Let’s say it’s the patient’s seventh visit. 

“Not sure this is working, doc,” she observes. 

Thankfully, this doesn’t occur too often. However, if such a patient comment prompts you to become defensive, it may reveal some critical communication lapses:

1. You have little control over the speed of a patient’s recovery.

2. You may have neglected to explain how chiropractic actually works.

3. Have you linked your clinical competency with the speed of their recovery?

4. You may see patients as a flight risk.

5. You may have neglected to enroll patients as partners.

6. Overlooked that the pace of their recovery reveals more about them than you.

The fortitude required to avoid being seduced by a patient’s impatience and allopathic mindset is one of the greatest challenges of practicing chiropractic.

This is where your unshakeable confidence, recognition of razor-sharp boundaries, communication skills, and patient leadership are on full display.

Rather than swinging into defensive mode, curiosity might be a better strategy.

“I would have thought you’d be showing greater progress by now as well. What do you think is going on?”

Rather than pointing out the patient’s unwillingness to hydrate, stretch, improve their sleep, and follow your other recommendations, it might be a good time to refresh the patient’s memory, repeating the key principles of your original new patient orientation:

Whole Body Integrity

Unlike taking a medication that fools your body, putting it to sleep so you can’t feel the pain, chiropractic care wakes up the body so it can function as designed.

Your primary mission is to reduce nervous system interference with precisely delivered chiropractic adjustments. This is when having the objectivity of sEMG or thermography can be helpful, demonstrating that neurological change is underway, even if symptoms haven’t diminished.

Multiple Visits Needed

Chiropractic care relies on multiple visits to retrain the spine to embrace a healthier pattern so it no longer has reason to express symptoms.

Unlike an orthodontist who uses the constant pressure of braces to change structure and function, chiropractic care relies on multiple visits to restore wayward spinal bones.

Visits that are too frequent waste energy because the body is still processing the previous adjustment. Visits that aren’t frequent enough don’t create the momentum necessary to overcome established negative patterns. “We aim for the sweet spot in the middle, designed to produce the best results in the shortest amount of time.”

While there is tremendous pressure to reduce visit frequency, don't rule out the need to increase it in certain cases.

My Job – Your Job

At its best, chiropractic care is a partnership. You have things to do on each visit—and they have things to do between visits.

Many patients would love to delegate their headache or back pain, like pointing out to the plumber the leaky faucet. But chiropractic doesn’t work like that.

Make sure you identify specific action steps for patients. Not just the stretches, exercises, and improved hydration. Be sure to include better sleep, sensible sun exposure, deeper breathing, reduced alcohol and sugar intake, improved oral health, and of course, keeping their visit schedule. Here’s a helpful tool.

Doctors Don’t Heal

Since chiropractic care relies on restoring the functional capacity of the body, the patient controls the speed of their recovery. After all, it’s not as if you’re withholding “the good stuff” or phoning in inferior adjustments!

If patients have little health margin, are metabolically challenged, eating ultra-processed food, industrial seed oils, and lacking sufficient Vitamin D, recovery is likely to take longer. While it’s tempting to think of it as a spinal issue, slow recovery is likely to be a general health issue.

Ongoing Supportive Care

Once their symptoms subside, many patients will need some type of ongoing supportive care to help them stay well after they get well.

If an adult patient shows up after years of adaptation and degenerative changes, relief is highly likely. However, permanent spinal and neural reorganization is unlikely after a mere dozen or so visits doled out by their stingy insurance carrier that secure relief. Explain this reality and foreshadow the idea that they are highly likely have a relapse in the future. Which is why after two or three of these reoccurrences, some patients may see the wisdom of opting for periodic wellness visits, like the ongoing brushing and flossing of their teeth.

Notice that these communication strategies have little to do with the patient’s admitting complaint, your adjusting technique, or even philosophical orientation. It’s evidence that front loading patient education has limitations and like healthy habits, is never done.

Bill Esteb, a passionate chiropractic advocate since 1981, brings a fresh perspective to the profession as Patient Media’s creative director and co-founder of Perfect Patients. With 13 insightful books examining the doctor-patient relationship, he inspires chiropractors worldwide as a chiropractic speaker, through his chiropractor coaching program, and consulting. Since 1999 Monday Morning Motivation has been emailed weekly to over 10,000 subscribers, sparking breakthroughs across the chiropractic community.

Email Bill