Now just imagine you are in the patient’s place.  The scans have something to do with my spine.  The doctor has used the words nerve and stress and I still have some type of back/neck pain.  What the heck do all these colors mean?  What is he/ she satisfied with?  How much longer do I have to come for this problem?

Can you really blame the patient who comes in for spinal related pain, gets told a bigger story about stress, health and wellness and then judges their improvements on their comfort rather than their test results?  Well, before we blame the patient or ourselves, let’s look at the dynamics of the relationship and how we can ensure its honesty.  If you are seriously setting goals that go beyond pain and structure, then the scans are an ideal method of tracking progress.  If you are using the scans to measure NMS integrity alone, then the frustrations will mount within both parties. The starting point for all care plans must be built upon truths and consequences.

Truth#1: the scans identify habits that have been created by the body’s best intentions to maximize it’s efficiencies in light of the subluxated state.  They do not necessarily point directly to the subluxation or the pain and inflammation that may be attendant to the symptoms a patient is feeling.  These habits are identifiable in a variety of neural processing states and NMS positions and motions.

Truth#2: Pain and symptom management are early stage identifiers that the body is responsive to your interventions, NOT that it has healed the subluxation.  Subluxated systems are ridiculously inefficient and protective.  Scanning detects the efficiencies that neural processor possesses and relates them in regional color patterns or scores them numerically against normative scales.

Truth#3: A chiropractic care plan must have goals that identify the needs of the patient, the desires of the practitioner and the reality of the situation.  There are consequences of a short sighted plan and limited adjustments.  If the neural processors are persistently distracted then the system is out of sync and requires a chiropractor’s intervention.  Do your adjustments stabilize the spine, reset the neural sequencing, arouse innate or all of the above? 

Truth #4:  A patient will follow your care plan for as long as they value the outcomes that you are certain of.  If you have developed a certainty that your care model unwinds the neural-dural tension and sets the tone for healing and potential, then the scans will reflect your excellent work.  If your method is focused on structural integrity with the HOPE that the neural system SHOULD release its old habits, then the scan progression can appear more variable. Certainty and specificity wins the day.

Truth #5: Information is free; advice is valuable and at times priceless.  I suggest that you be more certain than speaking in generalities.  Trust your greatness and give exacting advice.  Tell the patient how long you feel it will take to clear a scan or raise the NSFi.  Develop an outcome relationship with the patient.  That’s what they are aiming at.  The days of endless attendance because of the elusive holy grail called wellness, are over. Be a master of your outcomes and assure your integrity with proper communication and commitment on your part.  Celebrate the shifts in the scans as much or more than the improving comfort in the patient.

There are a gazillion more truths to explore in practice but these were the ones that resonated as I wrote this blog.  Send me a whole bunch more of your truths and we can discuss them in this blogosphere.  As Pat Gentempo reminds us, ”You are not alone.”

I was recently on a call with my friend and colleague, Dr. Yannick Pauli.  He and I did a WNL session focused on the destructive nature of ADHD and the importance of being the powerful leader in your community where parents and children can go to be cared for. The transcript for this call has been generously shared by Dr. Pauli and is available in the “free stuff “section of the Docfletch.com website.  I twisted his arm and he is now offering an 8 module program to train DC’s on how to position your practice to be masterful at working with these wonderful souls.  Go to www.ADHDwellnessexpert.com for more info.  In the course of this call, Yannick suggested that the subluxation was better viewed as an invitation by the body to let us in and begin  the necessary change.  This is contrasted to the notion that it is a lesion that needs to be cut out or removed.

One of the great challenges that we face as chiropractors is to step away from the medicalization of disease and focus on the principle of dis-ease.  We need to do this away from the quasi-religious notion that we hold the power to heal people.  Chiropractic is a science that understands and utilizes the relational aspect of the subluxation to disease and the impact it has on reorganizational behaviors and strategies in the human experience.  A subluxation is a distinct measurable component of a system that has been mired in an adaptive loop, unable to break free to complete the healing experience.   Chiropractic sciences measure that adaptive response through the neurological and biomechanical windows primarily. In light of this we have a tendency to organize the care plans along those end stage repair strategies connected to movement, posture, pain and comfort. 

