Use the power of communication to improve the public’s perception of chiropractic care
THE CHIROPRACTIC PROFESSION HAS BEEN IN A CONSTANT STATE OF MOTION SINCE ITS INCEPTION. While expanding and contracting around a wide variety of techniques, the most common denominator has been the spinal adjustment. It’s easy to get fixated on the adjustment itself and potentially undervalue what we do before and after hands-on care. This may be an area we can improve on when you consider the power of communication and the lack of clarity the public has for all that chiropractic has to offer.
Clarify public perception
It’s no secret the chiropractic community is misunderstood. Just consider the divide among the public in their drive to use our services. On one hand, many people have come to know it only for relief of back pain; on the other hand, it has been recognized as a vital part of preventive health care strategies. We have largely been stuck on the former, the public regarding adjustments as an exotic alternative to traditional pain management and many doctors of chiropractic posting snap, crackle, pop videos, often without any patient education around it.
Set a high standard of care
While I understand the temptation to entertain the short-term relief model, I wonder if we have made the job of educating patients beyond pain more difficult than before. Some indicators suggest the world is collectively ready for more education, not less. Take the No Surprises Act: while it may be intended to protect consumers by ensuring they can make more informed financial decisions with good faith estimates, it may also spur a more honest conversation about health care solutions. If you offer a level of service that sets a higher standard of care rather than merely an alternative, this scenario represents a great opportunity.
Before the adjustment
In our office, the conversation begins with up-front disclosure that we only adjust the spine after performing a complete physical examination, including digital foot scan and any other necessary imaging. Far too often I see marketers giving away examinations — devaluating the process. Instead, we go on to explain that hands-on care begins with adjusting spinal subluxation first, after which we will likely address the feet and other extremities, as early as the second visit. We do this to better hold spinal adjustments and to address whole-body posture issues that may, in fact, originate in the feet and extremities. We’ll recommend custom three-arch orthotics and provide additional instruction for daily posture-building as early as the first week of care. If the patient is not responsive to these most conservative and efficient protocols in a timely manner, we’ll explore additional in-house rehabilitation. When combined with transparency of cost, these common steps can be communicated prior to initial care to build trust.
The program has yielded positive early returns. Patients have reported an appreciation for the disclosure of anticipated services and financial responsibility prior to receiving care. It opens the lines of communication early on and creates a space for them to digest and prioritize their care with the added benefit of developing a trusting relationship. After that, the plan you provide in the report of findings sets the tone for what you may expect of them as well, creating mutual accountability. Any modifications you make after that could make it seem like you weren’t aware of what it would take to get results. We have also heard countless times from patients that communication throughout care really matters. We have come to see these pre-adjustment communications as our responsibility as leaders in health care, and why not, when we have so much to offer?
Take pride in the investigation
We need to remain curious when going through the exam process so we can go beyond pain and find causes of disease no matter where they hide. If we can take as much pride in the investigation as we do in the adjustment, we can find more ways to hold posture and identify causes of subluxation both in the spine and extremities. We have already seen the failure of the myopic, symptom-driven approach in traditional care and the enduring opioid crisis. An example of our success over the so-called standard has been identifying foot and ankle issues that can silently undermine stability of the spine. Without curiosity and a commitment to examination, many hidden causes of spine disruption go unnoticed, hence they go without ever being addressed. Our approach may be new and different for our new practice members, but we make time to overcome this with communication, starting as early as patient registration.
Pain can leave doctors desperate for quick answers, and they may not pay attention to the reality that without corrective care, pain will more likely return. When we slow down and ask the right questions, most people come to realize that long-lasting results and renewed confidence in their bodies is more desirable. Further, most patients are open to addressing any issues related to the spine that may hinder progress and accept it as an integral part of their treatment plan. Are you committed enough to the healing process to share the complete story?
I do understand much chiropractic progress has occurred with focused, if not straight-line strategies, like upper-cervical only care. It’s appealing to streamline your approach, but the reality of confronting the complex needs of our diverse population — both beyond pain and the 12%-14% we are reaching — is we need to make space for all of our perspectives. Communication is the platform allowing all of our techniques to flourish and improves utilization.
Define the formula of care
Regardless of your preferred approach, when you follow through on the plan presented in the report of findings, you answer the question of why we invest into examination and imaging while declaring your formula for care. Activate from spine to feet, and connect home care to office care, to hold adjustments better and optimize care. In our office, even exercise looks different when movement deficiency is addressed through whole-body posture. Better adjustments and improving function are the focus of our patient education (See Part 2 of this article in Issue 18 of Chiropractic Economics).
Patients have also reported they recognize and appreciate the importance of monitoring progress and periodically reassessing where they are in the process. Setting the tone for proactive care that is drug-free and completely natural works well when patients are well-educated, which can begin at first contact. Communication paired with transparency at the administration level opens the door for us to be equally sincere about what it will take to get results. The estimate equals clear understanding. Financial clarity and establishing mutual responsibility create a foundation for empowered, proactive care.
ANISH BAJAJ, DC, is a 2000 graduate of Life University in Atlanta, Georgia. He is the owner of Bajaj Chiropractic in New York City. Bajaj serves on the executive board of the New York Chiropractic Council and was the recipient of their Chiropractor of the Year Award in 2022. As a member of the Foot Levelers Speakers Bureau, he travels extensively, sharing his chiropractic knowledge and expertise with audiences around the country. He can be reached at email@example.com.