Charles Clement of Quebec, Canada believes showing the patient what to expect helps ease their fears. He writes, "I work with an open-door policy. Many years ago a new patient was watching and when she saw a five-year-old come into the office, press the button and the table went down, watched me give the adjustment then pressed the button to come up, and then leave, the new patient told me how frightened she had been but when she saw the little fellow so unafraid, she lost her fears.

"I use the Activator technique and have for 20+ years. As a result of the above new patient, I invite all new patients to come into the treatment room, with the permission of the patient on the table, and explain what I am doing, how the Activator instrument is used, demonstrate it on their hand and go about the treatment. Patients are delighted with the approach, and only one person in about 15 years has asked for the door to be closed (and no, I could not invite the new patient in to watch). As there is no undressing, people are not shy and are quite pleased to share their experience. It takes a few extra minutes, but then I'm not concerned with rushing."

Keep Lines of Communication Open

Frank Lanzisera of St. Louis writes, "New chiropractic patients may not understand what doctors of chiropractic do or fear that chiropractic treatment will hurt. Excellent communication is the key to quelling the concerns of apprehensive patients who want assurances that their concerns and questions will be thoroughly answered in a well thought out, caring manner. The combination of caring staff members who communicate that they are there to help and a thorough, caring doctor make an unbeatable chiropractic patient team.

"Alleviating the apprehensiveness of new patients begins with a staff member explaining that before any treatment is actually initiated, the doctor will perform a thorough history and physical examination, with a specific emphasis on the function and motion of the spine, to determine if they have problems that are responsive to chiropractic care. This should include a thorough recording of the patient's blood pressure, pulse, height and weight, as well as an evaluation of reflexes, posture and strength, which are components of an examination that all doctors perform. The motion of the spinal joints will also be tested to see if each vertebra in the spine can move in the six directions of flexion, extension, left and right lateral flexion and rotation. In addition to lab work, X-rays may be taken in certain cases, if indicated by the physical examination.

"After completing the initial history and physical examination, patients should be informed that when they return for a second visit, once the doctor has had a chance to review all of the information from the examination process, a report of findings will be presented. During this second visit, the doctor should explain the diagnosis and examination results including results of radiographic and lab tests. The DC should also explain the recommended type of chiropractic treatment, as well as its goals, length and frequency, and the benefits, risks and alternatives of the proposed treatment.

"Before the patient is given a spinal adjustment, the areas of the spine to be treated should be pointed out to the patient on a model of the spine that is placed on the adjusting table. I like to tell my patients that each time I see them I will check their spines to feel how the motion is improving and teach them to feel the difference between the abnormal "stuck areas" and the normal, freely moving areas. In this way, they can understand why a series of spinal adjustments to restore function is needed and what cavitations noise associated with a spinal manipulation represents. If any physiological modalities such as electrotherapy, heat, cold, traction, Graston technique, and/or ART are recommended, these options should be thoroughly explained to the patient regarding their physiological effects.

"When apprehensive patients comment that they have never been examined so thoroughly by any other doctor and leave the office with a smile and reduced pain, chiropractic physicians know that they have done their jobs well and have initiated the creation of a doctor/patient relationship that will last a lifetime."