There Has Never Been a Better Time to Be a Chiropractor

I have been reading some of my older blog posts and have been pleased and a bit amazed at how true and relevant they remain today.  So I have decided to share some of them with you.  Below is one I wrote in October 2007 — one of my very first blog posts.  That was before I even had this website.  It still reflects my core beliefs.  And I still think this is a great time to be a chiropractor.

There Has Never Been a Better Time to Be a Chiropractor                                    Original Blog Post October 2007, Abaco, Bahamas

There is nothing more powerful than an idea whose time has come.  Chiropractic is the idea and now is it’s time.

I can say this with the perspective of 40+ years of experience in the profession.  I entered Palmer in October 1963, and began practice in November 1967.  I have had the pleasure and great satisfaction of seeing chiropractic grow and develop into the highly respected profession it is, a force to be reckoned with in the healing arts.

It is very sobering to think of being in practice for 40 years. [Now 50] That means that I am not a kid anymore, even though I still feel like one. This has been a time of reflection and introspection.  It is also a time for looking forward to the future with excitement and great expectations.

Sometimes it seems like the blink of an eye, other times it seems like forever.  I vividly remember the early years:  The fight for licensure in New York, the satisfaction of watching my practice grow from one patient to thousands,  striving to grow as a person and a professional.  It’s been a great ride.  It has been a lot of things, but never boring.

Experience is a great teacher.  It is something you can’t buy, you have to live it.  Thankfully it is something that can be shared with those who are smart enough to learn from the successes and failures of others.

If you are a chiropractic student, I can tell you that you have made a wise choice, provided you are in it for the right reasons.  If you are already in practice or about to enter practice, the world is your oyster.   You need only decide what kind of doctor you want to be and what kind of practice you want to have.

If your idea of a perfect practice is to specialize in personal injury, workman’s compensation or to be a provider for a PPO or HMO, or if you want to engage in a DC/MD practice, then read no further.  What I have to say is probably not for you.

However, if you want a personal, private, cash practice, with low overhead and high net income, and a high level of personal and professional satisfaction, then you will probably find what I have to say interesting and chock full of the information you want.

My objective is to share with my readers the kind of information that I wanted as a senior student and later as a new doctor trying to find my niche in the profession and my community.

Transitional times are always difficult.  There are many unanswered questions, questions one would logically expect to be answered in chiropractic school, but somehow slipped between the cracks, remaining question marks in the mind.

These unanswered questions, and the insecurities and confusion they cause have given birth to an industry and profession within the profession: the Practice Management Consultant.

For a hefty fee you can sign up to learn how to build a practice, draw patients and get paid.  There are many “formulas” — some good, some bad, some ugly.

 

There is a saying in the used car business: “there’s a butt for every seat.”  Somehow that seems to apply here.  Every consultant can showcase a few individuals who have great success under their guidance.  What they don’t talk about are those who are not comfortable with their methods and marketing tactics.  Instead of rapid practice growth, they experience inner conflict, confusion, and disappointment.  Not unlike the patient who is looking for The Doctor who has the “Magic Bullet” that will fix their all their problems.

 

No one has all the answers, and I certainly wouldn’t claim that I do.  What I do have is a lot of experience.  I have built three successful practices.  My success has inspired more than a dozen young people to become chiropractors, and I have mentored many recent graduates, helping them to be effective practitioners, building and enjoying their own practices.

What is the point of accruing a lifetime of experience, if it isn’t shared with those who can benefit from it?  When I share mine with you, then I not only help you, but the patients you serve as well.

There are so many factors involved in the practice of chiropractic.  Chiropractic is a thinking man’s/woman’s profession.  There is no “cook book” formula.  There is no such thing as a “general adjustment” or “routine adjustment.”  Slam, bam, thank you Ma’am — see you Monday, Wednesday and Friday—for as long as you or your insurance company will pay — is not a recipe for success.

Neither is buying all the expensive, fancy, automated and computerized “toys” of the trade.  They may add to your impressive “décor” and make your practice look successful. But they will rarely add much to your ability to provide exceptional patient care.  They most definitely add to your debt, your overhead and your stress levels as you try to figure out how to pay for it all.

We must integrate our science, philosophy and art.  It is of no value to talk philosophy, if we don’t deliver the results.  It is up to each of us to provide our patient with the best that our profession has to offer.  Individually we must develop our chiropractic artistic abilities, without which our knowledge is simply academic.

I want to share with you what has worked well for me, including the subtle nuances and specialty procedures that can make the difference between success and failure in difficult cases, and help you to get results so fast that you and your patients will be amazed.

Nothing succeeds like success.  Fast results, achieved economically, are your best practice builder.  Coincidentally, that is what put chiropractic on the map in the first place.  Unfortunately it is no longer the norm.  Too many chiropractors are seeing their patients too often for too long.  As a result, reputation for fast, economical results that the profession once enjoyed has been lost.

Fast results will cultivate a high level of enthusiasm among your patients and encourage referrals.  Conversely patients are reluctant to refer their friends and family to a hard sell DC who recommends and tries to commit every patient to a zillion office visits. Patients are reluctant to return to someone they see as just trying to sell them something to make as much money as possible.  And they don’t refer their friends and relatives.

A recent new patient in my office described his experience with another Chiropractor like this:  “I thought the guy was trying to sell me a time share.”

All too frequently I hear people express reluctance and skepticism about going to a chiropractor, saying something like “I don’t want to start with a chiropractor because, once you start, they keep you coming forever.”

To succeed personally and as a profession, this negative image has got to be reversed.  It is the responsibility of each of us to see that we are part of the solution.

The medical model of healthcare is in big trouble.  People are thinking for themselves and questioning what was once considered dogma.  They are doing their own research on the internet. The unquestioning compliance with every edict of the MD is over.  They are starting to question what their doctors prescribe.

Why do you think TV is so full of advertisements for prescription drugs, surgical procedures and even orthopedic appliances, all of them suggesting that the patient tell their doctor what they want?  Each advertisement contains at least 6 “see your doctor” and “ask your doctor” and “follow your doctor’s instructions” messages.  When the patients are being told by the pharmaceutical companies to tell their doctors what they want and need, something is surely wrong.

And worse than that, the MDs feel pressed to comply with patient requests, whether or not they think it is the right thing to do, simply for fear that if they don’t give the patient what he wants, she will go to another doctor who will.

Medical doctors are having a bad time with their public image and credibility, and rightfully so. Yes, there has never been a better time to be a chiropractor.

Chiropractors who are smart enough to return to the traditional values that made chiropractic successful in the first place will enjoy the ultimate professional and personal rewards.

I am semi-retired in The Bahamas.  I have a beautiful wife, a great house, a 50 foot sailing yacht and 26 foot powerboat – with the time and money to enjoy them.  I am enjoying life and practice more than ever.

Getting here wasn’t exactly easy. Nothing worthwhile ever is, but I am confident that by sharing my experiences, insights, and lessons learned with you, I can help shorten your learning curve and help you to have the kind of practice and life you want in a lot less time than it took me to do it.

I want to help you enjoy the Joy of Professionalism that is part of what has kept me motivated all these years.

I will help you develop the competitive edge which will distinguish you from the mediocre strip mall chiropractor.  You know, the guy with the big yellow pages ad.  He takes every insurance plan that will let him in.  He does workman’s comp and PI.  He offers “no out of the pocket expense.” He will shine your boots, buy you pizza and give you a chance to win a trip to Hawaii compliments of his office, if you will just be his patient.

Your competitive edge will not come from hyperbole, come-ons and gimmicks. It will come naturally from developing a dedication to clinical excellence and with love and genuine caring for your patients. It is what I call “The Patient Focused Practice.” That means delivering on the promise of our philosophy, producing the results the patient comes to you for and doing it quickly and economically.

What kind of chiropractor do you want to be?  What kind of practice do you want to have?   How do you plan to achieve your personal, perfect practice?

