December 2003

Chiropractic can't help you -- go to hell

by Dr. Jonathan Sevy

In this day of HIPAA, MHOs, the continuous media attacks and other challenges, it's good to remember that chiropractic practice can be fun. One way I learned this was a bit unusual.

When I was young in practice, I was so arrogant I felt that if a patient failed to respond positively to my care, chiropractic had been tried and failed. As a graduate of Western States Chiropractic College, I knew exactly what to do: send the patient to a real doctor -- an internist, oncologist, pediatrician or whatever -- but a medical doctor.

After a couple of years of occasionally having to make such referrals, I was shocked one day to suddenly realize that in not a single instance had the medical profession been able to identify a diagnosis that I had not already determined. If I couldn't determine the cause of the patient's problem with my hands, a careful history and perhaps an x-ray evaluation, neither could medicine with all its technology. This brought back memories of Dr. Appa Anderson, the great chiropractic radiologist at my alma mater, who routinely found serious pathologies that medical radiologists had missed.

Truth told, this new awareness frightened me considerably at the time. I had really thought that medical science was more expensive and invasive, but ultimately more precise and powerful than chiropractic. Now I realized that if I did not find the cause of the problems, the medical profession almost certainly wouldn't either. Worse yet, sending my patients into the powerless environment and high risks of heroic medicine appeared to me to be telling them to go to hell.

By this time in practice I was discovering the truth of what many of our leaders have observed and summarized as 80-10-10. 80% percent of chiropractic patients enjoy good to wonderful results, 10% only obtain partial improvement and about another 10% fail to respond.

So I tried a new alternative to my chiropractic care -- another chiropractor's care.

I began referring non-responding patients to other D.C.s whose techniques were different than my own. Surprise! They got 80-10-10 with my failures. I even referred to D.C.s whose techniques were very similar to mine, and they got great results, too. And in the process, as Dr. David Singer points out, my 80-10-10 went to 80-10.

I learned two important lessons from this experience:

1. The responsibility to really help people return to health lies squarely on the shoulders of the chiropractor. There is no wizard behind the curtain.

2. Get Patient Out of Office (GPOO) is a powerful, legitimate and compassionate healing procedure and practice building tool. One of my goals now is to quickly identify the 10% who will not respond to my care, then GPOO.

If someone is not seeing definite, positive results within one-to-two weeks, I am dissatisfied and carefully reevaluate my early conclusions and treatment plan. If there is not a decisive improvement in three weeks, I change and intensify what I'm doing and warn patients that we have one more week to see a real change for the better or I will refer them out. (25% of them can't stand the rejection and begin to improve immediately.) After that week, if I cannot document dramatic positive change, I refer the patient to another D.C. -- down the hall, next door, or across town.

That may not be how I would run the practice if my primary purpose was to fund my chosen lifestyle. But that is how I would treat my mother, father, sister, brother or child -- and the "precessional side-effect," as Bucky Fuller called it, is that my bills get paid comfortably.

The question naturally arises as to why these non-responding patients have an 80% probability of getting good-to-great results in my colleague's office? I don't know for sure, but suspect that sometimes it's because I missed a diagnostic clue, sometimes my technique is inappropriate for the underlying cause, my voice reminds them of their horrid third grade teacher, or they can't stand the color of my office, shoes or C.A.'s hair. I keep trying to eliminate the first two, the rest I don't worry about, just GPOO.

It's fun. It's liberating. It gets patients well.

GPOO removes non-responding, and therefore non-enthusiastic, patients from my office. It creates a vacuum into which the Universe, Innate, God or whatever you choose to call it, can draw the kind of patients I serve and enjoy serving best.

If, as Jim and Karl Parker have so often urged, I use creative imagination to picture new patients who have the type of conditions that I excel in, then more of those patients are attracted to me. They get better results, I get better patients. They stay, pay and refer. Everyone's happy -- including those I refer out.

(Dr. Jonathan Sevy graduated from WSCC in 1988, and served on the executive staff of Parker Chiropractic Research Foundation and Parker College of Chiropractic from 1995-98. He now resides in British Columbia where he's working on a book to make chiropractic the global health care choice of the 21st century. E-mail comments are invited: DrSevy@chiromoms.com)