After Yannick suggested the invitational nature of the subluxation, I was struck by the image of “Alice through the looking glass”.  As we work over the patient, I envision that the subluxation is akin to a window through which we peer.  There are many veils that distract and obscure the perfection that lies within.  These can be categorized as neuro-mechanical, neuro-emotional, neuro-metabolic and of course, neuro-bio_logic.  Each of us has the opportunity and perhaps the responsibility to analyze and detect these distinct characteristics and then choose the most effective adjustive strategy to lift that particular veil.  The goal of course is to arouse the innate intelligence to be more evident.  We can accomplish this with specific adjustments targeting specific forms of subluxation.

There was a time in my career when the emphasis was on honing your adjusting skills by attending relevant seminars.  These days there are few seminars along these lines compared to the business/practice building ones.  My observation as a coach is that it’s pretty tough to build a practice when the outcomes are clouded in doubt.  A starting point might be to acknowledge that one size of adjusting does not fit all subluxations and that if it does then there is a distinct limit to the scope of your care plan. 

We’ll spend some more time exploring the use of certain scans to be more specific as to which subluxation class you are observing.  Classically, the scans are best to observe the chronic, neuro-emotional state and then tie that in with the neuro-mechanical outcomes.

So, consider the opportunity you have to peer into their Universe through their subluxations.  This perspective may just expand your horizons and keep you from being the Mad Hatter in your town.

Dr. David Fletcher is an accomplished coach and the co-creator of the Greatness Movement.  Spend a moment and get your own personal GAP (Greatness Action Plan).  Its’ fun and its free.  Send a request directly to docfletch@docfletch.com .

The “holy” words within chiropractic are probably best found in the Green Books rather than Dynamic Chiropractic.  Whether you are in church or in practice you will have to decide which direction you want to focus on and what words and messages you will follow. This all important decision defines the intent and the principles that will guide your actions and communications.  

“I’m a chiropractor, who is a doctor, trained to release and adjust the tension that is being held in a person’s spine and nerves.  This turns on the power to heal while turning off stress and it’s all done without using drugs or expensive therapies.”

I just came up with this 7 second, elevator statement and it sums up some of the important distinctions that are unique to chiropractic.  Embedded in the dialogue are the key words:  doctor, release, adjust, spine, nerves, heal, power, stress, drugs and expensive.   Regardless of the way we speak or tell the story, the content and context of the words we use are expressing our intent.  In this dialogue I didn’t use the words back or neck care; specialist, pain, therapy, relief, muscle, joint, manipulation, strain sprain.  These are words that, when put together, represent a form of therapy and a therapeutic outcome.  Healing starts with therapeutic benefit and then opens up to potential.

Its so useful to examine our words as they confirm our intent.  This is one of the reasons that I have eschewed the use of scripts in practice management. Regurgitating another person’s intent is useless.  Learning the content of what is in the scripts and then reframing it to meet your message is valuable.  This is on e reason that I have developed templates to insert, in an appropriate order, your own words and your own message.  However or whatever we speak, it must be the truth to us.  I am driven by the message that resides in full view in our kitchen:  “Choose to be kind rather than being right.”  It sort of goes along the route of the Golden Rule.  What messages deliver kindness?  You can be direct and still be kind. You can disagree with a person’s opinion and position and still be kind. You can give a care plan based on the kindness of the truth rather than the righteousness of a practice management dictate.  

The root of the word trust is truth.  To be at peace in practice and in life, tell the truth as you understand it and the trust will build. It takes courage to be truthful but the words are in you.  Choose them wisely and you’ll sleep comfortably.

