Tag Archives: health care

Phases of Care


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There are three phases of treatment that I usually tell to patients.  There are lots of ways to divide phases of recovery/care this is just one way that I explain things to patients.

The first phase is the Acute Phase of Care.  In this phase our goal is to reduce symptoms, such as pain.  Most people feel that if they aren’t in pain they are healthy.  Pain as discussed before is a lousy indicator of health.  For example a cavity in your tooth doesn’t become painful until after it gets to the root, but everyone knows that the cavity was there long before that.  With cancer you always hear about early diagnosis and treatment long before symptoms being the best way to treat the disease.

When you start chiropractic care because of pain you have been unhealthy for a while.  Pain is the first thing to go away, but you are often far from healthy and much of the problem still remains even though you are feeling fine.  This is often when insurance companies will try to stop paying for care, but if you do the chance of recurring injury is significant.

This phase of care can last from 2 weeks to 2 months.

The second phase is the Corrective Phase of Care.  In order to prevent or reduce the risk of recurring injury you need to continue treatment until the problem has been corrected and your body has been strengthened.  This is often long after your symptoms are gone.  You won’t need to receive adjustments as often in the corrective phase, and depending on your condition you may begin exercises and other home care to strengthen your body and provide accelerated healing.

There may be occasional symptom flare-ups in this stage of care. Like a bruise in this phase it doesn’t hurt unless you poke it and then it reminds you in no uncertain terms that yes it is still there.  Your body has not quite finished the healing process.   Imagine a scrape. scraped-knee The pain is gone in hours but the scab remains for weeks, still a reminder that your body isn’t done healing.

This phase of care can last a few months to years in extreme cases.

The third phase of care is Wellness Care.  Just like getting six-pack abs it takes a lot of effort to get them.  Maintaining them takes much less effort but must be done or they disappear a lot quicker than the time it took to get them.  Regular chiropractic care can help keep your body at it’s best and catch problems early.

When you make the effort to be healthy you are not reactionary, but proactive.  You will be able to avoid many of the problems that affect people.  This does not mean that you will never have health problems or injuries, but it does allow you to live your life as full as you are possibly able.  You can live life to the fullest and enjoy more of the activities that you love.

Disciplines of Health Care

Heath care has what I would call disciplines.  Each discipline has its strengths and weaknesses.  They use different tools or modalities and treat different complaints.  Many times there is overlap in their capabilities.  Medicine is excellent at managing life or death situations, or in other words keeping you alive by fighting disease processes.  I would however choose a dietitian for eating suggestions or a dentist for a root canal.  Like foods our variety provides for many different needs.  You get the idea.

To demonstrate and generalize: dentistry uses drills and amalgam, optometry uses lenses, surgery uses scalpels and lasers, medicine uses chemicals, psychiatry uses behavior and thought modification, chiropractic uses adjustments and manual therapies.  There are many others, (I’m not purposely leaving you out).  This is not to diminish any role, but to simplify for the purpose of making a point.  Each discipline is great with it’s own set of tools, but if you ask an oncologist to deliver a baby you might be in for some surprises.

I was taught in chiropractic school how to deliver a baby and even how to identify the rash on your backside.  I don’t use those things often enough to claim any ability or particular skill in that area however.  It’s true I am not utilizing all of my training.  I have others around me with more desire and experience at handling diabetes or blood pressure.  I have the training and could prescribe lifestyle changes that can allow people to avoid, manage or even turn around those issues early.  I have done in the past.  However the position I am in now allows me to focus on being the best at one thing.  I can focus on becoming the best adjuster around and get to know the manual therapies like no one else.  I still quickly and easily give advice on some of these other topics and then refer those patients to someone who is the best at what they need.  I don’t have to be a jack-of-all-trades.

