Practicing Chiropractors’ Committee on Radiology Protocols (PCCRP) Subluxation Based Guideline Accepted for Inclusion at the National Guideline Cleari

It is with great pleasure and humble honor that we inform you, our Chiropractic colleagues, that the PCCRP Radiographic Guideline has been accepted for inclusion at the National Guideline Clearinghouse (NGC). The NGC is a comprehensive database of evidence-based clinical practice guidelines that are accessible via the internet. On Wednesday, July 29th, we received the following letter from the National Guideline Clearing house:

“NGC- 7250: Practicing chiropractors' committee on radiology protocols (PCCRP) for biomechanical assessment of spinal subluxation in chiropractic clinical practice. The guideline has been accepted for inclusion in the National Guideline Clearinghouse.”--- Christina Latzko, MSc (Health Services Research Analyst, National Guideline Clearinghouse www.guideline.gov)

According to Dr. Deed Harrison (Chair of PCCRP), “The PCCRP guideline is the most comprehensive evaluation of the chiropractic and biomedical literature on the topic of the utilization of X-ray in a Chiropractic setting. PCCRP Contains a thorough review of the reliability, validity, clinical utility and risk-benefit ratio of numerous radiographic views, including all standard views and specialty Chiropractic views like the Nasium, Vertex, and Base Posterior.”

Also, according to Dr. Harrison, “The extent of evidence contained in the PCCRP (nearly 2000 references) robustly refutes the contention that radiography in the Chiropractic profession should be used for Red Flag conditions only (suspected tumor, infection, fracture, etc).”

Some of the key topics that are reviewed in the PCCRP Guideline include:

· Guidelines for the use of radiography in the assessment of subluxation of adults and children;

· Biomechanical definitions for 6 subluxation displacement categories with supporting evidence from the literature;

· Discussion of the risk benefit ratio associated with the use of radiography in Chiropractic practice, including the radiation hormesis vs. the linear no threshold (LNT) theory;

· Comprehensive reviews of the literature on the reliability and validity of measurement of the biomechanical component of the subluxation through line drawing mensuration, as well as the reproducibility of patient positioning for radiographic views;

· Evidence based foundation for video fluoroscopy and digital motion X-ray;

· Reviews and rates the evidence on post-treatment use of radiography, in addition to follow-up radiography to assess the effectiveness of the Chiropractic methods employed and the long-term stability of the improvements achieved;

· Legal issues of Chiropractic radiography usage as determined by the existing State Law.

The PCCRP serves as a clinical guide, specifically for Chiropractors, on the utilization of X-ray, versus adopting/supporting the guidelines written for the use of X-ray in a medical setting. It is anticipated that the PCCRP document will provide supporting evidence which may assist Chiropractors using methods that rely upon X-ray analysis to determine appropriate management and to assess the effectiveness of the care plan for a variety of patient populations.

Although, the PCCRP is officially a sub-committee of the International Chiropractors Association (ICA), the guideline committee members were a diverse group and included individuals such as Dr. Christopher Kent (one of the 5 Principle Investigators) and Dr. Dan Murphy. Of importance, the PCCRP was reviewed and endorsed by several major Chiropractic political associations and organizations:

1. The International Chiropractors Association (ICA),

2. The World Chiropractic Alliance (WCA),

3. The Federation of Straight Chiropractors Organizations(FSCO),

4. Council on Chiropractic Practice (CCP),

5. Norway Chiropractic Association,

6. Ukraine Chiropractic Association

If you would like a copy of the PCCRP Guideline you will be able to access these at http://www.ngc.gov/ in the coming weeks or you can contact the ICA at www.chiropractic.org for a printed bound copy.

Written On Behalf of the PCCRP Guideline Committee Members and the ICA,

Deed E. Harrison, DC--
Chair PCCRP Radiographic Guidelines;

Clinic Director- Ruby Mtn. Chiropractic Center, Inc.;
CBP Seminars, Inc.;
Vice President CBP NonProfit, Inc.;
Editor- American Journal of Clinical Chiropractic

PostureRay®: Building your practice through objective data!

