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Neuroconceptual Models of Chiropractic

By Frank M. Painter|October 19, 2009|Diagnosis, Education, Subluxation|

Neuroconceptual Models of Chiropractic

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 5 from RC’s best-selling book:

“Basic Principles of Chiropractic Neuroscience”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 5: NEUROCONCEPTUAL MODELS OF CHIROPRACTIC

by Gary C. Johnson, DC

This chapter offers a review of the highlights of preceding chapters that concern subluxation syndromes and forms a foundation of thought for following chapters.

INTRODUCTION: EXPLANATION OF CONCEPTUAL MODELS

Conceptual models are collections of ideas, principles, facts, philosophy, and experiences setting our attitudes and directing our behavior. Ideas and principles include hypotheses and theories (whether right or wrong) that generate new attitudes and behavior, the spirit of invention, and the accessibility to important facts.

Scientific facts and our philosophical hierarchy of importance (priority) provide selective (choice) groupings of knowledge and thoughts, comfortably placed in support of our experiences. How we perceive what we do, why we do it, why the results, and how the results occur set attitudes and practice activities and change our minds and activities as new concepts are developed and tested.

CLASSIC CONCEPTS OF THE CHIROPRACTIC SUBLUXATION

The structural spinal fault, the associated nerve involvement, and the ensuing functional alterations comprise classic chiropractic subluxation concepts. In contrast, limited concepts of spinal biomechanical faults, modes of possible nerve involvement, and etiologic rationales of functional changes promote narrow viewpoints, disciplines, and therapeutic approaches, as well as foster empiricism and dogma. Awareness of the varied concepts of structural lesions, neuroinsults, and the causes of abnormal functional changes promotes wider perspective for intuitive practices, multifaceted observations, and fewer practices with reliance on empiricism that is dictated by dogmatic frameworks. (more…)

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For CAs: Responsibilities of an Administrative Assistant

By Frank M. Painter|October 18, 2009|Chiropractic Assistant, Education, Practice Management|

For CAs: Responsibilities of an Administrative Assistant

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

Enjoy Chapter 7 from Dr. Schafer’s best-selling book:

“The Chiropractic Assistant”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 7: Responsibilities of an Administrative Assistant

Proper scheduling and planning help any office function smoothly with less possibility of omitting necessary actions. The doctor in charge will identify each assistant’s duties and functions and discuss her responsibility for the performance of each assigned task. During her initial orientation and training, these functions may be subdivided into procedural steps necessary.

Task plans and work schedules eliminate the confusion of whom should perform a specific duty. It eliminates the question, “What do I do next?” Work schedules based on good planning eliminate the need to work beyond expected hours, except for rare emergency situations. Keep in mind, however, that a plan is not a permanent thing. As conditions change, the doctor must revise schedules, duties, and responsibilities to reflect changes. Flexibility is a necessary qualification for a chiropractic assistant.

Patient handling and patient control are the two major factors determining the success or failure of any practice. As professional competence should be taken for granted, patient satisfaction makes the difference in success or failure. This one factor determines a high or low patient return and a high or low referral rate.

This chapter describes common duties of an administrative assistant. In both the professional and business world, however, specific job descriptions vary to meet the needs of management.

OVERVIEW

It is frequently stated that the doctor should not be required to do anything in his office that an assistant can do as well or better. Valuable clinical time would be wasted if the doctor had to answer routine telephone calls, make appointments, supervise patient flow, send out notices and reminders, type letters, make billings, file records, and attend to the various other duties necessary to administer and manage the business side of a practice. To be efficient in his profession, the doctor must delegate much authority and responsibility for many office details to his assistant(s) so that his time will be used optimally in doing that which he has been specially prepared—helping the sick to get well and helping the healthy stay well.

The extent of delegated administrative responsibility depends largely on the nature of the practice itself, the assistant’s experience and training, and the size of the administrative staff. In a small solo practice with one assistant, the assistant will be required to assume several small roles. In a large office with several assistants, the number of duties will be reduced, but their scope will be expanded for each assistant.