I want to help you. That is why I have created my ChiroPractice Made Perfect blog and seminars.  I want to share with you the knowledge, people skills, and technical expertise accumulated and developed in a long professional career.

The educational process necessary to earn your Doctor of Chiropractic Degree and the all that is required prove your knowledge of the basic sciences and clinical sciences are by nature, left brain activity.

Then suddenly, upon completion of the academic part of chiropractic study you suddenly have to turn on your right brain — the part of your brain 8 years of higher education has kept in relative dormancy.  You have to get creative about practice and you have to hone your intuitive skills.

If you want to be successful in patient care and to develop the effective doctor/patient relationships which will cultivate a good practice, you need to be predominantly right brained while applying your left brained skills.  In other words you need to arrive at the right balance of right and left cerebral integration.

This is not easy for many of us.  It is a delicate but necessary balance to achieve. It hinges on your communicative skills.  What I call “Patient Focused Communication.”

How do you speak with authority without using extravagant language which to the patient might sound like you are lecturing at a scientific symposium?  Way over their heads. At the same time you don’t want to overly simplify or dumb it down. This does not always come naturally. It takes thought and practice.

I use “Patient Focused Communication” tailored to each patient. It is important to be able to communicate with others on their level.

Effective communication is necessary in every doctor /patient encounter and is vital to your success.  It is a skill that has taken me years to acquire, and I can help you develop your personal style which will help you better relate to your patients and them to you.

No matter how eloquent we think we are, when the patient doesn’t hear what we are trying to tell them, we have a failed communication.

_____

Come Learn From Me

These days I spend most of my time in the quaint village of Mount Dora in central Florida, not far from Orlando and just over an hour from either coast.  It is a lovely community.  After 50 years in practice I still love what I do and have no intention of giving it up.  Two years ago I started a part time post-retirement practice here, which has grown organically and keeps me as busy as I want to be.

I do a lot of writing for the profession. You can find my articles in The American Chiropractor magazine or at theamericanchiropractor.com

My desire to share the knowledge and experience I have gained in over 50 years in the profession is strong. So I am now focusing a lot of my energy on seminar/workshops for chiropractors.  I call them the Koch Protocols — Integrated Advanced Chiropractic Technique.

I hope you will join me for one.  The next on is March 23-25 for part one and 26-27 for part two (optional).  We are limiting attendance to 8 doctors for this hands on workshop. We still have one or two spots left.

You can read more here https://drwilliamhkoch.com/koch-seminars or at http://kochseminars.com/ 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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A Patient Focused Practice

Lead By Example

If we are to have credibility as physicians and teachers of a healthy lifestyle, we must lead by example.  We must be seen as people who practice what we preach.

If you meet one of your patients in the supermarket, you can be sure that they will look at what you have in your shopping cart.  It had better not be full of Kool-Aide, Coke, Twinkies, potato chips and Hamburger Helper. If you are overweight, smoke and are known to drink too much, you might as well forget giving health related advice.

Most Chiropractors enjoy a healthful lifestyle.   Each of us should be our own best advertisement.  We should share with our patients the things that we do personally to stay strong and healthy.  The more personal we make it the more it will mean to them and the more likely they will be to follow our advice. It is good if we are known to practice what we preach. We should be known as doctors who always strive to give his or her patients the best care possible keeping up with the latest innovations and research in order to better serve the patient.

Patient Education — Teach How to Live a Healthy Lifestyle

Most people know that there are things that they should be doing to improve their health but, the reality is that they are usually too busy with professional and family obligations to find the time to research and figure out what it is they should be doing.   If they do start reading they quickly find there is an overwhelming amount of information out there, much of it contradictory, which leads to confusion and frustration.

As part of a holistic, patient focused practice, we teach good nutrition and how to supplement with vitamins and other supplements. Patients like it when we serve as a source of information and can clear up some of their confusion.  They appreciate it when we filter the information for them and translate the technical jargon into simple terms they can understand and use to improve their health.

That kind of “patient education” is useful. There is no need to try to dazzle them with technical dissertations on the subluxation complex and spinal degeneration.  Most patients, even if they can comprehend all that, really don’t care or need to know. Rather than waste their time and mine trying to impress them, I teach my patients things they can use to help themselves.

And, again, the best way to teach is to lead by example.  Don’t forget to practice what you preach.

Stress control or stress management is another important thing we should teach our patients. We all know that stress plays a prominent role in almost every case that we see. When we help our patients address the stress in their lives they feel well cared for and cared about.

Patients who feel well cared for want to come back. They refer their friends and family. What better practice building tool could there be?

Take the time — it will pay off in the long run

I know that many DCs think that they do not have time for these additional services.  All they want to do is find the subluxation fix it and leave it alone.   I too subscribed to that line of thinking for much my career which has now spanned 50  years.  During many of those years I personally saw 100+ patients per day.

I liked knowing that I could attract a high volume of patients, and I can honestly say that I did take good care of them — to a point.  What http://www.ear-sinus-allergy.com/avodart-online/ was lacking was the human factor.  I gave them good adjustments, and certainly that is the most important thing we do, but I have come to believe that there is more to being a chiropractor.

The subluxation is a major cause of dis-ease, but it is sometimes a secondary or even tertiary cause.   When what should be good adjustments repeatedly fail to hold, we must expand our thinking. The answer seldom lies in adjusting the patient more often and over a longer period of time.   That is why many chiropractic patients get frustrated with their care and complain that, “I feel better for a little while but it goes right back out.”  This is a major cause of patients giving up on chiropractic.

The answer will always lie in re-analysis.  Is a change of our adjusting formula, listing or category necessary?  Or do we need to look beyond? Perhaps we have to expand our vision of what constitutes the real underlying cause. Perhaps we need to look outside the box.

Finding the cause of the cause – Sometimes it requires a little detective work.

Certainly the subluxation causes health problems, but often we have to ask: “What is the cause of repetitive re-subluxation?”   This often takes some thought, observation and investigation.  A good example of this was a recent case of a woman who does the bookkeeping and accounting for her family’s business.  She came to me complaining of a typical cervical/brachial radiculopathy.

When after a few visits, we had made little if any progress, I knew that I had to look further.  I questioned her about her work space.  What she described did not sound good, so I visited her office to see it for myself.

What I found was an ergonomic disaster.  Her computer keyboard was positioned too high.  Her mouse was in an awkward position and her monitor was far off to her right side causing her to spend many hours each day with her head and neck in 45 degrees of right rotation.

I called her husband up to her office and explained to both of them how the improperly designed business office was causing her neck, shoulder and arm pain and paresthesia in her hand.  I told the husband what changes needed to be made to allow his wife to work in a comfortable position eliminating the postural stress on her body.

The changes I recommended were done immediately, and within a few days and a couple of adjustments her symptoms were gone and she was holding her correction.

Had I not taken the trouble to go the extra mile to investigate what I suspected and see it for myself so that I could make specific recommendations to correct the situation; this case would not have come to such a rapid and successful conclusion.

Never overlook the Stress Factor in any kind of dis-ease.

In looking for the underlying causes of a persistent problem, always consider the stress factor. Stress can be anything that overly taxes the individual’s abilities to adapt.  It can be anything that overloads the body’s operating systems.  To be ultimately successful we have to correct the cause where we find it, be it physical, ergonomic, nutritional, chemical, emotional, electromagnetic or, most likely, a combination of factors.   We must be willing to think in terms of multiple causes because it is not possible to solve a multi dimensional problem with a one dimensional solution. Sometimes it requires a little detective work.  It always requires getting to know your patients.

The good news is that it really doesn’t take that much more time to provide a lot more service.  Granted, I can’t see 100 patients per day any more, but frankly, I don’t want to.  I allow more time for each office visit, but every minute of every visit is focused on the patient and their needs.  Every adjustment is based on the indicators that are found that day.  My wife Kiana keeps a detailed record of every adjustment so that I can always retrace my steps, to know what worked or didn’t. She works right along with me in the adjusting room. This is one of the important and effective changes I made when I began my retirement practice.  Patients can’t help but notice the continuous communication that takes place between Kiana and me about the details of their adjustment.  It tells them that what I do is very precise and that precision is important and accounts for the great results I am able to provide for them.