Many times when either answering emails through our website or when at seminars, doctors question us on how we have used technology to aid in building and sustaining a thriving practice. For chiropractors who understand the need for x-rays and especially CBP® Doctors; x-rays do the talking when it comes to patient care, education and retention.

In the early years of CBP®, we were taught to give patients a “New Patient Report Package” which is like what many of you do every day.

The difference is that instead of simply using “tear off sheets” which though helpful – are generic, especially that you have to hand write on them which is unfortunately less professional, custom or specific to the patient. With x-rays, it was always challenging to make something patients would understand, and also objective and comprehensive enough that if they were shown to another doctor would be objective, concise, and in lay terms.

Before PostureRay®, we had a word document template and then would take digital pictures of the x-rays, insert them manually (of course painstakingly resizing, cropping and editing each image prior to importing into the word file), then edit the text for the patient as well as their pertinent subluxation findings and deviations from normal (i.e. Percentage the patient was from our normal model).

A new patient report handout is nothing new; Dr. Don Harrison trained us all to give this to all new patients. The difference now is to incorporate patient’s x-rays and have the reports that are very professional. The old manual way, each report would take at least half an hour to make, not to mention that we actually had to measure the subluxations by hand and calculate deviation percentages ourselves!

On follow up reports, we had to do the same thing, showing the patient’s pre and post x-rays, without the capacity to actually compare digitized numbers – again having to calculate everything and measure everything by hand.

The manual way works very well until an office gets busy, and you soon realize you have to dedicate a CA to make all new patient packets, taking them away from actually aiding in more critical office and patient procedures.

Now fast forward to today. Using the PostureRay® system, all x-rays are easily digitized, and the time to perform this task is mere minutes! Once digitized, any variety of reports can be generated, not to mention those comparison reports that took so much time at the resolution of a program of care.

Educating the patient at the time of the patient’s report of findings is necessary and should be common as nearly every chiropractor does this to some magnitude in his/her office.

Here are three tips for better exposure of your office using PostureRay®.

1. Place clinical x-ray reports in the x-ray jackets every time a patient checks his/her x-rays out of the office to go to a general practitioner, physiatrist, or surgeon. This should be done every time! Soon, the local doctors in your area begin to understand why you are on top of patient care due to the detailed nature of Posture Ray’s Impression reports, not to mention when comparison reports are placed in the jackets. Doing just this task has increased medical referrals back to our offices, and opened lines of communication with many top doctors in our local areas.
2. Another tip is to always find out the patient’s primary doctor and send him/her your initial reports with, of course, the PostureRay® Impression reports — regardless if the doctor ‘actually’ referred him/her to your office or not. You would be surprised on how many primary doctors begin referring patients, when they along with their staff realize that chiropractors such as yourself actually perform quality patient care and documentation.
3. For those doctors who care for patients involved in motor vehicle crashes or work-related injuries, here is a very easy tip: Find attorneys in your area and demonstrate how subtle ligamentous injuries such as instability can clearly and objectively be documented using the technology of PostureRay®. If attorneys know that your notes are bullet proof, and you have x-ray images that clearly demonstrate injuries, they will be more likely to refer to your practice.

It is common that many PostureRay® equipped offices report that attorneys actually ask to have the marked images exported by their office for them to use in the mediations as well as at trial. Of course, once the x-rays are digitized, generating reports, comparative reports (pre-post care or following injuries, Figure 1 & Figure 2), exporting marked x-ray images with normal spinal models superimposed is a snap to perform!

So if you are ready to take the next step in letting your x-rays market your practice, consider becoming more objective in your x-ray documentation on every case regardless if they are personal injury, cash, or Medicare, because not only does using PostureRay® save you precious time, it also makes your practice that much more marketable and bullet proof.

For more information on PostureRay®, please email sales@postureco.com or go to their website at www.postureco.com.