Review the complete Chapter (including sketches and Tables) at the ACAPress website

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Sports Management: Physiologic Therapeutics in Sports

By Frank M. Painter|October 17, 2009|Chiropractic Technique, Diagnosis, Education, Physical Therapy, Sports|

Sports Management:
Physiologic Therapeutics in Sports

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 13 from RC’s best-selling book:

“Chiropractic Management of Sports and Recreational Injuries”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 13: PHYSIOLOGIC THERAPEUTICS IN SPORTS

Chiropractic physiologic therapeutics is defined by the ACA Council on Physiotherapy as the application of forces and substances that induce a physiologic response and use and/or allow the body’s natural processes to return to a more normal state of health.

This section is not intended to be instructional in specific modality application, but rather to bring to attention commonly utilized procedures and their rationale within the management of sports injuries. For this reason, emphasis will be on application-rationale within athletics, indications, and contraindications, rather than technique.

Physiologic Therapeutics

Physiologic therapeutics make use of the therapeutic effects of mechanotherapy, hydrotherapy, electrotherapy, light, heat, cold, air, soft-tissue manipulation, and massage. The rational application of these natural forces requires a knowledge of the actions and effects on pathophysiologic processes.

The use of physiotherapy to facilitate basic chiropractic care has been popular within the profession since the turn of the century. However, any therapeutic agent possesses a potential for effectiveness and a potential for danger. Each modality has its indications and contraindications, and certain precautions must be observed if the modality is to be applied safely and effectively in line with the biophysics and physiologic responses involved. (more…)

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Science writer Simon Singh wins ruling in chiropractic libel battle

By John Wiens DC|October 15, 2009|Ethics|

In two previous articles, here and here, I talked about author Simon Singh’s battle with the British Chiropractic Association. The Guardian reported yesterday that the initial ruling has been overturned.
From The Guardian:

A science writer who is being sued for libel by the British Chiropractic Association is to fight on after a preliminary judgment against him was overturned on appeal today.

Simon Singh was sued by the BCA after he wrote an article in the Guardian criticising the association for supporting members who claim that chiropractic treatments – which involve manipulation of the spine – can treat children’s colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying.

Singh described the treatments, for which he said there is not a lot of evidence, as “bogus” and criticised the BCA for “happily promoting” them.

In May, Mr Justice Eady in the high court ruled on the meaning of the words, saying they implied the association was being deliberately dishonest. Singh said that interpretation would make it difficult for him to defend himself at a full trial.

Singh was initially refused leave to appeal, but Eady’s interpretation was rejected by Lord Justice Laws, who said Eady had risked swinging the balance of rights too far in favour of the right to reputation and against the right to free expression. Laws described Eady’s judgment as “legally erroneous”.

Many scientists and science writers have rallied to Singh’s support, claiming that the freedom of scientific opinion is at stake.

Speaking after the judgment, Singh said this was the “best possible result”.

“Simon Singh’s battle in this libel case is not only a glaring example of how the law and its interpretation are stifling free expression, it shows how urgent the case for reform has become,” said Jo Glanville, editor of Index on Censorship.

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Upper Extremity Technique: Adjustment of Upper Extremity Joint Subluxations-Fixations

By Frank M. Painter|October 15, 2009|Diagnosis, Education, Subluxation, Technique|

Upper Extremity Technique: Adjustment of Upper Extremity Joint Subluxations-Fixations

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 2 from RC’s best-selling book:

“Upper Extremity Technique”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 2: Adjustment of Upper Extremity Joint Subluxations-Fixations

This chapter describes adjustive therapy as it applies to articular malpositions of the lateral clavicle, shoulder, elbow, wrist, and hand. Manipulations to free areas of fixation are also covered.

Screening Tests for the Upper Extremity as a Whole

The Shoulder Girdle

As with other areas of the body, it is good procedure during observation to first note the general characteristics and then inspect for details. Visualize the anatomy involved while observing the overall bilateral symmetry, rhythm of motion, swing during gait, smoothness in reach, patterns of pain, and general circulatory and neurologic signs. Inspect for gross abnormal limb rotation or adduction. Note skin discolorations, masses, scars, blebs, swellings and lumps, abrasions, and overt signs of underlying pathology. Carefully note the biomechanical relationship of the neck with the shoulder girdle and both with the thorax. Observation should be conducted on all sides.

