Chiropractors are well aware of the seriousness of the health landscape in the latter part of the 20th century and the epidemic of chronic disease that most of our patients face. Dorland's Illustrated Medical Dictionary states chronic disease "is slow in its progress and long in its continuance." It may take years before the multifactorial causes of a disease have taken effect and the individual receives a diagnosis.
One of our greatest tools for intervening during the years that chronic disease is developing is herbal medicine. With skillfully applied herbal protocols, the clinician can assist the patient to slow or even reverse the degeneration that is the hallmark of chronic conditions.
I use the chart below in my clinic during office visits to illustrate the progression of the disease process, starting with symptoms all the way to diagnosable disease. It's usually easy for patients to find themselves on this diagram. As the health conditions listed become more serious from left to right, we see that this corresponds to decreased adaptability to stress, and decreased healing capabilities.
In 1910, D.D. Palmer stated that the determining causes of disease were trauma (mechanical stress); poison (toxins, nutritional deficiencies); and autosuggestion (stress). Chiropractors are experts at handling the mechanical aspects of disease but if the "poisons/nutritional deficiencies" aspect of ill health is not handled, the healing process may be slowed or not happen at all, even if you deliver the correct adjustments.
The ability of the body to respond to demands including detoxification, trauma, stress, etc depends on its ability to regulate and prioritize these functions. Likewise, the ability of the body to utilize for healing purposes quality food, sleep, and Chiropractic adjustments also depends on its ability to regulate itself. When the body is overwhelmed by toxins and stress, it can move into a state of "blocked regulation" and cease to respond appropriately to even the correct healing therapies. Herbal medicines are one of the fastest ways to restore regulation to the nervous system.
Inflammatory Response
All chiropractors know that it's crucial to control the inflammatory response in both the acute and chronic phases of care in order to achieve the best outcome for the patient. Inflammation speeds the degeneration process and if chronic or severe enough may render the patient unable to tolerate an adjustment. The addition of anti-inflammatory herbs like Boswellia, antioxidants like Quercetin and enzymes like Bromelain offer safe, non-chemical pain relief and have virtually no contraindications.
Now let's look at just one type of inflammation that can be slow and insidious and sometimes have no symptoms at all. Irritable Bowel Syndrome (IBS) is the most commonly diagnosed digestive disorder, with symptoms ranging from heartburn to constipation. IBS creates constant stress on their adrenals, liver, brain and other organs due to the inflammatory process and production of endotoxins. Let's add a bad diet, stress at work, over-indulgence in alcohol and inadequate sleep and exercise. Is a patient like this likely to receive all possible benefit from an adjustment?
The efficacy and safety of herbal medicines when applied correctly has led many Chiropractors to at least consider adding these supportive protocols to their treatment plans, but the confusion about how to go about this prevents many doctors from taking action. If you map out the addition of herbal medicine to your practice and take these recommended steps, the transition will go smoothly.
Learn the Scope of Practice in Your State
Your state board of Chiropractic will have clear guidelines on the scope of practice in your state with regard to using herbal supplements in clinical practice. Make sure that you have a clear understanding of these laws. Decide before you introduce herbal medicine to your patients the extent of nutritional support that you would like to offer or focus on. For example, you may decide that you only want to provide anti-inflammatory and musculoskeletal support. That's fine, and you'll do your patients a world of good if you become an expert in just this one area. You may decide you want to add digestive support, and/or nutritional support to help patients sleep better or improve their immune systems. If you are clear on the boundaries of the nutritional support you will offer, you will be better able to education your patients on what you are providing.
[pb]Constantly Improve Your Education
Brushing off your biochemistry knowledge from college courses won't be enough to adequately apply herbal medicine in practice. It's important to get to seminars to keep current, and to continually improve your knowledge of the mechanisms of natural healing. Without knowledge and the ability to teach, incredible doctors can appear ignorant and unfocused. It goes without saying that improved clinical outcomes will follow even one informative weekend seminar. A commitment to working with herbal medicines in your practice must come with a commitment to continue your education in this field.