PostureRay®, Case Series, and Case Studies

In February, CBP® Researchers traveled to Huntsville Alabama to digitize more than 150 x-rays. Dr. Deed Harrison, Dr. Joe Ferrantelli, and Dr. Don Meyer met with Tad Janik, PhD, MSE to measure the reliability and concurrent validity of the PostureRay® system compared to CBP’s validated x-ray digitizer. At the same time, they digitized a Case Series of Dr. Meyer.

In the near future, several Case Studies are planned for x-ray information from the digitizer and PostureRay® system. The PostureRay® systems utilize code from the CBP® x-ray digitizer within a report of finding setting.

Why My Patients and Practice and the ICA Guidelines?

What I Didn’t Know

Some time ago, I received my annual statement from an insurance company telling me I was over-treating my patients. When I went through the numbers, they said for the people in that particular plan I had treated the average patient nine times over the past year. Thinking there must have been some mistake, I called the insurance company to ask about the nine visits being marked as over-treatment to help them correct their error. I knew based on my chiropractic education as well as research I had read personally, this must have been a mistake. When the representative from the insurance company came on the phone, they explained to me in their plan (which I was in the network for) they flagged any practitioner averaging over seven visits as likely over-treating / over-utilizing and implied abusing patient care. Luckily this insurance plan worked with a third party company responsible for approving clinical chiropractic treatment and really never approved many visits for their patients.

Needless to say, I sent a letter to leave the network quickly. Once authorization for care was not granted, I explained to any patients in need of additional chiropractic care, they should go to an out of network practitioner who did not need special permission from their insurance company to treat them appropriately.

I thought about this block to helping people. I thought, maybe the policy is there to save insurance companies money? Could the policy be there to protect the general public from overzealous chiropractors? I wondered if the consumer who purchased the insurance policy in the first place had been completely informed of how the policy they were purchasing for themselves or their employees actually behaved when put to use.

I called the insurance company back. When I spoke to my representative again, they asked me if I would consider not leaving their network if they made their pre-authorization paperwork more clear or if they approved a higher rate of payment for the treatment codes I billed. I let her know I was not interested in any of those things. I let her know I simply wanted to know what they were basing their seven visit treatment number on. She let me know they had research saying this was all the chiropractic care anyone needed to get better. When I asked what research she was speaking about she did not know. She only knew that in their company their training said this was the case.

I have the unusual honor of holding the role of vice-chair for the ICA Best Practices & Practice Guidelines, which is currently under review at the National Guideline clearinghouse where we are confident it will be installed as a major chiropractic professional guideline very soon.

While performing my tasks as vice-chair for the project over the past several years, it became clear to me that across approximately 1,400 published pieces of original clinical science utilizing chiropractic treatment including spinal manipulation and spinal adjustments; the numbers speak for themselves. The average number of treatments shown in the research was 24. Actually this number is misleading, because in the vast majority of cases only one health challenge was being addressed and co-morbid factors complicating healing and necessitating further treatment were not considered. In those cases more complex than one health challenge with co-morbid complications, the number of treatments needed for clinical success may go up depending on the case. Understand the low number of treatments in the research was merely one and the high number was nearly 300. It would seem research commonly uses one treatment as a means to control measurement of results.

In papers where specific clinical cases were discussed, treatments were commonly higher than the 24 number to achieve a comprehensive positive result. I didn’t bother telling this to the insurance representative on the phone as I am confident she was not familiar with all the clinical research that has been performed.

Protecting Patients

It is my perception the governing boards of chiropractic in each state and every country that has one have been charged with the responsibility of protecting the public from professional practices which may prove detrimental to that population of people. Insurance company politics and policy aside, is chiropractic clinically and cost effective? The overwhelming evidence says the answer is YES! Our ICA Best Practices & Practice Guidelines has three purposes:

“1. Locate, summarize, categorize, evaluate, and rate the evidence for Chiropractic Care of a variety of health conditions.