I appreciate the position that I am in that allows me to focus.  I recognize that there are places that don’t have this luxury.  A physician can be a master of many disciplines and rural chiropractors and other physicians have to at times.  In places where it is possible working together instead of against each other benefits the patients and the health care industry.  I hope to see the trend increase particularly in chiropractic where one chiropractor may want to treat mainly sport injuries or another surgery rehabilitation.  I hope that chiropractors will refer to one another.  I also hope that our fellow physicians and health practitioners will see the benefit of others and refer to the best person for the job.  I’ve said before, perhaps our gate keepers need to be health referrers someone you call up who can take your history and refer you to the best person for your condition.

Healthcare Reform More Powergrab than Reform

From what I can tell the major players are all fighting to get the most power from “Health Care Reform” that they can through positioning.  I get a sense of urgency from everyone in more ways than one.  There’s the hurry to the reform table  or we won’t get a seat.  That may be true, there are groups trying to cut people out now.  Second I feel like this reform is being pushed so fast so that no one will be able to see what it really is, kind of like the “Stimulus Bills” that no one even could read.

Here’s what I’ve seen at the meetings I’ve been too and in the news.  (I’m not even going to cite these things.  If anyone wants to link a story, feel free.)

The medical doctors are fighting a political battle to take away physician status from others.  They are doing this by trying to make it illegal to refer to yourself as a doctor unless you have the MD or DO degree.  This affects dentists, podiatrists, optometrists, chiropractors, lawyers, PhDs, etc…  They say it’s a public safety issue and they don’t want people confused, but in reality it goes to healthcare reform.  You see the “national health care” is to be modeled after medicaid/medicare (Oh that’s a good idea, they run great.) which places control with the physician.  If your a non-physician provider then you have less control and pay.  MD’s don’t go to management school, they are no better suited to be in charge of a musculoskeletal patient than they are to be in charge of a a patients teeth.  MDs have no extra special training.  It’s a power grab.

Physical Therapists are trying to become doctors for the same reason.  They don’t like being technicians and want some of that market share, so without really adding education they are trying to take the title or responsibilities.  Here in Utah recently they tried to sneak the term diagnose into their law, it’s just a term they said.  Well, doctors diagnose because they have the training, PT’s don’t have the training.

I know these turf wars are going all over throughout healthcare.  I’m just more aware of the chiropractic ones.  There are battles for control going between providers and insurance companies, and insurance and government officials, the only group that I don’t see fighting is the patients.  Why is that?  Why won’t the people speak up and take personal responsibility?  It’s your health take care of it!  Here’s one way you can: ChiroVoice it’s the voice of patients.

What a Chiropractor Can Not Do

A chiropractor doesn’t directly treat pneumonia, cancer, or chicken pox.  That doesn’t mean that he won’t recognize them when he sees them though.  This week in our clinic we had a patient come back with thanks for being the ones who finally caught his tumors.  This particular patient is a military veteran who has been having major problems for years.  He is constantly seeing multiple doctors and specialists.  He had been having leg pain for quite some time no one had really taken a look at it for what ever reason.  He has serious conditions, and so they may have been more focused on those.  What ever the reason it had not been addressed when he came in to Align Rehab and Wellness (Dr Duncan’s home) for treatment of his spine he mentioned the issue.  A history and X-ray was taken, only to show tumors in both the femur and the tibia.

While chiropractors often provide symptomatic relief for some types of cancer we don’t treat tumors directly.  This patient was appropriately referred so that further testing, more specific diagnosis, and treatment could occur.  Fortunately for the patient these tumors turned out to be benign, however he was surprised and happy that it was his chiropractor that discovered them.

Chiropractors receive extensive training in diagnosis.  Often more than medical doctors.  This training is not provided because our scope of practice includes the treatment of all conditions, but it does enable us to be primary care physicians able to recognize problems.  This is a benefit to the entire community and specifically to other health care providers.  It enables the problems to be found sooner by extending the eyes and ears of well trained professionals.  This patient and thousands of others every year are grateful to their chiropractor for recognizing something that they couldn’t even treat.

As a chiropractor it is nice to know, what I can not do.