One of the sad "moments of truth" in the management of a chiropractic patient comes at the end of your report of findings, when you give your Recommendations for care. Whatever your recommendations may be, the patient either resists, accepts and does not follow through or (rarely) accepts and does follow through.

In all the years I have been a teacher, facilitator and coach to thousands of chiropractors, this moment of truth seems to be the most troublesome problem. I'm sure there are many reasons why this is the case, however, let me offer the following observation and solution.

I believe that a major reason that lack of compliance is so common and PVAs are so low is the lack of respect for the "diagnosis" of vertebral subluxation. Patients have no clue just how severe this condition is.

Therefore, I believe that your entire office procedure and all of your patient education programs should be focused on the severity of vertebral subluxation. When chiropractic patients realize the serious trouble they are in with vertebral subluxation, they will be better able to follow through, even if it interferes with their usual daily activities.

Renaissance has developed an entire "clinical" and "general" patient education office experience that builds, procedure by procedure, a remarkable respect for vertebral subluxation and the damage it causes patients on every level.

Every phrase -- and at times every word -- has been sifted, evaluated and ground through the mill of everyday office practice. This subluxation-based wellness procedure takes patients further on their journey to optimum compliance (and many to wellness) than anything else I have seen.

This wellness journey begins with the first telephone call, then on through:

*** the case history

*** the case history review

*** the subluxation physical exam (Note: if you have instrumentation that validates vertebral subluxation scientifically, continue using it but the patient needs to experience the negative impact of subluxation in every part of the examination procedure)

*** the initial VSC Report of Findings

*** what to say during the regular visits that make up initial care

*** the progressive or graduation examination for initial care

*** and the VSC "graduation" ROF...

leading patients to wellness.

This procedure -- from the case history review through the admittance to wellness care and beyond -- is unique, thoroughly researched at the office level and extremely effective in increasing PVAs, your personal moment of truth when examining your own practice success.

These renaissance procedures have proven their worth on the level of increased PVAs with many chiropractors throughout the years.

Baby boomers are at the core of the wellness market and demand that any new long term addition to their wellness health care team be scientifically sound. This subluxation-based wellness procedure gives them choices and is vitalistic in nature.

Additionally, patients need to know the severity of the interference to their life expression that you propose to help them eliminate for a better life on all levels. Boomers are too busy living lives of increased wellness to bother with insignificant concepts. They need to know that vertebral subluxation is serious and a major threat to their wellness and total health expression.

I believe that medically based examinations involving orthopedic and neurological tests, lines on a graph or x-rays, philosophy (though that is my base), double salesman handshakes, big smiles, pinching fingers in a spinal foramin, blinking lights and lightning, medical clinical dress, etc. ... all have very little to do with making vertebral subluxation serious where it counts: at the subjective level of the patient -- where he or she will make the "condition severity" evaluation.

On the other hand, I believe patients must actually see their spinal distortions and feel the limitation of motion, the discomfort of limitation of motion and the pain of components #1-2-3 & 4 of the VSC. They should also actually see on x-ray (if they are taken) the spinal damage (subluxation degeneration) from vertebral subluxation as a barometer of body damage.

If we were inside a patient's mind during this VSC exam and ROF, I believe we would hear this type of internal self talk:

"Yes, I can see the spinal distortions in the mirror the doctor is pointing out. Yes, I can feel the limitation of motion due to these distortions and the pain in the distortion when I try to move my spine into the limited range of motion.

"I can also feel the severe pain of the pinched irritated spinal nerves that identify vertebral subluxation. Also, the cords of muscle spasms throughout my spine (they hurt, too) due to uncorrected vertebral subluxations throughout my spine.

"Yes, I feel the pain of the inflammation and swelling that leads to scar tissue and degeneration from the uncorrected subluxations in my spine. And I can see in the x-ray the damage (phase of subluxation degeneration) in my own spine from uncorrected subluxation.

"This subluxation stuff is very serious and I can just imagine the damage of uncorrected vertebral subluxation in my entire body."

Certainly, I have optimized the patient's internal comments, however, Renaissance doctors tell me this is very close to what happens.

Chiropractors who use the Renaissance wellness procedure in their office report very surprising results.

For example, national PVAs are five for acute patients and 17 for the entire practice, whereas in Renaissance and Dr. Guy Riekeman's Quest the statistics are 30-35 PVAs for initial care and more than 100 PVAs for wellness care. The Renaissance wellness procedure works and I highly recommend it to all doctors.

With this as a basis for your new wellness procedure, next time I will begin to outline a 16-point in-office clinical and general patient education strategy that can start you on your journey to a large wellness practice.

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Reading and supporting The Chiropractic Journal, an outgoing center for wellness information and publications, is a must for the subluxation-based chiropractor. I urge you to switch to the CBS Malpractice Program, the only wellness-focused malpractice program that I know of in the profession, and a malpractice company that supports real wellness chiropractic research (800-883-0412). Join the World Chiropractic Alliance (800-347-1011), a non-profit watchdog organization. The WCA is actively supporting the subluxation wellness basis of chiropractic.

They are putting their money where their mouth is. Refreshing, isn't it?