2. Assist the practicing Chiropractor in making sound, fundamental, clinical decisions when providing Chiropractic Care in clinical practice.

3. Provide Chiropractic colleges and educational institutions with a document to help assist future chiropractic practitioners in the criterion standard of care.” (Text in this article in quotations was cited directly from the ICA Best Practices & Practice Guidelines available at www.ICABestPractices.org.)

Let’s discuss clinical (Risk/Benefit ratio) and cost effectiveness of chiropractic care. Chiropractors are unique in that they are largely taught to treat subluxation rather than a medical clinical diagnosis. “According to a 2003 survey by Ohio Northern University, almost 90 percent of practicing Chiropractors adhere to the tenet that spinal subluxation creates interferences with normal nerve function.11” In treating subluxation versus a named symptomatic medical diagnosis, the chiropractor has the potential to affect holistically entire body health and not merely relief of a specific symptom. Contrary to popular belief, the scientific demonstration of subluxation has been well documented (see www.Chiropractic.org, www.IcaBestPractices.org, and www.PCCRP.org)

“It has been estimated that approximately 7-10% of the USA population seeks chiropractic care,7 this document is for practicing chiropractors and their millions of patients. It has been suggested that the majority of chiropractic patients seek chiropractic services for spinal (axial) pain syndromes. However, without considering patients with axial pain, patients who have been medical failures with a variety of diseases and structural abnormalities have sought chiropractic care in the past and continue to do so. In fact, our evidence appears to demonstrate that the majority of chiropractic patients prior to the introduction of anti-biotics sought care for a variety of non-pain syndromes, diseases and disorders.” In the vast majority of these cases, the patient’s health improved without detriment.

“Chiropractic care has a very low risk benefit ratio and very low costs compared to standard medical care… evidence in Chapter IV indicates that more utilization of chiropractic services would result in more saving in reduced utilization of medical services… From the British Medical Journal’s website (BMJ),75 one can determine that of about 2500 [medical] treatments supported by good evidence, only 15% of treatments were rated as beneficial, 22% as likely to be beneficial, seven% part beneficial and part harmful, five% unlikely to be beneficial, four% likely to be ineffective or harmful, and in the remaining 47% the effect of the treatment was, ‘unknown’.”

Wait a minute; did they actually conclude the result of chiropractic care is likely health cost savings? Yep. It looks that way. What about herniated discs? Can chiropractors cause them? Treat them? “It is very likely that reports of disc herniations caused by manipulation are in fact pre-existing conditions… In the Mercy Center Guidelines, it is stated that manipulation is only contraindicated in the case of, “extensive disc prolapse [herniation] with evidence of severe nerve damage”.100… Critical to the discussion of pre-existing disc herniations is the fact that chiropractic manipulation is actually the standard of care for patients who have cervical disc herniations.84, 91, 97-99…

In a prospective study of 27 individuals with MRI confirmed cervical disc herniations, BenEliyahu91 demonstrated statistically significant improvements in visual analog scales, pain intensity, return to work, and a reduced size of the disc herniation following chiropractic care… He states, “Chiropractic management of disc herniation, including spinal manipulation, may be a safe and helpful modality for the treatment of cervical and lumbar disc herniation”.91 Not only does spinal manipulation not cause disc herniations, there is strong evidence that it is of benefit to these cases.””

Ok, we now know chiropractic care should be healthy for helping those with disc herniations. What about the risk factors of spinal manipulation? “In 2007, Thiel et al11 studied treatment outcomes obtained from 19,722 patients…Data were obtained from 28,807 treatment consultations and 50,276 cervical spine [neck] manipulations. There were no reports of serious adverse events.”