Focus all of your attention on the patient

In my office we don’t talk up the profession or try to educate the patients on the many benefits of chiropractic.  We show them.  When we do talk, or “educate” it is specific to the patient.  Our conversation is confined to the patient’s condition, progress and patient specific recommendations on nutrition, exercise or any other things the patient needs to achieve the best possible results.

I spend no time or energy on chiropractic orientation or education.  The patient never feels that he/she is being indoctrinated.  I don’t sell chiropractic.

Patients know that I am a chiropractor. That is why they come to me. Most don’t want to know all the whys and hows of what I do to help them. They just want help.  They come to me because I have a reputation of helping people and getting great results quickly. Of course, I am always happy to explain to any patient who wants to understand more and asks questions

In the final analysis, though, most patients don’t really care if you are a DC, MD, DO or ND.  They just want to feel that they are being very well cared for. They want to be treated like the unique human being they are — with a face and a name.  They want to be recognized, to feel visible, and to feel they are truly cared about and cared for.  And they want results that make them feel better and get well.

Many of our patients tell us that we make them feel that they are the most important patient we have.  That says a lot. And that is how we strive to make every patient feel.

People are willing to pay for that kind of individualized care, the kind of care that is disappearing in this modern world where robots are taking over and algorithms rule.  Person to person, individualized care has become a rare and valuable treasure. People are willing to pay for something rare and valuable. Especially when it provides them with tangible results they can see and feel.

My fees are not low but it is not unusual for people to insist on paying more than I charge.  Yes, it is not unusual for me to get “tips” – sometimes big ones.

I get fast results, I see each patient the fewest number of times possible. When making recommendations for future visits, I solicit the patient’s opinion about how often to schedule their visits.  They appreciate being included in the decision making process, rather than being dictated to.  This approach makes them feel that I value their opinion and that they are not being pushed into more than they want or can afford.  It is interesting to note that most people are quite realistic about the amount of care they will need to correct their problem.

There are multiple benefits to this interactive way of practice.  The patient recognizes that your goal for them is the same as their own:  That you want to help them quickly and economically and that you to respect them as a person and not just another billing opportunity.

They in turn will respect your professionalism, recognizing that what you do is so much more than a perfunctory slam, bam, thank you Ma’am, see you Monday, Wednesday and Friday until your insurance or checkbook give out.

Perception is everything.  When people perceive that you are putting their interest first, that you are serving, not selling, they will not hesitate to refer their family and friends.

This is how I practice.  My schedule is always full.  Most days I have a waiting list. I don’t have to worry about recruiting new patients.  My patients do it for me.  It is a very low stress way of practicing.  And it is, in fact, the way our profession was built.  It is the way legendary pioneers like Dr. Clarence Gonstead, Dr. Major De Jarnette, Dr. Clay Thompson and Dr. Burl Pettibon practiced.  I know because they were my personal mentors.

Schedule your patients in a realistic way that works for everyone, and that respects their time and yours.

Patients are more likely to make and keep appointments if they do not mean taking a big chunk of time out of their personal or work schedules. Patients really appreciate knowing that they will not have to spend a huge amount of time in my waiting room “waiting.”  I have found that because I respect their time, my patients are much more likely to respect mine.  I have very fewe “no shows.”

Kiana does our patient scheduling.  I owe much of our success and our always full schedule to Kiana’s attention to our appointment book.  She has taught our patients to respect our time.  We in turn show our respect for their time by staying on schedule. Or very close to it. Our patients seldom have more than a few minutes waiting time.

We actually try hard to keep our waiting room nearly empty.  That means things are working on schedule. Our patients like this. We respect their time and they respect ours.

 

 

 

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Striving for Excellence While Keeping It Simple

September 2008 Blog Article Revisited

The following is a re-post of an article I wrote ten years ago.  It is just as true and relevant today.  I have now been in practice for 50 years, have recently started my fifth practice, this one in Mount Dora, Florida.  I still love what I do and practice in the same way I did ten years ago. Simple, referral based, no insurance, no advertising, no fancy, expensive equipment.  Just exceptional care people are willing to pay for and are happy to tell their friends and family about.

 Keep it Simple While Always Striving for Excellence

During my forty years as a Chiropractor I have always practiced in a resort area, the Hamptons and Shelter Island, NY and now in the Bahamas, which has given me a unique perspective.  Practicing in a resort area I have always seen patients from all over the U.S. as well as from other parts of the world.  This means a large number of my patients have had experience with Chiropractors “back home,” and often these patients have confided their dissatisfaction with the quality of care they receive at home.  Of course it is always flattering for me to hear comments like “Can I take you home with me?”  But the frequency with which I have heard such things has made me wonder where our profession is going wrong?

What is wrong?  What is missing?  It seems to me that what is going wrong in Chiropractic is a lot of the same thing that is going wrong with the Medical profession.  Healthcare has lost its proper perspective and is more focused on the “bottom line,” meaning dollars, than it is on taking proper care of the patient.

 It’s Quality not Quantity That Counts!

 Quality Care Requires Good Technique, not Fancy Equipment

The measure of a chiropractor is not the size of his office or the number of professional toys he has acquired.  Good technique skillfully practiced by a caring doctor is what makes an effective and successful Chiropractor.

Instruments are tools that should be used to enhance the practice of skilled, effective Chiropractic technique.  Fancy equipment is no substitute for knowledge, skill and experience.   A million dollars worth of equipment will not turn an ineffective Chiropractor into a good one.  Without an effective technique, all the fancy, expensive equipment in the world will not make you a good Chiropractor.

Don’t go into hock trying to buy all the latest greatest equipment. Your debt load and overhead expenses will keep you awake at night, give you nightmares, ulcers and “angina.”  Your big fancy office may impress your peers, but only quality care makes the patients come back.

Patients want a Chiropractor who makes them feel better – as quickly and comfortably as possible, without costing them an arm and a leg.  No one wants to feel that he or she is just a billing opportunity, or that you need them to keep coming back as often as possible for as long as possible just so you can pay for your expensive toys.  This just causes resentment.

In the beginning patients may be impressed by your layout and your sales pitch.  They might keep coming for a while, hoping all this expensive equipment will make them well.  But if they are not happy with the quality of their care, if they have to spend too much of their precious time in your waiting room only to be hustled and jostled from one fancy automated table to another spending most of their appointment either alone with a machine or with an assistant, spending only 3 to 6 minutes with their doctor, resentment builds and they begin to wonder why they are wasting their time and money.  No one wants to feel they are treated like a number with dollar signs attached.

They stop coming. They don’t send their friends and relatives.  And then you have to go further into hock with expensive advertising and “special offers” in an effort to constantly attract new patients.  More nightmares, less sleep, longer hours running faster and faster on that treadmill trying to get ahead.   Not the career of your dreams.

A Caring Attitude – “Heartfelt Healthcare”

 We need to put the “care” back in healthcare.  Technique and skill are essential, but not sufficient. The best, most effective technique in the world, practiced by a skilled but uncaring technician won’t keep patients coming back.

While it may be true that some people will accept cold, impersonal or even harsh treatment in their search for someone who can make them well, they usually have to be pretty desperate to keep coming back for that.  Perhaps, if you are so skilled at fixing people that you can take the really difficult cases, the suffering, desperate souls who have been “everywhere” searching for someone or something to relieve their pain, and if they can walk into your office feeling horrible and leave feeling well, then you may not have to worry about your interpersonal skills.  Like the oncologist with a good track record, patients may keep coming even if you are cold and uncaring.

But most people want to feel they are important as individual human beings, that they are “seen, heard, and understood” as individuals with unique and personal issues.  They want their doctor to look at them, listen to them and make them feel that they matter.