Docfletch trains doctors and their teams to use powerful and truthful words in practice.  His templates and dialogues have changed thousands of practices around the world.  Call today for a courtesy consult on how you can deliver the message that is inside of you. Join the Insight Academy and book a Mind the Gap session and get the New Year off on the right foot.

If we take this truism into the details of the practice then we need to ask ourselves the obvious questions: “What are we certain of ?”and “What and where are we fooling ourselves through inconsistencies and incongruencies? “  One question that I ask the attendees at my program is , “What is your product”.  Now of all the things that a business has to have nailed is the product along with the pricing and the delivery methods.  You wouldn’t believe what I hear.  I get health, vitality, change and wellness as answers.  This then narrows down to adjustments or care.  Generally the room goes very quiet as it becomes apparent that there is no consensus and the answers are asked rather than emphatically given.  The answer, as I see it, is none of the above.  With certainty, I can tell you that the product that a chiropractor sells is not an elusive or subjective  outcome.  Nor is it the adjustment alone.  It is the care plan.  This is the way health care and healing practices work. They create an avenue and a forum to develop a time-based relationship into which the doctor can add their extreme skills of  examining, analyzing adjusting, communicating, coaching, mentoring and being. 

Imagine how powerful and productive your practices could be if there was certainty in the communication of the care plan with every patient.  Imagine if every patient knew where they were going at all times in their care and were aware of their responsibilities.  The CA’s could be trained to be Care Plan specialists, dedicated to assisting the patient adhere to their plan rather than focusing on assisting the doctor.  Powerful practices run this way and the team gets paid at the level of the certainty that they project.

A case study in certainty can be found around the corner in any orthodontists office. These professionals are the very best at focusing on the outcomes  and having care plans that accomplish this.  Along the way they are certain that these results are going to be achieved and they get paid handsomely for this certainty. In fact, the client isn’t even told how often they need to be scheduled.  The intent is the successful outcome and the making of a new “smile”.  Damn, these guys are good!

Lets all take the next step in certainty development when it comes to the care plans.  Structure the care plan from exam to exam at the very least with goals that go as far as you are certain of the outcome you can achieve.  How cool would it be if the certainty of the outcome was based on the certainty of the value of clearing the scans. Imagine that the true goal was to observe neural clearing regardless how the patient felt and that the care plan reflected your expertise, like the orthodontist, on the momentum of the change.  Imagine that you could equate, without a doubt, that wellness was being acheived as the scans reflected the healing state and improved in their pattern. 

A solution to a lack of certainty is to dissect the care plan that you would love to deliver.  Write it out, step by step and fall in love with every bit of it.  Imagine and envision the scans and the healing  as the patient moves from a Release state to the Rebuilding phase.  How long and how frequent will you need to see the patient?  What are the outcomes you expect?  How will you communicate this each step of the way?  What media will you use?  What is the fee structure and the payment model?  How will you measure the success?  How does a patient grow into wellness?  How can they be trained?  Will they refer families and friends?  What do you do in the process?  Your staff’s role and duties?…These are the questions that develop certainty and I am certain that if you focus on removing the inconsistencies in your intent, actions and delivery, you will be repaid handsomely in so many ways.

The post today will be of a practical vein as most of the docs that I have worked with recently need an update on the discussion of the GAP.  As you know, my coaching program is styled after that principle hence the name, GAP Coaching.  Remember that GAP is a derivative of Selye’s original concepts of General Adaptive Syndrome.  At Total Solutions, we reorganize the GAS to become the GAP which now stands for General Adaptive Potential. 

In essence, we all operate within boundaries. Thankfully they are not rigid like a set of train tracks but rather flexible and responsive to life’s nuances.  If we look at the opportunities of living big and living on purpose then we would be well served to widen the GAP as often and as much as possible.   As A Dr. Beatrice Berry puts it,” When you walk with purpose you collide with destiny.”

The lower boundary of the GAP represents entropy.  It’s where life energy has depleted and the rigors of daily living have taken such a toll that the GAP is narrow and the dis-ease is the norm.  The lower boundary is where failed decisions come to rest.  The net effect of persistent dis-stress pushes the patient or the person closer to that lower boundary. The lowest level that can be reached is when life energy, the elan vital, can no longer be expressed and death ensues.

