Spinal Decompression as a New-Patient, Cash-Generation Tool
PRACTICE | MANAGEMENT
Jay Kennedy
DC
A tool is an implement to get work done more efficiently. A decompression system has been a cash-generation tool for innumerable DCs over the past decade. Certainly, axial-traction could be done by hand, but it is untenable; labor intensive, not reproducible, and a poor selling proposition. Obviously, a decompression system utilizing a belt, a visually impressive, multipositional table, and a pulling motor makes the job efficient, effective, reproducible, and a clinical profit center.
Many engineers, designers, and clinicians have contributed their expertise to produce decompression machines and accessories. The premise is and has always been to create a viable, effective, and safe mechanism with which to temporarily “unload, decompress, or unweight” the discs of the lumbar and cervical regions, with the intention of positively affecting internal metabolism. Until we introduced effective and low-cost decompression systems 18 years ago, most chiropractors needed a $ 120,000 loan to partake. Today one-tenth of that cost will get it done better and more efficiently, and that includes all of the accessories, education, and marketing necessary.
Discs are the only spinal structure likely to benefit from distraction due to their fluid-distribution (isotropic ) properties. The lordotic configurations of the cervical and lumbar spine facilitate decompression of the posterior disc, allowing an “artificial” reinvigoration of fluid, nutrients, and blood contact. There is an attendant outflow of metabolic waste products as well. The disc uses this natural diffusion/imbibition cycle to maintain integrity. Traction proponents believe this mechanically imposed distraction expedites the process exponentially.
The implementation of this tool from a business perspective is of equal importance to most doctors. We’ve tried diligently over the past 18 years to create a viable and valid educational seminar series with a utilitarian patient classification.
The original decompression tables (e.g., VAX-D, DRS, DRX-9000) all required exorbitant time and resources to create marketing paraphernalia (much of it later proven to be illegal) and much less time on clinical acumen (thus the inexplicable decision to make single-posture tables). However, clinics purchasing the newer breed of cost-effective, multipositional, multiuse tables still have
the same needs—new patient acquisition, patient care acceptance, patient retention, and patient referral.
The typical strategies used are similar to laser, massage devices, energy devices, etc., in that they offer an alternative/adjunct to “standard” chiropractic manipulation. Much of the public has developed an opinion (positive or negative) regarding our profession and its capabilities. That opinion has alienated us from some patients who think it’s unsafe, unsuccessful, or uncomfortable—or all three. Thus, an alternative device or procedure can become a new calling card for those who are not presently inclined to visit us.
Decompression affords an additional mechanical alternative-treatment option for patients seeking advice and a therapeutic solution for a recently diagnosed disc herniation or nerve root irritation. Decompression has been enthusiastically engaging large segments of this itinerant public. The key is to appeal to their natural inclination to mistrust surgery, opioids, and excessive NS AID use, and to avoid rehashing already unsuccessful treatments. There are tens of thousands of new disc patients in every city in the world, and decompression
offers an exceptional opportunity to create benefits for them and cash revenue for you.
With new patients, we typically present a short, informative video (or brochure) that substantiates the therapy, reiterates their symptom profile, and lays out a practical, utilitarian, safe treatment protocol, which will always include exercise and motion reeducation as a major component. The decompression consultation follows the exam.
A brief, generic example:
“Hello, Mrs. Johnson. You have seen our introductory video, met our staff, and I’ve completed my necessary examination. (I’ve also been able to review the MRI...). I have seen this type of problem many times and consider myself expert in helping it. I have specialized equipment and training, as well as years of experience with thousands of patients, so I really want you to feel confident that you have come to the right place. I appreciate very much being given the opportunity to help you.” (Note that referral pitches start in the consultation and exam as well).
“First, disc problems like yours are not uncommon, but they are serious and can have far-reaching consequences if not treated properly. My staff and I will work to the very best of our ability to get you back to good health, out of pain, and able to return to your normal life. If we
determine another referral is necessary, we have several specialists we refer to.”
“My examination reveals that you have a combination of problems in your back. There is clearly a compression issue with one of your lower discs, and this is why you have many of the symptoms you are experiencing (e.g., symptom list). It also explains why you are feeling pain in your buttocks and occasionally your calf. The good news is our exam suggests your pain is likely the disc bulge itself and not the sciatic nerve. Also, you have signs of a motion disorder. This means that some of your muscles are not working together in the best way, and this underlying disorder may well be creating an environment allowing the disc to go bad.”
“So our work over the next months will need to include therapies that help reduce the compression and improve the disc’s healing potential, as well as focusing on making those muscles do their job the right way. That will involve in-oflice and at-home exercises being added to your program as your disc heals and your pain starts to get better.”
“Without rehabilitation exercises, the improvements brought about by decompression therapy may be shortlived and another bout of pain may be in your future. The pain you are experiencing is because of adverse forces and inappropriate muscle control acting on that disc—a
disc you may have damaged when you were just a kid or young adult. We can’t make the disc young again, but we can certainly help get rid of the pain by improving the way the disc metabolizes nutrients and in helping reduce the bulging. This is the key to decompression therapy.” (Note that I then give a brief discussion of the propriety of the equipment I use.)
“So the program of care will involve 18 sessions of decompression done three times a week for five weeks and then tapering off over a few weeks until we reach our goal, which is determined by your progress and our reexam.” (Note that trained staff will discuss finances.)
“Laser (or...) will be utilized in a very particular manner. We will do it during decompression to most effectively introduce it to the injured structures, improve metabolism, and reduce pain simultaneously. This is unique to our treatment program, as is our rehabilitation.”
So this is generally how we approach getting the patient on board with our “decompression package.” Introduce them to the premise and underlying science, examine them for signs of compression, motion disorder, or both, and then simply but thoroughly explain that pain and pathology are not the same. Motion disorders must be addressed as pain subsides to create functional improvements. Obviously, it’s in our best interest to have well-educated, well-informed, and highly enthusiastic patients since they tend to pay and refer.
Kennedy is a 1987 graduate of Palmer Chiropractic College and maintains a full time practice in western Pennsylvania. He is the principal developer of the Kennedy Decompression Technique. Dr. Kennedy teaches his non-machine specific technique to practitioners who want to learn clinical expertise required to apply this increasingly mainstream therapy. Kennedy Decompression Technique Seminars are approvedfor CE through various Chiropractic Colleges. The author can be contacted @ decompression, (af ennedylechnique. com.