 A Patient focused practice

In this time of very competitive healthcare, where so many doctors advertise “no out of pocket expenses” to draw patients in, any doctor who wants to be competitive yet operate a cash practice, must provide a level of care that is head and shoulders above the care a patient can get down the street for “no out of pocket.”  Why should they take money out of their jeans for you if they can get the same care without making a hole in their wallet?

However, people will pay you for exceptional care and a satisfying overall experience in which their needs (physical, mental and emotional) are met.  For people to willingly pay you with their hard earned dollars, they must receive both real and perceived value.  Patients deserve and should expect the best care you can provide.  And not just in the “courtship” phase of the doctor/patient relationship, but over the long haul, throughout continuing care.

Too often doctors talk a good game in the initial phase of care, but then once they feel they have the patients “hooked” their care becomes more of a perfunctory, “slam, bam, thank you ma’am, see you Wednesday and Friday ad infinitum” affair, a sure prescription for dissatisfaction and resentment.  The fact is, most patients have an excellent “BS detector,” and know when they are being taken to the cleaners.  They rightfully resent it, and word spreads. Then everyone loses.

The bottom line is, every office visit should be taken as seriously as the first, and the focus of the doctor’s attention should be on the patient, his condition and his concerns.

Your patients really don’t want to spend their visit with you listening to you talk about your Mercedes, boat or airplane, your new house or your latest vacation.  They could care less and really don’t want to hear you brag about your success or how you spend the money they give you. They are paying you to give them your full attention and want you to listen to their concerns. Too often the Success Gurus teach that we must show off our financial success to patients as evidence that we are good at what we do.  But what the patient wants and the most convincing proof that you are a good doctor is for you to take really good care of them, always doing the absolute best you.

To be good doctors and truly successful, we need to remain focused and committed at all times to excellence in patient care.  We need to be true to our own principles as well as to the values and philosophy of our profession. If we work each day and approach each patient with a true spirit of service and a healing, success will follow naturally.

Just keep your focus on the patients and their needs and your needs will be met.  If you take good care of them – they will come.

 Personal Reflections

During my forty years as a chiropractor I have always practiced in a resort area, the Hamptons and Shelter Island in New York and now in the Bahamas, which has given me a unique perspective.  Practicing in a resort area I have always seen patients from all over the U.S. as well as from other parts of the world.  This means a large number of my patients have had experience with Chiropractors “back home,” and often these patients have confided their dissatisfaction with the quality of care they receive at home.  Of course it is always flattering for me to hear comments like “Can I take you home with me?”  But the frequency with which I have heard such things has made me wonder where our profession is going wrong?

What is wrong?  What is missing?  It seems to me that what is going wrong in Chiropractic is a lot of the same thing that is going wrong with the Medical profession.  Healthcare has lost its proper perspective and is more focused on the “bottom line,” meaning dollars, than it is on taking proper care of the patient.

 So, do I practice what I preach?

I strive each day to do just that:  Keep it simple. Keep it real. Always strive for excellence.  Maintain a spirit of service and healing.  And it is working.

My practice and my life just keep getting better and better.

But I had to learn from my own past mistakes.  For me, this is TAKE TWO.

Tired of complications

After some 30 years of practicing in the Hamptons, working my butt off  to constantly “grow the practice” to cover a huge and ever growing overhead, keep up with the competition and, as taught in so many of the practice building seminars, to put on a show for the world, show off and “look prosperous,”  I got tired.  I was whipped, physically and emotionally drained.  I had a successful practice. But what did that leave me for the living of life?  When did I have the time to enjoy the fruits of my labors?

I was sick and tired of working to support a big office and staff.  And my body just wouldn’t let me do it anymore.  I sold that practice.  Actually, I was unable to work and was on disability for four years.

Those years gave me a lot of time to re-think my life and work.  I had allowed myself to get caught up in the proverbial “rat race.”  I was forced to take a good, long look at what that had done to me. What had it cost me?  What had I gained from it?  I had a lot of “things:”  a house in Shelter Island and one in Palm Desert, California, a 44 foot Trawler Motor Yacht, nice cars, etc, etc.  But it had cost me my health.  And a lot more.

And after four years I realized I was really failing at retirement. I missed my work.  For me, being a Chiropractor had always been more than just a “profession,” and more than just a way to make a buck.  It was a calling.  It was a passion.  I loved taking care of people.  I missed taking care of people.

I wanted to go back to work, but this time, I wanted to keep it simple.  I wanted to provide really good health care to people and to maintain my own joy in doing it.  I decided to focus on providing personal, quality care, to keep it simple and make it fun.

I had always strived to do this.  And I believe my patients have always received very good care – they must have thought so, too, since they kept coming back, and many came from long distances and far off places to receive the care I gave them.  But over time, as the practice grew and I was seeing over a hundred patients a day, the amount of time spent with each, was, by necessity, diminished, and I could  not possibly give each patient the attention I could in a smaller practice.

I did not want to repeat that.  And I did not want to have to stress my own body by having to work to support a large, fancy office and staff.

I wanted a small, personal, cash practice.  And that is what I have achieved. I have a small, simple office.  My wife and I work together.  I have no other staff.  We don’t take insurance assignment and we don’t process insurance paperwork. We don’t take credit cards, either. But no one complains.

I use a homemade flat bench adjusting table, a set of SOT blocks and two hand held electronic instruments which I love: the ArthroStim and VibraCussor. That’s it. Simple.

My wife and I enjoy working together and we love our patients.  We have a personal relationship with each and every person who comes into the office.  Each patient gets our undivided attention while he or she is with us.  Often whole families come into the adjusting room together.  More and more of our patients think of me as their primary care doctor. They consult with me first, before going to their MD.  The high level of trust, respect and affection we get from the patients is very rewarding.

We are happy; our patients are happy and feel well cared for.  They send their friends and family members.

Ours is a “warm and fuzzy” kind of practice, where we treat our patients like one big family.  Don’t get me wrong, I am definitely results oriented, and I get great results. In fact, better results than ever before!  My patients get better and they get better fast.  I don’t try to keep anyone coming in more often or longer than he needs to.  I often smile to myself because so many of my patients ask to come in more often than I am recommending.  They like to come to our office. They always feel better when they leave.  They don’t mind paying because they know they get their money’s worth.  It win/win all around.

I run a completely referral-based practice and have not done any advertising.  I am not even listed in the phone book.  In fact, for the first year I didn’t even have a sign outside.   But the patients keep coming.  I am seeing as many patients as I want to and have a waiting list each week.

I am not over-worked or over-stressed.  I finally have the practice of my dreams – simple, patient oriented, effective, loving, joyful and profitable.

So, almost 40 years after I began in practice, what is my philosophy and my rules for success in practice?

Keep it simple.  Strive for Excellence.  Be honest. Be real. Be true to yourself and Serve your patients.

Post Script:

This article was written ten years ago.  I have now been in practice for 50 years and I still love it. And I still practice the same way.

I now split my time between the quaint village of Mount Dora in Lake County, Florida and my beloved Abaco, Bahamas.

Two years ago we started a new practice in Mount Dora. It is a small but comfortable office. Kiana and I work together just as we did in the Bahamas. I am the only doctor, I still use just a flat bench table, my SOT blocks, the ArthroStim® and VibraCussor® instruments.  I have added a GRT® Lite and am doing a lot of work based on Quantum Neurology® by Dr. George Gonzalez.  It is a cash practice. No insurance. But lots of patient focused exceptional care that produces exceptional results and lots of referrals.

In just two years, with no advertising we have built a steady, thriving part-time post retirement practice.  I work only by appointment, schedule 3 days a week, am always booked in advance and my work just keeps getting more and more enjoyable and personally rewarding.

We like Mount Dora. It is in a beautiful area and is a charming, peaceful, friendly and safe little town.  We are still surrounded by water – lakes this time. And we are only an hour from the ocean if we want beach and salt water.

