Thanks Danny for an excellent blog! Please read on…

As a practicing Chiropractor I have made 2 brief lists of things to be aware of when visiting a Chiropractor for the first time. The lists are also good to see how your current Chiropractor compares.

All professions have good and bad practitioners, as you can imagine people’s abilities to treat differ just as a persons abilities at sport can differ. Some people are naturals, some take time to improve and others well… the less said the better. There can also be differences in how one practitioner views a patient as a human being similar to how people in general life have different views on individuals in the human race. One practitioner may run a clinic with a patients health in mind whilst a minority would put the business overwhelmingly first and see patients as number rather than a person.

Here are some bad things that from my experience I would recommend to watch out for when you go to see a Chiropractor:

1. Treatment times less than 15 minutes long.
2. Offering of a full spinal x-ray on consultation rather than an x-ray of a specific area, an x-ray is only required in 10% of patients and is often not necessary straight away.
3. A “spinal scan” that miraculously highlights areas of the spine that need “correcting” or “re-aligning”. A spine with graph like projections coming out to the sides may be seen on the print out of one of these.
4. Being told you have a “subluxation” or “subluxations”. This is an old Chiropractic term that is in the process of being phased out in the UK due to its misuse by a minority of the profession and the confusion it causes to the public. I do not have a problem with the term when it is used correctly (rarely), however it has been abused and used as a scare tactic by a minority of individuals.
5. Treatment ‘pre-payment packages’ or ‘set number of treatments’, for example: “buy 10 treatments for the price of 9!” or “book all 20 treatments now and save 10%” or “you need 22 treatments for this problem” These are sales tactic, no practitioner can per-determine the number of treatments required for an injury as everyone heals at different rates. I tell my patients that it will take anywhere from 4-16 treatments. Post treatment the patients then usually books in the next 1 or 2 to ensure they get the times they want for the next session. I find on average 6 treatments is sufficient for most simple spinal problems with occasional management options to prevent injury in the future.
6. Not doing any soft tissue work. Chiropractors that only manipulate and mobilise joints are considered lazy and their treatment outcomes will be less effective as a result. A good practitioner will do soft tissue work whether it be with or without manipulation or mobilisation or they provide some one else such as a masseuse to do it for them.
7. Not providing home exercises or rehab. Again considered lazy as home exercises are great for the patient to maintain the benefits felt in clinic and to get involved with their treatment plan.

Here are some good things I would recommend to watch out for in a good clinic:

1. Treatment times 15 minutes or longer.
2. Recommendation by a trusted friend, family or colleague.
3. A clean, open friendly practice environment centered around the patient.
4. Soft tissue work before/after treatment with or without manipulation or mobilisations as manipulation and mobilisation are not always used whereas some form of soft tissue almost always has a use even in very acute patients.
5. Prescribed exercises or stretches at the end of the consultation, checked regularly and progressed in following treatments.
6. Accessible staff by phone and e-mail in case of complications.
7. Chiropractors registered with the British Chiropractic Association (BCA), the BCA is considered the “original and best” association to be a member of, they are currently leading the profession and are striving to further Chiropractic in co-ordination with the best chiropractic international and encourages the profession to better itself based on high quality research and interaction with other professions.
8. A PPQM (Patient Partnership Quality Mark) or a CMQM (Clinic Management Quality Mark) these are a sign that clinics have met high standards set by the “College of Chiropractors” in the UK. The clinic I am currently working in does not have these yet as the clinic is relatively new. Though we are in the process of applying for both of these for the first time, they are very long application forms!!. You can see if your clinic has these awards as they will be up on Bronze plaques in the clinic.
9. Look for the membership certificates for the associations and awards I have mentioned. If you cannot see them out on display, then ask to see if they have them.

I have to say, as you might expect, that the clinic I work at here in Longlevens, Gloucester is a very good clinic but hey! What do you expect me to say?!?! We advocate good practice within the profession and try to lead by example. Some practices put the business before the patient, this is wrong, the patient experience and treatment outcome should always comes first.

The standard of Chiropractic practice is constantly improving as the governing body clamps down hard on practitioners not adhering to the strict guidelines that are updated and handed out regularly.

A great piece of news I saw recently was that the The College of Chiropractors (a group dedicated to educating and furthering the profession) recently released a document. This document suggests guidelines of good practice for Chiropractors to follow regarding what is considered best practice during the management of a patient that has presented with an episode of acute lower back pain (back pain with an onset within 6 weeks). Though they are not strict rules to follow I feel this is a big step toward the profession locking down an identity as to what the public should expect from the Chiropractic profession. Feel free to read the document as it will give you a good idea of what to expect and what you should expect when consulting a good Chiropractor if you or those you know suffer from Acute lower back pain. It is available here: Chiropractic Quality Standard for the management of Acute Low Back Pain

If you have any questions regarding this topic please comment or feel free to e-mail me on danny@longlevenschiro.com