What happens in Vegas apparently stays in Vegas. However, what happens in a chiropractic practice will be known all over town. This is a fact of life in our high-stakes chiropractic world of hands and flesh. E-mail traffic I received after my last article ("Lost in Translation") impressed upon me that doctors always are interested in what other doctors are doing. This goes beyond just techniques and treatments. If medical doctors differ from each other like oranges and tangerines, we chiropractors differ from each other like onions and kiwis. Since most of us are in solo practice, why wouldn't we want to know what each other is up to?
In my community, I know a lot of the DCs, or at least know something about them. Consequently, when I see a new patient who was treated by a previous chiropractor, I always want to know the identity of that former DC. Why did the patient leave? Was it something negative? If not, and the patient confesses the name of the DC, it's disheartening to me to realize that sometimes the person left a perfectly good doctor because of a $5 increase in the office visit.
That is why I am tickled to learn the previous DC is retired or dead. I might then have the opportunity to make the new patient feel more comfortable with me; the new guy. If I know anything about Old Doc's family, habits or hobbies, the patient often warms right up. "Did Old Doc still smoke those cheap cigars when he was treating patients?" "Was Millie still running the place when Old Doc retired?" "Did he ever get rid of that tattoo of a pot-belly pig from when he was in Saigon?"
Yes, it helps to know something about a patient's previous chiropractic care. "Did Dr. Linda always smear a particular essential oil over your back before she adjusted you?" I once asked. "Oh yeah, and on my feet too!" the patient replied. "She had a foot fetish, you know. I bet she owned more than 300 pairs of shoes, most of them high heels!" OK, maybe I didn't need to know that.
I once had a DC tell me even prospective patients who declined his treatment proposal would never forget his name. That's because his treatment plans were so expensive. He may have been correct. A phenomenon that occurs frequently when interviewing a new patient is finding out they can't remember the name of a previous chiropractor.
A game I play in this situation is to ask the location of the DC's office. "Yeah, I don't remember his name, but his office was on the third floor of the Metropolis building, just to the left of the elevator." Sometimes, with this additional information, I can identify the chiropractor. This might not mean much to the patient, but it makes me feel like I've won a quiz game and brightens up my day a little.
Other health care providers have their idiosyncrasies, too. Take the case of the Humming Dentist. It seems a dentist who practices in an office building next to mine has the habit of humming loudly when he works on patient's teeth. He hums away in some alien melody with no rhythm or discernable tune in mind, annoying most of his patients. As one patient told me, "The humming starts off softly until he starts drilling. Then, he gets louder and louder. If he's fitting you for a crown, you almost have to get drunk before you go in." Indeed, patients have been said to ask for laughing gas for even the simplest procedure in an effort to take the edge off the doctor's irritable, incessant humming. I once asked him why all the humming. "I can't help it," was all he could offer as an explanation. So, I suggested he try humming real songs and have a daily musical theme. He could have a placard in the waiting room, saying something like, "Today's humming selections will be American folk songs."
I love to visit chiropractic offices, just like a baker likes to visit other bakeries. But instead of smells and taste, I am looking for style and service. Signs at the front desk are my favorites. So many of them try to be firm in collecting payments. "Payment Is Required at the Time of Service" is very common. I often have wondered if these signs do any good. A better sign might be "Pay Here Before You Can See the Doctor." One sign I dreamed up recently is simple: "I Can't Adjust Your Neck While You Are Talking on Your Cell Phone."
Don't trade dirty jokes with your patients. After all, what if one of them ends up as a new patient in another DC's office? What will they tell about your practice? "Let me tell you the joke Dr. Hanks told me. It's really naughty!"
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