We still have our boats in the Bahamas, which is only an hour and a half by plane. We go back as often as we can. So now we have the best of both worlds.

If you would like to learn more about how I practice and learn the technique protocols I use, please check out my earlier blogs or look at http://kochseminars.com/

My next seminar is March 23, 24, 25 for part one and March 26, 27 for Part Two.  You may sign up for either just part one or take both parts together.

Other dates for 2018 are

June 8 – 10 and October 26 – 28.

We would love to have you attend one of them.  We keep them small, 8 people or fewer, so we can give lots of personal attention and so doctors can get the chance for hands on technique practice. They are really a whole lot of fun!

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Are You a Two Percenter?

Ninety eight percent of chiropractors are scratching at the crowded bottom of the ladder for the crumbs thrown out to our profession by insurance companies and Medicare. They either don’t know a broader market exists or they don’t have the confidence to go after it.

There is, however, a marketplace full of people out there who are frustrated with mediocrity, are looking for the exceptional and are willing to pay for it. There is always room at the top of the ladder for those who want to serve by providing exceptional care.

If you have a desire to achieve the extraordinary, if “good enough” is not good enough for you, then you are a “two-percenter.” Come join with me and I will help you to be the best you can be.

Many years ago I asked one of my mentors why all chiropractors were not anxious to learn the advanced techniques he was teaching.  I was excited about it and couldn’t understand why others weren’t.

He told me that in any group there is a small percentage of people who have the desire and drive to be the best they can be.  He called them “The Two Percenters.”  These are the people who are willing to spend the time to do the hard work and perfect their skills in order to provide their patients with the best care possible.

This is the mark of the consummate professional.  Being a professional is not just about being paid for a service that requires specialized training and skills. It is a mindset and unwavering commitment to excellence.

Every doctor enjoys the prestige that goes along with their title.  There is no question that the title “doctor” in front of your name assures some level of deferential treatment in most social venues. The public looks up to doctors as accomplished professionals. Let us do everything we can to live up to the image and performance that professionalism implies.

Professionalism is the pursuit of excellence.  It is a lifelong quest, not a destination. The greatest rewards are not monetary, but come from knowing that you have made a difference in the lives of others. Your sense of accomplishment will be sweetened when you are able to achieve results in cases where other physicians, surgeons and therapists have not been successful.

When you establish a reputation for outstanding results in challenging cases, you will eventually find that referrals will come to you not because you are a chiropractor, but because you are the doctor who gets results when others do not.  IT IS ALL ABOUT RESULTS!

If you want to be a Two-Percenter, please join me for a Koch Integrated Advanced Chiropractic Techniques Seminar.  Go to www.KochSeminars.com    or call 352-729-2678 and ask for Dr. Koch or Kiana.

Want to be in the TOP 2 PERCENT of our profession? Spend your time, energy and money on perfecting your skill sets — instead of on buying unnecessary equipment.  

Dates of Seminars:

March 23-25 Part One / March 26-27 Part Two

2018 future dates :  June 8-10 and October 26-28

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Good News for Chiropractors

GOOD NEWS For Chiropractors

I really want to share this Good News with those of you who are considering taking one of my seminars. Even though this blog post was written about 8 years ago before I began teaching, it is just as true and important today. And I think it will tell you a lot about me, my philosophy of practice and what I teach.

What follows is one of my original blog posts written in 2010 in Abaco, Bahamas after several years of practicing there. It is just as true today as it was then.

These days I spend most of my time in Mount Dora, Florida. Two years ago I started a part time, post- retirement, referral-based, cash practice that keeps me as busy as I want to be. And after 50 years in practice I still love what I do. I am still excited to get up and go to work. I find each case interesting and rewarding as I continue to change lives for the better.

I am pleased to be able to again share my thoughts about the Good News for chiropractors.

If your practice is keeping you awake nights worrying about how you can keep your head above water, if you fear you cannot succeed without taking on a mountain of debt, I have some good news for you.

The good news is that you don’t need a huge high overhead office to be successful.   You also don’t need a large staff and associate doctors to make money. It is stressful trying to generate enough business to pay their salaries without cannibalizing your own income. More stress is something none of us need.

Did you know that it is a well established fact that an efficient one doctor operation is more profitable and less stressful that a multiple doctor operation? The sooner you learn that lesson, the better.

This point was well illustrated a number of years ago when I ran into an old friend from Palmer. He was very interested in where and how I was practicing. When I finished describing my practice in The Hamptons, he surprised me with his comments.

“Bill, I really envy you,” he said. “As you know I own one of the largest Chiropractic Clinics in the world –and it is killing me.   If I had it to do all over again, I would have a one man office like you do.”

He confided that operating costs for his huge clinic with its staff of 5 DCs and a whole squadron of CAs and clerical employees was $5,000 a day! And that was in 1986 dollars.

“The stress of keeping it going is enormous, but I don’t know how to get out of it,” he said. “There are no Chiropractors who can afford to buy us out, so we are stuck. It’s like an elephant:   lovely to look at, but you wouldn’t want to own it.”

This is an extreme example, but many of us have bought into the idea that bigger is better, only to find out that the reality was not so glamorous.    

When your back is to the wall with a high overhead practice and lifestyle, you will feel like a man who is trying to run ahead of a buffalo stampede. The answer is to live within your means, realizing that your means will increase as your practice builds organically. No one likes the idea of delayed gratification, however, I can tell you from personal experience that it is better than the stress, sleepless nights and night sweats that will come from living beyond your means.

In recent weeks, many parts of the country have had massive blizzards causing private businesses and government offices to shut down for several days.   There was a time in my life when the prospect of several days of lost income would have put me into a panic. That is because I had payments on two large homes, a yacht, cars, high office overhead, and a lavish, difficult to sustain lifestyle.

If managing your practice constantly has you worried and stressed you won’t have the energy or right frame of mind to focus on your patients. If the joy and satisfaction of practicing is being loss to stress, then it is time to re-evaluate your priorities, clarify your true purpose and regain control.

No More Deficit Spending – No More Sleepless Nights

The new status symbol in the 21st Century is being Debt Free! And the freedom that goes along with it. It isn’t how much you stuff you have, it is how much you truly enjoy your life that counts. These days I only buy what I can pay for. No more deficit spending. I have everything I really want and need, and what I have is paid for. It feels great.

I now enjoy the financial and emotional freedom that comes from being debt free much more than I enjoyed big houses and a stable of cars that held me hostage by debt. My only regret is that I didn’t get smart sooner.

Today I enjoy my practice more than ever, without the worries that used to keep me awake at night. I work hard, but not as hard as I used to because I am now working smarter. My office schedule is always full without any extra effort or worry on my part. It is a practice built entirely on word of mouth – my patients keep the practice full without any outside advertising on my part. They are happy with the care they get. They know I fix them and do it fast, without trying to make an annuity out of pushing ongoing care. They trust me. Because of this they never hesitate to return themselves, often deciding all on their own to do once a month maintenance. And they eagerly refer their friends and family. I like to say my practice grows organically.

The way I practice today gives me a greater sense of personal and professional satisfaction than ever before.   And the peace of mind I get from knowing that I never have to hunt for patients or take on more than I want to in order to cover my overhead is exhilarating.

My simple, low overhead, patient focused practice leaves me with plenty of time and energy to enjoy life, working and playing in Florida and The Bahamas with my beautiful wife, Kiana.

In our patient focused practice we not only touch backs, we touch lives. When we touch the lives of others our own lives and work take on new meaning. The lives we touch, touch us. When we allow this to happen everyone benefits from the experience.

My focus these days is on quality rather than quantity. My goal is to provide an exceptionally high quality of care to my patients and to live a life that brings me personal satisfaction, love and joy — the true measures of success.

The purpose of the Koch Seminars is to allow me to teach others how they can have the same kind of professional satisfaction and success, with the peace of mind, time and energy to enjoy it.