Educating

As a chiropractor, I believe a large part of my job is to help educate patients and the general public about their health and the role chiropractic can play. For those too scared or skeptical to go to a chiropractor, the information here should be helpful. If they remain scared or skeptical, they will miss out on a safe, powerfully effective and natural means to address their overall health. The honor in playing a role in the ICA Best Practices & Practice Guidelines is I get to see first hand what the research actually says about the benefits of chiropractic care and collaborate with patients in my office on a safe and cost effective way to address their health needs. For many, not using chiropractic care results in unnecessary furthering of health problems they may not have even known about without a chiropractic evaluation. As for insurance policy and politics, I am still not sure which research they are using to get their data for granting permission for chiropractors to help people.

Practice Success In a Recession

In tough economic times it becomes increasingly more important to put your attention and energy into strategies which are proven to work. There is less room for error and there can be a fine margin between success and failure. So, what has proven to work in times like these?

The most important thing for you to possess is knowledge. Not random knowledge but the specific knowledge required to succeed in practice.

In my experience, a successful practice in today’s environment requires knowledge in at least these key areas…

1. Service Delivery

2. Communication

3. Marketing

4. Management of Staff

5. Organization

6. Handling of Finances

Most doctors are competent with the service that they deliver. This is not to say that this area shouldn’t be improved, but for the purpose of this article, I shall move on to #2.

Every aspect of what you do in practice can be viewed as a communication. Whether you look at treatment, marketing, a Report of Findings, or billing an insurance company, it is all communication.

The Prescott Group has worked with thousands of doctors and staff over the years and discovered that most people are deficient in the basics of communication. A lack of these basics can result in the rote use of scripts in situations where they don’t really apply—or to some degree of failed communication.

If this occurs in marketing, it means less new patients; in the ROF, it means less patient compliance; in patient education it means less understanding; in billing, a lack of communication basics means less pay for your services.

To handle this problem, we train each of our clients on the basics of communication. With these basics understood and applied, every aspect of practice is easier.

Without marketing to create a consistent flow of new patients into the office, it is impossible to operate a viable business, and it is unlikely that you will achieve your purpose—to any great degree.

There are two aspects to the Marketing Training that we teach our clients. One aspect is training on all the successful actions of chiropractic marketing—some of which you’re familiar, and some which will be new to you. In either case you’ll be trained and drilled in proper procedures to maximize efficiency.

The second aspect that we teach is the key to marketing success—and is generally not known by most chiropractors. We teach all of our clients the fundamentals behind what makes any marketing activity succeed. It is the underlying basics of how your message is formulated, delivered, and then received by another person. Without this understanding a doctor is left doing the motions of marketing without an ability to control the outcome because he is doing something he does not understand.

With mastery of both aspects of the Marketing Training, our clients have plenty of new patients in need of chiropractic care.

The proper management of staff is the foundation for sustained growth and efficiency. Although every area of my practice has been improved over the years, the successful management of staff has been the breakthrough that has allowed me to achieve long term success in a stress free practice.

Having staff that are trained to competence and can produce at a very high level is the foundation on which to build a stable practice that thrives in any economy. At The Prescott Group, we assist our doctors by not only teaching them how to hire and train competent staff, but we also actually help train the staff, as well!

If you have to run around your practice and do almost everything to make sure it is done right or you have the revolving door syndrome of staff replacement, our training will help you handle these problems.

A system of standard organization is the hallmark of a well run efficient practice. It is also what gives a practice the ability to

survive in the long term. This is important for the long term survival of chiropractic, as well as provides you with a stable economic future.

We train our clients on the basic fundamentals of organization and help them to implement standard systems. That is why our clients can achieve long term success, take vacations, phase out of any aspect of practice they prefer not to do day to day, sell their practice for a significant price, or run multiple clinics.

In today’s economy the proper handling of finances is essential. We train our clients on proper strategies for creating a reserve fund, paying down debt, and expanding income. We teach our doctors to plan their income in advance rather than wait until the end of the month to see what is left over after practice expenses.

Maybe the best aspect of our training aside from the fact that it works, is that we guarantee your skills for life by allowing you to return at any time to retrain on your courses—at no additional cost. Every month we have former clients return to retrain on their courses and sharpen their skills.

