history of birth trauma. The scoliosis previously was treated with traditional Chiropractic Care. The standard CLEAR Scoliosis examination was performed. Her X-rays revealed a loss of the cervical lordosis and forward head posture (FHP) with left alar ligament damage. There was a primary right thoracic Cobb angle of 48 degrees, with compensatory left cervical dorsal Cobb angle of 35 degrees and a left lumbodorsal Cobb angle of 24 degrees. When the addition of the “compensatory” Cobb angles is larger than the primary Cobb angle (35 + 24 = 59), the scoliosis will advance. Treatment consisted of CLEAR protocols with 11 visits. The Mix, Fix, Set procedures consisted of warm-ups, adjustments and rehabilitation. The Mix phase consisted of cervical traction to improve the cervical lordosis and decrease forward head posture and vibrating traction (VT) to improve the cervical and lumbar lordosis. This mechanical traction (VT) allowed relaxationof soft tissue, specifically ligaments and discs to allow for separation between joint surfaces. Cervical drop traction was used to reduce the forward head posture and increase normal lordosis. The Spinalator allowed mechanical traction to decrease the degree of tension in the soft tissues and also allowed for more separation between joint surfaces. The Eckard Table created mechanical traction with mirror image positioning of the patient’s X-ray configuration. The Eckard Table provided motion as well as traction for therapeutic exercises and decreased disc wedging.  The Fix or adjusting phase consisted of specific spinal adjustments based on 8 precision X-rays and the supine neurological leg check. They included anterior thoracic adjustments, lumbodorsal pelvic side posture and drop adjustments, cervical dorsal adjustments using the Arthrostim, long axis traction adjustments, as well as extremity adjustments to the shoulders, 1st ribs and TMJ. To correct the scoliosis, the upper and lower cervical angles must be corrected and the legs must be balanced. The Set phase teaches the spine to stay in position. This included the: LD ball exercise, ball twist exercise, standing strap stretch exercise and vibration therapy and rotatory twist exercise. These exercises are therapeutic and assist in developing strength, endurance, range of motion and flexibilit. Pneumex gait training with spinal weighting is a style of walking including rhythm and speed. The patient also used the Scoliosis Traction Chair (STC), which is a combination of traction and whole body vibration (WBV), with a mirror image placement of the patient and tension straps utilized to pull rather than push the spine towards normal alignment. Tightrope exercises were utilized for gait training with spinal weighting. Next, The VibeTM was used with head, shoulder and hip weighting. This is a vibrating platform for proprioceptive neuromuscular re-education with cervical traction. Spinal weighting with WBV causes the spine to “react” to the unbalanced forces returning the spine to a normal position. The patient’s re-evaluation revealed an improvement of the scoliosis. The right thoracic Cobb angle of 48 degrees decreased to 34 degrees, the left cervical dorsal Cobb angle of 35 degrees decreased to 18 degrees and the left lumbo-dorsal Cobb angle of 24 degrees decreased to 11 degrees. More importantly, the forward head posture (FHP) returned to normal. The patient showed significant improvements in the cervical and lumbar lordosis, correction of the upper and lower angles as well as other spinal units, stabilization of the alar ligament, and a balanced neurological leg check. Lastly, the patient was instructed to continue with home protocols including head weights with limited vision glasses (to improve the cervical and lumbar lordosis, decrease forward head posture, and improve neuromuscular re-education for movement, balance, coordination, kinesthetic sense, posture and proprioception), specific spinal isometric exercises and scoliosis stretching exercises (to develop strength, endurance, range of motion and flexibility), cervical traction, and the Scoliosis Traction Chair (STC), as well as continued chiropractic care and a follow up evaluation every three months. Discussion: The scoliotic spine does not follow what we would consider normal spinal biomechanics. Therefore, normal chiropractic procedures may not be effective in some cases. This patient did benefit from previous chiropractic care symptomatically, but not structurally. The CLEAR hypothesis is that Adolescent Idiopathic Scoliosis (AIS) is caused by a combination of neurological (subluxation) and biomechanical deficits, FHP and a loss of normal spinal lever arms. Additional follow up and research is necessary to improve upon the chiropractic profession’s understanding of the scoliotic spine.