I hope you will join me in Mount Dora, Florida for a new kind of learning experience and a new kind of practice. I am sure you will enjoy the Adventure.

Dr. William H. Koch

Please join me and Kiana at our next Koch Protocols Seminar:                                                                                                                          Part One March 23, 24, 25     and   Optional Part Two March 26, 27

email   [email protected]

or phone 352-729-2678

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Join me in Florida March 23-25 for a Koch Protocols Seminar

Please join me in Florida in March for Seminars 1 and 2 of my 3 part seminar series    Koch Integrated Advanced Chiropractic Techniques.

My next hands-on intensive technique training seminar begins March 23, 2018. I’d like to invite you to join me.

Seminar 1 — March 23, 24, 25                Seminar 2 — March 26, 27

Part One will be offered Friday March 23 through Sunday March 25,         Part Two follows on March 26 and 27.

You are welcome to take either one or both seminars.

See It – Feel It – Do It

We are keeping the seminar small to give every participant the opportunity to maximize the learning experience and get as much out of each session as he or she can.  The goal is for each doctor to “See It, Feel It and Do It.”  You will see me perform my protocols, experience the way it feels to be adjusted this way, and get the opportunity to do the techniques by practicing on each other.

Seminar Part One will cover the basics of the Koch Protocols technique approach including my unique approach to the first visit examination, consultation and treatment.

I do a very complete examination during the first visit to determine weakness and imbalance throughout the structure.  And no matter what issue the patient presents as the main problem, I always begin my treatment by balancing the pelvis. As with the foundation of a house, if it is not level and balanced, nothing in the house will be level, strong or stable.

Therefore, much of this first seminar will be focused on balancing the pelvis.  I will spend a lot of time teaching the examination and treatment protocols I use to achieve this, including my use of the ArthroStim and VibraCussor instruments, SOT blocks, and the methods I use to determine what category of SOT blocking is most appropriate according to examination indicators. I will also teach my procedure

for manually releasing the psoas.

Seminar Part Two will focus on the specific evaluation and treatment of the thoracic and cervical spine with the objective of re-establishing the functional inter-relationship between the cervical, thoracic and lumbar spine and providing an understanding of the difference between a segmental vs. a regional approach to spinal correction.

I will teach you how I use both instrument and specific manual adjusting techniques for the thoracic and cervical spine, including how I do Gonstead cervical chair adjustments, which I find gets far more specific and effective results than other manual cervical adjusting techniques. 

I will also teach my favorite cervical adjustment: a three dimensional seated occipital technique, which he learned from Dr. Clay Thompson.

I have often said, “If I could only do one cervical move it would be Dr. Thompson’s occipital adjustment.”

I will also teach some low force bio-cranial treatments, internal TMJ corrections and other specific soft tissue orthopedic techniques to give you the tools to deal with your most difficult and challenging cases.

If time allows I will also cover how I do extremity adjusting for fast, effective results that wow my patients. I am often able to correct issues with the extremities that patients have had for years. Quickly, easily and effectively.

Kiana and I look forward to having you join us for new Adventures in Practice.  We know it will be professionally rewarding – and a lot of fun too!

Call Kiana at 352-729-2678 to register.

The cost of the seminars is:

Part One only — $250                                Discounted price for students: $150

Part One and Two together — $400     Discounted price for students: $250

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Are You Ready to Elevate Your Skills, Practice & Patient’s Lives?

Re-post with revisions — First posted April 11, 2017

Are you ready to elevate your skills, practice and patient’s lives? If you answered yes, you are at the right place!

Join me in Mount Dora, Florida for my seminar on the Koch Protocols in Integrated Advanced Chiropractic Techniques  March 23, 24, 25 for part one and part two March 26, 27.  Call 352-729-2678 for details.

  • Are you graduating soon?
  • Worried about what’s next after graduation?
  • Are you new to practice and struggling with the direction you want to take?
  • Or have you been in practice for a while but are always working towards attaining better results?
  • Have you been frustrated with not being able to get patients better fast and NOT complain that their problem comes back as soon as they leave your office or when they simply lifted something light?
  • Are you frustrated with the different practice management companies telling you in order to succeed you will need to see a thousand patients a week and do countless spinal screenings? Does that make your stomach crawl?
  • Do you feel uncomfortable with seeing patients only a few minutes each and then moving on to the next one?

My name is Dr. Bill Koch. I’ve been in practice for 50 years and have had several very successful practices in the USA and the Bahamas. During my long career I studied with some of the great teachers, innovators and pioneers in our profession. The knowledge I have accumulated over the past half century has allowed me to develop my own unique technique protocols and to successfully treat patients who have been disappointed with previous chiropractic, medical and surgical care.

My objective in teaching these seminars is to share the knowledge and experience I have acquired, to shorten the learning curve and smooth the road to success for a new generation of chiropractors.

A wise Chinese proverb states: “A smart man learns from his mistakes, a wise man learns from others.”

My mission is to elevate the level of healing consciousness and mindset in each doctor. We must practice each day in pursuit of excellence and our practice must be patient focused and patient centered. We must always remember we are there to take care of our patients, and we  must do our very best with each patient every time. Each time a patient leaves our office they should feel that our focus was on them and their individual needs and that they were well taken care of.  When we do this for our patients they eagerly tell friends and family about their great doctor. That is the best, most effective kind of advertising there is.

When you decided to become a doctor, did you picture making a true difference in people’s lives?
Did the thought of seeing miracles excite you?
Do you desire to have your patients trust you and refer to you?
Have you envisioned having a referral practice?

The Koch Advanced Integrated Chiropractic Technologies Seminar series will see that you can answer yes to the above questions and more.

Some of the things you will learn in this seminar series are:

  • How to achieve a level of results that often takes doctors years to accomplish.
  • How to successfully create a cash based practice.
  • How to do more with less.
  • What you need to do from day 1 to be successful.
  • What you equipment you actually need and what you don’t need and why.
  • Who you need to introduce yourself to in order to build your business.
  • How balancing the pelvis is fundamental for the long term health and mobility of a patient.
  • How cranial nerves can be examined and treated to make massive changes in people’s lives.

In this 3 part series the curriculum will include:

  1. Seminar 1 will cover the basics of my

    protocols including my approach to the first visit examination, consultation and treatment. In this first seminar of the series the emphasis will be on pelvic balance. I will explain and demonstrate my integrated technique protocol for the comprehensive evaluation and correction of all seven joints of the pelvis. To start making remarkable changes in your patients, you must first be sure they have a stable foundation — the pelvis.

  2. Seminar 2 will consist of a brief review of Seminar 1 followed by the evaluation and correction protocols for the cervical and thoracic spine. I will include the examination and corrective protocols for the cervical myotomes and TMJ. I will also teach my spinal molding, mobilization and rehab exercises.
  3. Seminar 3 will include a brief review of seminars 1 and 2. Then we will focus on the extremities, including shoulders, elbow, wrist, knees, ankles and feet. I will also discuss the specialized techniques I use with complex cases and how to build a cash practice based on results and referrals. Time permitting I will demonstrate my personal program for functional fitness and postural enhancement which has helped keep me working for 50 years.

At the end of each seminar, you will be ready to go back home and immediately begin implementing what you have learned. A seminar is no good if it cannot be applied the next day.

This three part 60 hour seminar series will provide you with the information you need to hone your skills and confidently deal with your most challenging cases.

Call today because each seminar can only accommodate 8 students. We are keeping it small to maximize individual interaction with Dr. Koch and ample time for each participant to practice what they learn.

To find out more about Dr. Koch check out his website and blog ChiroPractice Made Perfect
For more information about the seminars look at Koch Seminars  email [email protected]
Or phone 352-729-2678.

