Is an Adjustment a Treatment?

Another example in the Sloppy Language Department is the chiropractor who says that they “treat” patients or go into the “treatment” room. Naturally, if you wish to treat patients, you’re free to do so. However, you might want to be mindful of what it means to deliver a treatment and what it means to the relationships you have with patients. Looking past the implication of this word choice can invite unwanted consequences.

A treatment constitutes ministrations designed to alleviate a set of symptoms. Taking a pain relief medication to suppress the symptoms of a headache would be considered a “treatment” for headaches. As is adjusting a patient for the purpose of relieving their headaches. Both are treatments.

“Yeah, so? Anyway, that’s why patients show up in my practice. What’s the big deal?”

Actually, it’s a huge deal. Since the words we use reveal our heart, our intention and our worldview, using the word treatment in lieu of “care” or even “adjust,” could be a telltale sign of one or more of these errors:

1. It implies a mechanistic-linear-recipe-cookbook model of healing. As appealing as it may be, this misguided notion suggests that we’re merely a collection of “parts.” It creates an overly simplistic “if this, than that” approach to patient care. As in, if patients have headaches, you’ll need to adjust their cervical spine. Likewise, if patients have low back pain, you’ll need to adjust their lumbar spine. Further, this linearity virtually ignores the emotional and spiritual circumstances of the patient. Having not attended chiropractic college myself, I’m uncertain how this perspective is formed, however, my guess is that many believe that the aberrant biomechanical spinal pattern that is the focus of so many chiropractors is the problem, rather than merely a symptom.  

2. It sets you up for assuming credit (or blame) for outcomes you can’t control. When you tell yourself (and the patient) that you’re “treating” them for X, Y or Z, you’re suggesting that it’s you and/or your intervention that's producing the desired outcome. In the “Pride Cometh Before the Fall Department,” this is a broach of the highest magnitude. First, if there’s going to be any healing, the patient’s body will be doing it. And if so, the self-healing capacity installed by God will be responsible. The fact that you know where to give their body a releasing nudge, is great, but you’re hardly the star of the show. Oh sure, patients will give you credit, but you might not want to accept it in favor of congratulating them for having the self-healing capacity given them by God.

3. It minimizes and reduces what chiropractic intervention is capable of producing. Treating an obvious ache or pain, while perhaps the “first right answer” is hardly the highest use of chiropractic. When you help reduce nervous system tension in the patient’s body, just about anything is possible. Perhaps this is why those in chiropractic with an analytical/mechanical bent never see any so-called “miracles.” If your paradigm is pain relief, then visceral and organic cases don’t resolve. Maybe, because patients with visceral and organic cases don’t show up in your practice. The “I’ll-believe-it-when-I-see-it” crowd have it backwards. Instead, when you believe it, you’ll see it.

4. It blurs the distinction between medicine and chiropractic. While there are powerful forces attempting to promulgate the idea that the success of chiropractic depends upon seeking and receiving the approval of medicine, this is a bad idea. I’ve covered this elsewhere, but just remember your very right to practice, written into the licensure laws, relies on chiropractic being a nonduplicative, separate and distinct healing art. As the symptom-treating model embraced by mainstream medicine proceeds to bankrupt us, if chiropractors position themselves as the antidote to this wrongheaded thinking, there may be hope.

Treat patients if you wish. Take credit for the results your adjusting technique produces if you dare. Use the words treat or treatment because they’re handy, insurance carriers see it that way, patients assume that’s what you’re doing and it’s become a difficult habit to break.

Sloppy language has a price. And many chiropractors pay dearly because it obscures the truth. Consider the advice of the March Hare to Alice:

"Then you should say what you mean," the March Hare went on.

"I do,” Alice hastily replied,” at least I mean what I say, that's the same thing, you know."

"Not the same thing a bit!" said the Hatter. "Why, you might just as well say that "I see what I eat" is the same thing as "I eat what I see!"

Originally posted February 20, 2008