The first step for you to learn more about what The Prescott Group can do for you is to call our office and schedule a free practice analysis. I look forward to working with you!

Be Proactive & Consistent on Informed Consent

Effective risk management requires every chiropractic practitioner’s daily attention. Consistent attention to detail and regular examination and re-evaluation of the risk-management basics are essential to your practice’s protection and your peace of mind. It is vital, however, that on key risk management issues and procedures, you never let your guard down and do not let staff members drop the ball or cut corners on record keeping, confidentiality issues, and, on the doctor’s “MUST DO” list, make sure that informed consent documents and procedures are always in place and consistently applied.

Informed consent has emerged as a cornerstone of risk management procedures because the lack of it in malpractice cases has become a common and effective claim. Clever and aggressive lawyers have hit upon the informed consent issue as a means to strengthen otherwise weak claims of clinical misjudgment or injury, based on a number of landmark court decisions and trends in other professions. In a landmark 2005 Wisconsin case, the state court found:

“Chiropractors, like medical doctors, are health care professionals involved in the application of procedures and treatments to the human body. We see no reason why the scope of an individual's right to be informed of the risk inherent in bodily intrusions via chiropractic treatment and procedures should be any different from his right to be informed of the risk inherent in bodily intrusions in medical treatment and procedures.”

Thus, the fact that chiropractic is non-invasive provides no additional margin on demands for informed consent according to the Wisconsin court, a position reaffirmed by an often cited 1999 New Jersey Supreme Court decision, which similarly held that: “…informed consent applies to both invasive and noninvasive procedures,” holding that physicians must inform patients of the possible risks and benefits of all “medically reasonable” treatment options—including those he or she does not recommend. If that is not complicated enough, courts are regularly finding that patients must be updated throughout their course of care in terms of relative risks and alternate care choices, and that not telling a patient about other care pathways and their risks becomes an issue in itself.

In fact, actions based solely or largely on the lack of formal and written informed consent have emerged as a malpractice growth industry, even though such charges may have nothing to do with whether a chiropractor has actually committed an act or acts of malpractice as it has historically been understood.

The message here is clear: Be consistent and proactive in obtaining both written and verbal informed consent from every patient, in advance of both examination and the active delivery of care. Yes, get informed consent prior to care to cover your examination procedures, as well as in advance of delivering chiropractic adjustive care.

Informed consent starts with a standardized form. Your malpractice carrier is always a good place to obtain a model form, followed by your state or provincial association, with, as is almost always the case, close attention paid to any direction available from your state or provincial regulatory board. On this form, the key information needed will always include the patient’s name, address and of extreme importance, the date.

The exact nature of the form’s contents should reflect the requirements in your jurisdiction. This is why a visit to the regulatory board’s website or information from your local association is so vital. Different jurisdictions have different specifics on informed consent. You will need to comply with state and provincial directions as to the degree of specificity regarding risks inherent in the procedures you are about to apply.

In recent months, as more and more technology and especially mechanical devices are incorporated into chiropractic practice (from mechanical adjusting devices to spinal decompression units) it is becoming important to obtain separate informed consent forms for each new level of intervention applied by your clinic. A form for the adjustment, a form for traction, a form for mechanical spinal decompression, and a form for any procedure that can be argued to be separate and different, and not arguably covered by a general form, will serve you well. Remember also that the absence of such forms becomes a problem in and of itself.

In addition to the form itself, most legal advisors will encourage that a note be added to the patient’s file stating that the form was signed and that a verbal exchange took place, with you as the provider (not a member of the staff) highlighting the contents of the form. Indeed, some malpractice experts argue that the verbal exchange is the essence of informed consent, where the patient has the opportunity to question the doctor’s choice of procedures, and that without the verbal component, the written form loses much of its meaning.