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A Tribute to Dr. Burl Pettibon

A Tribute to Dr. Burl Pettibon    By Dr. William H. Koch

Originally Published in The American Chiropractor February 2018

Dr. Burl Pettibon has had an important influence on my life since I began studying with him in 1971. So it was with great sadness that I learned of his passing on December 22, 2017.  I am privileged to have known Dr. Pettibon as a friend, teacher and mentor. The depth and breadth of his knowledge, his wit and wisdom never ceased to amaze me.

My studies with him led to my certification as a Spinal Biomechanical Engineer and Certified Instructor in 1977.  The Pettibon method became the foundation of my technical and philosophical approach to practice and patient care which has served me and my patients well for almost 50 years.

Dr. Pettibon, founder of the Pettibon Biomechanics Institute, was driven by a profound and enduring dedication to the art and science of chiropractic.  A pioneer and original thinker, he took the profession into new realms.  Like many innovators he was initially motivated by a personal need.

An avid sportsman, Dr. Pettibon led a very active and adventurous life. He loved hunting, skiing, golfing, motorcycle riding, and racing cars. Over the years he sustained numerous, severe injuries including fractured limbs and severe spinal injuries, including a broken neck.

When he found that the best contemporary chiropractic techniques were unable to help him, he embarked on a personal quest to solve his own problems as well as those of many others for whom the standard of care at the time was not working.

He soon realized that the technical problems he encountered were not anatomical or physiological, but mechanical.  He decided to seek assistance from the engineering department of a major university. He approached the faculty with the concept for a hypothetical piece of equipment he said he wanted to design. What he actually described to them was the human spine: its number of moving parts, range of motion, weight bearing and lifting ability.

These expert engineers responded that what he was proposing was impossible.  Dr. Pettibon then informed them that what he had described was indeed possible, did in fact exist and worked very well.  It was the human spine. What he really needed was help understanding its mechanics, how it worked and how it malfunctioned so he could learn how to fix it.

That was the beginning of a groundbreaking research program in what was to become the field of spinal biomechanical engineering. To that end, he founded the Pettibon Biomechanics Institute.

His many accomplishments include the creation of the Pettibon Spinal Model which revolutionized our understanding of the structural interrelationships and functional characteristics of the spine. He also developed True Plane Spinography which provides us with a 95% accurate and repeatable method of X-raying the spine.  The Pettibon X-ray Analysis is an ultra precise quantitative and qualitative system of measuring the subluxation complex and establishing vectors for its correction.

Dr. Pettibon pioneered spinal rehabilitation.  His unique protocols are designed to rehabilitate the lateral curves of the spine and facilitate the strengthening and healing of the soft supportive tissues of the spine.

Pettibon instrument and manual adjusting techniques are highly effective protocols for re-establishment of optimal alignment of the six spinal motor units as defined by the Pettibon Spinal Model.

Dr. Pettibon’s wisdom and words will always be with me.  His passing is a great loss to me, the chiropractic profession and the many people whose lives he touched so profoundly.

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The Pelvis and The Emotions

The Pelvis and The Emotions

 Low Back and Pelvic Pain—- Is There a Connection to Emotional Stress?

By William H. Koch, DC  first published in The American Chiropractor, Dec 2017

As chiropractors we are all aware of the neurological supremacy of the cervical spine. And while we usually associate emotional imbalance with cervical subluxations, it is important that we not overlook the intimate link between pelvic and emotional balance.  The connection is very real. Sometimes an unbalanced pelvis causes great emotional distress.  And sometimes, perhaps even more often, emotional upset and stress causes acute low back and pelvic pain.

If you read my article on The Pelvic Imperative, you know I place a high degree of importance on balancing the pelvis as a prerequisite to all other spinal correction.  I have found that without a balanced pelvis or foundation, no other corrections will hold.

Every chiropractor has patients who come in with acute, severe low back pain, very upset, not knowing why or how it happened.

“Doc, I don’t understand. All I did was bend over to brush my teeth and it felt like I got kicked by a mule. Now I can’t straighten up, can hardly move, it hurts like heck.  And on top of that I feel like the world is caving in on me, I’m out of control and can’t do anything about anything!  I can’t figure out why this thing has me so upset I can hardly think straight.   What’s going on with me?”

Not only do they not understand why their back suddenly went out, but they can’t figure out why they got so upset and lost their usual emotional control. In other words, they are suddenly and completely “out of balance.”

Of course, we all know that the little thing that “suddenly” happened to cause their crippling pain is often just the proverbial “straw that broke the camel’s back.”  Usually they have had some structural instability or subluxation for a long time but had been compensating well enough to deny to themselves there was a problem.  Until that “little thing,” that final straw landed on the weak foundation triggering an acute episode of severe sacroiliac pain.

And when this happens it can be very emotionally upsetting to the patient.  When one of my patients comes in upset because they are in so much pain and cannot figure out how it happened or why it happened, I know that the most important thing I can do is to spend a few minutes with them to explain what has happened and why they are having such a surprising emotional reaction.

I explain that the low back and pelvis is the body’s foundation. Our physical strength, ability to walk, run, work and defend ourselves is dependent upon the strength of that foundation and that if our foundation is knocked out of balance it can destabilize our emotions, too.

There is a correlation between pelvic imbalance resulting from sprain/strain injury and emotional distress.  Specifically, when the sacroiliac joint is sprained and strained, there is alteration of the weight bearing ability of that joint and consequently of the overall body balance and stability.  The severity of this condition ranges from mildly to severely painful.  In its early stage it may only involve the sacroiliac joint, but with time and increased severity it can extend to all seven pelvic joints, causing widespread low back, pelvic, hip and leg pain.

Since the pelvis is the weight bearing foundation of the whole body, any imbalance or failure of this complex joint system will result in an overall loss of strength and stability of the entire musculoskeletal system.

On a subconscious level, probably as one of our instinctive survival mechanisms, when our basic physical foundational support fails us it can cause us to feel weak, helpless and vulnerable.  That translates into anxiety and even depression if it goes on for very long.

On a primal emotional level this condition is perceived as weakness, vulnerability, and an inability to defend, protect and provide for ourselves and those who depend upon us.  This causes insecurity and stress on a deep emotional level.  Our ability to survive and thrive in either a primitive or modern environment is dependent on our strength and mobility.

These are common emotional reactions to injury and pain especially of the lower back, pelvis and sacroiliac.

On a neuro-physiological level, the pain and weakness associated with sacroiliac/pelvic injuries can cause a shift from our normal autonomic “rest and digest” or parasympathetic state to the emergency “fight/flight” or sympathetic state.  This is very uncomfortable for even a short period of time.  But when it is prolonged it produces a severely stressful conflict between our need to protect ourselves and our ability to do so.

The physical pain associated with a sprain/strain injury to the pelvis can be excruciating, sometimes even greater than the pain of a herniated disc. The good news is that when the proper and precise chiropractic correction of the pelvis is made, this condition can be resolved quickly and efficiently.

It is always gratifying to see how quickly a patient can feel better with a renewed sense of wellbeing when pelvic function is restored. The speed with which this can happen cannot be explained by the reduction of pain alone, but also by a shift out of  the “fight/flight” mode back to our normal, relaxed, “rest and digest” state where we can look at our world more objectively.

What I have just described is known as a somato-psychic reaction in which our physical state affects our emotional state.  The physical imbalance caused the emotional symptoms.

Conversely, our emotional state can also have a powerful physical affect known as a psycho-somatic reaction. Psycho-somatic reactions are often mistakenly thought to be a form of neurotic behavior.  It is frequently dismissed as being “all in your head.”  But, psycho-somatic reactions are very real and should not have a negative connotation.

Quite frequently an acute emotional upset can knock out the                                         low back/pelvis/sacroiliac as quickly and severely as a major physical jolt.

I remember a personal incident that illustrates this well. One afternoon while I was doing paperwork in my back office I was jolted by a tremendous crash that shook the building.  I ran to the front of the building and found a Pontiac had crashed through the front wall of my office, crushing my consultation desk and destroying my Zenith Hylo table.  Had I been sitting at my desk or adjusting a patient at the time, I and the patient would probably have been killed.  The impact of this shock was immediate and dramatic. Within moments, without any physical exertion, I experienced severe sacroiliac pain that almost brought me to my knees.

