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September 2006

Missed appointments

by Dr. Ogi Ressel

Many doctors ask me how they can make patients understand their care so they don't miss their appointments.

Here's the way I see it. Patient understanding of chiropractic starts with you. Your patients don't come to know chiropractic through osmosis. No. They learn it from you, their doctor. This means that you really need to understand what you do ‑‑ and why you do it. It means you need to know the vertebral subluxation inside and out. And I have to tell you, there's a vast difference in knowing about something, and actually knowing it.

It begins with you

Let me be brutally honest. Do you really understand why you adjust your patients ‑‑ and what happens when you adjust them? Are you really familiar with the effects of a vertebral subluxation on human physiology and potential? Are you truly aware of what your adjustment does? If you're feeling a bit uncomfortable at these questions, it's okay. You're not alone. These are very direct questions and answers to them are difficult to find.

Follow my train of thought for a moment. In a child, for instance, neuromuscular, neurogenic, and functional adaptive reflex development represents a critical period of time when a young, developing nervous system assimilates, differentiates, and adapts to external and internal stimuli. By means of these processes, this young nervous system learns proprioceptive patterns and acquires future habits and reactions by responding to repetitive stimuli.

However, such a developing nervous system isn't always able to distinguish between proper and improper stimuli. Therefore, it responds to both appropriately for itself. This is the conundrum ‑‑ the response is neither "good" nor "bad," but rather adaptive to the presented stimulus. These adaptive responses are remembered and patterned and thus the young nervous system is conditioned for future response. This process of neurological "learning" or "programming" of the central nervous system with respect to locomotion, posture, proprioception, physiological response and function, and body kinetics, begins right after birth.

As chiropractors, our main course of care should be concerned with chronic "low‑grade" and so‑called, "subclinical," efferents from the central and autonomic nervous system that result from, and thereby not only disturb, this neurological "learning, but also initiate "learned" and adaptive reflex kinesiopathology, dysautonomia, and dysponesis. It is then of paramount importance to eliminate any faulty programming as soon as possible ‑‑ your goal.

Your mission (should you choose to accept it ‑‑ and you have, otherwise you wouldn't be reading this column) is to initiate specific corrective procedures designed to alter and change these learned and adaptive neural patterns, correct vertebral subluxations, restore normal articular function, reduce disc stress, and optimize neurological integrity.

It's important for you to resolutely strive to reach your goal, the aim being correction, not merely the achievement of some temporary relief. The regimen of care should not be rushed, and patient care should not be based on symptomatology. Recovery should be measured by objective findings. (Adapted from my research paper published recently in the JVSR)

So there you have it. The reason you do what you do. If you're now wondering what all this means, let me state it simply. It means that the vertebral subluxation belonging to the child or adult in front of you has become his or her habit. It represents an erroneous adaptive response. It's an error in programming, a virus executing its own program, a shortcut, a fault. It is not normal.

Explaining this to your patients is necessary, but not difficult. You need to explain that what you're doing is changing their habit, and that their habit is what caused their problem. It's their own programming. Something that their nervous system has learned, and accepted as normal. Your "mission" is to substitute it with a different one. This one is called normal. Therefore, it's very important that they don't miss their appointments with you.

People will get this very easily. It's logical and makes sense.

So, get out there and help tons of kids and their parents. And, if you have any questions, please feel very welcome to call me. That's MY mission ‑‑ to help you reach as many people in your lifetime as you can, especially children!

(Dr. Ogi Ressel, author, researcher, and an x‑ray and pediatric specialist, teaches The Practice Evolution Program, the "fastest‑growing coaching program on the planet." Visit online at www.practiceevolution.com and take the Practice Health Mini‑Checkup. Dr. Ressel may be contacted by e‑mail at drogi@practiceevolution.com or by calling 800‑353‑3082. Interested in receiving his weekly THOTS "on seeing tons of children and families in your practice?" Send him an e‑mail and asked to be added to the list.)