With the patient sitting, inspect the anterior aspect of the shoulder girdle starting with the clavicle. A fracture or dislocation at either the medial or lateral end of the clavicle is usually quite obvious by the apparent change in contour and exaggerated round shoulders to protect movement. Note the normally symmetrical fullness and roundness of the anterior aspect of the deltoid as it drapes from the acromion over the greater tuberosity of the humerus. Unusual prominence of the greater tuberosity of the humerus suggests deltoid atrophy, while a sharp change in contour unilaterally suggests dislocation. A forward displacement of the tuberosity exhibits an indentation under the point of the shoulder and a loss of normal lateral contour. The most common points of abnormal tenderness are at the acromioclavicular joint and in the rotator cuff.

To test the general integrity of the shoulders, have the patient place the hands on top of the head and pull the elbows backward. This will be painful, if not impossible, in shoulder bursitis, arthritis, and rotator-cuff strains. Apley’s scratch test is another good screening procedure. Note if the scapula and humerus move in harmony.

Branch points out that spasm above or over the scapula will be readily recognized if the examiner observes the patient from the back during horizontal abduction. If such spasm exists (eg, from cervical radiculitis), horizontal abduction of the arm will occur with little motion of the scapula. However, if the origin of pain is within the shoulder, a “shrugging” motion occurs, in which the apex of the scapula sharply swings laterally but glenohumeral motion is restricted.

The Elbow and Forearm (more…)

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For New DCs: Patient Education and Motivation

By Frank M. Painter|October 14, 2009|Education, Practice Management|

For New DCs: Patient Education and Motivation

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 7 from RC’s best-selling book:

“Developing A Chiropractic Practice”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter Seven: PATIENT EDUCATION AND MOTIVATION

We described in the last chapter how an individual who is sick, in pain, or worried must be dealt with in a special atmosphere of understanding and consideration to lessen the anxiety involved. When health is lost, the sense of security is lost, and the person is operating on the basic motivational levels of self-preservation and threatened personal safety.

Patient education and motivation are two important solutions to this problem, and these are the primary subjects of this chapter. Professionally, these disciplines begin with and end with the professional services offered. Other major topics addressed include motivational communications, practice development, office systems, and auxiliary techniques.

Introduction

While the doctor’s diagnostic and therapeutic skills help to restore hope and relieve some of the patient’s emotional stress, a strictly technologic approach is not always enough. A patient’s emotions and frame of mind must also be considered as a component of a patient’s holistic state of health. The state of rapport between patient and doctor can be just as important as the technical care provided, and this rapport is established on a foundation of sincerity, understanding, kindness, and personalized care.

A doctor has moral obligations and professional responsibilities for each patient’s health. Thus, the physician should anticipate possible patient stress by questioning the scope of everyday activities. This questioning and the resulting consideration, however, does not mean to conclude with blunt condemnations. The alert doctor will be aware that typical patients are not interested in the technical aspects of their conditions. They are interested in the removal of pain, discomfort, immobility, and how the condition affects their life-style. Therefore, it is important that the patient’s everyday activities, hobbies, work and personal habits be considered along with the clinical aspects of the patient’s condition.

Many years of study does not guarantee a doctor a successful practice, nor does an attractive office with a nice location that incorporates modern equipment and pleasant furnishings. These factors only establish an opportunity for success. Every professional needs new patients to replace dismissed and self-dismissed patients.

Professional Services

Comprehensive health-care involves certain professional services to meet certain situations. Basically, all office policies and procedures are designed to support a chiropractic office’s four major services:

(1) consultation,
(2) examination,
(3) treatment, and
(4) education.The initial consultation and history are required to help determine the type of initial examination procedures necessary to isolate the cause or causes of a patient’s complaint or complaints. The second consultation follows examination and data evaluation and is held to review the findings with the patient and recommend a treatment program or referral. Ongoing consultations are necessary to receive progress reports from the patient, to counsel the patient against harmful acts, and to provide education toward healthy behavior and performance. The initial examination is necessary to profile a patient’s structural and functional status at the time of entry into the practice and to arrive at a diagnosis and prognosis under recommended therapies. Periodic examinations are necessary to monitor the results of recommended therapies, challenge the prognosis, and offer data to objectively confirm a patient’s subjective reports. All therapies should be designed to assist the patient in returning to as near a state of health and resistance to disease or normal stress as is possible.

These continuing services are involved in most all cases to some degree, but emphasis is considerably altered depending upon the type of case presented and the type of health care necessary at a particular point in time. For example, the typical office will offer five forms of health care:

Review the complete Chapter (including sketches and Tables) at the ACAPress website

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