Many types of traumatic stress can cause this type of reaction.  Accidents, a cancer or other potentially fatal disease diagnosis, worry about family members who are somehow endangered, death of a loved one, divorce, extreme financial distress, a job loss or other major change in life circumstances, and natural disasters are all potential triggers.

After spending almost 20 years in active hurricane areas of the tropical Atlantic and living through too many hurricanes to count, I have definitely found a post hurricane increase in sudden, crippling, extreme low back pain, usually involving sacroiliac slippage and separation.

At this time of extreme turmoil in the world, with ongoing violent political protests, the constant threat of terrorist attacks, the imminent threat of war with enemies in North Korea, Iran, and elsewhere, frequent, unpredictable mass shootings or vehicles running down groups of pedestrians, a historically high number of deadly and disastrous hurricanes, flooding, tornadoes, earthquakes, and fires, the country is under assault from all directions and severe stress is epidemic.   Because of this, chiropractors across the country may notice a huge increase in emotion driven pain disorders, especially involving the very low back and sacroiliac.

We as chiropractors are in a unique position to provide essential support for emotion driven conditions. When emotional trauma is sudden and acute and we address the problems right away, often we can obtain quick and lasting results by achieving pelvic balance and good cervical alignment.  When traumatic stress is ongoing and life altering, structural imbalance and pain may become chronic and recurrent.  In chronic cases with ongoing stress we must recommend the patient address the emotional issues through counseling, meditation, yoga, tapping (EFT), hypnosis or other means of stress management in addition to continuing chiropractic care.

With a little detective work, an understanding of the dramatic effect emotions can have on our bodies and some good chiropractic care, we can help our patients with psychosomatic as well as somato-psychic disorders.

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The Koch Protocols

NEXT SEMINARS MARCH 23, 24, 25 and 26, 27   near Orlando, FL

What does a Koch Protocols Seminar look like?

The Koch Protocols

My objective in my Koch Protocols seminar series is to give good doctors the tools and skills to help them become great doctors. I will share what I have personally learned from the legendary greats and pioneers of our profession.

Extraordinary careers and practices are not built on hype and glossy marketing, but by an extraordinary commitment to excellence in patient care that is a cut above. If you want to stand out from the crowd, to be far above average, if “good enough” is not good enough for you, then you will benefit from learning The Koch Protocols: Integrated, Advanced Chiropractic Techniques.

In Koch Protocols seminars I will teach the advanced and specialized techniques that I have learned over the course of 50 years of practice experience in my continuing quest to provide my patients with the best care possible. And I will show you how I put these techniques together into my unique Koch Protocols for exceptional patient care.

In my current “post retirement” practice here in Florida, the majority of my patients come to me with extraordinary, complex conditions of longstanding which have been unresponsive to the best efforts of other DCs, MDs, PTs and surgeons.

In the Koch Protocols Seminars I will share the insights, information and skills necessary to achieve successful outcomes with your most challenging cases.  I will show you how to get results that that will elevate you from a good to a great doctor.

You will learn how to use technique protocols that are easy on your body while getting the kind of results that will give you increased confidence in your ability to help your patients. You will learn how to get the kind of results that will make your patients want to brag about you to their friends and family. That is the kind of advertising you want and cannot pay for!

                        The Koch Protocols — Course Description — Seminar 1

Seminar 1 will cover the basics of my technique approach including my unique approach to the first visit examination, consultation and treatment. I do a very complete examination during the first visit to determine weaknesses and imbalances throughout the structure.  And no matter what issue the patient presents as the main problem, I always begin my treatment by balancing the pelvis. As with the foundation of a house, if it is not level and balanced, nothing in the house will be level, strong or stable.

Therefore, much of the focus of this first seminar will be Balancing the Pelvis.  I will spend a lot of time teaching the examination and treatment protocols I use to achieve this, which will include the use of SOT blocks and how I determine what category of SOT blocking is most appropriate according to examination indicators.

To start making remarkable changes in your patients, you must first be sure they have a stable foundation — the pelvis.

I will demonstrate my integrated technique approach which includes many of the techniques I have learned over my years in practice.  While I use many manual technique methods including SOT, Gonstead, Pettibon, and others, I have integrated these with the use of hand held instrument adjusting to get exceptional results very quickly. Instrument adjusting is a major part of the Koch Method.

In recent years there have been enormous improvements in the design and technology of hand held chiropractic instruments, as well as in the various technique methods for their use. This has resulted in the opportunity for significantly better, faster results for our patients. It has also resulted in effective treatment options that are much easier on the doctors.

Mostly I use just a flat table, SOT blocks, the ArthroStim®, VibraCussor® and GRT Lite®

Main Benefits of Instrument Adjusting

  1. Patients love instrument adjusting. It is gentle and eliminates the joint cracking sounds many find intimidating and offensive. While gentle it can achieve very fast and dramatic results that “wow” the patients.
  2. Instrument adjusting allows greater precision and versatility in adjusting the spine and extremities.
  3. Instrument adjusting dramatically reduces the stress on the doctor’s body. Too many chiropractors’ careers are cut short by injuries which occur at a rate comparable to professional football players. Instrument adjusting extends and even saves careers.
  4. Instrument adjusting permits adjusting of the full spine or selected areas in a wide range of positions: the usual prone and supine or with patients sitting or standing or even with the patient in motion. In fact, instruments allow for dynamic adjusting of the patient while walking in place, adding a whole new dimension to the corrective process by allowing adjustments to be made in motion and under full weight bearing loads.

Koch Advanced Technique Seminars

Course Objectives

  1. Provide the doctor with a detailed and purposely sequenced protocol for examination leading to evidence based analytical conclusions. All corrective procedures are chosen to directly address the positive examination findings and conclusions.
  2. Introduce a high level of precision and specificity to the corrective process.
  3. Demonstrate and instruct how instruments can be used in a variety of ways and for various specific results.
  4. Demonstrate how instruments allow us to address specific, objective examination findings and make appropriate corrections with a degree of effectiveness that allows the doctor to show immediate functional improvements on post adjustment re-examination. This clearly demonstrates to doctor and patient that his protocol has had a positive effect.
  5. Give participants a chance to work one on one with me for “hands on” practice with the technique protocols I use.  Each attendee will experience my examination and treatment protocols first hand as “the patient” and as the doctor.

Course Includes Demonstration and Hands-on Instruction of Instrument Adjustment Techniques Using ArthroStim, VibraCussor and GRT Lite

  • Prone
  • Supine
  • Sitting
  • Standing
  • In motion
  • Specialized techniques for shoulder, elbow, wrist and hand, hips, knees, ankles and feet.
  • Use of Instruments for Myotome Adjusting

The Koch Protocols — Course Description — Seminar 2

Seminar 2 — The Koch Protocols for Evaluating and Correcting the Thoracic and Cervical Spine, Bio-cranial Procedures, TMJ and Other Specialized Soft Tissue Techniques

Part Two will be a continuation of Part One but will focus on examination and correction of the thoracic and cervical spine with the objective of re-establishing the functional inter-relationship between the cervical, thoracic and lumbar spine and providing an understanding of the difference between a segmental vs. a regional approach to spinal correction.

I will teach you how I use both instrument and specific manual adjusting techniques for the thoracic and cervical spine and which includes Gonstead cervical chair adjustments.  I will also teach my favorite cervical adjustment: a three dimensional seated occipital technique, which I learned from Dr. Clay Thompson. I have often said that if I could only do one cervical move it would be Dr. Thompson’s occipital adjustment.

You will also learn some low force bio-cranial treatments, internal TMJ corrections and other specific soft tissue orthopedic techniques to give you the tools to deal with your most difficult and challenging cases.

Call 352-729-2678 and ask for Kiana

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