By Freddie Ulan, DC, CCN
The Most Serious Errors:
Some of the most serious errors I’ve seen chiropractors commit in their enthusiasm to help people in this way is that they tend to include in their regular chiropractic office visit a nutritional evaluation. This adds a great amount of time to visits for which they are not compensated – there’s no insurance code for a nutritional consultation. This primary error is actually costing the chiropractor quite a bit in terms of effectiveness as well as net income. His trying to include the nutritional evaluation and consultation in the same visit as a chiropractic visit is serious error number one.
Serious error number two is starting people on nutritional programs without fully orienting them as to why they really need to do the nutritional program and getting their full understanding and complete commitment to real health restoration. Far too often the doctor will do an evaluation of the patient, whether it’s by case history, various questionnaires or physical examination and believe that they know what product the patient needs and sell that to the patient. The major error here is attempting to sell the patient a supplement without first fully educating the patient on the purpose of the supplement. The patient needs to understand the role it plays in their overall health plan and be fully educated as to what this health plan actually consists of.
Further, you need to get their full agreement to do the program that is going to restore their health. You can easily sell a bottle of anything to a patient but can you get them to actually do a real nutritional program? The point being that there’s far more to a nutrition program than getting somebody to take a particular supplement until the bottle runs out.
One of the things that we discovered in implementing nutrition into our practices is that each of these therapeutic approaches has its own rhythm and they don’t mix well. Chiropractic adjustments themselves are extremely valuable and they need to be done but there’s a rhythm to a chiropractic practice which can make it very viable and very easy to administer. When you interject random nutritional consultations and evaluations in the middle of that rhythm, it tends to disrupt the practice and distract the chiropractor from the chiropractic adjustment side of things. The doctor loses income, it lowers practice volume and it routinely fails to transform the chiropractic patient into a nutritional believer as well.
The most effective solution for that has been to separate the nutritional consultations from the regular chiropractic visits – do them on separate days and then make sure you charge for that nutritional consultation so that you’re actually being paid for your service. The way we have seen this done most effectively is by recognizing the difference in rhythm required by the chiropractic program versus the nutrition program. Most chiropractic programs require a starting visit schedule of 3, 4 or even more visits per week. Then gradually building the patient up to a point where they are coming once a week and then once a month.
The rhythm for a nutritional patient — from my observation after a couple of decades of experience — starts with about one visit a week during the “fine tuning phase.” Then every other week for the “healing and observation period,” and once optimal health has been attained, reduced to an appropriate maintenance schedule which could be as often as once a month but generally is every three months. These are done on their own day, separate from the chiropractic adjustment day. It is much more efficient and more effective in many ways. It’s a service that you are compensated for and which the patient highly values. And it has proven to increase compliance, retention and referral generation.
The third major error is trying to match a supplement to the patient’s symptoms. In other words, it becomes a medical or a symptom-oriented approach. For example, if the patient has excess stomach acid you give him a natural antacid instead of a pharmaceutical one. This is the medical model and while it’s safer than pharmaceutical medicine, it doesn’t actually answer the question: “Why does this patient have this excess stomach acid?”
From a chiropractic viewpoint, yes, we’re going to be correcting subluxations and taking the stress off the vagus nerve but there are also actual reasons why that subluxation continues to recur. And these symptoms respond to correct nutritional evaluation and therapy.
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