Open Adjusting

Dwight DeGeorge, D.C., MS

Practice Coach & Mentor

CBP Instructor

The initial reaction of visiting doctors at my office is one of interest and apprehension. The first obstacle visiting doctors have is the open adjusting and therapy rooms. The therapy performed at my office involves corrective traction and some ice for acute patients. A very common question asked by visiting DC’s is, “Don’t patients have a problem with being adjusted out in the open like that?” My response is always, “No, not at all. But sometimes our visiting doctors do!” Everyone thinks the “open” adjusting concept is a new and progressive one. Yet, hanging on the wall behind the adjusting tables is a picture of B.J.’s clinic in Davenport, Iowa. The picture shows an auditorium-like room with at least twenty doctors on a staging platform. The doctors are side-by-side adjusting as a line of patients are entering and exiting the stage. People are packed into the auditorium waiting for their turn to be adjusted. This picture was taken in the 1940’s. It seems patients have never really had a problem with open adjusting and those doctors who have been able to overcome their fears of the open adjusting concept report that they could not imagine working any other way now.

Let’s discuss some possible aspects of open adjusting. Our office does not reflect, in any way, a sterile type of medical establishment. It is bright, open and lively; even noisy at times. There is a definite air of energy and enthusiasm apparent to both patients and visitor alike. I have observed chiropractors, in my time, who wear surgical scrubs and spend most of their time evaluating, diagnosing and writing reports who may be appalled at this office concept. I believe our office is a nice mixture of old time DE philosophy and present day science of spinal correction. The main benefit of open adjusting is better patient education. The average patient has little understanding about health, or more so, chiropractic. With open adjusting and therapy patients can listen to other patient’s problems, some they are experiencing, while some a family or friend are experiencing. They hear the same messages over and over, and for many patients this repetition leads to their education. Dr. Jim Zigafoose tells a story about a female patient who had to have the same report of findings explained to her about “ten” times before she either claimed to understand it or was ready to accept it!

The open adjusting concept naturally lends itself to many educational benefits and often can be a determining factor of whether a patient will follow through with their care plan. For example, a patient recently started care with you and is apprehensive about chiropractic and still very symptomatic after several visits. Before you can adjust him, the patient complains about his continuing symptoms and is questioning whether he should continue with chiropractic care. A patient on the next table overhears and begins to interject with his positive experience and encourages him to stay with care. In some instances, this encouragement can be more effective than when it comes from the doctor.

Open adjusting makes it very easy to stimulate referrals. A patient who sees you for low back pain, often only understands that chiropractors can help low back pain. However, the patient next to him is telling you how much better his asthma (headaches, blood pressure, hip pain, etc…) is since he has started under your care. Often, the doctor will find his patients sharing “war” stories, ask each other questions, and encourage each other. Friends and family members who are with your patient during a visit are experiencing these exchanges as well. The doctor will observe a lot of chiropractic education occurring among patients while they are working with another.

The patient who fears being adjusted will often relax while watching other patients receive an adjustment. How nervous can a person be about being adjusted when he just watched the five year old next to him receive an adjustment and enjoy it? Patients observe newborns receive their first adjustment and listen as a mom brings in her family for adjustments because the flu has hit the schools. All these scenarios lend to an educational benefit to others in the room.

The open adjusting concept is also attractive to busy clientele. Patients do not like to wait or feel that they are waiting longer than they should for their time to see a doctor. Open adjusting lends to less waiting, and patients appreciate the respect given to their time. There is very little, if any, wait time in our office. Patients are treated and educated within a short time and the quality of their care is never compromised. Dialogue with patients requiring privacy is easily dealt with by stepping into an exam or consult room to discuss any issues.

In my experience, the overwhelming majority of patients who have treated in my office have been extremely pleased and comfortable with the open adjusting concept.

I could not imagine practicing any other way than using an open adjusting concept for treating patients. Many doctors who have come to use the open concept in their offices regret not converting to the idea earlier in their practice. If you want to bring some life and energy into your practice, this might be an important step for you to take. As Dr. Guy Riekman has said many times, “You need to be able to step outside the nine dots if you want to break out of your self-imposed cages.”

Chiropractic BioPhysics