Step Up Your Patient Education Efforts
It's my personal belief that although displays like posters and brochures can start a conversation, it's the responsibility of the doctor to convey the true value of nutritional support to the patient. Experienced clinicians know that compliance goes down and the potential benefits to the patient are lost if the purpose of a nutritional protocol can't be conveyed.
Good communication: "The herb Boswellia in this supplement works through the same chemical pathways as non-steroidal anti-inflammatories, by inhibiting inflammatory chemicals in your body." True, and it may help you on a board question, but the patient may not resonate with this statement.
Better communication: "The herb Boswellia in this supplement works like Ibuprofen but without the side effects. And unlike medications, it's actually healing to the body as well as pain-relieving."
Office Organization
As with any other aspect of office management, organization with regard to your nutrition practice will maximize profit and minimize stress. The first area to consider is that an office is divided into a clinical area and an administrative area, each with its own function in day to day operations. The area where these two worlds collide should be at the front desk.
Our front desk and our office systems are designed to maximize the education and compliance of the patient so that he or she can achieve the best clinical results. We have a large flat screen television displaying workshops put on in the office as well as small advice column pieces that answer client questions from the doctors. These have proven a wonderful education tool and can be found at functionalhealthminute.com.
Our staff training always begins and focuses on communication and relationship strengthening. We are aware that in any fast moving office there can be stress in the procedures. Common topics of conversation are always converted into patient education handouts and made available by the staff. Often times we have programs that would be right for one patient but not as effective for the next. We listen to the patient, we understand the care profile, and we offer specific education for each specific patient.
Revenue
Profit, although never the prime driving component of a practice, is necessary for a successful practice. Incorporating herbs into the practice will allow you to generate significant income by adding a very powerful service component. They keys to maximizing this service would be to find a streamlined system to minimize the stress of integration.
A common fee structure for a clinical nutrition clinic may be:
While the above model would be specific to a nutrition-based practice model, you can also use supplements to generate additional income streams within a chiropractic model. If you see an average of 100 different patients per month, each of which is given a basic program of a multi-vitamin, organic trace minerals, and a high quality fish oil, you would be able to increase your gross monthly profit by $6000 or $72,000 per year. And this basic program of quality supplements will accelerate results and increase patient excitement.
The biggest draw from incorporating herbs into the practice is the magnetic effect it has on stimulating referrals to the practice. Patients see that in your office you are using very powerful natural systems to help patients succeed and they talk to their friends about it. Using herbs also provides the data to pull together very interesting in-house education talks that are often well attended with interested new patients. Using proper marketing techniques we can fill up a room with twenty-five or thirty interested people in just days.
Nutrition, as a practice model or a secondary service inside a chiropractic office, can be a professional extension of natural healthcare and lucrative business model when properly applied. The keys to remember are first, the clinicians who are truly interested in the mechanics of how nutrition effects change have the edge; secondly, profit follows your ability to use nutrition successfully in patient programs; and finally, the key to marketing and practice growth is telling a story that someone else is interested in. Virtually all patients in your office are interested in better health, and how to gain it.
Continuing to impress the advertising and marketing world, The Foundation for Chiropractic Progress (F4CP) has again been recognized by industry organizations for its excellence in educating consumers on the benefits of chiropractic, this time through social media, newsletters, and demonstrating thought leadership by promoting holistic well-being.
Dr. Louis Sportelli received the Lee-Homewood Chiropractic Heritage Award during the annual conference of the Association for the History of Chiropractic (AHC). During his nearly 60-year career, Dr. Sportelli has embodied the spirit of the award, given to “living individuals who have made outstanding contributions to the chiropractic profession.”
Presently there is no consensus on the best treatment for Achilles tendon rupture; and its management is still controversial. The treatment options are conservative treatment and surgical repair. With either treatment, be it conservative or surgical, Achilles tendon tears necessitate prolonged recovery and rehabilitative management.
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