The upper limit is actually limitless.  It represents the opportunity of expressing human potential at its nadir.  This boundary is self and evolutionarily imposed.  We mere mortals live with glass ceilings where we can envision what lies beyond but feel the constraints of self imposition.  Who knows when the next barrier to human performance and creativity will be shattered?

At each station in life we develop a state of ease that “fixes” these boundaries.  These set points become our relevant and dominant perspective.  We activate our neurology to allocate a state of ease where physical, mental and biochemical stressors are viewed as eustress (beneficial to growth and maintenance). What is one man’s poison is another’s pleasure.  We operationalize our tasks to use enough stress to get pleasure and enjoyment in life which may or may not be enough to “raise the bar”.  Eventually, we accept these limits until creativity and purpose push us to expand.   So long as the added stresses are deemed to be advantageous to our future well being, the body-mind deems these to be eustress, thereby expanding the limits.  When unintentional stress is applied, a downward force is activated and the GAP begins to close.   This can be from any one or all three dimensions of stress, simultaneously, instantaneously or insidiously.   Regardless, the perspective is altered and what used to be tolerable now changes to aggravating as the upper limit slumps.

 Stress is cumulative by nature and design and so if unmanaged or emotionally charged, a snowball effect begins.  But something worse is at play. This snowballing isn’t linear.  As stress affects the processing in the neural core and perceptions are altered, the original tranche of stress becomes another stress to deal with.  This snowball is rolling downhill, gathering speed and overcoming the inertia that has taken years to develop.   This is now an exponential problem. That is verging on “out of control”. 

Somewhere along this chain of events, the body-mind recognizes this altered state and begins to produce defensive strategies.  This guarded response is to protect and alert the stress owner that something big is amiss.  Sadly the owners are rarely tuned in to their bodily state. In effect they are disembodied.  This shift from stress/ eustress to distress creates a measurable response that we term the subluxation.  It is identifiable through its spinal component, the vertebral subluxation in ways that chiropractors are trained to analyze.  For this reason, we can apply the results of the scanning technology to the concept of GAP.  WE can use the combined score of an NSFi to represent the width of the GAP that a person is operating through at the time of exam.  We can identify where and how deep the stresses( distresses) are being stored and to what extent they are altering the health of the patient by reviewing the thermal scans.  Algometry allows us to measure the sensitivity of the inflamed, upper tissues while inclinometry detects the global guarding associated with subluxation.   Dysponesis is a state of total energy inefficiecy and can be identified through sEMG readings to understand the failing state of energy management in dis-ease.  Finally the HRV is a point of reference for the doc and the patient to see how the narrowing GAP is affecting the patient’s ability to adapt and “dance on the head of a pin.”

As you can see, the goal of the chiropractor is to “widen the GAP”.  Innate allows us to have a GAP and Innate is programmed to widen the GAP so that we humans can accomplish our purpose and destiny.   If distress can narrow the GAP then adjustments can jack it open.  Keeping it open and pushing the boundaries is a combined effort of purpose, chiropractic and hygienic decisions.  I registered the website, www.widenthegap.com for some future project that could inspire, teach and train the world how simple it can be to take charge of one’s health, perspective and future.  Send me your thoughts on how this may look and we can collaborate on widening the gap in our communities. 

So, all of the airports and recycled airplane air have narrowed my GAP.  Writing to all of you has begun the process of easing the downward push on my system.   The healing is in play.  Use the GAP wisely and train your people how good it is for everyone to get “gapping”. 

DocFletch blogs are shared around the world.  Pass on the link and let the scanning and chiropractic communities know that this is the destination to learn and grow as a chiropractic warrior.  I invite all of you to drop me a line in the comments section or do as many do and write an email to docfletch@docfletch.com.  Let’s widen the GAP one patient and one family at a time.