Rather than look at the required informed consent exercise as a burden, practitioners should look at the interaction with the patient on relative risk and informed consent as an opportunity to orient them to what they can expect from the adjustment process, especially if they are first-time patients. While most patients feel an immediate sense of relief from the adjustment, a frank discussion on possible temporary or short-term discomfort from a first adjustment, possible stiffness, etc., helps patients keep things in a much better and more realistic perspective, and puts you in a position of both greater credibility with the patient, as well as defensibility should any unforeseen issue arise. Such frank and open dialogue can only strengthen the doctor-patient relationship and enhance the positive nature of their chiropractic experience.

In today's litigation-happy (or many might argue litigation-crazy) society, even the best, most conscientious and responsible doctors of chiropractic, applying the highest standards and most established procedures and protocols, can still be named in a malpractice claim. When it comes to informed consent, a whole new dimension of malpractice reasoning comes into play, where patients and their attorneys regularly argue that if a patient was fully informed of all risks and possible negative outcomes, then they may have decided not to receive the care and would not, as a result, been injured. The proactive doctor of chiropractic will respond accordingly, with sound and well-researched forms and procedures, all consistently applied and included in the patient’s file. It pays to do the work and, consequently, minimize the risk.

And, as every doctor of chiropractic should know by now, a reliable malpractice insurance carrier is your best partner in protecting your practice and yourself from malpractice claims. In that process, ChiroSecure stands ready to serve and assist in making sure that you have the coverage you need, and in implementing risk management procedures that will provide the best possible firewall to jeopardy.

Shop around, compare and see what you find. Then, call ChiroSecure today and find out how you can have the best protection on the market, multiple policy options at highly competitive rates. The result will be both excellent coverage and peace of mind. You deserve both.

Call ChiroSecure toll-free today at
1-866-80-CHIRO or 1-866-802-4476, or visit ChiroSecure on the web at http://www.chirosecure.com.

Hanumans v. Boyson, No. 2003AP1527, 2005 WL 1522624 (Wis. June 29, 2005).

Matthies v. Mastromonaco, 160 N.J. 26, 37, 733 A.2d 456, 462 (1999).

Schreiber v. Physicians Insurance Company of Wisconsin, 223 Wis.2d 417, 588 N.W.2d 26 (1999).

I Can't Cure Patients

As a young chiropractic student, I once heard a famous D.C. state, “I can’t cure patients anymore than I can cure a ham.” The statement struck me funny in the late seventies. It took many years to not only agree with him, but to understand his flamboyant statement.

The biggest problem with young and old chiropractors alike is not believing and seeing the fact that they do not cure people. The greatest chiropractors and philosophers in this profession have reiterated this in many different forms. “Take no credit, accept no blame.” “The body heals itself.” “Innate knows better than you.” The real problem is for you to get this understanding and to see and believe it. The more the science of chiropractic grows, the more it demonstrates that you are in charge of finding and correcting interference to the expression of nerve impulses from brain cell to body cell and from body to brain cell and not the treatment of diseases.

Your life and practice would be so much more successful and fulfilling if you were to only be responsible for correcting nerve energy and not cure back pain, neck pain, asthma and allergies or any other diseases that some of our peers believe that we do.

The most miserable chiropractors in the world are those who think it’s his or her job to make people feel better or have less pains and aches. These poor chiropractors spend minute to minute in their practices feeling ultra successful or feeling that they are the worst doctor in the world. All of this pain is based on their belief that they are responsible for the patients’ health, well being and level of pain. Quit this today, do the research, read the books and know that you are not responsible for your patient’s state of health or lack thereof.

You are only responsible for finding and correcting the interference to the expression of nerve energy in the body, NOT CURING THEM! See yourself in your mind’s eye correcting subluxations, allowing free flow of the nerve energy. This is what you do, what you are. Anything else you do in your practice takes away from the essential truth of what chiropractic is, and that takes energy, time and focus away from you serving more people. Yes, people need advice on exercising, diet, mental attitude and more, give it to them. But always remember the only true job you have and are qualified to do is to reverse nerve interference.

Til next time…