3 Decompression and Your Practice: An Overview for Implementation
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Dynamic Chiropractic

Decompression and Your Practice: An Overview for Implementation

By Jay Kennedy, DC

Decompression may well stand alone in the arena of capital equipment having been marketed extensively (and at times almost exclusively) as a get-rich-quick scheme. Though a remarkable (and typically erroneous) success rate was often claimed (via some magic, proprietary mechanism), the outcome potential still took a back seat to the income potential.

Though much of the fanfare and hyperbole of the past decade is subsiding due to low-cost, highly efficient machines entering the market (and a new calculus as to a reasonable treatment cost), the awe of added profits and enthusiastic patients waiting in line continues to fuel and burgeon interest.

Much of the interest comes from doctors who, just a few years earlier, would have scoffed at the notion of it; many denying it as "not chiropractic."

Fortunately, our profession has an inclusive nature and tends to adopt what works, irrespective of its' philosophical dissonance.

The need to address increasing doctors' bottom line is a standard approach when selling capital equipment. Commodity products like soap, paper and pens don't need a marketing strategy, per se, other than price, but capital equipment almost always does. A suggestion of high profit via high treatment price and patient demand is very compelling to any clinician. High patient demand is typically, but not always, linked to exceptional outcomes. I say typically, but not always, in that there are many practices with modest competence (and outcomes), but huge patient volume.

If the doctor believes they (or their equipment) to be the best, all the potential contrary evidence will remain unconvincing. Decompression systems (manufacturers) have been quick to play on this.

For more than a decade, decompression manufacturers had been able to convince numerous clinicians that their systems were technologically advanced, proprietary and not traction (all in the face of evidence to the contrary), and that the purchase would set their practice way above the average. This was often enough to instill a dramatic confidence in the doctor, who in turn transferred that confidence to potential patients. The result was a booming new practice. That the outcomes promised often failed to materialize was mitigated in various ways (not the least of which was the difficulty in admitting to the error in accepting a $40,000-$100,000 lease).

Interestingly enough, however, these companies also inadvertently demonstrated traction works (since there really aren't any true decompression systems).

And that has helped us all.

New equipment (and seminars) can be the vehicle(s) that create renewed confidence and commitment. Many of us need to latch onto something if and when our self-confidence wanes. That may come in the form of capital equipment, a "new" technique, etc. The good news is that the price of entry has become very reasonable. It is simply unnecessary to spend more than $12,000 on equipment these days!

I have seen many practices double collections in a few short months from just such an acquisition. I have also seen many practices pay off their entire equipment investment in the first month. Something aligns in the doctor's awareness and they commit to a new success proposition: "I can do this" or "I know this will work; this is the advantage I need."

Once we accept someone or something as an authority, we in effect give ourselves permission to achieve greater financial and personal success. A new piece of capital equipment is often that vehicle.

It is important to avoid falling prey to wild and exaggerated claims. Recognize cost-effective equipment is available. Disc problems may be better, less stressfully and more lucratively treated with a decompression/traction system than through other therapies - but there are no magic machines.

How It Works

It is important to properly understand decompression therapy. First, we are talking about axial traction (recognizing that, like it or not, it is more easily understood and sold when referred to as decompression therapy).

Decompression is an outcome when compression is removed and/or traction is added to any intact, hydrostatic disc. Axial traction is the efficient, saleable mechanism used to create a rapid, reproducible and safe decompression effect. Manual traction, weight-bath therapy, inversion, etc., are certainly "decompressive," yet are more difficult to sell and codify compared to a mechanical traction system.

We have discovered that nearly 80 percent of disc cases (classified via functional testing) are candidates for some form of decompression. That could be modified inversion, directional preference positioning, CPM, static, etc., with the decision based on the classification algorithm.

Traction on a specialized, efficient, non-threatening and comfortable table has been, and will continue to be, an intuitive and highly sought-after intervention for HNP, nerve encroachment, degenerative disc and their associated referral symptoms.

Second, it is important to remember that much research is focused on the proposition that there are four mechanically responsive conditions: 1) manipulation responsive; 2) directional preference responsive; 3) stabilization responsive; and 4) traction responsive. Traction is considered by most authorities as a primary, nonsurgical intervention with specific clinical prediction rules and indications.

Traction is a viable, intuitive and sensible therapy for compressive disc lesions and most notable leg (or arm) referral symptoms. We can really ask no more from it. It satisfies the patient with its comfort, technology and safety, and it satisfies the doctor with its ease of use, its ability to be delegated and (at least in the past few years) its cost-effectiveness. My experience is that it also can be successfully used to engage the patient in referring family or friends with disc-related pain/symptoms. Since it is a specialized method based on decompressing compressed structures and is different than "chiropractic," many patients often inquire along these lines: "I wonder if this would help so and so; they've already tried chiropractic."

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