“I just want to adjust”.
I hear that quite a lot and (if I’m honest) I’m actually the same when I’m in my Chiropractic environment.
If I can SUSTAINABLY improve function with neuro-mechanical intervention and the patient is remodelling/healing, they will tell me they are feeling better, then I am happy to do neuro-mechanical intervention on its own aka “I just want to adjust”. Though actually while it could be a joint manipulation, it could also be a myofascial release, a organ release, cranial technique, the point is I am making a neuro-mechanical intervention.
If they are keen on some health & wellness intervention as well, game on.
But the reality is SUSTAINABLE changes are getting harder and harder to achieve because of the metabolic issues our patients come in with.
The average diet is appalling, the stress levels are high, the alcohol intake is high, and the toxic load from “preventive drugs” and the environment is high.
The key to picking these patients is their history.
The patients will tell you the SYSTEMS that are under stress, by giving you a list of SYMPTOMS/DIAGNOSES.
The SYSTEMS are driven by root causes, which is a combination of a lack of good nutrients and too many toxins/bad things – together they slow down normal pathways and your SYSTEM starts to become dysfunctional and you get SYMPTOMS.
You just need to listen.
Just wanting to do your Chiropractic/Osteopathic magic without understanding the context behind WHY they have the issues you are working on, is just burying your head in the sand.
You become a therapist, not a clinician.
Let me give you a related analogy to illustrate what I mean.
Reflexologists are therapists because they just to treat the feet (to affect the whole body) but lack the depth of knowledge to pick up on signs and symptoms that could suggest they need something more than just reflexology.
Podiatrists/Chiropodists are clinicians because whilst they treat the feet and can affect the whole body, they also have a depth of knowledge that allows them to pick up all sorts of information that might be relevant to how the patient will respond to their care (and if the patient may have something that needs urgent medical attention)
Doing a comprehensive history used to be an hour long affair and was frankly a pain in the gluteus maximus.
A few years after graduation I got lazy and wanted to jump right into the exam after a few obligatory questions about their symptoms.
I would tick a few boxes about family history, OK, so they have a few family members with IBS and thyroid issues, blah blah blah.
Note a few “co-morbidities”, yes I see they have eczema and asthma and are a controlled type 2 diabetic on meds.
A therapist may or may not note these, but ultimately, they just want to do their thing and crack on.
But a clinician recognises the core themes of a SUSTAINED LOW GRADE INFLAMMATORY RESPONSE running through the patient and his/her families history.
Did you know a heightened response to gluten (gluten sensitivity with or without enteropathy aka Coeliac disease) can cause an auto-immune form of under active thyroid?
Or the symptoms labelled as “IBS”, or be part of skin conditions like eczema?
Did you know that metformin blocks the absorption of vitamin B12?
And that B12 blood levels are unreliable to rule out deficiency (not my opinion but the NHS guidance)
and that as B12 levels drop, pain levels go up?
Do you really want to be another therapist that blindly treated what they wanted and failed to get results?
Some of my best refers of new patients I no longer see for care and some of them I didn’t even treat them with neuro-mechanical intervention because that was not the cause of their symptoms.
So as my referral practice has grown, I have attracted more and more complex patients.
So I developed a comprehensive health questionnaire the patients fill in before they see me, with data on all the critical areas of lifestyle from sleeping, to time sitting, diet analysis and a full systemic symptom check.
This has allowed me to quickly assess those patients that are likely to need more than just neuro-mechanical care and which SYSTEMS need addressing.
It’s been a game changer – it shortened my initial consultation and allowed me to target my metabolic care with laser focus to allow my neuro-mechanical care to work just as it should.
Moral of the story….become a clinician not just a therapist, take a 3 dimensional view of the patients health and use the TRIAD of health to view the patients issues though for a more sophisticated and complete model care.